So I'm going to get to a question here from a viewer and it's again on procrastination and what it refers to is I talked in the past about my method for beating procrastination and it is basically to Stop to put it simply right the the controversial part of my approach really is As soon as you procrastinate on a task You basically put in a boundary with it and say okay. Look. I'm stepping away from this now I'll come back to that tomorrow. I've tried today. I procrastinated. I have to stop and that's the consequence There's a lot to it It's as simple as that really to be frank But to explain that fully to people sometimes it takes a book right and let me show you my book here This is procrastination decoded and I outline my approach to overcome and procrastination in the book But I have a question here from I think it's Bella and Bella has implemented this so I guess for Billy it was They realized okay, I keep I keep telling myself I'm going to start I keep moving the time I'll do it later. I'll do it later and they've stopped doing that and now they're being more consistent with the work Okay, it's counterintuitive. I realized that it's completely counterintuitive You know the typical advice we get is to oh, I have to do it do more do more you need to do you need to do it And of course that doesn't work if that worked it'd be pretty simple to solve this issue the truth is it is pretty simple to solve and As long as you know the dynamics of procrastination But Baylor says okay, I get it I Did that and it worked But what they're struggling with now is they're not making any commitment to set an appointment to to to do their project, okay? So you do have to pick a time in my system, right? I tell people just pick a time and You either show up and do it which is fantastic or you don't show up and do it And then you put that consequence in of that's it. I'm walking away from it now Okay, because we're trying to do is stop reinforcing That habit of procrastination itself, which is what I meant by just stop Okay, just stop doing it You'll find after two or three days of implementing that approach Your nervous system realizes that when a decision is made it needs to be followed through one or else it isn't okay It's non-negotiable So Bill's problem is okay. He's doing that, but he's now stopped setting a start time at all Okay, so what I would say about that is pretty simple I get it I get that there's a Reluctance to just pick a time for yourself now at this point, okay? Or you notice that you're procrastinating on picking a time for that and I want you to take all the pressure of yourself I want you to see setting picking a start time for yourself as Almost even not up to you. Okay, it's like Okay, I'll pick pick a start time give myself plenty of rest and I'll pick a start time and you almost want to be turning the tables on the Inner voice that leads to procrastination that inner critic You almost want to be picking a start time to test it Put all the pressure on that inner critic. Okay, almost like you're calling it out almost like you're hoping you procrastinate Right. I know it sounds a bit strange But it's like, let's just see Where I am with this today and if I don't show up, that's fine But pick in the time itself just call out that inner critic The inner critic is the thing that tells you, you know various Contradictory things that really lead to the paralysis in the first place. So if you can just say it yourself Okay I'm gonna pick a start time, but it's not up to me really if I do it or not It either gets done or it doesn't But one thing is for sure, there'll be no more procrastination, right? So the voice that's telling you not to commit to a start time is the procrastination voice trying to make you procrastinate through the back door So take all the pressure off yourself Right, just pick it and call it out to see it as it's not even up to me whether it gets done or not so I'm hoping that that is an approach one other thing to think about with that Is to show you that that voice telling you not to pick a start time at all is the procrastination voice It's telling you oh you need to pick a time. You need to pick a time, right? That's what it'll sound like and then you're not picking the time Realize something it's it feels like you're not making a decision to start. Okay There's already been a decision at that point not to start and if this the decision is I'm not going to start Okay, so you can't really avoid making decisions in this You either pick a time or you don't those are the two decisions the two choices There's always a choice being made you either choose to choose or you choose to not choose Okay, but that way kind of it meta here, right? but Really, it's you can't lose with this. Just call out that inner critic. Oh pick a time. Let's just see I don't know like this thing about promise in myself. Oh, I have to show up at that time The truth is when we're when we're rehabilitating procrastination We actually don't know if we're gonna show up at that time when we pick it. That's what it feels like at the beginning, right? I Don't know if I'm gonna show up. So just don't worry about it. Just say well, let's just see today Let's just test this out Do it as an experiment, but I know if I don't show up to do it. I'm finished. I'm walking away from this I'm no longer going to do this game of Shifting the boundary with work all day long tormenting myself beating myself all the way up with that so Let me know what you think about that and let me know if that is helpful and I know that a few people have had a little stumbling block on that at the beginning, but Basically, it's to choose to make the choice to be more assertive with that inner critic voice Okay, call its bluff put all the pressure on it to see what happens take all the pressure off yourself because You either show up in your work or you don't and both of those options are fine The only thing we're interested in is stopping this shifting boundary all day long. That's it As soon as that's resolved procrastination ends and it happened and you become ten times more productive Than in the past. Okay, so bill. I hope that was helpful and Guys if you want to Check out my book the link is in the description in this video and thanks a million for watching. I'll see you next time


This research examines the effects of different levels of traction force on patients suffering from discogenic low back pain. The study found that higher levels of traction force resulted in greater improvements in pain relief than lower levels of traction force. Additionally, younger patients experienced greater improvements in pain relief than older patients. This article was authored by Zahra Masood, Adif Ahmed Khan, Aisha Ayub, and others.


Welcome to English in a minute. A swamp is an area of land that's often covered with water. So what do you think this idiom means? To be swamped. I am so tired. I don't think I've slept for two days. Why haven't you been sleeping? I've been swamped with work. It just seems like I'm never able to get everything done. Jonathan, you need your sleep. Your health is more important than work. You're right, but what I really need is a vacation. As a verb, swamp means to cover or fill with too much water. The idiom, to be swamped, means to have too much to do. It might feel like you'll never finish everything you have to do.


All right, so you talk about the ending you're not quite there. I think at the end. That's what you mentioned there Looking at the beginning. There's some really neat stuff there. I can see There's some more there's some more sliding a lot of the rotation thing I think we need to kind of do more of a the fingers kind of like the thumb You know, that's your thumb here and then on the down like thumb come out kind of a spreading as opposed to a constant sliding there of the hands Not too bad Nothing crazy. Like you're starting off with more foot stuff here, which is good This feels a bit linear how you get that foot off It also feels like very straight on as opposed to kind of a bigger arc Same thing here. This was a bit a bit linear Something about this foot as it comes off It's kind of angle of the foot is the same and then the way it comes down here doesn't feel like there's a lot of Rotation in the leg there and the foot it kind of works This is a bit tricky where it feels a bit too post-to-pose where even though there's an offset in arms If I watch in hands if I watch this in real time, they kind of come up pretty much at the same time And I know if I frame through I see the offset But there's something about this coming in Not too bad, but the tricky thing with this one is that the moment you lift this up Like it feels like you want to have get into a pose like this with one arm one hand and a bit earlier As opposed to hold and I feel like if both go up here He will kind of lose his grip and start sliding down. It's interesting Timing theory feels a bit off And it's a bit too you hold is too long to be kind of an anticipation to this thing It's a bit tricky Watch out this this hand kind of pops out up here A bit too linear also. It's kind of a big move On that throw I'm not sure if I saw it at last time too what it feels like on that on that um Push off and throw what's called twist There's something about this coming down and rotating which works But then once you hit this point, it feels like you're suddenly rotating out of really this neck And he's not really falling down anymore. It's like a full rotation with the pivot in the neck as opposed to continuous translate down So watch out how you suddenly have that It's kind of a weird pivot point on that on that drop Oh But the offset there is good Like I look around um, you might still argue that potentially this is a bit too close the knee and And the hand there Same thing here that hand and that foot there close in terms of tangents Same thing with this guy your rest is and you got that hand right there with where that leg is I think you can you know bring out that arm just more And uh and really separate that thing Careful how long you linger that spear with that leg here so it doesn't overlap as long It's a bit tricky. I mean it's not So that's super short killer We're just like right where that leg rests you got a lot of overlapping Moments where leg and spear kind of line at the same the same angle Then you get a moment of stopping here where that tip is kind of too close at hand again forming a tangent And this being a bit too aligned But you go back here, which is good And then he goes forward and again. I will keep this guy. It's a bit longer If you can just it feels like you're lifting The amount of push off from that foot is not quite enough And I don't see like there's no change in the rotation that foot Like you want to keep this so that you can go really far back with that foot roll It feels like he starts to use this leg to push the body over here But by the time you lift his leg he's still kind of leaning Back here. He would he would start falling back You want the body like here the body over this leg You're really over that and then this leg can come off It's a bit late You kind of boom comes to Just a bit pose to pose on that stop there I mean come everything kind of stops almost at the same time Then you got that move where arm and body and leg everything kind of goes up and stops at the same time So it's a bit too pose to pose But it's better. It's just being picky here just something about this being Comes in goes into one two But I like how you have that sub pose where he stops and then does that little peak just great And this is still something that I've always been mentioning And it's a little bit tricky where like he feels like he's really leaning and like he's getting ready And he got that nice curve and it's going yeah, I am ready And then he goes into this and everything kind of drops and it feels more like it's kind of tired Tired kind of a Sunday stroll It doesn't feel as energetic As it should be Same thing here with your push-off you're getting at this point already lifting this up While send the gravity is not quite over this leg enough. So at this point he would again fall over should be around this point With the head here This was a bit more balanced. So the foot would be rolling off here Giving again more of a lean forward a bit more dynamic pose That's better and then you mentioned the same which Not good there. So yeah, it's kind of that pause and Goopy is a bit more dynamic there. It's kind of neat though You can probably bring this guy just further back a bit So that's kind of I see it you're getting there. It's definitely in the right spot. So tangent things there and kind of offset and Watch out your your If you hold the pose and it starts like make sure that you kind of ease out enough It doesn't kind of pop out And watch out how you get into that kind of a tired pose there But overall it's it's really heading into the right direction It's being super picky making sure that I'm covering everything and you know and depending on how much time you have You can also kind of choose What is important to you or where you want to push things, but I'm just mentioning what I'm seeing But compared to what you know, you first submitted. This is a really really really good progression there All right, there's an email you can sign up you can start whenever you want You can submit whatever you want you get 16 submissions either way a like and subscribe would be awesome. All right. Thank you


Hi there, everybody. I'm Nathan Roach, the Marketing Director at Accelerant. I'm speaking to you from sunny Spain today. I'm super excited to be giving this session, and I'm really grateful to the Drupal Association, which has provided this excellent option of uploading content for their content library for those that aren't able to attend the event physically. I'm going to be speaking to you today about how agency partnerships are becoming the new normal in the Drupal ecosystem and beyond. I'll be sharing some data points. I'll be talking about my experiences speaking with agency leaders, and I hope that you'll find some of this valuable in your decision-making or at least that it's helpful to review when you're considering how agencies in the agency marketplace is changing. Okay, so are agency partnerships the new normal? So I'm, as I said, the Marketing Director at Accelerant, and we're an agency for agencies in the Drupal ecosystem. We've partnered with other agencies like Wonderman Thompson, Proctor and Stevenson, Blue State and many others, and we've learned a thing or two about agencies, how they operate, how they scale, fill talent gaps over the years. We've been doing this actually since 2017, where we gave at the Business Summit a talk at DrupalCon Vienna, how agencies are outsourcing how they are turning to global partnerships in order to fill gaps, and since that time giving that first talk, we've had all sorts of relationships established with others, and we've seen a real ramp up in agency-to-agency partnerships, and not just in Drupal, but everywhere. In between 2018 and 2020, we saw that agency partnerships were a new way to offer a blended rate to lower costs to ensure that a unique value proposition was, that a unique value proposition was more competitive in the marketplace, and then in 2022, we saw all of this accelerated. COVID changed everything, borders dissolved, minds were changed about how to hire or how to partner, and where one could find partners. It was no longer about who or which partners were in your city or in your state, in your country or region, offices in office life disappeared, and digital distributed models became dominant in our mid-market agency landscape. So, since 2017 to 2022, we've seen a major increase in how agencies approach partnership and the volume in which agencies approach partnership as a new normal. So, here's what I'll be giving you today, perspectives across this decade of working with agencies. Piyosh and I, my colleague at Accelerant, we've hosted lots of agency leader roundtables and dinners all around the world, and I'll also be sharing some points from some qualitative research like that of the Society of Digital Agencies, SOTA, and others so that you're able to see this data in an easy to digest table form, and you can draw your own conclusions based on these sources. So, let's look at revenue growth from 2017 to 2021 in the agency landscape. You see this dip in 2020, right? You have 16% in 2017, 20% in 2018, 18%, that's the dip in 2020, and then back up and beyond to 44% revenue growth. This is a pretty amazing reflection, and this is coming from the SOTA report, which is referenced below the table, and it shows that post-pandemic optimism among agency leaders, that has been realized through revenue gains. Profit margins have also increased. In 2021, there was a 36% profit margin gain for most mid-market agencies, which is phenomenal, and it shows that agency leaders are feeling more confident after this disruption. They're returning to pre-pandemic levels of optimism and maybe going even beyond that. In 2022, 87% said that they were far more confident and far more optimistic about the marketplace. If you were to ask these agency leaders what their top priorities were last year, 51% say operational efficiency, which is of course saving money and getting more done. We also see 49% say that attracting talent and retaining that talent is top priority for them, because of course we had this thing with the great resignation post-COVID, which really shook up retention and nutrition rates in mid-market agencies. There's a lot of focus now on employee engagement, increasing compensation levels in order to retain the talent base that they currently have in-house. And then 43% have said that sales and marketing resources, this is really important for them to ramp up pipeline in order to come back off the pandemic with a lot more rigor. We see at least in Europe, and I mentioned I'm sitting here in sunny Spain, that domestic hiring through online portal media buying is really increasing. In 2021, across 28 European countries, the number of online jobs, these ads were at 52%, which is a pretty big increase from the previous year, which means that unmet talent search, that this is on the rise as recovery progresses, businesses are becoming a lot more optimistic and they're looking to hire a lot faster. Agencies are addressing this gap differently, though, and it's not just in Europe. Agencies from all over the world are addressing these capability gaps differently. These are the actions taken in 2021, which shows that more agencies were using contractors, about 54%. Some agencies were up to half, were increasing salaries, this is a retention and marketplace correction move on their part. And then 33%, which is unfortunately a pretty lower number, they are upskilling and training their staff to fill gaps. We would like to see this increase, of course, but that hovers at around 33%. But 31%, actually, they turned away work, which is something you don't want to see. That means they've generated so much pipeline or so much work has come to them that they have been unable to deliver this work alone. But if you look here below, we have these two percentages, which are quite interesting. 29% say that they partnered with other agencies to deliver value. And 22% say that they used offshore or near shore vendor partnerships in order to do that. Now, if we club these two numbers, we get to 51%. That means agencies, 51% of agencies over half have invested in agency to agency partnerships from all over the world as a solution to filling capability gaps. And the question is why? Why the change or why is partnership becoming the new normal? Well, working models have certainly changed globally in the U.S. and across Europe. Employee expectation about remote work, fully distributed expectations, or at least hybrid models of workplace setups. This is forcing agency decision makers to change the way they operate. And it's changing their viewpoint in terms of where they can get talent from. Because if all of your employees are effectively telecommuting from the same state, what's to stop you from hiring people in the next state or in a nearby region or outside of one's country, right? So the pandemic actually forced this change and employee expectations were catalysts to this change so that major talent gaps today have to be solved differently. So in many ways, borders have sort of dissolved because in a fully distributed model, localization is no longer relevant. So agencies are ultimately realizing these three things. And we hear this from agency leaders at all sorts of conferences and roundtables that my colleague Pius and I host. First of all, local is old. Hiring employees in your city, even if you live in a metropolitan area, is no longer a really viable option for you. And those talent pools are drying up because people are moving outside of those metropolitan cities because they can get jobs working from wherever they like. Borders are becoming weaker. The pandemic showed us how connected we actually are for better or for worse. But in the case of for the better, we can see great opportunities in people hiring outside of their country. Borders in this sense are becoming weaker because agency decision makers recognize that they can hire contractors or forge partnerships outside of their own backyard. And third is that selling in this marketplace is now very different. Right now we're in a composable digital solution marketplace where you're not just selling one tech stack anymore, right? Even in the Drupal agency marketplace, we see different services are diversified, right? Different technology stacks are integrated, different service lines are being opened, even with small shops, right? And that's because when you're selling in this marketplace, which is demanding composable solutions, you have to be able to offer more, right? And you're not the subject matter expert at your agency over everything, right? So you have to bring together the right specialists to fill gaps. Even the speciality that you have, your bandwidth may be fully consumed with active projects. So you're going to have to bring in a near peer specialist in order to accelerate your growth. Either way, composability is really affecting the way agencies have to sell. The demands for these solution stacks are more complex today than they were a number of years ago. There isn't a one size fits all solution. In other words, which means there isn't a one agency solution for end clients today. So you have to do a lot of things. You have to hire more people. You have to keep those people, acquire more clients. You have to retain those clients and expand that business, stay profitable. All admits this changing complex composable demanding ecosystem that we find ourselves in Drupal and beyond. So what are agency decision makers to do, right? With all of this weight on their shoulders? What are they supposed to do? How do they approach this problem? I wonder if I could tell just a brief story. And I'm here in Europe. So I wonder if I could pull from a really old European story in order to illustrate a point. So a long time ago, and legend has it in 300 BC, the Macedonian conqueror Alexander the Great entered the city of Gordium, which is in modern day Turkey. And when he entered the city, he and his armies, they found this wagon, this golden cart, which was tied to a post with many complex knots, knots upon knots upon knots. This could be an allegory for the position an agency decision maker is in today. And he saw this knotted bunch of rope and this cart and he asks people, what what is this? He asked the local population and they say, well, this wagon belonged to Gordius, the father of the great King Midas. And there's a prophecy said that whoever could untie these knots, all of them would become the ruler of all Asia. So Alexander the Great is looking at these knots and he's thinking, he's thinking. And suddenly he says, it does not matter how it's untied. And he takes out his sword and he slices through the Gordian knot, right? He takes a radical decision to solve a complex problem in the simplest of ways. And if I could just comment that in many ways, agency partnerships are a radical and simple solution. They haven't been thought of often by decision makers in the past. But in today's marketplace, certainly, this is a simpler means of solving more complex problems. And we're going to see a lot more agencies in 2023 and beyond cut the Gordian knot by this means of agency to agency partnerships. I hope this was interesting that this data, at least you're able to take away something from it. If you want to contact me because you have some questions, please reach out. I've left my contact details there for you on the right hand side. For all of you at DrupalCon Pittsburgh, I hope you have a fantastic time and I hope to see you next time in person. Thanks so much for your time and attention.


With the launch of The Last Jedi, I think it's about time how we talk about how the dark side actually relates to mental health. First, we're going to talk about how this adorable young kid turned into this dude, right?  I was the angriest person you could ever meet. And so many people kept telling me that my fears were actually leading to my anger and my hatred.  But in this video, let's talk about how my man Yoda might actually know what he's talking about. So stay tuned. What's up everybody? This is Chris from the Rewired Soul where we talk about the problem but focus on the solution. And yes, we're going to talk about how fear really drives to poor mental health as well as a bunch of toxic behaviors. So let's take young Anakin Skywalker here for example. So for those of you who haven't watched the prequel movies about how Anakin turned into Darth Vader, basically young kid, this Jedi, this chosen one if you will, he falls in love with Princess Padme. He breaks the Jedi code, ends up doing a little elope action and marrying her on the side. And he starts to have visions that Padme is actually going to die while giving birth to their child. But it's actually twins Luke and Leia. Anyways, out of this fear, Anakin starts being manipulated by Emperor Palpatine. And Palpatine is actually Darth Sidious. So by using Anakin's fear, he helps to turn Anakin to the dark side.  Now what are the quotes from the prequels that Yoda actually says is, and excuse me while I do my terrible Yoda impression, this. Fear is the path of the dark side. Fear leads to anger. Anger leads to hate. Hate leads to suffering. And this was very, very true. I never thought that this was the source of my toxic behaviors. Now for me personally, my fears not only turned into toxic behaviors, but it also turned into my drug addiction and alcoholism. But let's take a step back and talk about how your fears might actually be affecting your mental health. Something that I talked about in a previous video, which will be linked up in the info card, is how this fear of being alone leads to a lot of toxic relationships. So let's take a look at this real quick. Getting into toxic relationship after toxic relationship after toxic relationship, not being able to be single and wait for the right person. Fear of being alone and fear of not being loved. Makes sense? One of the things that I started to realize too about myself when I started to get angry with my son was that this was fear driven as well. And often times when I look at parents snapping at their children, I try to acknowledge what kind of fears are actually driving them in this moment. So let's say a parent is out in public at the grocery store with their kids and their kids like freaking out, right? And the parent just snaps on their kid, right? Without even realizing it, they are being driven by fear. Which fears? Fear of not being in control of the situation. Fear of their child making them look bad, which in essence is a fear of being judged by everybody else around them, right? Now, let's look into some of the toxic relationships you might have been in and some of those jealous rages. Maybe this jealous rage came from seeing a text message or your own paranoia. Some of us are crazy out there, we make up these stories, but this jealous rage. This can come from a fear of being abandoned, fear of being lied to, and fear of being taken advantage of. Now, let's look at one of my favorites, road rage, right?  Is that maybe a fear of being disrespected? Is that where that anger and rage is coming from? Or what about that anger and frustration that you get when you're stuck in traffic and you need to get to work? Could that be a fear of being late? So without even realizing it, our entire lives are being run by this fear. And in Star Wars, it leads to the dark side, and I'm not saying you're going to go blow up a planet, but when you started acknowledging that your life is being run by fear, now you can start doing something about it. Today, I'm able to sit back and separate myself from this anger, from the loneliness, from the depression, from the anxiety, and recognize that these are a lot of fears. And then I can start to categorize them and start to ask myself, okay, is this irrational or is this an irrational fear? Right? And one of the things when we're first working on our mental health is that a lot of the irrational fears sound very rational. So one thing that you can do is, before doing something crazy, run this by somebody else, a completely objective point of view, and say, hey, is this rational or is this irrational? Is this a rational fear? Right? Because when you start doing that, you're able to start rewiring your own brain. So something that you've heard me talk about in a lot of my other videos is the amygdala, the part of the brain responsible for fight, flight, or freeze. This is our fear response. This is the most powerful part of the brain lying in the limbic system. So knowing how powerful that part of the brain is, we start to kind of understand why it is taking control over our lives and how so many of our actions are based on these fears. So once we can start realizing what this thing up here is doing, we can start turning towards the solution and getting out of that problem. So I hope this helped you out, and I hope you're also stoked for the new Star Wars movie like I Am, my son and I are seeing it opening night. It's going to be sweet. But anyways, if you liked this video, give it a thumbs up and share it with somebody out there who might have a life that's being run by fear so they don't turn to the dark side. But anyways, if you are new here, please click that little round subscribe button right below.  And check over to the left of me right here. Click on one of those thumbnails, check out some of the other content on this channel. But anyways, thanks for watching, and I'll see you next time.


Culverts are collapsing beneath Athens roads, causing a dangerous situation for drivers and an expensive funding deficit for taxpayers. Fortunately, the commission is considering raising the stormwater fee by 25% next year as recommended by the advisory committee. This fee helps prevent flooding, erosion, and keeps up the quality of our water supply, but it's never been enough to maintain the stormwater infrastructure itself. Since this critical infrastructure will continue to age, we need a sustainable funding mechanism that will support upkeep in perpetuity. If nothing is done, the stormwater management program's costs will exceed their income by 2029. We literally cannot afford to not act. The commission made a step towards sustainability at Tuesday's meeting and may vote to raise the fee soon.


Equal access, universal design of an academic department. The student population at universities and colleges is becoming increasingly diverse. Both students and staff need equal access to courses, facilities and all aspects of campus life. Yet people with disabilities still find inaccessible websites, course materials and facilities. One solution is the implementation of universal design. Architect Ron Mace defined it as the design of products and environments to be usable by all people to the greatest extent possible without the need for adaptation or specialized design. The value of universal design is that it's simple and it's easy and it will be able to impact all of your students. It suggests that rather than designing departmental offerings for the average user, design them for people with a broad range of abilities, disabilities, reading levels, learning styles, native languages and other characteristics. Universal design is really a goal. It's a way to approach education so that you maximize the number of people that are benefiting from the education. Planning and policies. Campus stakeholders need to think about planning and policies. Ask yourself if people with disabilities and members of other underrepresented groups are on your staff, faculty or student body. In looking at developing policy at a university level, I think it's important to recognize, first of all, gathering the right collection of folks to have that discussion and not just include faculty representation, but also includes folks that provide services, students of the recipient of those services, students that are in those classes, people that will be a part of the design of what's going to be then the effect of the policy. When courses or services are being evaluated, be sure to include items that ask about the experiences of those with disabilities. I think if an institution, a college, and a department is going to be friendly to people with disabilities, I think it's really a cultural aspect, a social normative attitudes and beliefs that's prevalent and pervasive throughout the institution and colleges and into the departments. Facility and environment. Campus facilities should be accessible and welcoming. Ensure physical access, comfort and safety for visitors with a variety of abilities, racial and ethnic backgrounds, genders and ages. A great place to start assessing your accessible facilities is in the parking lot. You should make sure that you have a sufficient number of accessible parking spots and they should be well marked. Routes from the accessible parking to a building should be well marked with large, high contrast signs. A front door should be for all users, whether they're in a wheelchair or are walking up to the front door. A front door for one should be a front door for all. Students need to know where they are. Signage needs to be plentiful, really accurate, high contrast. It can't blend into the facade of the campus. None of this lovely brushed silver nickel stuff that blends into the building. It has to stand out. As far as elevators go, I think that the most important thing for me is having the controls at the lower level so that I can reach them. Restrooms should be wheelchair accessible with well marked signs. Counters and desks in student service areas should be accessible from a seated position and aisles should be wide and clear of obstructions. So faculty who require students to use labs on campus to complete coursework have to also be mindful of if a lab itself is accessible. So yes, can they get in the building? Yes, can they get into the lab itself? But within the lab, there's features that they may not think of. So is there adjustable height workstation for someone who may need to move the table up or down? Other Zoom text or screen readers on lab stations within it? If there's somebody who is there to help desk, can someone go and ask a question? And is that an accessible desk or area? Or are there things like printers or phones that might need to be used? All those things still need to be accessible to a student with a disability. Before faculty brings technology into classroom, they definitely need to be aware of what it is and not just use it because it's the new hot flashy technology on the market. They have to really know how to use it and the pros and cons of how accessible it is or how it will impact the student's learning environment. It's also important to consider computing equipment and software and to provide access to assistive technology for those who need it. And software can range from text to speech, voice recognition software, screen enlargement can be used in the classroom, outside of the classroom and really benefits a wide variety of users. I believe we should have at least a minimum accessibility requirement checklist so we can ask the campus to follow that. So if we are going to provide a product or develop a product, we have to ensure those minimum accessibility checklists are met. Websites are a very interesting place for a department to start because where else does a student go to find out basic information or even their initial information about an academic department they are looking at? So if a student with a disability cannot find out how to contact you, what you do, how are they even going to be able to get more information or pursue you as a program? So I personally think it should be the responsibility of their respective web developers or webmasters to ensure that first their own framework, their own application or websites are accessible and at the same time they have to provide training. They just need to consider accessibility as important as say security and privacy. Courses. Faculty members should deliver courses that are accessible to all students and accommodations must be provided in a timely manner. Make sure that video presentations used in courses have captions and where appropriate audio descriptions. Captions allow a wide variety of people to understand content and captions can often be searched to accelerate access to information. By doing so we're reaching a large number of individuals and those include of course deaf and hard of hearing people who would get nothing out of a video that's not captioned. Individuals whose English is their second language. Individuals with ADD and LD for example may help them focus more on the words as they see it go across the screen. I don't think that we totally understand how people take in and use information so the more ways that we can offer it up the better we all are. As an instructor in a course you can make your material accessible, you can make sure that the student isn't excluded and so even if you can't in a short amount of time change the policy on a university you can change the policy in your own classroom. I always feel like if I have a student that has an accommodation that I as a teacher have to give a little too. I can't just do everything exactly the same way. So we have to be a little adaptable as a professor so they can reach the most students and that's what I practice. Speaking as both a student and an instructor assessment really needs to be flexible. We focus as instructors on exams but there are many ways to assess student learning. Problem sets, exams, projects, writing. Accommodation requests. Although applying universal design minimizes the need for accommodations for students, faculty and staff with disabilities it's also important to have a plan in place to respond to additional accommodation requests. And so the way that we ensure timely and effective accommodations is by planning our policies and planning our practices that include our academic departments. We have to do it faster. We have to do it with fewer resources and we have to do it for a broader range of the population and we're all under the hook for that and we should be. For more information consult Dewitt's Center on Universal Design and Education www.uw.edu.coite.com This video is based on work supported by the National Science Foundation under grant number HRD 0833504. Any opinions, findings or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. Copyright 2015 University of Washington. Permission is granted to copy these materials for educational non-commercial purposes provided the source is acknowledged.


Naval and I just calculated we started in 2004. So this is our 21st report to you. I do hope you will find the numbers and the commentary that we present with them useful to you in preparing your own plans, giving you a perspective on what has happened, why it happened and what to expect next year. And more importantly, I think we have a galaxy of very eminent speakers for you talking on subjects that are relevant to advertisers today. So I'm sure we learn a lot from them. Now the way I see it, I think ad-ex continues to surprise us year after year, either positively or negatively. COVID may be finally behind us, but the uncertainty levels in the business world seem to continue to rise. The political situation in most parts of the world could be considered uncertain. Elections coming up in many countries around the world, not to mention the huge disruption happening in the startup world because of what is now referred to as the funding winter. And all this obviously has taken its toll on our ad-ex. In our estimate, ad-ex in 23 grew by just 10% against our forecast of 16% and a growth of 21% that we had achieved last year over the previous year. So despite GDP having grown at 7.3%, ad-ex seems to have grown at only 10%, which is the lowest growth Indian ad-ex has seen in the last six years, except of course COVID year. Looking at medium-wide spends, there was a huge slowdown in the growth of digital, which grew only by 15% against our projected 25%. For context, in 22 over 21, digital grew by 35% and before that in 21 by 50%. This 15% growth is to be seen with the compounded annual growth of 26% that digital achieved over the last decade. Traditional ad-ex is still growing in India, something that not many countries can say today, although the rate of growth has been slowing down year after year. According to us, traditional ad-ex grew only 7% compared to our forecast of 10%. If we look at the figures at a quarterly level, one sees some gets one more surprises. One sees that quarter four was the best performing quarter with a contribution of 31% to the full year and in absolute terms added as much as 4500 crores or 50% of the annual growth. So we did see quite a bit of tension for the first nine months of last year. For the first nine months saw a single digit growth and quarter four saw a very high growth of 18%. Boosted of course by the festive season and the ICC T20 World Cup. All of this contributing to 31% of total ad-ex. If you see this slide, you will see that as the year progress, ad-ex seems to have gained momentum quarter on quarter. From a historical perspective, last year witnessed the slowest growth rate in five years in excluding 2020. In absolute terms, ad-ex close just a little short of one lakh crores closing at 99,038 crores. It added 9,200 crores. Again, for context, ad-ex added a little over 15,500 crores in 22 over 21. So in 23, the addition has been only 60% of the previous year. For some more perspective, we looked at work that estimates global ad-ex and ad-ex around the world. They estimate that ad-ex in 23 closed at 971 billion USD, that's nearly a trillion. Global ad-ex makes the Indian ad-ex look good though in terms of growth. Because having achieved a 10% growth, global ad-ex achieved only 5%. The construct of the Indian market also continues to be very different from the global market, which is dominated by digital, which has a share of 73% versus our India share of 40%. If you look at what is happening in other countries around the world, Brazil and India are now the two fastest growing markets in a market that is dominated by US, which accounts for 31% of the 970 billion. The top 11 nations of ad-ex, which contribute to 63% of global ad-ex, grew by only 2%. US also grew by only 2%. India unfortunately continues to be a very minor player on the global ad-ex stage with a share of just 1.2%. Now looking at growth rates of individual mediums, digital has grown by 15% only and TV2 has grown at a slower rate of 7%. The figures we look at and the way we calculate them, I know there's a little dissonance with the financial results that have been put out by the major television companies, but we are giving you a consistent year-on-year sort of performance the way we see it and we arrive at this slower rate of growth of 7%. Print the second largest traditional medium has registered a single digit growth of only 4% and is still shot by around 800 crores of its pre-COVID level. OH and radio recovered quite well with higher growth rates of more than 11%. Digital continues to dominate ad-ex with a 40% share and gain 2 percentage points against gaining 6 percentage points the year before. TV, the largest medium till 2021, further dropped share in 2023 and is now behind digital share by a full 7 percentage points. Print is losing its share year-on-year and contributes 19% to the overall ad-ex. Cinema, radio and OH maintained share over the last two years. Looking at the same data category-wise for traditional media we see that FMCG continues to be the largest contributor with a 33% share and the category added almost 1500 crores in the year last year. E-commerce continues to be the second largest category with a share much lower share of 14%. E-commerce and education both saw a degrowth. Automobile sector however saw a dramatic recovery and with multiple launches in 2023 grew by a whopping 18% to become the third largest contributor with a share of 9%. According to a list of top advertisers it is significant that the top 10 advertisers grew to X of total ad-ex growth demonstrating to us that large advertisers seem to have greater confidence in advertising and what it can do to a brand and the company's profitability experience the benefits of advertising in the last few decades and using it effectively. Six of the top 10 in our list are FMCG players. We have only 11 new entrants in the list compared to 14 last year. Predictably we have only one start-up this year in our list compared to nine last year since start-ups have all slashed their advertising spends some stop totally being uncertain about their future rounds of investment. The contribution of top 50 advertisers to total ad-ex is 30% same as last year and so is the contribution of top 10 at 14%. Television and digital continue to be the favorites of top advertisers accounting for as much as 88% of their total spend. Depending at who the top 10 advertisers are Unilever, Rekit and Reliance continue to maintain the top three ranks. Godrich Consumer Products has moved up in rank dramatically from number 12 to number 5 having increased its spends by over 50%. The next five brands in our elite list are Mondalis, PNG, Coke, Maruti and Dream11 who has now dropped in rank to 10 from number 4 last year. Let's now take a closer look at the individual mediums. First we'll start with digital. So as I gave you the highlight, digital too seemed to hit a speed breaker after a very long time probably the first time in its history in India at least. Despite this slow down, digital again increased its share of ad-ex to 40%. I must remind you that in digital, we recognize spends of only those who you and I consider as advertisers and do not include the lack of small sort of spenders like individual shops, beauticians, interior decorators, samsari shops and housewives on Google and Facebook who as we know contribute a very, very substantial part of their revenue. So we believe it would be misleading to just look at the financial data from an advertiser's perspective because that vitiates the construct of ad-ex. Now what caused this slow down in growth in digital? This is widely known. A lot of startups who earlier focused on top line thanks to easy availability of funding at inflated valuations are now in distress to find further investments. Many businesses within startups like edtech have substantially reduced their youth's spends if not stopped totally. Byju's a very, very large advertiser and the naming sponsor of IPL some years ago seems to be in a survival mode. Real money gaming has got crippled because of the government's stance against it leading to a levy of 28% GST and so has cryptocurrencies fallen out of favor with the government. But with a 15% growth digital ad-ex stands at 40,000 crores. Now whilst from an Indian perspective digital is the number one medium with a 40% share we must remember that in global ad-ex digital accounts for 73% share. China and UK are even higher at 80%. Many countries like Japan, Germany, France, Australia are somewhere between 50% and 70%. So it kind of tells you where possibly India is headed over the next few years. When one looks at digital figures by quarter again the figures are surprising. Quarter one and quarter two figures are really dismal having recorded a low growth rate of just 4% and 6%. Digital picked up only in quarter three and quarter four achieving a growth of 20% and 24% respectively. So basically digital reflects the same pattern as total ad-ex. E-commerce platforms as by now we all know have seen high traction amongst advertisers and we expect advertising on e-commerce to be almost 7,000 crores registering a growth of 25% over the previous year which in turn has seen a 35% growth over 21. So dramatic increase in e-commerce over two years. With that growth e-commerce stands with a share of 17% in digital ad-ex. Video though continues to be the largest category within digital with a share of 33%. Let's take a closer look at television now. The darling of most seasoned and serious brand builders has once again skidded for the second year in succession with a low single digit growth of 7% and now stands at almost 33,000 crores. A saving grace for television was a busy sports calendar in the second half starting with Asia Cup in September followed by India versus Australia series Asian Games and then finally the ICC Cricket World Cup in October November. In our assessment TV ad-ex without the sports genre would have grown by only 4%. TV share is steadily declining from a high of 42% in 2020 to 33% in 2023. You will all will recall that according to us in 2022 digital became the largest shareholder in ad-ex overtaking television's numero uno status which it had maintained for eight long years. In terms of revenue by quarters all three quarters, quarter one, quarter two and quarter three were subdued quarter two despite IPL and registered only a growth of 2%. Quarter four brought cheer to TV ad-ex when it grew 17%. Broadcasters I believe have to give due recognition to FMCG advertisers who unlike other categories are not their fair weather friends and despite everything that happens in the environment despite the pressure on their profits because of increase in raw materials and what not increase their spend on television from 13,725 crores to 15,353 crores an increase of 12% and which resulted in increasing their category share from 45 to 47%. Production and ad-tech predictably saw a dramatic drop of 41% taking the categories rank from number four to number eight. Automobile on the back of good sales and new launches increased their spends by 21% and so did household durables. Hindi satellite mainline along with second line and sports are the two major genres and contribute to over 45% in value but Hindi satellite in fact marginally de-grew in FCT while sports increase its FCT by 8%. Hindi movies de-grew 6% and English movies and infotainment de-grew by around 30% by FCT volume. Regional genres ad volume remains stagnant except Marathi which witnessed almost a 10% volume growth. Let's see print now. Print in 23 has failed to reach its pre-COVID high of 20,045 crore and reached only a figure of 19,250 crore registering a 4% growth rate. But you must remember that ad-ex growth of 4% whilst growth in space consumed by advertising is 6% seems to indicate that publishers are now pricing their medium appropriately to attract advertisers and help them get good ROI from print advertising something that advertiser friends should take note of and not abandon print. In terms of absolute numbers print in 2017 was at 18,650 crore and today after 6 years is at 19,250 crore which means a compound annual growth rate of only 0.6%. In terms of share of course print continues to be the second largest traditional medium but continues to drop share from 22% in 21 to 21% in 22 and now 19% in 23. When you view a print figures in a global context you have to admire a print ad-ex resilience. Walk estimates print to be only 4% of global ad-ex compared to 19% share in India. In 22 share of print in both India and Germany the two citadel's of print was the same at 22%. However in 23 pulse Germany retained its share more or less India has lost two percentage points. When you see the quarter wise figures of ad-ex in value you see that quarter two figures are invariably the lowest and quarter four the highest. This split across the year is not seen when you do an analysis by space consumption indicating that publishers vary their rates by quarter depending on demand. Auto FMCG education retail and real estate contribute 50% to print ad-ex. This year auto is the leader of the pack with a 14% share and contributed most to the growth of print ad-ex. Travel tourism, BFSI, corporate clothing fashion and jewelry have also contributed well to the growth of print. In terms of languages Hindi newspapers with a growth rate of 10% have witnessed higher growths than English at 8%. Both the languages continue to contribute close to 65% of the total print volume in 2023. Vernacular publications of these languages show a flat to marginally negative growth in volume. Coming now to OH, OH seems to be finding favor with more and more advertisers and believers in OH are rushing to use it more intensively. This is reflected in the 13% growth rate OH achieved in 2023 which is substantially higher than that achieved by TV and print the two dominant mediums amongst traditional media. But all this has not helped OH gain its share, it has maintained its share of 4% similar to OH's share in global ad-ex. After the COVID crash in 2020 when OH understandably collapsed from a high of 3500 crores to 1292 crores we have witnessed steep increases in OH's spends almost every year till last year when we closed the year with 4,140 crores. In the past there have been large variations from quarter to quarter and quarter to and quarter three were much softer with ad-ex speaking and quarter four. In 2022 we saw more uniform spend across quarters and this trend has continued in 2023. Looking at the revenues category wise the top four sectors maintain their share of 55% of OH ad-ex with real estate leading the pack with a share of 19% followed by retail FMCG and consumer services. FMCG which moved up in share to 13% in 2022 rolled back to a 11% share last year. Organized retail maintained its share at 13%. Let's see radio now. Radio's road to recovery post COVID has been a gradual one. It has experienced a growth of 12% in 2023 to reach an ad-ex size of 2272 crores. Four years after the pandemic radio ad-ex has finally reached its pre-pandemic level and radio share seems to have stabilized at just around 2%. Here again a quarter-wise analysis by ad-ex throws up that in terms of value there is a considerable drop in quarter two indicating that sellers offer special incentives in quarter two to fill inventory. Ad-ex failed to experience substantial growth in age two despite the festive season and assembly state elections and quarter fro grew only 5%. The largest share in radio ad-ex continues to be held by real estate at 16%, followed by FMCG at 12%, auto 11% and BFSI 9%. In terms of growth auto registered a 48% growth followed by real estate 26% and retail 24%. Lastly let's review cinema. Here again you'll find the figures surprising despite blockbuster movies getting released almost every month in 2023 and many movies doing a box office collection of more than 500 crores Cinema advertising in India grew by only 36%. I say only 36% because the base is very very small. We had projected an increase of 75% to reach close to 800 crores. I remember several years ago our prediction was that we would reach a thousand crores the next year. The figure is still short of pre-COVID level by almost 300 crores. Cinema advertising contributes less than 1% to our ad-ex now. So it's time now to share with you our growth forecast for 24. As I alluded to earlier with so many major countries around the world including the US going in for elections this year and three continuing wars around the world global uncertainty is at its peak. Because we live in a connected world the negativity that prevails in the western world we think will have some impact on Indian ad-ex. Our forecast for growth in 2024 is therefore more realistic. 12.2% with which we believe will cross the 1 lakh crore landmark finally. Warx forecast for global ad-ex in 24 is a growth of 8.3%. In the past years Indian ad-ex has grown always many times the rate of growth of global ad-ex. This time the gap has decreased. I would encourage all of you to read the last section of our report titled economic insights driving our projection. One of the highlights identified by our Nagraj our in-house economist is that while GDP growth is at a high of 7.3% which we all talk about and so do all the foreign expert visitors who come to our country. In 23-24 Nagraj finds that the private final consumption expenditure component of GDP one of the three components that make up the GDP in fact is expected to come down in 23-24 which may explain to some of the marketers why buying of products and services in our country especially by the masses is a bit sluggish. We expect digital to grow by a modest 17% and traditional medium once again at a slower rate of 9%. Key factors that will contribute to this growth are the upcoming T20 Cricket World Cup, general elections leading to heavy spends by political parties, organic growth coming from the largest contributor FMCG, new launches in the automobile sector and more and more advertisers adopting the digital medium. We recognize that we may be further aided by tailwinds which could come from post-election results when we expect new aggressive reforms being introduced to stimulate the economy and growth in volume of FMCG. But we feel we'll get a little pulled down by headwinds from global uncertainties, the continuing war and the aggravation of disputes among many nations and funding winter which is likely to continue at least in the first half keeping start-up spends subdued. We expect no medium to degrow in 2024. We witnessed last year a dramatic slowdown in growth of digital whilst digital will continue to be the key driver of ADEX. We expect it to grow by a modest 17%. Despite the onslaught of digital and the popularity of video on digital and connected TV and whatnot, we believe linear TV will continue to grow because large and seasoned advertisers continue to believe in the brand building power of television. We expect TV to add another 2700 crores and grow by 8% in 2024. I can't help but say that we get the feeling that broadcasters seem to have less confidence in linear TV than my advertiser friends have in India. We expect print to grow by 7% in 2024 against an expected degrowth of print of minus 4% in global ADEX. We expect radio to grow by another 12% on the back of 12% growth in 2023 and we estimate a further 15% growth in outdoor and a 35% growth in cinema. Looking at shares, digital will further gain share and will now be 10 share points more than TV share. Outdoor radio and cinema are likely to maintain share. Linear TV is expected to lose share despite growth. As against global ADEX, in 2024 it is estimated that share of TV in India will be 2x of global but digital share will be half of global. Finally, as usual, we would like to end with some advice for all our advertiser friends. Our advice number one is, please do focus on volume growth. Do not sacrifice brand building advertising activity to protect quarterly profit. Market analysts, we believe today understand the game reasonably well and reward volume growth, not just profit growth. Also, you can't build a sustainable successful company through the years, every year, through cost cutting alone. A second piece of advice, at least for the immediate years, is to focus on premium products. There is a growing realization that we now have in India a sufficiently large number of upwardly mobile individuals who are upgrading, buying larger cars, travelling more, taking more holidays, upgrading to larger homes, buying larger TV screens, buying more gizmos and what not. And we need to cater to their needs. In contrast, the large lower middle class are a bit constrained with low increases in income and inflation reducing their purchasing power. As a corollary to this point, our next point is to focus on modern trade. Because modern trade we have seen is growing at a much faster pace than Kirana stores. Our fourth piece of advice is increase media reach. This is necessary, we believe in a country like India, to take full advantage of India's demography. TV is efficient and effective for brand building, but some viewers are watching now less of linear TV, are not watching it at all, having moved to connected TV. So we have to use digital and mobile to reach those audiences who now watch less linear TV. And our last point is, again flowing from the earlier point, that there is now a very urgent need in the industry for advertisers to establish a common measurement system for multimedia. With more and more brands using multimedia and more and more of them are going to do so in the next few years, this should indeed be our priority. And advertisers should take the initiative to do this and fund this study. We cannot expect media owners with conflicting interests to agree on a common methodology for doing this. Thank you very much ladies and gentlemen for listening to me.


Hi, this is Julie Nanavadi, clinical informationist at the Welch Medical Library. Today I'm going to talk about evidence-based clinical tools and resources available to you to support your clinical decision making. We'll start by discussing clinical tools used for finding disease summaries and drug information. These tools are designed to be easy to use so that you can quickly access high-quality evidence-based information on a topic. Then we'll discuss resources available to you for instances when you need to dig a little bit deeper. Perhaps the overview does not provide enough information or does not apply to your specific case. For these situations you can turn to high-quality literature or practice guidelines. I'll show you the resources to use to find these. We'll also talk briefly about when using Google, Google Scholar, and Wikipedia are most valuable and when they should be avoided. Next we'll talk about some resources that you can use to find patient education handouts. Let's get started. You can access most of the clinical tools and resources that we'll talk about from the Welch Medical Library's website. When you're at the hospital, you can access them from the workstations. Now let's move on to the clinical tools for finding disease summaries. I'm sure you've used up-to-date before, but tools like Dynamed and Clinical Key are also valuable resources to add to your toolkit. Dynamed provides evidence-based disease summaries. The literature used for each summary is linked throughout so you can easily access the referenced primary studies. The best part about Dynamed is the information is current with entries being updated daily. There's also a free app available for Dynamed that you can download for your phone. You might notice from the screenshot that Dynamed and Micrometics are now combined into one seamless database. We'll talk about Micrometics shortly. Clinical Key is produced by Elsevier, one of the largest publishers of biomedical books and journals. You can use it to find disease summaries similar to those in Dynamed and up-to-date. You might also find it a valuable source for journal articles, e-books, medical images, and procedure videos. Because Clinical Key has so many resources, it can be a bit overwhelming to search this database. If you're just looking for disease summaries, pull down the arrow next to the search box and limit to clinical overviews. Up-to-date is the largest of the disease summary tools providing access to summaries on over 11,800 clinical topics. It is often referred to as an evidence-based resource, but this is a bit of a misnomer. While the topic summaries that you find in up-to-date are based on the literature and incorporate findings into the information provided, the authors do not perform systematic reviews of the literature on a topic. Rather, they combine a synthesis of selected literature and their own expert knowledge to form patient care recommendations. That being said, medical students and residents tend to appreciate this resource for its reliable information, ease of use, readable format, and access to quick answers to clinical questions. I'm guessing you're wishing we'd just tell you one clinical tool to use for finding disease summaries. That would certainly be easier, but the reason you have access to three separate tools is that it's important to not rely too heavily on one resource of information, even if it's of high quality. If you do, you could miss out on important information that can make a difference in your patient's care. Because each of these tools references different pieces of evidence, Dynamed might bring up an important point that isn't mentioned in the up-to-date summary, or vice versa. For this reason, it's vital to reference more than one of these tools when answering a clinical question. Let's move on to drug information clinical tools. Remember what I said about referencing more than one disease summary tool? The same goes for drug information tools. For this reason, there are two drug information tools I'll recommend for you, Micromedics and Lexicomp. In both databases, you can find overview information about a drug and lookup interactions. In addition, Micromedics has a mobile app that's freely available. You can access Micromedics two ways. If you use the Dynamed plus Micromedics database, you get seamless access to both databases. In it, you can access drug monographs, check interactions, and access medication calculators. You can also use the standalone version of Micromedics to get a little bit more information regarding drugs. In this tool, you can also get patient handouts and compare drugs side by side. To access Lexicomp from the library's website, you need to search for it in the database search box on the right-hand side of the screen. Lexicomp is used as the hospital formulary, so when you look up the formulary from the hospital workstation, Lexicomp is running behind the scenes. What this means for you is that you can quickly search for additional drug information from Lexicomp whenever you have the formulary open. As mentioned earlier, while clinical tools are great for understanding the basics about a condition or medicine, you may need to dig deeper on a topic. Tools like the TRIP database, Cochrane library, and PubMed clinical queries will enable you to find these resources. The TRIP database is a clinical search engine a little bit like Google, but designed for evidence that will inform your clinical practice. You can access it by going to www.trippdatabase.com. In TRIP, when you enter your search terms and see your search results, you'll be able to filter by systematic reviews, evidence-based summaries, guidelines, trials, and more. The Cochrane library is accessed on the Welch library website and includes a collection of Cochrane databases. One of which you'll find highly valuable for answering clinical questions is the Cochrane database of systematic reviews, which contains over 7,500 Cochrane reviews. Cochrane systematic reviews are considered the gold standard for systematic reviews because of their rigorous methodology and transparency. If you find yourself needing more in-depth information than what you can find from disease summaries, see if you can access a high quality systematic review such as one published by Cochrane. You can feel comfortable that the review analyzed findings from high quality trials to make its recommendations, alleviating the need for you to do the same on your own. In addition to systematic reviews, the library also contains a collection of controlled trials. These are taken from bibliographic databases, mainly PubMed and MBase, but records are also derived from other published and unpublished sources, including CINNL, clinicaltrials.gov, and the HOOS International Clinical Trials Registry Platform. The last Cochrane resource that I'll mention is the Cochrane Clinical Answers, which is also found in the library. It provides a readable, digestible, clinically focused entry point to rigorous research from Cochrane reviews. I'm sure you're familiar with PubMed, but did you know that there's a clinical tool you can use in PubMed to quickly find primary studies related to your clinical question? This tool is called PubMed Clinical Queries. You can access it from the PubMed homepage underneath the find heading. In it, you can search for high-quality primary research related to therapy, diagnosis, prognosis, etiology, medical genetics, and COVID-19. Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. These guidelines are available in the TRIP database, in Dynamed and Micrometics, Clinical Key, and also from major societies like AAP or ACC. Let's briefly talk about Google, Wikipedia, and other internet resources. With so much out there, it's important to know what to use and when. Google or Wikipedia both have their place. For example, they are both useful when you are just getting started learning about a topic and you need general background or overview information. Google can even be helpful in finding medical images, procedure videos, or epinence. When using Google or Wikipedia, it's important to evaluate the information that you find and make sure that it's credible. It's important to keep in mind that not all information found in Google or even Wikipedia is reliable or based on the most current evidence. And most information that you find by Googling or in Wikipedia is not geared for clinicians. For this reason, you won't find dosing information on the Wikipedia page for a medication. What about Google Scholar? Google Scholar can be a very handy tool for a couple of purposes, but proceed with caution. Know that searches conducted in Google Scholar are based on your past Google search history and are not reproducible. Google Scholar scans the internet for scholarly and gray literature and may be helpful for a particularly difficult topic. You'll often be able to locate hard-to-find PDFs through Google Scholar. Also, you can use Google Scholar to find seminal works on a topic. If you want to read more about this, here are a couple articles that might interest you. And the last thing I'll mention is that it's good to know what's out there on the internet, because chances are this is where your patients are looking before they come to see you. You can help your patients by providing them with information from more authoritative and evidence-based sources. Which leads us to the last set of resources I'll talk about, consumer health resources like MedlinePlus and patient handouts. MedlinePlus is the National Institute of Health and the National Library of Medicine's Consumer Health Information Resource. It provides easy-to-understand information about diseases, drugs, and laboratory tests in a wide range of languages. In addition, clinical key, up-to-date, and micromedics all have patient education handouts that you can print out and give to your patients. These are written to a fourth- to fifth-grade reading level, include links to additional credible resources, and are available in many languages. So in conclusion, there are a wide variety of resources available to you for answering clinical questions and providing information for your patients. Most resources are available through the Welch Medical Library website and hospital workstations. Others are freely available online.


I think what we have benefited is the network of colleagues from different countries and then we have had a very good opportunity to benchmark with others what we are doing. The University of Cyprus has been benefited as its library is an open or not. Since we are the main actor of open science in Cyprus, we were collaborating with national bodies in the creation of the national policy. We are participating in focus groups and ad hoc groups for open science in Cyprus and in the European level. This created the national policy of Cyprus in 2016 and in 2022 the revision of the national policy for open science in Cyprus. The benefit to participate in Open Air is the alliance that we have in Spain so they support us, so we can support our national community and facilitate our participation in the different horizon Europe calls so we can be there and be the strategic partner. And also we belong in the international community so they can help us in the different guidelines and the different projects that we have to be as national contact point. It has allowed me to really engage with a network of international partners and currently my position within GISC is to collaborate the international work within GISC so making sure all the different efforts within GISC are talking to one another and that really has come about because of my engagement first and foremost with Open Air. So the University of Malta is the main educational institution on the Maltese Islands. We are leading open science on the Maltese Islands way back in 2014. We've set up our institutional repository. It was the first institutional repository in Malta which serves also as the national repository. Immediately after that we have also implemented an open access policy for our university and all this was done basically with the support and expertise of Open Air. Open Science was relatively new to us and with the support of Open Air as well as with networks that we've built immediately after joining Open Air. Obviously these were extremely beneficial for us to ensure that the implementation of policies and infrastructures to support Open Science for the Maltese Islands are to the maximum of our academia and researchers in Malta. Open Air is helping us with our activities by giving us guidelines, materials and by just having someone to talk about certain things and to see how other countries did the same thing that we are trying to do. Ok, the University of Minho is a member of Open Air since the beginning so basically we work a lot around the support and training but we also act as a national open access task trying to do the connection between the national open science initiatives, the national infrastructure on the scholarly communication and the Open Air and then working several projects on support, open science of tasks and open science and RBM training.


This 2021 GMC Sierra 2500 Crew Cab Short Box is stock number 12280Z. We're here at Summit Automotive in Fond du Lac, Wisconsin. You're new and used heavy-duty truck headquarters. This 2021 GMC Sierra 2500 has the 6.6-liter Duramax diesel with the L5P engine. It pumps out 445 horsepower. It's paired up with the Alice in 10-speed heavy-duty transmission. This truck has been fully-safetyed and inspected by our service shop for the state of Wisconsin inspection process. It has a fresh oil and filter change. All the fluids have been checked and topped off. And this truck is 100% ready to go. Summit White is the color we shoot all of our videos in 1080p, 60 frames per second. So if you have HD capabilities on your computer, tablet, smartphone, or television, turn them on right now because it is definitely your best way to check out the quality, condition, and options of the truck before seeing it in person. And if you liked the video and would like to subscribe to our YouTube channel where we do videos of our new and used inventory each and every day, in the bottom right-hand part of the screen is a subscribe button. Click that and then click the bell notifications to our YouTube page. And you'll be updated every day we do videos here at Summit Auto. This one comes with the factory-painted alloy rims. They're in really nice shape and it has Firestone Transforce LT24575R17 tires. These tires look like they have probably about 70-80% of the tread left on them. Front fender is in excellent condition. I didn't see any dents or dings on that. This one has, I believe, the LED headlights and running lights on there. We'll turn those on at the end of the video. Front bumper is in really nice condition. I didn't see any major dents or dings on there. Get the chrome trimmed grille. The cowl induction hood. Hood is in nice shape. Looks really good. Passengers side front fender is in excellent condition as well. No dents or dings on there. And the passengers side rim, no scuffs or scrapes. It's actually kind of a painted and then a polished aluminum on the outsides right there. As you go down this side of the truck, take note of how clean the body is, how reflective and mirror-like that paint is. We take these HD videos so if you are far away or even if you're close by and just cannot make the trip down but you're still interested in purchasing the vehicle, you can see the truck here, the truck, and have confidence in the vehicle that you're looking at before you even get here. So when you do get here, there's absolutely no surprises and you can make a smart and informed buying decision from wherever you're at. And if this video helps you make a buying decision, let them know that Brett sent you. Very nice down that side. Didn't see any dents or dings. Backroom is in excellent shape as well. And these back tires have just about as much tread as the front tires. A little bit less tread in the back but still pretty decent tread. Framing on your body other than a little bit of South Dakota dust on there is in really nice shape. I didn't see any corrosion. This is a one owner out of South Dakota. And you can see the body is in really nice shape. Dust just seems to stick to that frame. Cab corners, lower rockers look all really good. Comes with bed rail covers, side box steps, rear bumper steps. Rear bumper is in great condition. No dents or dings on that. The tailgate is in excellent shape as well. I'm assuming this is a power drop down tailgate. Has a shock down assist so it's never going to slam down on you. Comes with a goose neck hitch, sprained bed liner, four pin and seven pin wiring back here as well. Bed is in really nice condition. I didn't see any dents or dings back here. Tailgate shuts nice and solidly. And as you go down the driver's side, just as clean as that passenger's side, no dents or dings on the box. And for full disclosure, this back rim is in excellent shape as well. No scuffs or scrapes. Down the rest of the side of the truck, really nice, really clean. Has the directional signals on the mirrors. These are telescopic so they telescope out like so. They also fold in like that. Inside the truck has the SEL-1 package. S-L-E-1 package I should say. Gray cloth interior. No rips or tears on the seats. Comes with factory all-weather floor mats, auto headlamps, push button four-wheel drive, tilt, telescopic steering wheel, wood grain trim on the doors, power windows, power locks, and power mirrors. We'll hop inside, take a look at the miles and the radio and everything that the interior has to offer. You can see that this truck only has 7,244 miles. You do get the digital spinometer on there, compass display. Instrument cluster is very nice and clean. Comes with the leather wrap steering wheel, Bluetooth and information center controls on the right, cruise controls on the left, and it does have audio controls on the back of the steering wheel. There is your 10-speed automatic transmission with the optional tap shift on it. This one comes with the GMC infotainment system, AM, FM, and Sirius XM radio capabilities on this radio. It also has a projection manager where you can actually Apple CarPlay and Android Auto capabilities on it where you can project your cell phone to the screen. So if you have a navigation system on your cell phone projected to the screen, use it through there. It's like you have nav right on the screen. It's a very nice system to have. It's elsewhere here. I believe that's where your backup camera shows up if you have a backup camera on here. Heated mirrors, exhaust brake, power dropdown tailgate, hazard lights, stability control. There's your factory brake controller to USB-C and a USB 12-volt power point right there as well. And you can see the carpeting and floor mats are in excellent condition. This truck's never been smoked in. Side passenger side seat, excellent condition. The headliner is absolutely perfect. Up here you do get map lights, on-star, and SOS buttons as well. We'll take a quick look at the back seats and then we'll start it off. Take a look under the hood. Back seats are just as clean as the front seats. No rips or tears back here. It does have the latch child safety system for any child car seats you may have. Fixed glass rear window. I know these headrests do fold down for better visibility if nobody's sitting back here. And the seats are all in really nice shape. All-weather floor mats back here, they do fold up. It's almost a completely flat floor back here. All-weather floor mats and you do get a receiver hitch reducer. Child safety locks on the back doors and the bottoms of the doors all look really good. We'll start it up. Take a look under the hood. Check out those LED headlamps. Starts right up. No check engine lights or anything like that. There's your HD backup camera. They finally made them HD in the GMs. I would personally like to thank you for checking out the video today and hopefully from this HD video you will have been able to verify the quality and condition. That's kind of cool. They have a GMC logo in the corner marker there. There are those LED headlamps, LED running lights. But I would personally like to thank you and hopefully from this HD video you will have been able to verify the quality and condition of this truck inside and out. Under the hood we have the 6.6 liter Duramax diesel engine L5P. That is a true coal hood. Got the air intake goes right there. There's your mission sticker. Once again this truck has been fully inspected by our service shop as a fresh oil and filter change. All the fluids have been checked and topped off. And this truck is 100% ready to go. I would highly recommend this truck from a quality and condition standpoint. And to see more pictures of this truck or one of our other 450 new and used cars, trucks, SUVs, minivans, wranglers, halftones, three quarter tons, one tons. You name it, we got to go to that website right there www.summitauto.com Full pictures and descriptions of every single vehicle from two locations all at www.summitauto.com And if you'd like to check out more HD videos you can go to www.youtube.com slash www.summitauto.com Remember to like, subscribe, and share on this video and all the videos that you see there. Click the bell notifications, you'll get updates on the videos we do each and every day here at Summit Automotive. In fact in a second you will see a link to subscribe to our YouTube channel on the upper left, a link to more GMC Sierra 2500 truck videos like this one on the upper right. Link to this vehicle on our website on the lower left of our YouTube channel. Check us out and we're super excited to help you with this Ultra Clean 2021 GMC Sierra 2500 True Cab Short Box Duramax Diesel SLE-1 in Summit White Clear Coat. Thanks again for checking out the video.


How much can I earn teaching English in Mexico? Mexico is a hugely popular destination for teaching English abroad due to its booming job market, vibrant culture, diverse and beautiful landscapes, and the worldwide popularity of its cuisine. The country's close ties to its neighbor the USA also ensures Mexico has a very strong demand for the English language in every town and city, no matter how big or small. What are TEFL salaries in Mexico? Although a teacher's salary is much less than you would earn in the US, the low cost of living means that what you earn goes a whole lot further. Your income will vary depending on the type of job you secure and the location in which you choose to live and work. On average, you can expect to earn between $500 and $1,000 USD per month. When looking for a job, it is best to shop around to find the best deal, as hourly rates can be very different in different schools in the same area. Some employers will also offer some assistance with housing, transport and teaching materials. Most employers in Mexico will insist that you have a TEFL or TESOL certification. Who are the main employers of English language teachers in Mexico? The best salaries for teaching English in Mexico are generally found with local businesses. Many companies hire teachers to deliver lessons to their staff who are usually highly professional and motivated. On the downside, lessons are normally scheduled for before or after normal working hours and you will often have to commute between different companies. Private language centers offer the largest number of teaching jobs in Mexico, although the hourly rate is likely to be less than working with private companies. These positions also often involve unsocial hours both in the early morning and evening and also at weekends. Your classes could be young learners or adults, depending on the center. Public schools offer the most stable work hours, however, the pay is often less than other teaching jobs. Teaching hours are generally from 7am to 2pm Monday to Friday. Many of these jobs actually require you to teach specific subjects in English rather than just English, so previous classroom experience would be a real help. Whichever type of job you have, many teachers also take on a few private students to teach in their free time. This is a common way of topping up your main salary for just a few extra hours each week. What is the recruitment process for English teachers in Mexico? The best approach to finding a suitable job in Mexico is to first identify the area where you want to live. You can then compile a list of potential employers to contact. Ideally you should apply in person looking smart and with your CV or Zoom ready to be handed over. It is also a good idea to take along your TEFL TESOL certificate to prove you have completed a training course. Although jobs can be found all over the country, the largest number and the best salaries are mostly found in big cities, particularly Mexico City. Jobs can become available at any time of the year, however, the best time to look for jobs in language centers is August and early September. Public schools often start their recruitment process in July for the first semester and again in December-January for the second semester. What is the cost of living for English teachers in Mexico? While salaries in Mexico are not large by American standards, the cost of living is much lower, so your hard-earned cash will go much further. On average, a teacher's cost of living is around $300 USD per month. This means that most people should be able to live comfortably on their income, particularly if their contract includes free housing or a housing subsidy. Teachers who take on private tutoring should also have plenty of spare cash to make the most of their free time. Most remember to avoid expensive imported luxuries and to enjoy the cheap local food.


Good morning U.S. Navy Facebook fans, I'm Lieutenant Amberlynn Daniel and I am back once again from the Sea Air Space Expo for our final broadcast here at the Expo and joining me this morning I'm very excited to introduce you to Dr. J. Thomas from Navy History and Heritage Command. How are you doing this morning? I'm great, thanks. Good morning. Good morning. Alright, so to kick it off for our Facebook fans, can you tell them a little bit about what Navy History and Heritage Command is? The Naval History and Heritage Command is sort of the Navy's corporate memory. We have the Navy Department Library, we have historians, we have a large classified archive. We manage the Navy's museum system all over the country and then my part of it, the collection management part is the Navy's historic artifact collection, the Navy's art collection and then the Navy's collection of artifacts associated with underwater archaeology. We also manage the sunken ships and aircraft that the Navy has all over the world. Well it sounds like you have a pretty cool job. What is the favorite part of your job? Well my favorite part is working with a remarkable array of individuals who know so much about their collection, who know so much about the Navy, I learn something from them every day. Within the collections we have things like a trumpet that was recovered from the wreck of USS Houston, which was lost off the coast of Indonesia in 1942. A diver picked it up, shouldn't have, but he returned it to us and so it's in conservation. We have art that dates back to the beginning of the Navy actually and then particular artifacts that just, it's hard to choose a favorite. They're all my favorites, but there are some that just have particular power. We have a laptop that was in the Navy Command Center on 9-11 and so it's just a black laptop that's melted around the edges and coming apart a little bit, but that artifact, it does what artifacts are good for and that is carry so much emotional power connected to that event that is a recent event, which just highlights that the Navy makes history every day. It's a really important part of our history and speaking of that, Sina was talking earlier this week about maritime superiority. Can you tell me how our history plays a role in our maritime superiority? Well, I think the Navy's been doing maritime superiority for a long time and not just in the context of war either. The Navy, after the Second World War, for example, the Turkish ambassador to the United States died while he was in Washington and so the government shows to return his body to Turkey aboard the battleship Missouri, which then made a series of portcalls throughout the Eastern Mediterranean at a time when the Soviet Union was trying to expand its influence into that part of the world and so the Navy was able to reestablish the U.S. presence there at a time when it was really necessary using a ship to return the body and make that case. We've been doing humanitarian assistance for decades, for centuries, the Great White Fleet. As it was passing through the Mediterranean, there was an earthquake and the Great White Fleet was able to stop and provide humanitarian assistance sort of accidentally and of course we've been doing that ever since. But I think, for me, one of the most remarkable examples of the Navy providing maritime superiority was almost the entire year of 1942 because Pearl Harbor, of course, the attack on Pearl Harbor was in December of 1941, but within three months the Navy was supporting the raid on Tokyo and five months later engaged in battle with the Japanese in the middle of the Pacific and by the end of the summer, landing forces in Guadalcanal, landing forces in North Africa, just within eight months of Pearl Harbor, just a remarkable mobilization of people and force and planning and industry to begin the road back, to begin the road back towards victory. That also reminds us too that when bad things happen, you use the forces that you have at the beginning. You don't often have a lot of opportunity to say, okay, hold on for a little while, we need to build back up again. All of those forces that were doing all of that great work in 1942, the Navy owned in 1941 on Pearl Harbor Day and so it's important to be ready because you never know one of the great lessons of history is you never know when you're going to need the things that you've got. Absolutely and here at Sierra Space, all week we've been talking about our present and our future, but certainly our past plays a part as well. Can you tell me how history plays a part in shaping our future? Sure. I think the past is good for several things for people who are practicing naval officers or sailors or civilians. First of all, it helps us to remember what we've done right over the years. We've done a lot of things right. There have been a lot of examples of individual heroism and valor that are, of course, important to remember. It's also important in that it reminds us what we did wrong sometimes and how not to repeat those mistakes and that's important. Of course, we'd rather make our own mistakes and not repeat past ones. And then just the Navy is a part of the country. The Navy is a part of the United States and most people who are in the Navy come to the Navy and do a hitch, do four years, do their obligated service, and then return to civil life and become the veterans who provide such great support. And that's been happening for the entire history of the Navy. And so it's important for them to remember their service, to commemorate their service, and to think about it all as a part of the larger history of this institution, but also the country that we're a part of. All right, so for our final question for the Sea Airspace Expo, we've been talking about why history matters. And I know we've got a ton of people that are looking to join the Navy. We've also got sailors following these broadcasts. Can you tell me why history matters to our sailors and also to those that are interested in joining the Navy? Sure. I think it matters because a lot of the parts of being a sailor never change since the beginning of the Navy, you know, just the sea itself has not changed. A lot of the experience of being on a ship have never changed. But importantly, one of the things that hasn't changed is that you have a chance to make a difference both in your life, both to your country, but also to your shipmates and to your ship or to your squadron.  From the day a new sailor steps on board a ship, you're a part of the damage control team. If three months later something happens to your ship like USS Cole, if something happens to the ship, everybody aboard needs to be a part of the solution. And people wonder, naturally, everybody wonders if they'll be able to rise to that occasion. Now, I truly believe that every generation rises to the challenges that they've been given. And I truly believe that every sailor has the chance to do great things if they're called upon to do it. And that's the opportunity to look back and learn from the stories of people who have been through that as recently as Cole, but as far back as the Revolutionary War, reminds us, reminds everybody who serves that they're part of a large, long family that has been doing great things since the very beginning. And we can't be reminded of that often enough. Absolutely, sir. I couldn't have said it any better myself. So Dr. Thomas, thank you again so much for joining us. And to all of our Navy Facebook fans that have been following us all week, we really appreciate you following us. If you missed any of our broadcasts, be sure to check us out on the Navy Live blog. And hopefully, we'll see you again here next year.