Thursday, May 31, 2007

CONSUMER INDIA

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ConsumersIndia.com Announces the Second Referral Contest
Worth Rs.50,000/- in Cash
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M GINGER- READ SMS, GET PAID

Hi,
mGinger.com pays you to read ads on your cellphone!
These ads are only about your interests.
Not only that, you get to decide when you want these ads.
Check it out...
http://www.mginger.com/index.jsp?inviteId=551616
You will like it...
-Lokeshwar

proof
CNN news
You can now make money by just receiving messages on your cellphone.
A Bangalore company has offered to pay users to receive SMS advertisements.
Cellphone users once shunned SMS advertisements but mGinger has changed all that. It has turned the advertising cell phone into a source of income.
It's using permission-based marketing to turn SMS advertising into a lucrative proposition for users.
"What mGinger tries to do is it eliminates spam from your phone. But it does it in such a way that the ads that you do get on your phone turn into useable information," said mGinger CEO Chaitanya Nalla.
And it's simple too. All you need to do is log on to mGinger.com and register yourself with details of the kind of advertisements you want to receive.
Users get to choose the number of ads they want and when they would like to receive them.
The company will pay users 20 paise for each ad read and 10 paise per referral. And advertisers are excited.
"The day we launched, we got our first advertiser. So that tells us that this medium is powerful, and that advertisers are interested in such a medium," said Nalla.
The company has already run eight campaigns in different sectors, and talks are on with another 200 clients. The website, which started on April 19, has over three lakh registered users.
This may not be a money-spinner for you, but it still has users excited about the additional income. Particularly college students are looking at this as an additional source of pocket money and a reason to stay hooked to their cellphones -

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Sunday, May 27, 2007

ACLS ITLS PALS COURSES


Dr.Venugopalan.P.P,
D.A,DNB,MNAMS.
Chief, Emergency Medicine,
Coordinator MIMS Academy
MIMS Calicut
email -venugopal@mimsindia.com

website


FELLOWSHIP IN EMERGENCY MEDICINE-Apollo hospitals

Duration : One year (12 months)
Eligibility : MBBS degree with Medical Council of India (or regional) registration certificate
Selection Criteria : Those fulfilling the eligibility criterion will be called for a personal interview following which the admission list will be drawn

Course Fee
At the time of admission-Rs 30,000/-
At the start of Qtr 2 *-Rs 15000/-
At the start of Qtr 3 *-Rs 15000/-
At the start of Qtr 4 *-Rs 15000/-
Total Fee-Rs.75,000
* to be given as PDC
Assessment :

Internal Assessment - Written and Orals at the end of 3rd, 6th and 9th months
External Assessment - Theory paper to be sent by Royal College of General Practitioners
Viva - To be taken by the RCGP Examiner along with an internal examiner
Project Work
Each trainee will be allotted a dissertation guide at the beginning of the program. The guide will allot a topic for dissertation within the first 30 days of beginning of the course. The trainee shall conduct an original study and present it to the department after due certification from the guide and Head of Department atleast 30 days before the final examinations.
Continuing Education
In addition to fulfilling the training requirements, the trainee should have:

a) Attended at least 90% of the Academic programs
b) Attended and successfully completed the following life support training course
Basic Cardiac Life support
Advanced Cardiac Life Support
Criteria for Certification
Minimum Attendance of 90% in theory & clinical sessions
Completion of log book
Completion of Project work
50% Marks in Internal assessment
50% Marks in external assessment
SUCCESSFUL CANDIDATES TO RECEIVE, FELLOWSHIP IN EMERGENCY MEDICINE JOINTLY FROM AHERF (India) & RCGP (UK)

Curriculum
1. Emergency Medicine Department. 2. Airway Management 3. Cardiac Emergencies 4. Management of Shock 5. Neurological Emergencies 6. Respiratory Emergencies 7. Surgical Emergencies 8. Orthopedic Emergencies 9. Trauma Emergencies 10. Obstetric And Gynecologic Emergencies 11. Pediatric Emergencies 12. Wound Assessment And Management 13. Local Anesthetics And Anesthesia 14. Analgesia In Emergency Room 15. Chronic Pain Management 16. Imaging 17. Toxicology 18. Otolaryngologic Emergencies 19. Ophthalmic Emergencies 20. Endocrine Emergencies 21. Acid Base And Electrolytes 22. Burns 23. Anaphylaxis 24. Bites And Stings 25. Envenomation 26. Dive Emergencies 27. Environment Emergencies 28. Mechanical Ventilation 29. Urogenital Emergencies 30. Transfusion Emergencies 31. Hepato Biliary Emergencies. 32. Psychiatric Emergencies 33. Legal Aspects Of Emergency Medicare 34. Protocols & Procedures 35. Pre Hospital Care
Clinical Postings

The following are minimal posting requirements of EM trainees
Internal medicine 1 month
General Surgery 1 month
Emergency Medicine 3 months
Orthopedics 1 Month
Cardiology 1 Month
Intensive Care (Medical ICU) 1 Month MICU
Intensive Care (Surgical ICU) 1 Month SICU
Intensive Care (Paediatrics ICU) 15 days PICU
Radiology 15 Days
Intensive Care (Cardiology) 15 days CICU
Ambulatory Services Emd. Dept(Pre Hospital Care) 1 Month
Anaesthesia in Pain Clinic 15 days


website: www.medvarsity.com
contact
Fellowship in Emergency Medicine (Affiliated with the Royal College of General Practitioners, U.K.)
The Royal College of General Physicians has recognised Apollo
Hospitals, Chennai and Apollo Hospitals, Hyderabad for fellowships in Emergency Medicine in 2002.
For information contact:
Co-ordinator Dr. T. Srinivas Reddy M.B., D.Ortho., MS Phone: +91-40-23554726 e-mail:
drtamma@rediffmail.com

MAN-WOMAN




IFEM


IFEM-
International Fellowship in Emergency Medicine
A 2 year PG Fellowship under George Washington University,USA
Under direct guidance of Ronald Regan institute of Emergency Medicine-
Supported by IIEMS –India
At
MIMS-calicut KIMS- Trivandrum
THOSE INTRESTED HURRY
Interview at mims on june 8th/9th.
Contact MIMS/KIMS for latest info.
Dr Venugopal P P
Chief of Emergency Medicine- MIMS can be contacted by mail directly at
venugopal@mimsindia.com
he is very much helpful in guiding to know more about this fellowship

Fellowship is not recognized by IMC.
Entire 4,00,000/- will be credited towards the course fee of IFEM only.
ACLS ,ITLS, PALS are not included in 4 lacs . But MIMS may be able to provide these courses at 50% rate for fellow students.
Duty details
a stipend of 12,000/- rupees ,
day duty will be 8am to 5pm.
5 night duties per month.
eligible for weekly off, night off, plus three leave per month.
Extra duties will be paid separately.
Fee remittance schedule-
2,00,000/- before admission, 1,00,000/- at 6 months,50,000/-at 12th month and 50,000/- at 18th month.
try to provide economy accommodation.
program is recognized in more than 30 countries world wide.
WISHING YOU GOOD LUCK!!
plz quote that you got this info through this blog,!!

Sunday, May 13, 2007

AIR AMBULANCE WORKSHOP-update

register your name for the Course which is scheduled for the first week of June.
they are scheduling the in flight training & location for the training.
As soon as it is done, the exact dates for the Course and location will be confirmed to you.
The fee for the course is Rs10, 000/-(Rupees ten thousand only)
The same may be sent by DD to
Rotary Wing Society of India, Noida Warm regards,

Dr. G.Sairamanan M.D.
Convener,
Aero medical Evacuation Course
Jaya Clinic & Global Air Rescue 999
#4 Venkatesa Agraharam Rd
Mylapore, Chennai 600004.
TEL: +91(0)4424640623
TELEFAX:+91(0)4424611257
Email: gsairamanan@dataone.in / gsairamanan@vsnl.net
Web: http://www.marinemedicare.com

more about dr sairamanan
Dr G Sairamanan
critical care physician
visiting consultant-St Isabel's hospital-Chennai
Medical Advisor- Consultant Physician(directorate general of shipping approved)
http://www.marinemedicare.com

Saturday, May 12, 2007

Bloggerwave



BLOGGERS
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products,
services,
and companies
and get paid for it.
Disclosure required.

TEN THINGS GOD WONT ASK!!

1 ...God won't ask what kind of car you drove;
He'll ask how many people you drove who didn't have transportation.


2...God won't ask the square footage of your house,
He'll ask how many people you welcomed into your home.

3...God won't ask about the clothes you had in your closet,
He'll ask how many you helped to clothe.

4...God won't ask what your highest salary was,
He'll ask if you compromised your character to obtain it.

5...God won't ask what your job title was
He'll ask if you performed your job to the best of your ability.

6...God won't ask how many friends you had,
He'll ask how many people to whom you were a friend.

7... God won't ask in what neighborhood you lived,
He'll ask how you treated your neighbors.

8...God won't ask about the color of your skin,
He'll ask about the content of your character.

9... God won't ask why it took you so long to seek Salvation,
He'll lovingly take you to your mansion in heaven, and not to the gates of Hell.

Wednesday, May 9, 2007

USMLE ORIENTATION PROGRAM


those intrested in usmle exams can make us of this piece of information

ADDICTED TO INTERNET, E MAIL?


A jobless man applied for the position of 'office boy' at Microsoft.
The HR manager interviewed him then watched him cleaning the floor as a test.
' You are employed.' He said.
' Give me your e-mail address and I'll send you the application to fill in, as well as date when you may start.'
The man replied
'But I don't have a computer, neither an email.'
I'm sorry', said the HR manager,
'If you don't have an email, that means you do not exist.
And who doesn't exist, cannot have the job.'
The man left with no hope at all.
He didn't know what to do, with only $10 in his pocket.
He then decided to go to the supermarket and buy a 10Kg tomato crate.
He then sold the tomatoes in a door to door round.
In less than two hours, he succeeded to double his capital.
He repeated the Operation three times, and returned home with $60.
The man realized that he can survive by this Way, and started to go everyday earlier, and return late
Thus, his money doubled or tripled every day.
Shortly, he bought a cart, then a truck, and then he had his own fleet of delivery vehicles.
5 years later, the man is one of the biggest food retailers in the US .
He started to plan his family's future, and decided to have a life insurance.
He called an insurance broker, and chose a protection plan.
When the conversation was concluded, the broker asked him his email.
The man replied, 'I don't have an email'.
The broker answered curiously,
'You don't have an email, and yet have succeeded to build an empire.
Can you imagine what you could have been if you had an email?!!'
The man thought for a while and replied,
'Yes, I'd be an office boy at Microsoft!'
Moral of the story:
M1 - Internet is not the solution to your life.
M2 - If you don't have internet, and work hard, you can be a millionaire.
M3 - If you received this message by email, you are closer to being an office boy, than a millionaire
Pls Note: - I'm closing all my email addresses & going to sell tomatoes!!!

Sunday, May 6, 2007

MOBILE PHONE ETIQUETTES


Safety - Pay attention to the road.
cell phones may distract drivers and cause risks for themselves and other drivers.
never use a mobile phone while driving unless it is "hands free."
Not only are both hands free to shift and steer, there seems to be a very significant difference in the degree of attention deficit when using an ear phone.
The ear phone makes it much easier to focus on driving.
limit conversations in cars to traffic areas and conditions requiring low amounts of decision-making.
In high volume, tricky driving situations either turn the phone off or let it ring.
pull over to the side to speak if the conversation is important.
"Drive Now - Talk Later."

Volume - Speak softly.
speak in hushed tones-a mobile phone has a sensitive microphone capable of picking up a soft voice.
set the ring tone at a low level with a tune that is soft, gentle and not annoying.
The more crowded the situation, the quieter and softer the volume of voice and ring.
move to vibrate mode in any situation like a church, a workshop or a meeting where a ringing sound would prove disturbing to other people.
try to gain as little phone attention as possible. The goal is to communicate effectively without anybody else noticing or caring.
The cell phone bore speaks loudly and employs loud, obnoxious ring tones at all the wrong times and in all the wrong places. The cell phone bore calls attention to herself or himself.
Some people seem incapable of speaking on their cell phone in a normal tone of voice. Perhaps they are subconsciously worried that the party on the other end cannot hear them very well, so they double and triple their volume. Sometimes it seems as if they are shouting.
Watch the reactions of people near the cell phone bore when the voice or the ringer are too loud.
Proximity - Keep your distance.
Each person is surrounded by a personal space. This space provides feelings of safety and calm, especially in crowded places.
When strangers come into our personal space, it can make us feel uncomfortable.
respect the personal space of other people and try to speak in places 10-20 feet or more away from the closest person.
If there is no private, separate space available, wait to speak on the phone until a good space is available.
Sensitivity to other peoples' needs and comforts is a sign of good character.
Crowded rooms, lines and tight hallways are not good places to carry on phone conversations.
Next time you find yourself in a crowded space, watch the reactions of non mobile phone users to those who speak loudly into their phones while standing next to them.

Content - Keep business private.
Many personal and business conversations contain information that should remain confidential or private. Before using a mobile phone in a public location to discuss private business or issues, make sure that there will be enough distance to keep the content private.
Some stories, some issues and some conflicts should be saved for times and locations that will allow for confidentiality.

Tone - Keep a civil and pleasant tone.
others might overhear a conversation, so be careful to maintain a public voice that will not disturb others. At the same time, certain types of conversations may require or inspire some tough talk or emotional tones. reserve these conversations for more private settings.do not fire employees, chastise employees, argue with a boss or fight with a spouse or teenager on mobile phones in public settings.

Location - Pick your spot.
Some locations are better for conversations than others. They offer more privacy and less noise. keep the mobile phone turned off much of the time, to handle incoming calls under good conditions rather than struggling against interference of various kinds such as flight announcements in the hallways of an airport.
learn which spots will offer the best signal and the best conditions. Rather than hold an important business discussion or negotiation under poor conditions,wait for good conditions in order to make the best impression and provide a professional communication experience.
Timing - No cell phone before it's time.
think about when to turn the phone on or off. There are many situations where it would be rude if a phone rang, interrupting the transaction at hand.
Stepping up to a service counter, entering a restaurant or joining a meeting, turn off the phone and rely upon voice mail to take incoming calls.
There may be sometimes when a particular incoming call or message requires an exception, but the vast majority of callers do not require immediate access.
Multi-Tasking - One thing at a time.
reserve multi-tasking for situations and times when it is safe, convenient and appropriate. Approaching a counter to work through a problem with an airline ticket,turn off the phone or its ringer to protect the coming transaction from interruption. One thing at a time. Focus. Efficiency. Manners.
stop other activities such as typing when a call comes through in order to give the caller, full attention. Free of distraction, make the most of the call.

Friday, May 4, 2007

TRY NOT TO CRY!


i received this fine story in e mail and wanted to share!
She jumped up as soon as she saw the surgeon come out of the operating room.
She said: "How is my little boy ? Is he going to be all right ? When can I see him ?"
The surgeon said, "I'm sorry. We did all we could, but your boy didn't make it."
Sally said, "Why do little children get cancer ?
Doesn't God care any more ?
Where were you, God, when my son needed you ?"
The surgeon asked, "Would you like some time alone with your son ? One of the nurses will be out in a few minutes, before he's transported to the university."
Sally asked the nurse to stay with her while she said good bye to son.
She ran her fingers lovingly through his thick red curly hair.
"Would you like a lock of his hair ?" the nurse asked.
Sally nodded yes.
The nurse cut a lock of the boy's hair, put it in a plastic bag and handed it to Sally.

The mother said, "It was Jimmy's idea to donate his body to the University for Study.
He said it might help somebody else. "I said no at first, but
Jimmy said, 'Mom, I won't be using it after I die.
Maybe it will help some other little boy spend one more day with his Mom."
She went on, "My Jimmy had a heart of gold. Always thinking of someone else.
Always wanting to help others if he could."

Sally walked out of Children's Mercy Hospital for the last time, after spending most of
the last six months there.
She put the bag with Jimmy's belongings on the seat beside her in the car.
The drive home was difficult.
It was even harder to enter the empty house.
She carried Jimmy's belongings, and the plastic bag with the lock of his hair to her son's room.
She started placing the model cars and other personal things back in his room exactly where he had always kept them. She laid down across his bed and, hugging his pillow, cried herself to sleep.

It was around midnight when Sally awoke.
Laying beside her on the bed was a folded letter. The letter said :

"Dear Mom, I know you're going to miss me; but don't think that I will ever forget you, or stop loving you, just 'cause I'm not around to say "I Love You" .
I will always love you, Mom, even more with each day.
Someday we will see each other again.
Until then, if you want to adopt a little boy so you won't be so lonely, that's okay with me.
He can have my room and old stuff to play with.
But, if you decide to get a girl instead, she probably wouldn't like the same things us boys do. You'll have to buy her dolls and stuff girls like, you know.
Don't be sad thinking about me.
This really is a neat place.
Grandma and Grandpa met me as soon as I got here and showed me around some,
but it will take a long time to see everything.
The angels are so cool. I love to watch them fly.
And, you know what?
Jesus doesn't look like any of his pictures.
Yet, when I saw Him, I knew it was Him.
Jesus himself took me to see GOD !
And guess what, Mom ?
I got to sit on God's knee and talk to Him, like I was somebody important.
That's when I told Him that I wanted to write you a letter, to tell you good bye and everything.
But I already knew that wasn't allowed.
Well, you know what Mom ?
God handed me some paper and His own personal pen to write you this letter.
I think Gabriel is the name of the angel who is going to drop this letter off to you.
God said for me to give you the answer to one of the questions you asked Him
'Where was He when I needed him ?' "
God said He was in the same place with me, as when His son Jesus was on the cross. He was right there, as He always is with all His children.
Oh, by the way, Mom, no one else can see what I've written except you.
To everyone else this is just a blank piece of paper.
Isn't that cool ?
I have to give God His pen back now.
He needs it to write some more names in the Book of Life. Tonight I get to sit at the table with Jesus for supper.
I'm sure the food will be great.
Oh, I almost forgot to tell you.

I don't hurt anymore. The cancer is all gone.
I'm glad because I couldn't stand that pain anymore and
God couldn't stand to see me hurt so much, either.
That's when He sent The Angel of Mercy to come get me.
The Angel said I was a Special Delivery !
How about that ?
Signed with Love from God, Jesus & Me.

Take time to share this, within the hour, you will have caused a multitude of believers to pray to God for each other.
Then sit back and feel the Holy Spirit work in your life for doing what you know God loves "When you're down to nothing, God is up to something."

SMS 4

A lady in a bar walks to the barman & puts her finger in to his mouth.
He lustly kiss &licks each finger.
she says-
"tell your manager that there is no toilet paper!!"
---------------------------------------------
Never kiss a LAWYER,
she will say"I OBJECT THIS"
Never kiss a NURSE
she will say"WHO IS NEXT?"
Always kiss a TEACHER
she will say"DO IT 5 TIMES!"
--------------------------
Doctor:you know , you should never tell a lie to a doctor and a lawyer....
just be frank....tell me whatever it may be!!
Naughty patient:Dr,.... your wife is really gorgeous!!
------------------------------------
(jus a joke-no other intention)
NEW EXAM PATTERN
GENERAL CATEGORY:
all Qns to be answered
OBC:
write Qn only
SC:
put only Qn No. ,if possible
ST:
just read the paper
-------------------------------------
My nights are becoming sleepless...
My days are becoming restless.....
So i asked God..
IS THIS LOVE?
GOD said-
"idiot,...summer has started!"
------------------------------
2 men searching for their lost wives...
1:hw does your wife look like?
2:bold,blue eyes, very beautiful,charming....
what about yours?
1:forget mine ...lets search yours!!
------------------------------
The marriage which is most blessed is that
which is least in burden!
QURAN
-----------------------------------
Best charity is that given when you
are healthy,
feel stingy,
fear poverty,
& hope to become rich...
QURAN
-------------------------------

Thursday, May 3, 2007

DON'T WE ALL ?

I was parked in front of the mall wiping off my car.
I had just come from the car wash and was waiting for my wife to get out of work.
Coming my way from across the parking lot was what society would consider a bum.
From the looks of him, he had no car, no home, no clean clothes, and no money.
There are times when you feel generous but there are other times that you just don't want to be bothered.
This was one of those "don't want to be bothered times."
"I hope he doesn't ask me for any money," I thought. He didn't.
He came and sat on the curb in front of the bus stop but he didn't look like he could have enough money to even ride the bus.
After a few minutes he spoke. "That's a very pretty car," he said.
He was ragged but he had an air of dignity around him.
His scraggly blond beard keep more than his face warm.
I said, "thanks," and continued wiping off my car.
He sat there quietly as I worked.
The expected plea for money never came.
As the silence between us widened something inside said, "ask him if he needs any help."
I was sure that he would say "yes" but I held true to the inner voice.
"Do you need any help?" I asked.
He answered in three simple but profound words that I shall never forget.
We often look for wisdom in great men and women.
We expect it from those of higher learning and accomplishments.
I expected nothing but an outstretched grimy hand.
He spoke the three words that shook me.
"Don't we all?"
he said.
I was feeling high and mighty, successful and important, above a bum in the street, until those three words hit me like a twelve gauge shotgun.
Don't we all?
I needed help.
Maybe not for bus fare or a place to sleep, but I needed help.
I reached in my wallet and gave him not only enough for bus fare, but enough to get a warm meal and shelter for the day.
Those three little words still ring true.
No matter how much you have, no matter how much you have accomplished, you need help too.
No matter how little you have, no matter how loaded you are with problems, even without money or a place to sleep, you can give help.
Even if it's just a compliment, you can give that.
You never know when you may see someone that appears to have it all.
They are waiting on you to give them what they don't have.
A different perspective on life, a glimpse at something beautiful, a respite from daily chaos, that only you through a torn world can see.
Maybe the man was just a homeless stranger wandering the streets. Maybe he was more than that.
Maybe he was sent by a power that is great and wise, to minister to a soul too comfortable in themselves.
Maybe God looked down, called an Angel, dressed him like a bum, then said, "go minister to that man cleaning the car, that man needs help."
Don't we all?

Wednesday, May 2, 2007

DETERMINATON






BROOKLYN BRIDGE
















JR's son WASHINGTON

















JOHN ROEBLING

In 1883, a creative engineer named John Roebling was inspired by an idea to build a spectacular bridge connecting New York with the Long Island. However bridge building experts throughout the world thought that this was an impossible feat and told Roebling to forget the idea.
it just could not be done.
It was not practical.
It had never been done before.

Roebling could not ignore the vision he had in his mind of this bridge. He thought about it all the time and he knew deep in his heart that it could be done.
He just had to share the dream with someone else. After much discussion and persuasion he managed to convince his son Washington, an up and coming engineer, that the bridge in fact could be built.
Working together for the first time, the father and son developed concepts of
how it could be accomplished and
how the obstacles could be overcome.
With great excitement and inspiration, and the headiness of a wild challenge before them, they hired their crew and began to build their dream bridge.
The project started well, but when it was only a few months underway
a tragic accident on the site took the life of John Roebling.
Washington was injured and left with a certain amount of brain damage, which resulted in him not being able to walk or talk or even move.
"We told them so."
"Crazy men and their crazy dreams."
"It`s foolish to chase wild visions."
Everyone had a negative comment to make and felt that the project should be scrapped since the Roeblings were the only ones who knew how the bridge could be built.
In spite of his handicap Washington was never discouraged and still had a burning desire to complete the bridge and his mind was still as sharp as ever.
He tried to inspire and pass on his enthusiasm to some of his friends, but
they were too daunted by the task.
As he lay on his bed in his hospital room, with the sunlight streaming through the windows, a gentle breeze blew the flimsy white curtains apart and he was able to see the sky and the tops of the trees outside for just a moment.
It seemed that there was a message for him not to give up. Suddenly an idea hit him.
All he could do was move one finger and he decided to make the best use of it.
By moving this, he slowly developed a code of communication with his wife.
He touched his wife's arm with that finger, indicating to her that he wanted her to call the engineers again.
Then he used the same method of tapping her arm to tell the engineers what to do. It seemed foolish but the project was under way again.
For 13 years Washington tapped out his instructions with his finger on his wife's arm, until the bridge was finally completed.
Today the spectacular Brooklyn Bridge stands in all its glory as a tribute to the triumph of one man's indomitable spirit and his determination not to be defeated by circumstances.
It is also a tribute to the engineers and their team work, and to their faith in a man who was considered mad by half the world.
It stands too as a tangible monument to the love and devotion of his wife who for 13 long years patiently decoded the messages of her husband and told the engineers what to do.
Perhaps this is one of the best examples of a never-say-die attitude that overcomes a terrible physical handicap and achieves an impossible goal.
moral:
Often when we face obstacles in our day-to-day life, our hurdles seem very small in comparison to what many others have to face. The Brooklyn Bridge shows us that dreams that seem impossible can be realised with determination and persistence, no matter what the odds are.
Even the most distant dream can be realized with determination and persistence.