Qubits and Hilbert spaces
Sep 24 2018 April 8, 2019
When you use your favorite search engine to search for information on quantum computing, the first term that will most likely jump at you is the qubit. In this post, I will try to explain what this is and how it is related to the usual framework of quantum mechanics.
Please be aware that this post is not meant to be a general introduction into quantum mechanics. I will have to assume some familiarity with the basics of quantum mechanics and the underlying mathematics (Hilbert spaces, states and measurements, operators, eigenvalues and so forth).
In classical computing, the world is binary – information is expressed in terms of bits, i.e. units of information that can take on two values only – 1 or 0, true or false, high or low and so on, depending on the actual physical representation.
In the world of quantum computing, the smallest unit of information is represented by "the smallest quantum system". But what is the smallest quantum system? Any nontrivial quantum system can actually be in an infinite number of states, and therefore it does not make sense any more to look for systems with only two states. What we can do, however, is to look for systems that have only two degrees of freedom. Mathematically, these are quantum mechanical systems that are described by a two-dimensional Hilbert space. In a certain sense, these are the smallest nontrivial quantum systems one can conceive, and similar to the classical world, where is a bit is the smallest nontrivial unit, these systems are called qubits and the fundamental building blocks in quantum computing.
I admit that this definition is a bit abstract, to let us look at some examples. An example that is often cited but mostly of theoretical interest is the spin. Imagine we are looking at a single, isolated charged particle, say an electron. Classically, this particle is described by its current position and its current movement (speed and direction). On a quantum mechanical level, it turns out that there is an additional property that becomes important – the electron somehow behaves as if it were rotating around an internal axis (this is only a very vague analogy as an electron is a point particle and does not have a classical size, but it is a useful description). Classically, you would expect that that rotation can happen in two ways – clockwise and counterclockwise. Let us use the notation and for these two possibilities. In a classical setting, we could then try to encode one bit in the state of such a system, where TRUE might correspond to and FALSE to .
However, quantum mechanics is more complicated than this. In fact, it turns out that the correct description for all possible states of such a system is not just the two options and . Rather, the system can be in so called superposition of these two states. Mathematically, the two states and are taken to be the basis of a two-dimensional Hilbert space, and the superposition is described by a linear combination
with complex numbers a and b (more precisely, by the ray in the projective space of that Hilbert space).
There is no good classical analogy for such a state – trying to imagine that something is spinning "a little bit clockwise" and at the same time "a little bit counterclockwise" will make your head spin in either direction, but not take you anywhere. However, we get closer to the classical world if we conduct a measurement. In quantum mechanics, a measurable quantity is described by a hermitian operator, the possible outcomes are the eigenvalues of this operators and after the measurement, the system will be in the state described by one of the (normed) eigenvectors of the operators. In our case, a measurement might be set up in such a way that this operator has the basis as eigenvectors, with eigenvalues 0 and 1, i.e. it is given by the matrix
Of course, any two quantum systems which are described by a two-dimensional Hilbert space are equivalent, so every other system with that property could serve as a physical implementation of a qubit as well. This could for instance be a linearly polarized photon, with an eigenbasis given by the two orthogonal directions of polarization, or it could be a hydrogen atom with the ground state and the first excited state as the states and . From a theoretical point of view, all these systems will do, but of course there are huge differences when it comes to a physical implementation of a quantum computer that we will discuss in a later post in this series.
Multi-qubit systems and Hilbert spaces
It is nice to have a qubit, but you will probably anticipate that there is not so much we can do with a single qubit. Instead, we will need a large number of qubits that can interact. As always in quantum mechanics, the state of such a combined system is described by another Hilbert space, namely the tensor product of the single qubit Hilbert spaces.
So suppose that we are describing a single qubit by a two-dimensional Hilbert space H. A system of n identical qubits would then be described by the n-fold tensor product
of H with itself. Given states , we can form the tensor product
of these states. This gives us elements of the tensor product, but conversely, not every element of the tensor product can be written in this way (this is an important fact to which we will return below). It is, however, true that every state in the tensor product is a finite linear combination of product states. This is a major difference to the other common way to define a product of vector spaces, the direct product. In a direct product, the dimensions add up, in a tensor product, they multiply. Thus when we add a qubit, the dimension of our Hilbert space doubles and therefore grows exponentially with the number of qubits.
This is a good point in time to simplify our notation a bit. First, it is common to suppress the tensor product when it comes to states and to express the vector above simply as
Going further, we can also combine everything into one bra and write
If we do this for the elements of a basis, we can simplify our notation even more. Let us do this for the states of a 2-qubit system first. By building tensor products of the base states and , we obtain four vectors
These four states actually form a basis for the tensor product. This is true in general – all possible tensor products of the vectors of a basis are a basis of the tensor product space. Now recall that, in binary notation, the 2-bit sequences 00, 01, 10 and 11 stand for the number 0 – 3. Using this, we could also write this basis as
For a three qubit system, we could use the same notation to arrive at the basis
and so forth. In general, for a combined system of n qubits, we can label our basis with the numbers 0 to 2n-1, and our tensor product will have dimension 2n, with a general element being given as a sum
To close this post, let us come back to one very important point that is a major ingredient to the theoretical power of quantum computing – entanglement. Suppose we are given a two-qubit system. We have seen that certain states can be obtained by taking the tensor product of single qubit states. Can every state in the tensor product be obtained in this way?
Let us try this out. If we take the tensor product of two arbitrary single qubit states and , we obtain
Now let us consider the state
To decompose this state as a product, we would need ad = 0 and ac = 1, which is only possible if d = 0. However, then bd = 0 as well, and we get the wrong coefficient for . Thus this is an example of a state which cannot be written as a tensor product of two single qubit states (but it can be written, of course, as a sum of such states). States that can be decomposed as a product are called separable states, and states that are not separable are called entangled states.
The state above is often called a Bell state and it is worth mentioning that states like this and entanglement features in one of the most famous though experiments in the history of quantum mechanics, the so called Einstein-Podolsky-Rosen paradox or ERP paradox – a broad topic that we will not even try to cover here. We note, however, that it is entanglement that is responsible for the fact that the dimension of the state space grows exponentially with the number of qubits, and most quantum algorithms use entangled states somehow, so entanglement does seem to play a vital role in explaining why quantum computing seems to be superior to classical computing, see for instance section 13.9 of "Quantum computing – a gentle introduction" for a more in-depth discussion of the role of entanglement in quantum algorithms.
Visualizing quantum states
Before closing this post and turning to quantum gates in the next post in this series, let us quickly describe a way how to visualize a multi-qubit quantum state. Our starting point is the expression
for the most general superposition in an n-qubit system. To visualize that state, we could use a bar char as in the diagram below.
Each tick on the horizontal axis represents one of the basis states . In our example, we have eight basis states, corresponding to a quantum system with 3 qubits. The bar represents the amplitude, i.e. the number in the superposition above (of course this is only a very incomplete representation, as it represents the amplitudes as real numbers, whereas in reality they are complex numbers). The upper state in the diagram represents a superposition for which all of the amplitudes are different from zero. The second diagram represents a state in which all but one amplitude is zero, i.e. a state that is equivalent to one of the basis vectors ( in this case). These states correspond to the eight states of a corresponding classical system with three bits, whereas all states with more than one bar are true superpositions which have no direct equivalent in the classical case. We will later see how similar diagrams can be used to visualize the inner workings of simple quantum algorithms.
Qubits are nice, but in order to perform computations, we have to manipulate them somehow. This is done using quantum gates which I will discuss in my next post.
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20 Dogs Dead in Freezer, Nearly 200 Rescued From Squalid Hoarding Situation in New Jersey
The animals appeared to have had little veterinary care or human contact
Published Jun 12, 2019 at 11:33 AM | Updated at 6:43 PM EDT on Jun 12, 2019
Nearly 200 Dogs Rescued From NJ Nightmare
//www.nbcnewyork.com/on-air/as-seen-on/Nearly-200-Dogs-Rescued-From-NJ-Nightmare_New-York-511203522.html
Nearly 200 dogs were rescued from a nightmare hoarding situation in New Jersey on Tuesday; 20 dogs were also found dead in a freezer. Brian Thompson reports.
(Published Wednesday, June 12, 2019)
Nearly 200 dogs were rescued from a nightmare hoarding situation in New Jersey on Tuesday; 20 dogs were also found dead in a freezer
The Monmouth County SPCA said it was called to the undisclosed location in Hunterdon County; dozens of dogs were in a garage and the home
The house is linked to a breeder whose dogs have in past won Best in Breed at the Westminster Kennel Club
Nearly 200 dogs were rescued from a nightmare hoarding situation in New Jersey on Tuesday — some pregnant, many sick and most having had only limited human contact.
Law enforcement sources said the dogs were rescued from the home of a prominent breeder, whose dogs have won Best in Breed awards from the Westminster Kennel Club. It was not immediately clear if the breeder was facing charges.
The Monmouth County SPCA said it was called to the undisclosed location in Hunterdon County on Tuesday, where it found 20 dogs dead in a freezer and 188 more living in a home and garage in squalid conditions.
"All of these dogs seem to have had limited human contact and minimal to no veterinary care," the organization said in appealing for donations to help get the animals treated. As of Wednesday morning it had raised more than $12,000 for their care.
20 Dogs Found Dead, Nearly 200 Rescued From NJ Nightmare
Nearly 200 dogs were rescued from a nightmare hoarding situation in New Jersey on Tuesday; 20 dogs were also found dead.
Photos of the dogs released by the MCSPCA show emaciated animals with matted hair, clouded eyes and a variety of other apparent ailments.
Given the amount of treatment and assessment required, the group said it would be weeks before any of the rescued dogs — almost entirely terriers and dachshunds — would be available for adoption.
"Supporting and promoting responsible dog breeding and ownership has been a key core value of the Westminster Kennel Club for over 140 years," the organization said in a statement. "We are saddened to learn of this unfortunate situation and are grateful for the care being provided to the affected dogs."
NYPD Swarm City Streets After Mysterious Cages Appear
This week's incident was the latest in a string of gruesome dog hoarding finds in New Jersey.
In June 2018, authorities charged a man who was living in squalor with more than 40 dogs. In late 2016, a couple plead guilty to charges after authorities found 276 dogs hoarded in their home.


Home » Local Crown Heights Organizations Rallies in Front of Developer's Apartment
Posted inBusiness & Innovation
Local Crown Heights Organizations Rallies in Front of Developer's Apartment
With an eviction deadline approaching, Associated supermarket in Crown Heights and local organizations protest developers.
by York Chan April 12, 2021 April 12, 2021
Rally outside of the apartment of John Usdan, CEO of Midwood Investment and Development. Photo: York Chan
As the 30-day eviction notice for the Associated supermarket on 975 Nostrand Ave. in Crown Heights came to an end last Wednesday, local organizations rallied outside the home of Midwood Investment and Development CEO John Usdan.
Organizations such as Save Associated and Crown Heights Tenants Union have been rallying outside of Usdan's Park Avenue apartment in Manhattan several times now since the developer sent the Associated supermarket a 30-day eviction notice in March.
The rally on Wednesday began at 6:00pm with a dozen or so participants, chanting and reading poems to the sound of whistles and clinging pans. Flyers were passed out and some passers-by even shouted in agreement with the protesters to save the supermarket.
"It's really heartbreaking to know that we share a city, a neighborhood with a New Yorker, John Usdan, a company, Midwood Investment and Development, that thinks it's perfectly fine to do something like this, to take away access to fresh food from a community in the middle of a pandemic," AJ De Jesus of Save Associated said.
The Associated has been the cornerstone of the Crown Heights Community for three decades, providing locals with fresh affordable food and a close place to shop. But with the supermarket's closure, many fear that the area will become a food desert, as the local population– including the elderly and young teenagers– would have to travel further to get food.
Rally outside CEO John Usdan's apartment on 775 Park Ave. Michael Hollingsworth (center). Photo: York Chan
Michael Hollingsworth, a candidate for New York City Council and member of CHTU, said that all one had to do was stand outside the supermarket on a Saturday to see that most of the elderly who shop there have mobility issues.
"Telling them that they can walk a couple of extra blocks to get to another supermarket is at its core, immoral and unfair," said Hollingsworth.
James Yolles, a representative for Midwood, said that although the developer appreciated the concerns of the local community for the temporary loss of the Associated. He added, concerns should be directed towards the owner of the supermarket, Pablo Espinal, who they said for at least five years had known of the redevelopment but made no attempt to relocate his store nearby, even when they offered to help him.
"We are hopeful that community members will see the benefits of replacing an oversized surface parking lot and a 50-year-old obsolete building with much-needed affordable housing and a new, larger supermarket to serve the neighborhood," said Yolles.
BK Reader reached out to the Associated for a comment, but they did not respond.
Research from the Urban Displacement Project, showed that some areas around the Associated have already begun the process of gentrification, displacing low income households.
"We don't need more luxury housing, that won't be affordable to people who actually live here, we have enough of that," said Hollingsworth, adding that the city has a habit of stripping everyday resources, such as education and housing from people of color and now even food.
Tagged: associated supermarket, Brooklyn, Crown Heights, Crown Heights Tenant Union, food desert, gentrification, James Yolles, John Usdan, Michael Hollingsworth, Midwood Investment and Development, Pablo Espinal, Save Associated, Urban Displacement Project
York Chan
I am a Brooklyn native and journalism student. I Love to know about what's happening in the world and learn about the different views and lives of people. Writing and media production of video, audio and...	More by York Chan


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Mike Oliver looks at semantics and use of words in addressing disability issues, and refers to Bob Dylan's "The times they are a-changing" to make his point about exclusion and discrimination. Internet publication URL: www.independentliving.org/docs4/oliver.html
Literacy Volunteers of America. 1999. Disabled to Raise Funds for Non-Disabled - Labor Day weekend radio event to benefit Literacy Volunteers of America.
To show that people with disabilities – like all other humans – can be both on the receiving and giving end, "On A Roll," the weekly syndicated radio program on disability lifestyle issues, produced by people with disabilities, raised funds for Literacy Volunteers of America, Inc. (LVA) through an on-air event on Sept. 5, 1999. Internet publication URL: www.independentliving.org/docs6/onarollathon1999.html
Richter, Linda K, Richter William L. 1999. Ethics Challenges: Health, Safety and Accessibility in International Travel and Tourism.
William L. Richter and Linda K. Richter explore ethical dimensions of accessible travel for people with disabilities, citing trends, issues, and strategies for public administrators to deal with these concerns. Internet publication URL: www.independentliving.org/docs1/richter.html
Dr. Adolf Ratzka. 1999. European Network on Independent Living: disability rights.
Andrich, Renzo. 1999. EUSTAT Study (Empowering Users Through Assistive Technology), Training Manuals.
EUSTAT, a European project carried out within the EU/Telematics Programme, has published educational material specifically addressed towards end-users of Assistive Technology - people with disabilities. Internet publication URL: www.independentliving.org/docs1/eustat99.html
Clare, Elizabeth. 1999. Exile and Pride: Disability, Queerness, and Liberation.
This book by Eli Clare, explores the landscape of disability, class, queerness, and child abuse, telling stories that echo with the sounds of an Oregon logging and fishing town, and with the lively political debates of crip crusaders and transgender warriors. Internet publication URL: www.independentliving.org/docs4/clare99.html.
Gill, Carol J. 1999. Facts About Disability and 'Quality of Life'.
If only Kevorkian and others would read the research literature before deciding it is reasonable to want to die when you have an extensive disability! Internet publication URL: www.independentliving.org/docs3/gill99sv.html (In Swedish.)
Krause, Carol. 1999. Federal Resource Center for Women with Disabilities - Added to the National Women's Health Information Center.
The Office of Women's Health in the Department of Health and Human Services (DHHS) announces the first-ever federal resource center for women with disabilities as part of the expanding National Women's Health Information Center (NWHIC). Internet publication URL: www.independentliving.org/docs5/nwhic.html
Kulkhanchit, Topong. 1999. First fully accessible city buses in Thailand.
On August 5, 1999 Thailand's first accessible buses will begin accommodating passengers with disabilities on routes in Bangkok. Internet publication URL: www.independentliving.org/docs5/thaibus.html
Batavia, Drew, Gallagher Hugh Gregory. 1999. Gallagher and Batavia on Physician-assisted Suicide - An Open Letter to People with Disabilities.
Hugh Gallagher and Drew Batavia clarify their position on physician-assisted suicide and people with disabilities, including a declaration of disability rights. Internet publication URL: www.independentliving.org/docs1/gallbat.html.
British Broadcasting Corporation (BBC) News. 1999. "Health - Euthanasia controls failing.".
Internet publication URL: www.independentliving.org/docs6/bbc990216.html.
Kaplan, Karen. 1999. High-Tech Dawn for People with Disabilities: Typing by Eye Movement, Non-Visual.
High-tech solutions attract a lot of interest. Whether people with disabilities can actually benefit from them remains to be seen. Internet publication URL: www.independentliving.org/docs5/karenkaplan.html
Dr. Adolf Ratzka. 1999. A história da sociedade inclusiva na Europa.
Ratzka, Adolf. 1999-11. "A história da sociedade inclusiva na Europa." (In Portuguese.) Internet publication URL: www.independentliving.org/docs6/ratzka199911.html
Nakanishi, Yukiko. 1999. IL-rörelsen breder ut sig i Asien.
Yukiko Nakanishi reports on Independent Living seminars, workshops and exchanges that are helping to spread the philosophy across Asia. Internet publication URL: www.independentliving.org/docs1/dpidi299sv.html (In Swedish.)
Nakanishi, Yukiko. 1999. Independent Living movement spreads in Asia.
Yukiko Nakanishi reports on Independent Living seminars, workshops and exchanges that are helping to spread the philosophy across Asia. Internet publication URL: www.independentliving.org/docs1/dpidi299.html
Independent Living Institute. 1999. Independent Living World Summit.
The first global meeting on Independent Living was convened in Washington, D.C., September 21-25, 1999. Over 100 leaders evaluated the movement's 30 year old history and set the agenda for the future. This publication provides links to conference reports and reflections from participants in their respective languages. Internet publication URL: www.independentliving.org/docs2/ils0.html
Brown, Steven E. 1999. Institutional Madness: Speaking out against institutionalism.
Dr. Steven E. Brown speaks out on institutionalism: "No one I know who has lived in a nursing home wanted to stay there. Institutions by their very nature constrict freedom; suppress life, liberty, and the pursuit of happiness." Internet publication URL: www.independentliving.org/docs4/brown1.html.
Council of Europe. 1999. Integration of People with Disabilities: Discrimination.
The Council of Europe recommends disability policy guidelines for Member States. With the knowledge that governments follow different approaches to achieve equal opportunity policies, the Council of Europe established a Working Group in November 1996 to elaborate a collection and comparative analysis of legislation against discrimination of persons with disabilities in member States. The final report will be published in autumn 1999. Internet publication URL: www.independentliving.org/docs3/coedisc.html
Rosen, Fred. 1999. Is International Travel Accessible for Persons with a Disability?
Fred Rosen outlines travel accessibility policies in 5 countries, including problems and recommendations for improved standards. Includes a list of publications on accessibility in the U.S.A., Canada, Britain, and Australia. Internet publication URL: www.independentliving.org/docs5/fredrosen.html
Charen, Mona. 1999. Kevorkian's death crusade finally stopped.
Internet publication URL: www.independentliving.org/docs6/charen19990429.html.
Gill, Carol J. 1999. Korrekta fakta om funktionshinder och 'livskvalitet'.
Carleton, Gwen. 1999. Making Technology Accessible To All.
Universal design in Information Technology is slowly becoming standard in the industry. Internet publication URL: www.independentliving.org/docs5/gwencarleton.html.
Bayha, Betsy. 1999. Media's crippling coverage misses real story of disability experience.
Why do the media continually use the same ill-fitting and inaccurate phrases such as "wheelchair-bound," "afflicted" and "special needs," that the disability community rejected long ago? Internet publication URL: www.independentliving.org/docs1/bayha1999.html.
Digh, Patricia. 1999. Misplaced Modifiers: Respectful Language Improves Accuracy.
Print and broadcast media often describe people with disabilities with archaic and demeaning phrases. Patricia Digh provides guidelines for writing about people with disabilities. Internet publication URL: www.independentliving.org/docs4/digh.html
National Council on Disability (NCD). 1999. NCD Releases Report on Improving the Enforcement of Civil Rights of Air Travelers with Disabilities.
The NCD has released a groundbreaking report documenting ineffective enforcement of the Air Carrier Access Act (ACAA) since the law's passage in 1986. Internet publication URL: www.independentliving.org/docs5/ncd199.html
National Council on Disability (NCD). 1999. Ny rapport från NCD om förbättringar i tillämpningen av rättigheter för flygresenärer med funktionsnedsättgning.
The NCD has released a groundbreaking report documenting ineffective enforcement of the Air Carrier Access Act (ACAA) since the law's passage in 1986. Internet publication URL: www.independentliving.org/docs5/ncd1999sv.html
Longmore, Paul K. 1999. Paul Longmore's testimony before Assembly Judiciary Committee Protesting Assembly Bill 1592.
A testimony before the Assembly Judiciary Committee against AB 1592 which would legalize physician assisted suicide in California. The committee voted for the bill 8 to 7 - there is a long fight ahead. Internet publication URL: www.independentliving.org/docs5/longmore1592.html
Rajkov, Gordana. 1999. A Personal Letter from Belgrade, Serbia - Written during the current NATO bombings in Yugoslavia.
Internet publication URL: www.independentliving.org/docs6/rajkov1999.html
Independent Living Research Utilization (ILRU) Program. 1999. Perspectivas Globales Sobre Vida Independiente Para El Proximo Milenio. Washington, D.C. 21-25 de setiembre de 1999.
Internet publication URL: www.independentliving.org/docs2/ils99sp.html
Godinho, Francisco. 1999. Portuguese Parliament promotes Web Accessibility.
Portugal became the fourth country in the world to officially promote web accessibility for people with disabilities, after the United States, Australia and Canada. Internet publication URL: www.independentliving.org/docs5/portweb.html
Physical Disability Council of NSW, Inc.. 1999. Position Papers '99, Attendant Care.
Internet publication URL: www.independentliving.org/docs1/pdcnsw99.html
Harrington, Candy. 1999. The Problem with Travel Misinformation.
The biggest problem for travelers with disabilities is the alarming increase of misinformation about accessible travel, claims Candy Harrington. Internet publication URL: www.independentliving.org/docs3/ch1999.html
Harrington, Candy. 1999. Problemet med desinformation.
The biggest problem for travelers with disabilities is the alarming increase of misinformation about accessible travel, claims Candy Harrington. Internet publication URL: www.independentliving.org/docs3/ch1999sv.html (In Swedish.)
Konczei, Gyorgy. 1999. Rethinking Disability and Discrimination - A social and economic approach (Comparative Study).
Internet publication URL: www.independentliving.org/docs5/equalisingopps.html and www.independentliving.org/docs5/equalisingopps.pdf
Miles, M, Hossain Farhad. 1999. Rights and Disabilities in Educational Provisions in Pakistan and Bangladesh: Roots, Rhetoric, Reality.
Educational opportunities for children with disabilities in Pakistan and Bangladesh are seen in the context of the countries' religious, cultural and economic development. The relevance of Western concepts such as "human rights", "inclusion" and "empowerment" is critically examined. Internet publication URL: www.independentliving.org/docs5/mmiles3.html
Coleman, Diane. 1999. A serial killer of disabled people, out on the streets - Will Jack Kevorkian be convicted?
The courts of Michigan are preparing to send a worldwide message about the euthanasia of people with disabilities. Will Jack Kevorkian be convicted and imprisoned? Or will he be acquitted once more, never to be charged again? Internet publication URL: www.independentliving.org/docs5/Kevorkian.html.
Connally, Patrick Wm. 1999. Singer/Crips/Animals.
Patrick William Connally, visionary, (Disability Rights, Enforcement, Education, Services) DREES President and founder, discusses the controversy over the appointment of Peter Singer, author of "Practical Ethics," to a teaching position at Princeton University. According to Connally, Singer seems to support euthanasia for new born babies with disabilities. Connally discusses the morals and values concerning this issue, providing a historical perspective as well as a strong negative to Singer's ideas. Internet publication URL: www.independentliving.org/column/conn1_00.html.
Dart, Justin. 1999. Speach on the value of human life to The Trustees of the Center for Human Values, Princeton University April 14, 1999.
Disability activist, Justin Dart, condemns the appointment and ethics of Princeton's Bioethics professor, Dr. Peter Singer. Internet publication URL: www.independentliving.org/docs4/dart99a.html
Kruse, Douglas L, Schriner Kay, Schur Lisa, Shields Todd. 1999. A Study of the Political Behavior of People with Disabilities - What Determines Voter Turnout, Executive Summary: Empowerment through Civic Participation.
Are people with disabilities as likely as those without disabilities to vote, and to engage in other forms of political and civic participation? If not, why not? Internet publication URL: www.independentliving.org/docs5/disvoters.html
Dr. Adolf Ratzka. 1999. Taxi för alla: Förslag till pilotprojekt.
För allmänheten utgör taxin ett viktigt komplement till de kollektiva färdmedlen buss, pendeltåg, spårvagn eller tunnelbana. För människor med funktionshinder gäller det i ännu högre grad. Vi vill visa att enkla och eleganta lösningar kan förbättra även vår rörlighet i stadstrafiken. Internet publication URL: www.independentliving.org/docs5/taxiSv.html (In Swedish.)


ICEF graduation ceremony hosted by HSE Cultures Centre
© МИЭФ
ICEF hosted its first in-person graduation ceremony since the pandemic led to restrictions. Diplomas were awarded to two classes. Hosted by HSE Cultures Centre, the day-long ceremony unfolded in sessions, one for Bachelor's students and one for Master's. Congratulating graduands were the faculty of ICEF HSE and professors of the University of London (LU) and the London School of Economics (LSE).
Despite the pandemic, the last two years have seen unprecedentedly high academic performance among ICEF students – in terms of exam results, quality of graduation theses and class of diploma.
In 2020, the HSE-UoL double-degree bachelor's programme graduated 172 students. Of them, 80 graduated with First Class Honours from UoL and 31 with honours degrees from HSE. The students of ICEF have coped with the new challenges brilliantly, remaining among the brightest students in the world, as noted by the University of London in its annual appreciation letters to ICEF.
The Bachelor's class of 2021 has 225 members. Of them, 144 graduated with First Class Honours from UoL and 26 with honours degrees from UoL and HSE. This is a significant milestone, as the number of ICEF graduates didn't exceed one hundred students until nine years ago, and the first class of 2001 had only 13 students.
Addressing the graduates from stage were Sergey Yakovlev, ICEF Director, and Oleg Zamkov, ICEF Deputy Director and BSc programme academic supervisor. Sergey Yakovlev referred to the difficulties caused by the pandemic as providing ICEF the opportunity to adopt new, more effective learning modes and online technologies. Online lectures and online exams are now part of the learning process. The two graduating classes have found themselves in more difficult conditions and were forced to adjust. It did take them some effort, but it had a positive effect. "You had to work twice harder than your predecessors, and your good exam grades speak to the fact that you did work hard. I would like to wish you every measure of success in coping with whatever challenge may come your way. And you surely will cope, as you have passed the test and you did it early," said Sergey Yakovlev.
Mary Stiastny, Pro Vice-Chancellor at the University of London, International Learning and Teaching
Studying for a University of London degree is a challenging undertaking under any circumstances, but what you have achieved over the past eighteen months is truly exceptional.
I speak for everyone at the University of London, when I say how proud we are of what you have achieved. To obtain one degree over the past two years is celebration enough, to have achieved two, and with such distinction, is truly exceptional. Today is an opportunity to celebrate your hard work, and also to reflect on how you got there.
You will all have your own individual stories of how you have achieved your goals over the past few years, whether they are personal or academic, and you will have faced numerous challenges along the way. The way in which you will have faced these challenges, and succeeded despite them, is what sets you apart. I hope you are all able to take time with your family, your peers and your tutors to truly enjoy this moment.
As a University of London graduate, you are by statute a Member of the University; and I hope that you will keep in touch with us through our global alumni network, to which we look forward to welcoming you.
Oleg Zamkov expressed his admiration for the impressive number of First Class Honours awarded to the classes of 2020 and 2021 by UoL, and the record number of honours degrees from HSE. "You are the two classes that boast special accomplishments. Some of you hold awards from Student Research Paper Competitions, some won first place in CFA Institute Research Challenge Russia in 2020, and many of you have shown outstanding performance in Econometrics Universiade," said Oleg Zamkov. A testament to graduands' excellent academic performance are the Letters of Commendation awarded to them along with diplomas.
The Class of 2021 celebrated 36 Masters of Financial Economics, thirteen of which graduated with honours. In the class of 2020, honours degree were awarded to four members. Expressing his best wishes to the two master's classes was Maxim Nikitin, the MSc programme academic supervisor.
For many years, the graduation ceremonies have been hosted in the residence of the British Ambassador. But this year, given capacity restrictions, this venue hosted the event in new format with only the highest-performing of the graduands in person to receive congratulations from the honorable guests.
The representatives of the University of London and the London School of Economics shared their congratulatory video messages and letters, shown to the graduands at HSE Cultures Center. In their messages, they expressed their admiration for the outstanding performance shown by the students over the past two years, wishing them success with their career endeavors and summing up the progress of cooperation in anticipation of ICEF's jubilee year.
Professor Wendy Thomson, Vice-Chancellor of the University of London
The circumstances of the past 18 months have challenged all of us; and I know very well the additional focus, skill and determination that have enabled you to achieve your world-class degree with the University of London despite the obstacles. Which is why I'm delighted to send you this message, and to be there in spirit with our friends and colleagues at ICEF, where I know you have received such excellent academic and practical support. Your graduation is something that you should feel very proud of, and today we share that pride in your achievement with you. But, of course, it is only part of your story.
Have belief in yourselves, and as you face the future remember how strong you have all had to be, and all you have learned, to be here today. You are ready for anything.
Many congratulations from all of us at the University of London, and very best wishes for the future
David Webb, Academic Head of Extended Education at the London School of Economics (LSE)
It's unfortunate that we can't be doing this in person today. Two years ago, I was fortunate to be in Moscow at your graduation day and British ambassador's house by the Moskva River. It was a beautiful sunny day, and I remember it extremely well when I met a number of your predecessors on that occasion.
I am very proud, as indeed we all are at LSE, of our relationship with ICEF. It is a jewel in the crown of the University of London programme. ICEF's history of success shows what an important role international collaboration in education can have. And indeed, the collaborations that we have now extend beyond pure teaching to research.
Since its founding in 1895, the LSE has been proud of the generations of leaders that is has trained in the international governance world, in administration and in business. Hopefully, our students have added to the world through their achievements, and indeed you as our graduates will do the same.
In a world of accelerated invention with increasing challenges politically, including climatic change, et cetera, having people that are well education, able to handle arguments, discuss things constructively and engage in clear, well-informed debate is crucially important. And you as students of this programme will have those skills, that's absolutely crucial in the modern world.
You've got to where you are also because of the support you received from your family. And, of course, the faculty at ICEF have been absolutely crucial to that achievement. We all must recognize what they have done to make it happen for you. It happened in very difficult circumstances. I would like to take this opportunity to express our thanks, on behalf of the LSE, to the faculty here at ICEF.
You go from being a graduand to a graduate, but you are not leaving the community you've been a part of because this is a long-lasting experience. You'll continue to learn – some of you through further education, some of you obviously through the jobs that you get as you develop working with others – but we'd also like to welcome you to the wide global community that we have here at the LSE, and you will of course be the alumni of the University of London, the best alumni network. We hope to see some of you in London at future ICEF Alumni events.
Welcome to our LSE global community!
About persons
Oleg O. Zamkov
Sergey Yakovlev


Bluesocket Announces Version 4.0 Software for Enterprise Wireless LANs
LAS VEGAS, NV (Booth 2847, N+I 2004)–May 11, 2004: Bluesocket Inc. (www.bluesocket.com), the leading vendor of open-systems wireless local area network (WLAN) systems to secure and manage wireless access to networks and the Internet, today announced Version 4.0 software. Version 4.0 adds features for security, scalability, policy enforcement, and management of data and voice traffic in enterprise-class WLANs.
Version 4 of Bluesocket?s gateway software will provide intrusion detection and worm protection, enhanced support for Cisco WLANs and the new EAP FAST protocol; secure roaming with VoIP over WLAN; load sharing across wireless gateways, and support for HP OpenView network management.
At Bluesocket's booth (#2847) in the Interop Wireless Pavilion, the company will showcase its line of award-winning Wireless Gateways including the WG-5000 Wireless Gateway, a core network system for airtight, HIPAA-compliant security and policy-based management for Wi-Fi networks that can support up to 1,000 simultaneous users and hundreds of Access Points from any vendor.
Version 4.0's Enterprise Focused Features
Intrusion Detection and Worm Protection
Unlike signature based tools or OS specific scanners, Bluesocket has implemented real-time monitoring of Wi-Fi users' data to detect malicious traffic based on the users' actual behavior without requiring any client-side software. This enables administrators to automatically block network access to hackers or worm infected users even for ?zero-day? attacks well before traditional signature-based tools have updates available.
Enhanced Support for Cisco WLANs and the new EAP-FAST Protocol
Bluesocket continues to expand its industry leading support for complementing Cisco AP based WLAN environments. With Version 4.0, Bluesocket is the first vendor to support the new EAP-FAST protocol for 802.1x and WPA, published by Cisco as a proposed IETF Standard. Along with other EAP methods such as LEAP, PEAP, TTLS, TLS and MD5, Bluesocket now provides the widest variety of authentication and security methods among all WLAN infrastructure vendors. Additionally, Bluesocket Wireless Gateways now provide deeper user to AP monitoring for Cisco APs and also has added support for Cisco Discovery Protocol (CDP), thus offering superior integration into existing Cisco-based networks.
Secure Mobility ™ Roaming with VoIP over WLAN
Bluesocket was the first vendor to introduce Secure Mobility ™ (secure Layer 3 wireless subnet roaming) and builds upon its innovation with this new software iteration. Version 4.0 introduces advanced stateful firewall support for VoWLAN devices, which removes the need to build a separate VoIP VLAN and can prevent hackers gaining entrance to the network by hijacking open VoIP sessions. Bluesocket's fast roaming handoffs provide the low latency, jitter suppression and session persistence required for VoIP, while maintaining a secure environment. Mike Houston, Marketing Director at TeleSym, Inc. (software leader in voice over IP & Bluesocket partner): "Enterprises are clamoring for secure and reliable roaming on their voice networks. Working together, Bluesocket and TeleSym delivers robust, reliable voice services to laptops, PDAs and other mobile computers, with the security users expect."
Load Sharing Across Wireless Gateways
As enterprises move from initial WLAN pilot deployments to enterprise-wide WLANs, the number of users grows rapidly. Bluesocket supports higher numbers of simultaneous users on the same network using its new Load Sharing capabilities. This enables administrators to manage and scale WLAN performance by distributing user traffic across WGs in the network.
HP OpenView Support
Bluesocket has expanded its management functionality, required for large Wi-Fi deployments by incorporating Bluesocket management functions into HP OpenView. This allows NOC admins using HP OpenView to expand their traditional "wired view" into the wireless world.
Illustrating its leadership position, the company also announced it has sold its Wireless Gateway systems into more than 600 different end-user organizations (in more than 40 countries worldwide). "In an crowded market clouded by hype from competitors, Bluesocket stands out as the clear WLAN leader with more customers, more installed units, in more countries and a stronger channel than any of the wireless switch vendors," said Bob Darabant, VP of worldwide sales.
"Mobile applications will grow enterprise WLANs to $1.7 billion by 2008," said David Gross, senior analyst, Wireless Data Research. "Bluesocket's Wireless Gateways are a proven solution for enterprises to manage and secure wireless networks, while integrating and extending their existing networks and systems. Through its new version 4.0 software, Bluesocket continues to improve the capabilities of heterogeneous networks based on architecture from Cisco, HP, and other vendors."
About Bluesocket
Bluesocket, Inc. (www.bluesocket.com) is a leading manufacturer of systems to control and secure wireless local area networks (WLANs) for enterprises, institutions and public access venues in more than 45 countries worldwide. Thousands of Bluesocket Wireless Gateways are deployed by enterprises including the National Security Agency, Lehman Brothers, University of California, Parker Hannifin and others who required an elegant open-systems solutions to secure, manage, and profit from their WLANs. With offices in North America, Europe and Asia, Bluesocket, Inc. is a private, global corporation managed by executives from BT, Cisco, Digital, GTE, Ericsson, Intel, NetScreen, Nortel; other industry leaders.
Secure Mobility is a trademark of Bluesocket, Inc. All other trademarks, trade names and company names referenced herein are used for identification only and are the property of their respective companies.


ARTISTS AT HOME
16 Grove End Road
Contemporary view of Calderon's address
Philip Hermogenes Calderon lived at 16 Grove End Road in St. John's Wood from 1876 to 1886, followed by a move to Burlington House in Piccadilly, where in his capacity as Keeper of the Royal Academy he occupied the official residence. The St. John's Wood neighborhood was known as a place of "faint impropriety" because of the number of "kept" women thought to reside there, but artists had always lived there, with more flocking to the neighborhood in the 1850s and '60s, thus improving its reputation.[1] The artists William F. Yeames, George D. Leslie, George A. Storey (Calderon's brother-in-law), and John Hodgson were neighbors and founding members of the St. John's Wood Clique, a "latter-day Pre-Raphaelite Brotherhood." These men enlarged the homes already present in the neighborhood, and Calderon had a large annex built onto an existing house, previously owned by the portrait painter and copyist John Jackson.[2] Calderon's home was admired for its luxurious interior, warranting mention by the artist and critic Philip Gilbert Hamerton in a letter to his wife: "Calderon's studio that I saw a few days ago is richly tapestried and very lofty; it is quite as fine as that of Millais. . . . All these artists . . . complain of nothing but the too great prosperity of the profession in these days; they tell me an artist's life is a princely one now. They live and dress like gentlemen, and their daughters might be 'clothed in scarlet.'"[3]
Many London artists gravitated towards the architect Thomas W. Cutler for his understanding of the Queen Anne-style, popularized in Kensington, with its red-brick exteriors, white wooden detailing, and towering chimneys. In this neighborhood, however, the custom studio-home was rare, although like Calderon, artists often adapted the houses to suit their needs. When Calderon's close friend Lawrence Alma-Tadema moved into the house formerly owned by J. J. Tissot, Tadema commissioned Calderon's architect son, Alfred, to design additions and changes to the house to fit his family and ambitions, which took ten years to complete.[4] Philip Calderon's own house was right next door.
Anna Mahony
[1] Giles Walkley, "Decadent St John's Wood: Grove End Road," in Artists' Houses in London 1764–1914 (Aldershot, Hants, England; Brookfield, VT: Scolar Press, 1994), 118.
[2] Walkley, Artists Houses, 121.
[3] Philip Gilbert Hamerton, Philip Gilbert Hamerton: An Autobiography, 1834-1858, and a Memoir by his Wife, 1858-1894 (Boston: Roberts Brothers, 1896), 305-6.
[4] Walkley, Artists' Houses, 128.
Calderon's brother-in-law, G. A. Storey, wrote a tribute to the artist in 1898 in which he speaks of a series of decorative works including The Olive, The Vine, Flowers of the Earth, "and four or five others of a similar character" exhibited in 1881. These were all painted in Calderon's studio in his Grove End Road home, "where there was not only a fine studio, but ample room in the grounds for lawn-tennis and such-like games, in which Calderon himself took the greatest pleasure." G. A. Storey, "P. H. Calderon," Magazine of Art 22 (1898): 450/52.
← Calderon the artist
Further Reading →
PHILIP HERMOGENES CALDERON, R.A.
The Author-Editor
The Publishers
The Photographs
The Photogravures
T. O. BARLOW, R.A.
Stephens on Barlow
Barlow the Artist
Auburn Lodge
JOSEPH EDGAR BOEHM, R.A.
Stephens on Boehm
Boehm the artist
Stephens on Calderon
Calderon the artist
SAMUEL COUSINS, Hon. Retired R.A.
Stephens on Cousins
Cousins the artist
24 Camden Square
FRANK DICKSEE, A.R.A.
Stephens on Dicksee
Dicksee the artist
No. 2 Fitzroy Square
SIR JOHN GILBERT, R.A.
Stephens on Gilbert
Gilbert the artist
Ivy House
THE RIGHT HON. W. E. GLADSTONE, M.P.
Stephens on Gladstone
Gladstone the prime minister
GEORGE A. LAWSON
Stephens on Lawson
Lawson the Artist
6 Marlborough Road
SIR FREDERIC LEIGHTON, P.R.A., D.C.L., LL.D
Stephens on Leighton
Leighton the artist
Leighton House
ROBERT WALKER MACBETH, A.R.A.
Stephens on Macbeth
Macbeth the Artist
Wychcombe Studios
JOHN MACWHIRTER, A.R.A.
Stephens on MacWhirter
MacWhirter the artist
No. 1 Abbey Road
WILLIAM CALDER MARSHALL, R.A., H.R.S.A.
Stephens on Marshall
Marshall the artist
115 Ebury Street
JOHN EVERETT MILLAIS, R.A., D.C.L.
Stephens on Millais
Millais the artist
2 Palace Gate
JOHN PETTIE, R.A.
Stephens on Pettie
Pettie the artist
The Lothians
EDWARD JOHN POYNTER, R.A.
Stephens on Poynter
Poynter the artist
VALENTINE CAMERON PRINSEP, A.R.A.
Stephens on Prinsep
Prinsep the artist
1 Holland Park Road
RICHARD REDGRAVE, Hon. Retired R.A.
Stephens on Redgrave
Redgrave the Artist
18 Hyde Park Gate South
BRITON RIVIERE, R.A., M.A.
Stephens on Riviere
Riviere the artist
Flaxley
MARCUS STONE, A.R.A.
Stephens on Stone
Stone the artist
8 Melbury Road
GEORGE ADOLPHUS STOREY, A.R.A.
Stephens on Storey
Storey the artist
19 St. John's Wood Road
LAWRENCE ALMA TADEMA, R.A.
Stephens on Alma-Tadema
Alma-Tadema the artist
Townshend House
W. H. THORNYCROFT, A.R.A.
Stephens on Thornycroft
Thornycroft the artist
Moreton House
GEORGE FREDERICK WATTS, R.A., LL.D.
Stephens on Watts
Watts the artist
New Little Holland House
THOMAS WEBSTER, Hon. Retired R.A.
Stephens on Webster
Webster the artist
MR. WILLIAM FREDERICK YEAMES, R.A.
Stephens on Yeames
Yeames the artist
Acomb Lodge
Victorian Artists at Home


Annabel Leventon & Robert Meadmore
Mon 10th June
Love is a feeling, marriage a contract and relationships damned hard work.
Fresh from the British premiere of Jerry Herman's Dear World, Annabel Leventon and Robert Meadmore explore songs of experience in their new show, IMPERFECT RELATIONSHIPS.
Annabel Leventon's singing career spans pop, rock and musicals. As an actress, her West End credits include Hair!, Spokesong, Jeffrey Bernard Is Unwell, Rocket To The Moon, The Philanthropist and The Dresser, the Olivier-award-winning Honk! The Ugly Duckling for the National Theatre and Sir Andrew Aguecheek for the RSC, cabaret at the Ritz and in Paris. Her films include Wimbledon, Defence Of The Realm, M. Butterfly andThe Rocky Horror Show. She created, with Gaye Brown and Diane Langton, the celebrated three-woman group Rock Bottom on which the award-winning television series Rock Follies was based.
Robert Meadmore's appearances in West End leading roles include The Phantom of the Opera, Oklahoma!, Brigadoon, The Best Little Whorehouse in Texas, two separate productions of Camelot, The Gondoliers, Bless the Bride, Pickwick, A Patriot for Me and most recently, Dear World.
His classical album After a Dream reached number 2 in the classical charts and was nominated Record of the Year at the Classical Brit Awards.
Annabel and Robert are thrilled to be sharing a stage, once again.
"Wit and charm" Whatsonstage
'"An evening to treasure" Musical Stages


2023 Semester 2: Jul – Dec
In Stellenbosch
Stellenbosch About the Program Activities Calendars Courses Fees & Deadlines Photo Gallery
Stellenbosch Courses – 2023 Semester 2: Jul – Dec
USAC's partnership with Stellenbosch University provides you with a wide array of academic options. You will enroll in mainstream university courses alongside regular Stellenbosch students and may choose from additional courses offered through GEP - Global Education Programmes specifically for study abroad students. To help facilitate immersion with local students, USAC participants may either enroll in all mainstream courses, or in a combination of GEP and mainstream courses. You may only enroll in a maximum of 2 GEP courses while at Stellenbosch. Courses are subject to availability and host university approval of prerequisites.
USAC requires that you take one course designed to familiarize you with South Africa's unique history and current social, cultural, and political climate. Past options have included:
Sociology: Politics and Cultural Change in Contemporary South Africa (GEP)
Overview of South African History (GEP)
Introduction to Political Science and South African Politics (Mainstream)
Survey of South African History (Mainstream)
South Africa in the 20th Century (Mainstream)
Undergraduate instruction at Stellenbosch University is available in English. USAC students have a robust catalog of courses to choose from. The majority of courses are lectured in English, however a small number of courses may be lectured bilingually (English and Afrikaans). In such case, all study materials is available in English and a live translation service is offered.
Global Education Programmes (GEP)
GEP courses have been created specifically for international students and are offered in English only.
Recent GEP course offerings include:
Beginning Chinese, French, German, Spanish
Xhosa: Language and Culture
Digital Photography and Visual Studies
Social Sciences and Other
Global Service Learning (GSL)
Overview of South African History
Politics and Cultural Change in Contemporary South Africa
Practical Conservation
Understanding HIV in South Africa
South African Pop Culture and Identity
Sustainable Agriculture: Community Gardening
World Views, Ethics and Belief Systems
Mainstream Courses
Mainstream courses comprise all the other courses offered by Stellenbosch University which form part of the university's degree programs. USAC students must enroll in at least one Mainstream course
Courses in English are available in the following Faculties:
Faculty of AgriSciences
Faculty of Education (may be limited)
GEP Courses and Descriptions (2022)
Popular Mainstream Courses. Course descriptions are available upon request. Contact your USAC Program Advisor for more information.
As you review courses, keep in mind you can only enroll in two GEP courses maximum (the bulk of your course load will consist of Mainstream courses). In general, these descriptions are enough for your host university academic advisors to give preliminary approval for you to take courses.
Remember, you must also enroll in a USAC-selected course designed to familiarize yourself with South Africa's unique history and current social, cultural, and political climate while at Stellenbosch University. More information on your options to meet this requirement will be provided by your Program Advisor after acceptance to the program.
Deadline: March 15
Deadline: Sept 1


Home / Insights / Event in Review: Investments ...
Ari J. Markenson
Event in Review: Investments in Professional Practice Management '22—Challenges and Opportunities
There are many things to consider if you plan to invest in middle-market healthcare professional practice management (PPM) businesses this year. The hypercompetitive market, combined with residual effects of the pandemic, has made it difficult to find the right professional partners for investment opportunities.
Ari Markenson, a healthcare corporate partner at Venable, recently moderated a panel of experienced executives who discussed some of these issues and the deal environment in general. The panelists—Roy Bejarano, co-founder and CEO, SCALE Healthcare; Andrew Colbert, senior managing director, Ziegler; and Dr. Bede Broome, managing director, Assured Healthcare Partners—answered questions about what's hot and what's not in specific subspecialties, transaction structures, and professional practice management investments. They also discussed developments in valuations, potential for exits, growth capacity, and other significant issues.
Q: M&A transaction volume as a whole is down, and healthcare deals in the aggregate are also down. However, PPM deals seem to be holding strong. What's going on?
A: If you look at the first two quarters of this year, physician deals are up 25% over the same period last year. A number of factors are driving that. About 50% of all physician practices are still independent, so there's a lot of opportunity for consolidation. COVID also served as a wakeup call for many business owners, including physician partners. The groups that got stimulus funding and grant payments weathered the pandemic better than expected, and that led business owners to think about the future and see the value in consolidation.
Additionally, there are few sectors in healthcare that have the degree of fragmentation that the physician landscape has, and if you think about the core private equity playbook, it's buy a platform asset, and then leverage down your multiple over time to do smaller tuck-in deals at lower multiples. It's much harder to do that in areas that are already heavily consolidated.
Also, with other segments getting hit harder, like tech and consumer products, it's actually making healthcare more attractive as an investment focus. Comparing it to other industries, there is no lights out, new technology risk that's putting all of us out of business. So, we can plan ahead, business as usual. You almost have this Goldilocks scenario in healthcare services where economies of scale are good, but they're not too good. If they were too good, we would be too late.
Last, through word of mouth and increased awareness, physicians are now much better educated about consolidation options than they were in the past, and they've seen the benefits and attractive returns enjoyed by their peers.
Q: What is the future of PPM deals in the healthcare sector? Will private practices soon be a thing of the past?
A: Over the next 10 years, small private practices will likely not be as large a segment of the healthcare sector and will change in nature, becoming narrower and more niched.
It used to be that if you were a young physician leaving your fellowship and deciding where to go, you had two choices: work at a hospital or start your own practice. Today, there is an additional option: large, consolidated private equity-backed management services organizations (MSOs).
Eventually, the practices that can be consolidated, will be consolidated. For some, however, while MSOs offer all kinds of upside incentive arrangements and lots of growth, some smaller groups of physicians will still find private practice attractive. Additionally, there will always be rural healthcare, where consolidation just isn't an option.
Q: What specialty health practices are investors interested in at the moment?
A: Every specialty has unique ways of creating value. In one specialty, it might be maximizing some imaging ancillaries, and in another it might be owning a particular type of outpatient center for doing certain types of procedures.
The early days of PPM consolidation focused on driving economies of scale and leveraging scale to negotiate better rates. The "ologies" have evolved as private equity firms have learned the intricacies and ins and outs of different spaces, and the physicians within those spaces have come around to private equity ownership. Now, it's about where you can take costs out of the system. It's focusing on services that can cost significantly less to provide outside of a hospital, such as gastrointestinal (GI) or orthopedic services. Some of that is driven in part by the Centers for Medicare & Medicaid Services (CMS).
Q: Platform acquisitions and add-ons in this space used to have a much lower valuation threshold. Why has that changed?
A: The more confidence and conviction you have in the success of something, the more you're willing to pay for it. And the more tools you have at your disposal to manifest that success, the lower the risk component; and less risk with the same or more return equals a higher upfront price.
We see almost a bell curve when we think about value relative to the size of the practice. There's a sweet spot where there's a maximum number of bidders and buyers and interest for a business. If a practice is too small, like one to three doctors, then it's naturally valued lower. But there's also the other end of the extreme, where you see the big public companies and massive platforms that have thousands of doctors, and the growth is just hard to keep up. It's challenging to continue to grow by 30% when you're earning $2 billion in revenue. There comes a point where you've gotten too big, and the multiple starts to come back down. If you're in private equity, you want to get in at the right moment, but you also want to get out at the right moment. No one wants to be trying to sell a multi-billion-dollar private practice. That's a challenging deal to do, and there's only a handful of buyers. The sweet spot is probably between $10 million and $200 million in earnings before interest, taxes, depreciation, and amortization (EBITA) to maximize value potential.
Q: How important is the alignment between the investors and the professionals? What are the keys to getting that right, and how can it go wrong?
A: It is extremely important to get it right. The relationship requires constant communication and a recognition that the relationship with the physician group is far and away the most valuable asset that you have. Most of the time, the feedback they provide is the right feedback for what the organization needs. So, you can't gather enough feedback from a physician group. Relying on one representative leader is a common mistake. There are many voices and opinions that must be heard and considered.
A partnership model will likely be more successful than an ownership model, because at the end of the day, from a legal perspective, the physicians maintain complete and total autonomy with regard to all of their clinical decisions. From a practice perspective, physicians have strong opinions on how they want to carry out their day.
Alignment begins with making sure that the physicians remain invested in the business from a financial perspective, and they are seeing a lot of that financial return over time. It's also important to think about both the younger physician and the older physician. Practices aren't just a group of 40- to 50-year-old physicians. There are some who are right out of fellowship and thinking about how they're going to have a 30+ year career in medicine, and there are others who are two years away from retirement. The incentives and the alignment that you need to create with each of those pools of physicians are very different.
Q: What are some other challenges in getting this alignment right?
A: A lot of effort must be put into informing and educating physicians throughout the entire relationship. Physicians are often on board as long as they see timely reporting. They become disruptive when you can no longer provide honest, open, reliable feedback on how your organization is doing.
Another challenge is understanding the different economic mentalities of private equity investors and physicians—they can be polar opposites. Physicians in private practice typically measure their economic success by how much they make in a given year or quarter. In private equity, it is fundamentally about what you bought at and sold at, rather than gains and losses in a single year or quarter. Investors are more concerned with long-term gains. So, a challenge is making sure the doctors understand that this alignment model will pay off, but EBITA may go down over the course of the investment, or it may stay flat for a few years. It's hard sometimes for them to see that and have the same confidence as the investor. They also need to understand the context of a bad quarter or a bad year and look at the larger picture.
You also must be very careful and selective about protecting and preserving the culture of the organization by being conscientious about who you let in thereafter. You must hold on to that culture of open communication and growth and orientation as well as risk management. Culture is probably more rapidly and more frequently ruined by excessive growth than anything else. Excessive growth equals dilution in the quality of the team around you and dilution in the ability of the operations infrastructure to handle that.
Q: From an operational perspective, how are practices doing? What challenges are they facing that private equity investors and consolidation can help with?
A: More patients in later-stage diseases are putting a burden on the practices. Many practices are feeling the pain of labor shortages and the complexity of the practice operations, and that is where private equity consolidation can help. By being part of a larger organization and having greater ability to recruit and optimize different components and practice operations, physicians can alleviate some of these challenges.
Q: Has there been any sort of challenge to the MSO model recently that has given investors pause?
A: There have been more attempts to hold investors liable for pulling strings they shouldn't be pulling. A state regulator may believe that an investor is sticking their hands in the professional practice more than they should be.
The likelihood that an investor is going to be telling a professional involved in investment whether they should be doing surgery is extremely low. An investor might share ideas on different ways to schedule patients and those kinds of things, but the likelihood that any investor is truly sticking their nose in the clinical practice of the professional is very unlikely. It must be very clear from the onset with any relationship that clinical autonomy is 100%.
The investment landscape is constantly shifting and evolving, but we're on top of it. Find out about the latest developments by contacting our Healthcare or Private Equity groups, and watch the full webinar here.
OIG Takes a Look at the Accelerated and Advance Payments Programs and the Provider Relief Fund Program
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As the Federal Vaccine Mandates Fall One by One, Employers Are Left to Navigate a Maze of Uncertainty Amid State and Local Laws
Investments in Professional Practice Management '22: Challenges and Opportunities
Wednesday, September 14, 2022 Venable LLP
View the Recap


How one processor went global and kept costs in check
Colin Staub
Processor EPC expanded globally in a relatively short period of time using a partnership model. | Pushish Images/Shutterstock
ITAD firms are increasingly asked to provide international service for their customers, but that can be an expensive endeavor. A Midwest-based processor recently laid out the benefits of partnering with foreign service providers.
St. Louis-based EPC has been on the worldwide partnership path since 2012, when the company began expanding to provide international service for its clients.
"Building out a footprint in far-flung places for maybe five or six projects a year was prohibitive to say the least," David Carite, director of global ITAD at EPC, said during a session at the 2019 E-Scrap Conference and Trade Show in September.
The company has a significant footprint in the U.S. and Canada, but in 2012 it had little overseas presence. And the prospect of developing new facilities everywhere its customers operated was challenging.
"Without going and building a facility in South Africa, Australia, India and China, the only way to get services there is through partnerships," Carite said.
The company began selecting and vetting possible collaborators in overseas markets, conducting site audits and ensuring processors would meet EPC's certification requirements. EPC looks to make sure its partner firms perform the exact same type of processing as EPC, provide the same level of data security, and more.
Carite explained that by going this route, EPC went from working primarily in North America to doing global projects on a daily basis in under two years. It also allowed the company to avoid breaking the bank.
"The very first and most obvious advantage to a partnership approach to doing ITAD for your customers is that it's cost preventative," he said. "I don't have to build out and maintain a facility in Tokyo, because a trusted, contracted reciprocal partner is doing that work for us."
Logistical benefits
The partnership model also takes advantage of the intrinsic regional knowledge that a company on another continent can bring to the table.
Like working with a local guide, partnering with a foreign ITAD firm allows EPC to smoothly navigate customs and regulations rather than spend time and money researching each local legal framework.
David Carite, EPC
Carite gave an example of EPC's experience working in Turkey. The company had a customer that needed service in the Mediterranean country, and EPC decided to work with a local recycling partner to fulfill the job.
During the project, equipment had to be moved about a quarter mile in distance. The local recycling partner informed EPC that any moving of e-waste equipment requires a special government certification. The company had that certification, so it was a smooth process.
"But they knew that; we didn't," Carite said. "If I had developed a site in Turkey it may have taken me months to get that certification. Instead, I was able to do that project within three weeks of being asked to do the project by our customer, because we had partners in the area."
A partnership model can provide reciprocal benefits to both companies in the equation.
Working with other ITAD firms avoids pitting processors against each other in the bidding process, Carite explained. This can help both firms when they don't normally work in each other's service area.
"If either one of us wins, we both win in this instance," Carite said. "Our coverage is their coverage and their coverage is our coverage."
The model also facilitates spreading positive practices throughout the industry.
Sometimes when EPC is starting a new partnership, the company will push for the other firm to adopt an industry certification at a particular location. The two sides will also frequently share best practices and processing techniques, and in some cases, this has led to improved operations in the U.S. for EPC, Carite said.
"The solution to being able to do global work is to take the people who are already existing in a given area and to bring them into what you do," Carite said. "Use their experience and their knowledge for where they are to your advantage, and provide the same to them."
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Toronto Catholic board's Northern Spirit Games was a day of learning and fun
Jortany Martienz, a Grade 5 student from St. Joseph Catholic School in the Leslieville neighbourhood, participates in an event at his school's Northern Spirit Games Feb. 27. Photo by Evan Boudreau
By Evan Boudreau, The Catholic Register
By hosting the Northern Spirit Games, Toronto's Catholic school board is giving students more than just a taste of traditional play for the day.
"This is a tremendous opportunity to give them a real voice about a real living culture," said Métis John Somosi, who facilitated the Games' opening ceremonies at St. Patrick Catholic Secondary School on Feb. 27. "I bring an awareness of a culture that is still alive and well, that is still surviving, however limited we are at this moment."
Two other Catholic schools in the city held the Games this year: Dante Alighieri Academy on Feb. 23 and St. John Paul II Catholic Secondary School on Feb. 28. Each site welcomed about 300 students, Grades 4 to 6, from 10 elementary.
Originally known as the Arctic Games, the annual event began in 2002 as a response to the Twinning Initiative established by former lieutenant of Ontario James Bartleman that paired native and non-native schools.
Since the inaugural Games, about 23,000 Catholic elementary students have been exposed to traditional aboriginal games, teachings and culture.
"The children in each tribe has the most important job in the tribe," said Somosi, summarizing his opening remarks. "The first most important job is to play and the second most important is to have fun. When they are playing and having fun they find a passion based on what they are naturally good at."
Once unearthed, that natural passion is to be integrated into daily life as a hobby and possible as a profession according to traditional teachings, he said.
"Just keep that joy of life so that life doesn't become a burden."
Following the opening ceremonies, students tried their hand at 10 traditional sports such as Stick Toss, which resembles lawn darts, the Seal Race where students collected rubber fish by crawling on their stomaches like the aquatic mammal, and Kick Ball which is similar to the high jump.
The latter ended up being the favourite of Jortany Martienz, a Grade 5 student from St. Joseph Catholic School in the Leslieville neighbourhood, who called the game "a really fun and creative thing to do."
The 10-year-old also said the Northern Spirit Games were about more than just a day of play.
"It's important for us to learn about First Nation culture because they're our ancestors," he said.
Martienz's teacher ,Simon Crisolago, said the Games help bring the curriculum to life for his students.
"(It's) a hands-on way ... to make a connection with what they are learning in school," said the teacher. "When learning from other cultures, the similarities with our beliefs and in our way of life, there is always a connection with something from the past."
Having brought students to the Games in the past, Crisolago said those connections aren't soon forgotten.
"They'll remember this next year, and the year after that," he said. "I've brought kids here before who are now in high school thay remember when they did this."
Selina Cunga, a Grade 11 student at St. Patrick, never had the opportunity to participate in the Northern Spirit Games while in elementary. So when she heard the Games were coming to her high school the 16-year-old knew she wanted to volunteer.
"I wanted to see what kind of activities they do," she said. "We're experiencing all kind of new things. It's fun to see people doing things that we don't normally do."
And it isn't just the students benefiting.
"This has helped me as much as it has helped the kids," said Somosi, who has worked with school boards across the province for 17 years.
He is an example of the intergenerational impacts of acculturation.
"(My mom) did go to a French Catholic school where any of the native language or any of the native culture or teachings was literally beaten out of them," he said. "When she got out of school she didn't know how to be a mother because she never had that role model."
Like many First Nations of his generation, Somosi, who relied on tribes like the Ojibwe adopting him for cultural education, had some reservations about Catholic schools
But after seeing the students Somosi knew he'd be coming back year after year. He estimates that through the Northern Spirit Games he's been able to help turn "the book learning that they get in school into a real personal interaction," for some 12,000 students.
"'This is an absolutely worthwhile project and the amount of smiles over the years," he said. "I come back because of this. It is a beautiful positive thing."
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File created: 6/19/2020 Departments: GOVERNING BOARD
Title: Acting as the Governing Board of County Service Area No. 1, conduct a public hearing to set the rate of the Special Parcel Tax for Extended Police and Structural Fire Services in County Service Area No. 1 for FY 2020-21 at $65 per parcel: A) Open Public Hearing B) Close Public Hearing C) Adopt a resolution setting the special parcel tax at an annual rate of $65 per parcel for FY 2020-21 to fund extended police and structural fire protection services in County Service Area No. 1.
Sponsors: Dave Pine
Attachments: 1. 20200721_r_CSA-1 Rate Setting Hearing.pdf
7/21/2020 1 BOARD OF SUPERVISORS adopted Pass Action details Meeting details Video
Special Notice / Hearing:	Public Hearing/
10-day notice
From: Supervisor Dave Pine, District 1
Subject: Special Parcel Tax Public Hearing for Extended Police and Structural Fire Services in County Service Area No. 1
Acting as the Governing Board of County Service Area No. 1, conduct a public hearing to set the rate of the Special Parcel Tax for Extended Police and Structural Fire Services in County Service Area No. 1 for FY 2020-21 at $65 per parcel:
A) Open Public Hearing
B) Close Public Hearing
C) Adopt a resolution setting the special parcel tax at an annual rate of $65 per parcel for FY 2020-21 to fund extended police and structural fire protection services in County Service Area No. 1.
County Service Area No.1 ("CSA-1") was formed in 1955 to provide enhanced fire protection services within its boundaries which include the unincorporated areas of the San Mateo Highlands, Baywood Park, Baywood Plaza, and Polhemus Heights. With the creation of this service area, a portion of the property tax paid by the CSA-1 residents was set aside for these fire protection services. In 1966, the Board of Supervisors adopted a resolution adding police services to the CSA-1 budget, with such services to be provided by the County Sheriff.
With the passage of Proposition 13, property tax revenue in CSA-1 was reduced. In response, a 2/3 majority of the voters of CSA-1 approved a parcel tax in 1982 to help fund the enhanced level of police and fire service they desired. The 1982 ballot measure set the not-to-exceed amount of the tax at $110 per parcel. The district voters renewed the special tax in 1986 and 1991 with a not-to-exceed amount of $110. In 1996, the not-to-exceed amount proposed on the ballot was reduced to $65 per parcel and that maximum amount has been approved by district voters in 1996, 2000, 2004, 2008, 2012, 2016 and 2020.
The Board of Supervisor...