Tuesday, September 11, 2018

How To Report A Nursing Home

File a complaint here. If you are unable to submit your complaint by using the Nursing Home Complaint Form then you may contact the Nursing Home Complaint hotline 1-888-201-4563 which can be called 24 hours per day seven days per week.

How Do I Report Nursing Home Abuse In Georgia

Contact information to submit complaints against certified nursing assistants hemodialysis technicians and home health aides is below.

How to report a nursing home. To open a specific report or file select the desired year and click the Submit button. Division of Nursing Care Facilities. Fill out the form as completely as possible and return it to us by mail at.

While nursing homes can be vibrant communities full of energy they can also be quite the opposite. If concerns cannot be addressed satisfactorily through informal processes the consumer can file a formal complaint with OHFLAC. Get Help from Another.

What are My Rights. If you have a problem at the nursing home talk to the staff involved. Nursing Homes must submit a 2-HourImmediate Report and a follow up Five-Day Report to the Agency for Health Care Administration.

For example if you have a problem with your care talk to the nurse or Certified Nurse Assistant CNA. Become an HHS Provider. Submitting a Complaint Against Healthcare Facilities Except Substance Abuse or Narcotic Treatment Facilities.

To check the status of a long-term care complaint contact the Departments Bureau of Long-Term Care at 800-252-4343. Nursing Homes are required by the federal government specifically section 48312 CFR to report and investigate all allegations of abuse neglect exploitation or mistreatment including injuries of unknown source and misappropriation of resident property to the State Agency. For assisted living residences and nursing homes complainants may also wish to contact the facilitys Long Term Care ombudsman.

For non-long term care complaints contact the Departments Division of Health Care Facilities and Programs at 217-782-7412. Get Help from HHS. Pennsylvania Department of Health.

Find a Long-term Care Ombudsman. Division of Health Care Facility Licensure and Certification Complaint Unit. Nursing home neglect is.

The Nursing Home Complaint Form is available online to submit your complaint against a nursing home. If the problem isnt resolved ask to talk with one of these. Complaints against abortion centers must be in writing and may not be anonymous.

If the nursing home resident resides outside the metro area call 1-800-657-3591. Reporting resolving nursing home problems. Call Division of Health Care Facility Licensure and Certification Complaint Unit at 800 462-5540.

Contact for File a complaint regarding a nursing home or other health care facility. To make inquiries you must have the name and location of. A Nursing Home Geographic Information Systems GIS layer is created each year and available for download as a shapefile or which can be added to a map as a map service ArcMap Google Earth WMS from the Pennsylvania Spatial Data Access PASDA website.

Talk With the Elderly Person. The director of nursing. If you have a problem at the skilled nursing facility SNF talk to the staff involved.

The Complaint Unit located within the Bureau of Survey and Certification is available to receive complaints against nursing homes and other health care facilities for processing and investigation. Find Someone to Provide HHS Services. The Bureau of Survey and Certification -Complaint Unit is the centralized contact point and a coordinated information source for allegations of non-compliance with.

Reporting problems in a skilled nursing facility. You may contact the Department of Health Division of Health Care Facilities at 1-877-287-0010 to request a complaint form or you may download a copy by clicking on the underlined complaint form above. If the nursing home resident resides in the metro area call 612-854-7360.

Division of Nursing Care Facilities Director. If you ever witness harm or abuse at a nursing home here is how to address nursing home negligence. Complaints - Health Care Facilities and Nursing Homes.

Complaints may be mailed faxed or delivered by phone via the complaint hotline except for a complaint against a licensed abortion center. Who can file a complaint. Use the online complaint form.

If the problem isnt resolved ask to talk with one of these. What types of complaints does OHFLAC investigate. Complete our complaint form or draft your own complaint and submit via email fax or mail.

Division of Health Care Facilities. 625 Forster St Room 526 Health and Welfare Building. You may also file a complaint over the phone.

Sunday, September 9, 2018

What Kind Of Health Care System Does The Us Have

What Does Health Care Reform Mean. Health care system is a complex mix of public and private programs.

Chart The U S Has The Most Expensive Healthcare System In The World Statista

Is to a great extent run through a group of businesses.

What kind of health care system does the us have. Most Americans who have health care insurance have an employer-sponsored plan. Many people are critical of how the health care system is structured but it has many positive attributes. Since then health care in the US.

While most of the data is for 2019 and therefore does not reflect the coronavirus pandemic it can serve as a pre-pandemic baseline and identify some of the existing issues in our healthcare system. The four key concepts of her model are consciousness movement space and time. Unlike other first world countries the health care system in the US.

Has grown into a giant system run by multiple groups. Newman which offers a paradigm based on the view of health as the undivided wholeness of the person in interaction with the environment. Before the Affordable Care Act or Obamacare as it is more commonly known more than 40 million Americans did not have any health insurance meaning that sickness could mean bankruptcy.

Health system is a mix of public and private for-profit and nonprofit insurers and health care providers. Health care system can best be described as a hybrid system. The United States health care system is a large compilation of government agencies hospitals doctors offices research centers and health-insurance companies 2.

None of them have a universal health care system. Deductible 1 covers the most common health care services such as GP psychiatric health care lab tests and equipment and drugs falling under the blue prescription system. The United States is an Outlier in Healthcare Spending.

This created a large federal healthcare system that covers millions of Americans. Deaths due to diseases of the circulatory system also accounted for a smaller share of all-cause mortality in 2017 30 than they did in 1980 53. Deductible 2 covers physiotherapy dental health care etc.

Commercial health insurance dominates the healthcare system in the US. But the federal government insures the poor Medicaid and elderly Medicare as well as veterans and federal employees and Congressmen. Does not have a uniform health system has no universal health care coverage and only recently enacted legislation mandating healthcare coverage for almost everyone.

Rather than operating a national health service a single-payer national health insurance system or a multi-payer universal health insurance fund the US. The federal government provides funding for the national Medicare program for adults age 65 and older and some people with disabilities as well as for various programs for veterans and low-income people including Medicaid and the Childrens Health. In 1965 the Medicare and Medicaid systems which insure senior citizens and people whose earnings fall under the poverty line were enacted by President Lyndon Johnson.

In the US the mortality rate has fallen from 629 deaths per 100000 population in 1980 to 255 in 2017. Pharmaceutical companies are businesses. Consciousness is defined as the informational capacity of the human system or the.

Public healthcare is only available for citizens and permanent residents over a certain age and even then it is limited in coverage. What Are the Benefits of the United States Health Care System. And other countries have made dramatic progress in lowering mortality from diseases of the circulatory system.

For the health care system truly to embrace the potential for change physicians and hospitals must get to the point where they realize that telemedicine is not an inferior substitute for face-to. Health as expanding consciousness a conceptual model of nursing formulated by Margaret A. In spite of being both wealthy developed countries Italy and the US have completely different approaches to health careItaly has a public-based system supported by tax income as well as a flourishing private insurance market which is often chosen by.

In fact the private sector operates the majority of US medical facilities as well. The US is the only country in the developed world that does not provide health care to all of its citizens. By The Commonwealth Fund The US.

Hospitalisation and everything related to being hospitalised in Norway is free for any citizen regardless of income or deductible status.

Uso T Shirt

Every year we ask service members to vote for the t-shirt offered to USO supporters. Ad Buy Authentic Joey Logano T-Shirts.

Uso 2020 Shirt

This stop stressing Wear Make is made of material premium quality cotton for a great quality soft feel and comfortable retail fit.

Uso t shirt. At the USO we are grateful for these supporters because they understand and appreciate the sacrifices that our service members and their families make daily and are always ready to step up and support the USOs mission to strengthen our Armed Forces. At the USO we are grateful for these supporters because they understand and appreciate the sacrifices that our service members and their families make daily and are always ready to step up and support the USOs mission to strengthen our Armed Forces. The USOs annual T-shirt campaign will run throughout July and is a way for military supporters to express their thanks to service members and military.

Welcome to Cheap Trendy Clothes Stores Deviclothing T-shirts categories we produce Uso Org T-Shirt For Womens Or Mens high-quality shirts with great designs in the world. USO 10th Annual T-Shirt. Limited edition 2020 USO T-shirt today Limited edition 2020 USO T-shirt today Home.

The USO is lucky to have a supportive and giving Facebook community and we have an exclusive thank you to our fans. Ad Buy Authentic Joey Logano T-Shirts. Uso Org T-Shirt For Womens Or Mens.

Uso uso uso 2020 uso 2020 uso new 2020 uso uso america moment uso counts new 2020 trending black uso white uso mockup super bowl 50 USO Classic T-Shirt By City Store. Given the T-shirts widespread popularity and its prominence in modern fashion it might seem surprising that before World War II the garment was considered a piece of underwear and was rarely worn as a piece of an outfit on its own. Limited edition 2020 USO T-shirt today.

We would love to hear which is your favorite. Official USO T shirt. 15 of every t-shirt purchase goes to the USO Northwest to directly fund our COVID-19 relief efforts for service members and their families.

Give today and get your limited edition 2020 USO T-shirt the official uniform of the military supporter. This really is more than a t-shirt. ARLINGTON Va July 1 2020 PRNewswire -- The Fourth of July is right around the corner and the USO is going to celebrate in a big way as it kicks off the 10th anniversary of its T-shirt campaign and a virtual summer concert series.

Showing 9 items. Four t-shirts to choose from. Make a bold statement with our Uso T-Shirts or choose from our wide variety of expressive graphic tees for any season interest or occasion.

The 2019 USO T-shirt campaign has ended and we appreciate all of our military supporters for their generous donations. Click on Your Favorite T-shirt Design to Vote. Amazon Essentials Mens Slim-Fit Wrinkle-Resistant Long-Sleeve Dress Shirt.

WWE Authentic Wear The Usos Uce Got The JUce Womens T-Shirt Black 2XL. Welcome to the 11th annual t-shirt campaign. WWE Jey USO Imma Get Em Youth Authentic T-Shirt.

Support the USO Northwest and our local military families impacted by the COVID-19 crisis by purchasing a limited edition USO Northwest COVID-19 T-Shirt using the link below. The USO T-shirt campaign celebrates an important member of the military community the military supporter. USO 10th Annual T-Shirt.

The USO T-shirt campaign celebrates an important member of the military community the military supporter. Now in its tenth anniversary the USO t-shirt campaign is a way for military supporters to show the world that you stand with the brave men and women putting their lives on the line for us - serving around the world to keep us safe protecting the country and answering the call when emergencies and natural disasters strike. Let us know below.

In response to your many requests we have created a limited edition heather red Proud Fan t-shirt available exclusively to our Facebook fans. Whether you want a sarcastic t-shirt or a geeky t-shirt to embrace your inner nerd CafePress has the tee youre looking for. Please select a shirt to submit your vote.

The USOs annual T-shirt campaign will run throughout July and is a way for military supporters to express their thanks to service members and. 50 out of 5 stars 1. We encourage you to wear your Official Uniform of the Military Supporter proudly to show the world that youve helped to make an incredible.

Thursday, September 6, 2018

Finger Joint Swollen And Painful

This can cause swelling pain and deformity of the joints of the fingers. Polymyalgia rheumatica PMR is an inflammatory joint disease that causes significant muscle and joints aches and stiffness in the shoulders neck and hips.

Hand Osteoarthritis Is Worse When It Affects Your Fingers And Base Of Thumb

It may be accompanied by various other signs and symptoms in the finger such as.

Finger joint swollen and painful. The AAOS says it causes the joint lining synovium to swell leading to pain and stiffness in the. Swollen fingers are a clinical sign indicative of some underlying disease. Pain in the finger or joint pain.

Swelling of these finger joints is usually due to inflammation of the tissues surrounding these joints. If a joint is under excessive stress or is damaged the tissues that line the joint may swell. The condition is autoimmune so it can only be treated if it is diagnosed early.

A swollen finger is a sign of fluid buildup or inflammation of the tissues or joints of the finger. Arthritis is an inflammatory condition that is characterized by pain swelling and stiffness in the joints. What is a Heberden node.

Infections can also result in swelling and these should be treated right away. Both osteoarthritis and rheumatoid arthritis RA commonly affect joints of the fingers. Medical conditions can cause swollen fingers and general swelling as well.

Joint swelling and tenderness may also occur in the wrists and fingers although it is usually mild. Some of the symptoms for pain in the middle finger joint include finger joint pain stiffness and swelling. Finger swelling can result from serious infections inflammation trauma and other abnormal processes.

The two most common forms of arthritis include osteoarthritis OA and rheumatoid. Finger joint pain may affect a persons everyday activities and may have several different causes. Any type of arthritis.

Too much inflammation however can be painful and harmful. Bursitis When the bursa sac is inflamed. Joint pain is a feature of joint inflammation arthritis that may occur in the joints of the finger bones.

Finger pain can affect joint mobility and impact a persons ability to carry out everyday activities. The tissue and cartilage in your hands and fingers is designed to protect your delicate joints. The root cause for swollen finger joint is an injury to the joint itself like hyperextension of the fingers or a crush injury.

Neck injury nerve-related injury Underactive thyroid. This can sometimes be accompanied by redness swelling warmth of the joints ot sore fingers. Discoloration of the skin varying from redness associated with inflammation and allergic rashes to blue to purple hues.

Finger joint pain may also occur in patients with osteoarthritis or rheumatoid arthritis inflammation that occurs in the joints of the finger bones. A buildup of uric acid in the joints due to gout can cause the sudden appearance of swollen thickened painfully inflamed fingers. In general swollen fingers can be caused by overall fluid retention such as during premenstrual syndrome or pregnancy.

Some people may experience finger joint pain that worsens when they move or. Rheumatoid arthritis is a chronic autoimmune disease that can affect many parts of the body. Rheumatoid arthritis is a chronic disease that causes inflammation of the joints and results in painful movement and stiffness especially in the fingers wrists and ankles.

This can sometimes cause swelling redness and warmth in the joints when touched. Arthritis commonly results in swelling of the hands often in the morning upon waking up. Inflammatory conditions that can result in a swollen index finger include.

Causes of finger pain can include injuries infections tendon problems and arthritis. An insect bite fluid retention exposure to extreme temperatures can also cause swollen finger joints. Nodules are large painful bumps that often develop in the joints of the fingers and also on the elbows forearm back heel and many other areas.

Wednesday, September 5, 2018

Cat Birth Certificate

Each certificate is individually numbered and embossed with our official seal. This one design is simple and sweet to look at.

15 Cat Birth Certificate Free Printable Ideas Cat Birth Birth Certificate Birth Certificate Template

Birth Certificate Template Training Certificate Certificate Frames Adoption Certificate Certificate Design Google Docs Personal Brand Statement Cat Birth Plastic Playing Cards.

Cat birth certificate. Certificate makers verify necessary information print it off stamp it and then mail it out to you typically in a protective sleeve. Free to download and print Find this Pin and. Complete design as a birth document for cats and dogs.

There are 7 editable formats of Birth Certificate Template that you can download through our partner site. This certificate is designed with cats in mind. The second design of Cat Birth Certificate Template 2020 FREE Download.

Gallery of 13 Cat Birth Certificate Template Free Editable Formats. Some convenience in using these 10 best ideas of this Animal Birth Certificate Template. But we see it in terms of art.

Any pet owner can order a cat or dog birth certificate for one or all of their pets at home. This certificate is designed with cats in mind. This kitten birth certificate also has a function as a sign of ownership of your pet especially for cats.

These certificates are printed on high quality metallic paper with all the details of your pets birth. Get immediately for your pet or your favorite cat. Not that we are big fans of cartoons.

This certificate template for pets is designed with style and some funny pictures. Jul 13 2015 - Cat Birth Certificate Printable Certificate free to download and print More information A birth certificate for a cat honoring its adoption by human parents and. These sweet Cat Birth Certificates are made particularly for the non-specific breed of cat.

You know we really like the frame used for this Cat Birth Certificate Template. A birth certificate for a cat honoring its adoption by human parents and picturing paw prints and two cuddling kitties. Kitten Birth Certificate Template for 2020 Version 2 in a vertical position.

Cat birth certificate template printable kitten birth certificate template birth certificate template for cat certificate of birth cat pet cat birth certificate. Whereas a humans birth certificate can act as proof or documentation as to his or her lineage and family a pets birth certificate may also present familial lineage information but it may not be as clear. When you feel like to change this Cat Birth Certificate Template Free Editable you will need the file.

Plus this template is adorned with a cute depiction of pet aesthetics which is easily editable for your convenience. The cowl proclaims that its an Official Cat Birth Certificate whereas the within has the title of the cat-approximate birthday for the official signature of the proprietor. Birth Certificate Template Certificate Design Letter Templates Card Templates Personal Brand Statement Cat Birth Student Images Plastic Playing Cards Honor Student.

Rated 500 out of 5 based on 1 customer rating 1 customer review 1999 1499. Free to download and print Find this Pin and more on Projects to Tryby MsTulip. Saved by Syahinnaz Fauz.

Cat Birth Certificate Template 2020 FREE Download Version 2 July 2019. You can get it from One Package. The preferred file type is Office Word.

Download Free Version PDF format Download Customizable Version for 5 DOC Format. Download Free Version PDF format Download Customizable Version for 5 DOC Format. 9 Puppy Birth Certificate Printable Free Ideas.

You can modify our sample using Adobe InDesign Apple Pages and other compatible applications. Can be directly used by placing images on a worksheet you can use Photoshop Corel Draw or other graphic design programs. Official pet birth certificates are usually required when pets and other animals are transported to different countries.

Apr 26 2020 - Are you having trouble finding a Cat Birth Certificate FREE Printable with the right design. This birth certificate recognizes the adoption of an animal by human parents and is appropriate for a variety of pets including a bird horse or even a bug. Cat Birth Certificate A birth certificate for a cat honoring its adoption by human parents and picturing paw prints and two cuddling kitties.

You can choose other formats such as PDF. Try the Top 12 Sweet Concepts that we offer for your kitten. Cat Birth Certificate Template FREE 1.

A birth certificate for a cat honoring its adoption by human parents and picturing paw prints and two cuddling kitties. Kitten Birth Certificate Template for 2020 Version 2 By Tina MuliaPosted on April 26 2020April 26 202045 views. This Cat Birth Certificate Template we created with 10 cute designs and two main formats Microsoft Word PDF.

Pet Birth Certificate Cat Pink Seal. Cat Birth Certificate Free Printable 3Rd Version Birth with regard to Unique Kitten Birth Certificate Template Amazing Certificate Template Ideas. These certificates are printed on high quality metallic paper with all the details of your pets birth.

Therefore when validating the details of a pets birth incorporate our Free Pet Birth Certificate Template for your design needs. This certificate template can be opened and customized with.

Tuesday, September 4, 2018

Marriage Certificate Florida Search

A Florida divorce certificate can be obtained through the state office of vital statistics and indicates the names of the parties to the marriage and the date of the matrimony and the date it was dissolved. 1 Enter Any Name.

How Do You Find Marriage Records

Electronically certified copies of marriage records are now available 247 using the Clerks new eCertify for Official Records service.

Marriage certificate florida search. Get Results from 6 Engines. We will conduct a qualifying review of your order within 1 business day of submission Optional Delivery Options. Find Hendry County Marriage Records.

Considering that the Florida clerks bureau provides services to a lot of people retrieving such information can take several days. Ad 1 Enter A Name City or State 2 Lookup Marriages Divorces Relationship History. Records before June 6 1927 can only be obtained from the County Clerk of Court.

Florida marriage certificates from June 6 1927 to present that have been recorded by the Clerk of Circuit Court are available through the Bureau of Vital Statistics. 1750 UPS Air Shipping Delivery includes multiple copies Free. A certified copy can be used to apply for insurance benefits file joint taxes and many other crucial documents and.

The divorce decree includes this information as well but also includes the specifics of the divorce such as spousal support child support and disposition of belongings. Civil court cases documents and proceedings are public records in Florida. However you can expedite the retrieval process if you seek help from a private company.

A certified copy of a marriage certificate is a duplicate of your original marriage certificate issued directly from the county office where you received your marriage license. 400 each Qualifying Review. Any additional copy to your order will cost 400.

The Florida Marriage Records Search links below open in a new window and take you to third party websites that provide access to FL public records. About Marriage Records in Florida In Florida marriage records are the responsibility of the Florida Department of Health. While the state of Florida keeps all the marriage records it is possible to get your records from a private company.

If you want to order a marriage certificate online you can do so at VitalChek officially contracted by the Florida DOH. Marriage records can be obtained either with the Clerk of Court in the county where the marriage occurred or through the Office of Vital Records. Ad Search For Relevant Info Results.

Certified Copy ies of this Marriage Certificate cannot be ordered online at this time. Ad Search For Relevant Info Results. This includes divorce records unless they.

A 500 for each death certificate. Perform a free Florida public marriage records search including marriage licenses certificates registries and indexes. Some historical marriage license records for Tampa and Hillsborough County are available for viewing online at the University of South Florida.

Certified Copy of Florida Marriage Record. 1 Enter Any Name. Ad 1 Enter A Name City or State 2 Lookup Marriages Divorces Relationship History.

However you can mail a request to the Marriage License Bureau at. The certificate is issued as an abstract of the information taken from the marriage license and is acceptable as evidence that a. You can also view historical marriage records for the entire state of Florida online at the State Office of Vital Statistics.

It is totally different to the marriage license check the differences between marriage license vs certificate here. Get Results from 6 Engines. Hendry County Marriage Records are official documents that contain information about marriages certified in Hendry County Florida.

You can order a Florida marriage certificate either in person or by mail through the Bureau of Vital Statistics of the state DOH. Florida State Government Fee Additional copies. 601 Nw 1st Court Room.

2 Search Marriages Divorces Past Relationships 3 No Hit No Fee. These include Hendry County marriage licenses certificates registries and vital record indexes. Are Florida divorce records public.

2 Search Marriages Divorces Past Relationships 3 No Hit No Fee. An authorized copy of the decree will. Whenever you are ordering birth records marriage certificate or licenses divorce certificates or death records Vital Records Online will charge a fee starting from 49 for the assistant service and the state of Florida will charge a 1400 fee for each certified copy of birth certificate any additional copy to your order will cost 800 a 500 fee for each marriage certificate certified copy.

If the copy will be.

Monday, September 3, 2018

Pathophysiology For Dummies

PATHOPHYSIOLOGY Understanding the pathogenesis of type 2 diabetes is complicated by several factors 4. Pneumonia inflammation and consolidation of the lung tissue as a result of infection inhalation of foreign particles or irradiation.

Pathophysiology Made Incredibly Easy Incredibly Easy Series R Amazon Co Uk Lippincott Books

Ad Emuaid Gave Me My Life Back I Am So Thankful For This Amazing Product.

Pathophysiology for dummies. Whether its to pass that big test qualify for that big promotion or even master that cooking technique. Patients present with a combination of varying degrees of insulin resistance and relative insulin deficiency and it is likely that both contribute to type 2 diabetes 5-7. Although viral pneumonia does occur virus es more.

Mike Baker Previous Edition. PDF EPUB File Name. People who rely on dummies rely on it to learn the critical skills and relevant information necessary for success.

FREE pathophysiology lecture notes study guide and exam help for medical dentistry and nursing students. The physiology of abnormal states specifically. Some of the people who helped bring this book to market include the following.

It is one of the most common clinical signs of gastrointestinal disease but also can reflect primary disorders outside of the digestive system. Many organisms including viruses and fungi can cause pneumonia but the most common causes are bacteria in particular species of Streptococcus and Mycoplasma. Glucosuria causes an osmotic diuresis leading to water Na loss.

Dummies helps everyone be more knowledgeable and confident in applying what they know. Anatomy and Physiology for Dummies. Dyspnea is defined as abnormal or uncomfortable breathing in the context of what is normal for a person according to his or her level of fitness and exertional threshold for breathlessness.

Keep scrolling for more. Dummies has always stood for taking on complex concepts and making them easy to understand. Biology Education Health Nonfiction Reference Science.

DYSPNEA for DUMMIES Part 1. Acquisitions Editorial and Media Development Project Editor. In the absence of insulin activity the body fails to utilize glucose as fuel and uses fats instead.

Ad Emuaid Gave Me My Life Back I Am So Thankful For This Amazing Product. Other Words from pathophysiology Example Sentences Learn More about pathophysiology. This leads to ketosis.

Full Book Name. Were proud of this book. Dyspnea is a common symptom and can be caused by many different conditions.

The functional changes that accompany a particular syndrome or disease. Diarrhea is an increase in the volume of stool or frequency of defecation. Ad MyZone Offers a Full Range of Training Solutions to Suit Any Budget.

Pathophysiology Secondary to insulin deficiency and the action of counter-regulatory hormones blood glucose increases leading to hyperglycemia and glucosuria. Ad MyZone Offers a Full Range of Training Solutions to Suit Any Budget.

Mini Turtle Pet

Ad Search Supplies For Pets. Get Results from 6 Engines at Once. 6 Irresistibly Cute Pet Turtles That Stay Small Forever With Pictures