text:
Stella Farnan (Single Launch)
Event Details
w/ GUS + Soren
TICKETS $10+bf ONLINE
Melbourne singer-songwriter Stella Farnan is launching her much anticipated second single, 'Act Like a Party' at the Gasometer Upstairs on Thursday 21 November, 2019.
Stella has a voice that possesses an earthy soulfulness, cannily weaving a tapestry of emotion and intellect over pop/rock chords and textures, channelling the likes of Lucy Dacus and Courtney Barnett.
'Act Like a Party' is anintoxicating indie pop song produced by Soren Maryasin, mixed by Callum Barter and mastered by Kathy Naunton. The track builds to a soaring chorus where Stella navigates the turbulence of growing up, fitting in and hoping to be invited…
Stella's debut single 'Love Spill' created a buzz earlier this year when it received airplay on Triple J and the song helped land her a support slot with Alpine in Melbourne and Castlemaine in June.
Stella will be joined by very special guests GUS and Soren.
We would like to acknowledge the Wurundjeri people of the Kulin nation who are the traditional custodians of the land and waters on which The Gasometer operates. We pass on our respects to their elders of past, present and emerging.
Other Events
Dan Kelly & The Alpha Males (2nd Show)
Sun 8 Dec 2019, 7.00pm | The Gasometer Hotel, VIC
w/ Olympia more »Get Tickets
Thu 12 Dec 2019, 7.00pm | The Gasometer Hotel, VIC
w/ Izy and Hannah Wilson more »Get Tickets
Austen (EP Tour)
Sat 14 Dec 2019, 8.00pm | The Gasometer Hotel, VIC
Special Guests TBA more »Get Tickets
Sat 21 Dec 2019, 8.00pm | The Gasometer Hotel, VIC
w/ A. Swayze & The Ghosts (Tas), The Pretty Littles, Full Flower Moon Band (Bris) + more more »Get Tickets
Mitch Tambo
Thu 9 Jan 2020, 7.30pm | The Gasometer Hotel, VIC
Special Guest TBA more »Get Tickets


text:
Explore our selection of blogs, case studies, research reports and more.
An effective menu is one of the best tools that any restaurant has when it comes to engaging customers and enhancing profitability. Read more.
Zonal has been working with a number of stadia to introduce hospitality-dedicated tech, to deliver a premier experience across multiple outlets.
At Zonal we know that during the festive period no-shows can be a huge problem to tackle. Read this blog to find out ways you could be preventing no-shows
The hospitality sector is not immune from this pressure to act and reduce its entire waste footprint. Menu management is the simplest way to reduce food waste.
According to the latest data, speed of service remains the second top gripe, with 17% of negative reviews relating to poor speed of service, despite a 4% fall from February.
Hospitality and Catering News, the essential information resource for those working within the industry, has called for operators to adopt Click and Collect
Are your hotel F&B operations as slick as your guest services? Discover if your use of technology is driving guest spend or forcing guests to go elsewhere.
UK restaurants and pubs are losing £16 billion every year thanks to no-shows. These stats reveal the scale of the problem, and how venues are fighting back.
Chat with our sales team to learn about how Zonal products could benefit you.
I would like to receive email communications, such as newsletters, industry updates, information about products and services, event/webinar invitations, and whitepapers (You can unsubscribe at any time).

subset: commoncrawl


text:
Like anything else in this world, you'll either need a lot of time or a lot of money. If you have both, then clearly, you're ahead of the game. But most people have more of the former rather than the latter. But considering that time is finite and we only have a certain amount of it, using your time wisely and managing your time properly is crucial to ensure your success.
Many gymnasiums will trade membership and often a bit more for a person willing and able to teach an exercise class. You can also find people who don't want to go to a gym and train them at home as a personal trainer. If you're in good shape, this is a great opportunity to earn some extra money, plus it can often lead to additional income with one-on-one instruction opportunities.
So, where are we supposed to turn to make money the legitimate way online? This isn't just about generating passive income; this is also about finding ways and means to create an active income through the conveniences afforded to us by the internet that will not only help us with our debt obligations, but also empower us to save, invest and get really rich in the future.


text:
It's August. It's hot and sticky. Summer reading at my library has ended. Back to school is right around the corner. Time to get some last enjoyment of the summer before the blessed cold of winter the season change. A time of year otherwise known as the "dog days of summer."
We needed a new book display, and I like word play. I think you can guess where this goes.
If you want to take a gander at my lists of dog books, its all here


text:
Today's Top Stories
An Epic, Extravagant High-Refresh Mega-Monitor
The HP Omen X Emperium 65, the first Nvidia Big Format Gaming Display (BFGD) is impossibly pricey and far from flawless, but play on it is unmatched, if you have the monster PC to support it.
Affiliate commissions may be earned by us through your purchaseLittle Bird Repeat Womens Fashion Canvas Lace Up Dhoes Low Top Hip Hop Tennis shoes For Women's
Akita Dog Triangles Pattern Womens Printed Canvas Boat shoes Low Top Trendy Running shoes For Woman
Top Reviews From Our Lab
Most Popular Stories
How well do vendors service and support their products? PCMag readers tell all.
Use PCMag's Speedtest tool to find out exactly how fast your internet connection really is.
Watch hundreds of video reviews from PCMag experts.
PCMag EIC Dan Costa interviews technologists and entrepreneurs about living in the future.
Was I hacked? Should I change my password? Read the latest on SecurityWatch to stay safe online.
All the technology and tips you need to connect all the rooms in your home.
Latest Stories
24 Hidden Roku Tricks for Streaming Success
Whether you've nabbed a new model or have had the same Roku for years, there's more to know about these streaming devices beyond the basics of a Marvel marathon. Running shoes for Women Womens Knit Breathable Trainer Sneaker Lightweight Walking shoes Women Air Running shoes (color White, Size 36)
Are We in a Blockchain Winter?
Three years ago, blockchain was the buzzword of the moment. But startups are now more circumspect about their use of the technology. Is it a true slump or are startup just trying to avoid blockchain fatigue? Cici shoes Simple Style Pumps Wedding Party Stiletto High Heels Fashion Heeled shoes for Women
Will VR Train the Next Generation of Soccer Stars?
With software from Rezzil and Incisiv Sport, soccer players are strapping on VR headsets to hone their skills and train safely while recovering from injuries. Fourever Funky Over The Knee Block Heel Women's Stretchy Vegan Black Boots
Ellie shoes 709-GLITTER 7 Pointed Stiletto Sandal Multi-color Size 6
The hidden camera was found after one of the family members scanned the surrounding Wi-Fi networks. Airbnb has removed the host from its platform, after the family initially claimed the home-sharing service had been dismissive of the whole incident. Read More
Hip-gift Adult Ladies Ballet Dance Pointe shoes Pads Toe Dance Pouch Pink
Gadget customization company ColorWare is now taking orders for custom second-generation AirPods. Expect to pay a hefty premium for a custom set. Slipper Cotton Spring, Autumn and Winter Slipper Female Wooden Floor Cotton Cloth Opening Home Indoor Non-Slip Soft Fit Feet Good Air Permeability (color Pink, Size 35-37)
The no-frills Edifier TWS2 earphones offer sub-$100 true wireless audio that is more accurate and less bass-heavy than much of the competition. Read More
F1rst Rate Women's Peep Toe Glitter Pump
Audioengine's A2+ Wireless speakers are ideal for anyone who doesn't want to sacrifice stereo separation, accuracy, or DSP-free audio in the Bluetooth era. Read More
Welcometoo Boots Women Faux Suede Ankle Boot Winter Warm Thick Plush Snow Womens shoes Soft Non-Slip Flat Ladies Casual Solid
Project management app ProofHub aims for simplicity without skimping on major features. It's an excellent app with a competitive price for small businesses. Read More
The Best Reseller Web Hosting Services for 2019
If you want to get into the web hosting business but lack the resources to manage servers and infrastructure, being a hosting reseller is a good option. These are the best reseller web hosting services in our tests. Elegantpark A610 Women High Heels Evening Party Wedges Closed Toe Buckle Satin Bridal Wedding shoes
Review: H&R Block Deluxe 2019 (Tax Year 2018)
H&R Block Deluxe is a comprehensive, easy-to-use tax service that helps e-filers claim relevant deductions and credits. The site is much improved, both in terms of the user experience and help options. It's our top choice for online tax preparation. JOJONUNU Women Pointed Toe Pumps shoes
Get More From PCMag
Subscribe to PC Magazine
Get the PC Magazine digital edition without ads for 67% off the newsstand price.Bar III Womens Victor Fabric Open Toe Casual Ankle Strap, Dark Tan, Size 6.0
Connect With Us


text:
- Server 1
Movie Yumurta was released on 11.09.2007. Directed by Semih Kaplanoğlu and lasts 97 min. The IMDB rating of Yumurta at the moment is 6,6. On 123Movies you can watch online official trailer of Yumurta as well as the full movie for free.
Views: 13
Genre: Uncategorized
Director: Semih Kaplanoğlu
Actors: Allison Tolman, Gülçin Santırcıoğlu, Kaan Karabacak, Nejat İşler, Saadet Isil Aksoy, Semra Kaplanoglu, Tülin Özen, Ufuk Bayraktar
Duration: 97 min
Release: 2007
IMDb: 6.6
Harvey Street Kids Season 2 Episode 1 watch onlineGold Rush: White Water Season 2 Episode 8 watch free on 123moviesGet Krack!n Season 1 Episode 5 watch onlinePool Kings Season 2 Episode 13 watch online


text:
Chitosan-functionalized gold nanoparticles for colorimetric detection of mercury ions based on chelation-induced aggregation. Microchimica Acta 182(3-4): 611-616, 2015
Colorimetric aptasensor for progesterone detection based on surfactant-induced aggregation of gold nanoparticles. Analytical Biochemistry 514: 2-7, 2016
Dispersion-aggregation-dispersion colorimetric detection for mercury ions based on an assembly of gold nanoparticles and carbon nanodots. Analyst: -, 2018
Visual detection of cancer cells by colorimetric aptasensor based on aggregation of gold nanoparticles induced by DNA hybridization. Analytica Chimica Acta 904: 92-97, 2016
Rapid and ultrasensitive colorimetric detection of mercury(II) by chemically initiated aggregation of gold nanoparticles. Microchimica Acta 182(13-14): 2147-2154, 2015
Colorimetric assay for protein detection based on "nano-pumpkin" induced aggregation of peptide-decorated gold nanoparticles. Biosensors & Bioelectronics 71: 348-352, 2016
Colorimetric detection of L-histidine based on the target-triggered self-cleavage of swing-structured DNA duplex-induced aggregation of gold nanoparticles. Mikrochimica Acta 185(10): 452-452, 2018
Colorimetric and visual mercury(II) assay based on target-induced cyclic enzymatic amplification, thymine-Hg(II)-thymine interaction, and aggregation of gold nanoparticles. Mikrochimica Acta 186(2): 105-105, 2019
Label-free aptamer-based colorimetric detection of mercury ions in aqueous media using unmodified gold nanoparticles as colorimetric probe. Analytical and Bioanalytical Chemistry 393(8): 2051-2057, 2009
A label-free colorimetric aptasensor for simple, sensitive and selective detection of Pt (II) based on platinum (II)-oligonucleotide coordination induced gold nanoparticles aggregation. Biosensors & Bioelectronics 85: 771-776, 2016
Direct colorimetric biosensing of mercury(II) ion based on aggregation of poly-(γ-glutamic acid)-functionalized gold nanoparticles. Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy 121: 527-532, 2014
A colorimetric sensor for the visual detection of azodicarbonamide in flour based on azodicarbonamide-induced anti-aggregation of gold nanoparticles. Acs Sensors: -, 2018
Colorimetric detection of mercury species based on functionalized gold nanoparticles. Acs Applied Materials & Interfaces 6(18): 15897-15904, 2014
Colorimetric detection of mercury ion (Hg2+) based on DNA oligonucleotides and unmodified gold nanoparticles sensing system with a tunable detection range. Biosensors & Bioelectronics 24(10): 3153-3158, 2009
A simple colorimetric sensor based on anti-aggregation of gold nanoparticles for Hg2+ detection. Colloids and Surfaces A: Physicochemical and Engineering Aspects 395: 161-167, 2012


text:
SonicWall SOHO - security appliance
SonicWall SOHO - security appliance
SonicWALL Security Dashboard
Dell SonicWALL TZ400 Quick Start Guide
Sonicwall tz 210 vpn client download stjohnsbh org uk
How to Integrate LDAP / Active Directory with SonicWall
SonicWALL TZ 105 Unified Threat Management Firewall
Configuring SonicWall Routers in the New Interface - 8x8 Support
How to Login to the SonicWALL TZ-205
SonicWall Mobile Connect on the App Store
Open Rights Group says UK "pornwall" will block web forums - Telcos
Basic Sonicwall Guide - activereach Ltd
Appropriate Web Filtering and Montoring for Schools and Colleges
Setting up SSLVPN connections on Mobile Devices | WhyReboot
Xbox live and SonicWall TZ205 setup | Mike Revitt - Cloud Computing
Sonicwall 09E Wireless 802 11 abgn Device User Manual
SonicWALL Site-to-Site VPN Tunnel in main mode Server 2012R2
SonicWall Mobile Connect on the App Store
SonicWall TZ series
SRA 7 5 User Guide
Why I hate web content filtering systems | We'll see | Matt Zimmerman
4 Ways to Bypass a Sonicwall Block - wikiHow
SSL-VPN: Erweitern der SonicWALL-Firewall - soft-management blog
Guide on how to configure SonicWALL for 3CX Phone System
Sonic Wall Net Extender
Port Forwarding on the Sonicwall TZ-150 Wireless Router
How to Download, Install and Set up SonicWall Analyzer
SonicWall Inc | LinkedIn
How to install Sonicwall NetExtender for remote SSL VPN Access | STM
SonicWALL Global VPN Client - Download
IE Embedded - Failed to open a pop-up - Remote Desktop Manager
How To Configure SonicWall Logging and Reporting
How to create site to site vpn between Sonicwall and linux with
Sonicwall tz 105 site to site vpn
Sonic Wall SoHo updating dyndns org (dyn account) – cpierce org
SonicWALL TZ 210 Review | ZDNet
SonicWall Tz 100 wireless connection: AP – Khmer Certified
Dell SonicWALL TZ500 Firewall Review | StorageReview com - Storage
Email Compliance and Encryption Project for Dell SonicWALL
Setting up Time-based One-time Passwords on SonicWall UTM
Dell SonicWALL SOHO Quick Start Guide
Sonicwall site to site vpn settings
How To Configure SonicWall Logging and Reporting
Use IP Helper with Sonicwall VPN for Active Directory across the
Sonicwall DMZ/VPN between multiple locations - The Cloud (Internet
Monitoring Web Searches to Prevent Radicalisation and Extremism
SonicWall TZ 180 Wireless - PCMag Australia
EXEs not downloading, SonicWall Gateway antivirus blocks downloads
Sonicwall vpn client software for mac
Sonicwall Global VPN disconnecting repeatedly – faultbucket
SonicWall Inc | LinkedIn
SSL VPN on Sonicwall
Sonicwall tz 210 firmware upload failed
Dell SonicWALL Firewall Appliance Overview - Code Exploit Cyber Security
how to configure walled gardens - activereach Ltd
How to install an SSL certificate on SonicWALL – HelpDesk | SSLs com
Dell SonicWALL Firewall Appliance Overview - Code Exploit Cyber Security
SonicWALL TZ 190 Configuring DHCP Option Objects
SonicWall Analyzer Licenses, Subscriptions & Renewals | SonicGuard com
SonicWall Reporting on Users, Departments and AD Security Groups
Florian Malecki – International Product Marketing Director April ppt
SonicWall Mobile Connect
SonicWall-SNSA pdf - Australia New Zealand SonicWall Training and
WXA 1 3 1 Release Notes
Sonicwall viewpoint virtual appliance download
Sonicwall global vpn client version 4 7 stjohnsbh org uk
Sonicwall NetExtender - Mobile Connect için SSL–VPN Özelliğini
5 Ways to Bypass Sonicwall to Watch YouTube - wikiHow
Sonicwall ssl vpn web portal
Dell SonicWALL Global Management System 7 2 Virtual Appliance
Sonicwall global vpn 4 2 64 bit
CT School District Apologizes For Blocking Conservative Websites
How To Configure Sonicwall Firewall ?
Dell sonicwall global vpn software
Site to Site VPN between a Sonicwall Firewall and Cisco ASA 5505
Dell SonicWALL Firewall Selling Services & More 2 SonicWALL
Microsoft Azure Site-to-Site VPN with SonicWALL OS- Part 2 Configure
How To Configure Sonicwall Firewall ?
Configuring a SonicWALL TZ-105 Network Security Appliance – Part 1
Managing firewalls with a GMS MySonicWALL sub-account | Virtual
Microsoft Azure Site to Site VPN with SonicWall Hardware Firewall
Sonicwall vpn for windows 10
Site To Site VPN Between AWS And SonicWALL UTM
How to configure dell sonicwall vpn client
Dell 01-SSC-0585 SonicWALL TZ300 Wireless AC Plus 1 | Comms Express
Firewall or Anti-Virus? Does my business need both? -
How to GEO-IP Exclusion in SonicWall - Step by step with screenshots
EdgeMAX - Configure the EdgeRouter to work with SonicWall VPN
Can someone please explain & help me - LDAP & Router access from
Configuring a SonicWALL TZ-105 Network Security Appliance – Part 1
Sonicwall vpn fritzbox
How do I reset a SonicWall using safemode? (SW8010)
Sonicwall site to site vpn kurulumu
Dell patches critical flaws in SonicWALL Global Management System
Is hide my ip a vpn
Sonicwall firewall and vpn
APL410BA Wireless Network Security Appliance User Manual Dell
Dell SonicWALL Firewall Appliance Overview - Code Exploit Cyber Security
SOLVED] Sonicwall: Facebook Like button blocked, covering article


text:
- You may also like...
- Reviews
- Description(adidas Outlet)
Good Sale Women adidas Stan Smith Sock Primeknit Shoes (Women Originals), Black/Legend Ink/Ash Pearl, adidas Originals Shoes Cheap Sale, Women Originals Shoes NCF37YH
£142.83 £68.68-52%
Factory Prices Women adidas NMD_R1 Shoes (Women Originals), Ash Pearl/Chalk Pearl/White, adidas Originals Shoes Cheap Sale, Women Originals Shoes BVL16UR
£148.29 £70.24-53%
Best Sale Discounted Men adidas Pharrell Williams Tennis Hu Shoes (Men Originals), Grey One/Grey One/Chalk White, adidas Originals Shoes Cheap Sale, Men Originals Shoes SDA44ZS
£131.12 £60.88-54%
Buy Cheap Men adidas ID Stadium Tee (Men Athletics), White Melange, adidas T-Shirts & Polos Cheap Sale, Men T-Shirts & Polos MEV25UE
£63.22 £28.10-56%
Clearance Men adidas X 17+ Purespeed Firm Ground Boots (Men Football), Aero Green/Unity Ink/Hi-Res Green, adidas Football Shoes Cheap Sale, Men Football Shoes MNB91GV
£207.61 £98.34-53%
Men Originals Shoes By adidas Official website ---- adiease Shoes, Iconic adidas low tops retooled for the skateboard. The standard for skating, these adiease shoes blend clean, classic looks with tried-and-true performance designed to tackle the streets. Made of durable suede with a vulcanised rubber outsole, the shoes provide top-to-bottom flexibility right out of the box.


text:
Sonam Kapoor Meets with Coldplay at Their London Concert
Sonam Kapoor, who was in the blink and miss Coldplay music video A Hymn For The Weekend had made it clear that she wanted a chance for a VIP all-access to her favourite band forever.
So it's no surprise that Sonam was recently spotted chilling backstage with the band members before the Coldplay concert in London. The Khoobsurat actress was photographed with Chris Martin, Jonny Buckland, Guy Berryman, Will Champion and Phil Harvey before the charity event at Kensington Palace.
Coldplay performs at Kensington Palace.
Sonam Kapoor will next be seen in Shashanka Ghosh's Veere Di Wedding alongside Kareena Kapoor Khan and Swara Bhaskar.
(The Quint is now available on Telegram. For handpicked stories every day, subscribe to us on Telegram)


text:
The other morning I met an old friend at the CP's grade crossing of Schmidt Rd.near the West Davenport,IA. yard office. We both started on the Milwaukee Road back in the 60's. I've been retired fo... (more)
The crew of the West Dav switch peer into the future through John's camera as they cross Rockingham Road on Davenport's industrial west side. The tracks behind are known to railroaders as the "Go... (more)
The Rock SW brings a cut of cars back to West Dav after working Oscar Meyer, as rebuilt GP7 4508 sits with sister 4506 waiting for assignment. This yard is still active today configured much the ... (more)
A Rock SW8 works the Oscar Meyer plant on Davenport's west side. This landmark still dominates the skyline along River Drive, but the tracks are buried and haven't been used in years.
A pair of ex-SOO veteran GP9's get started with their switching duties.


text:
Search NoVa Caps Site
Recent Posts
- Bears Top Phantoms 2-1; Joe Snively Scores 5th Goal In Last 6 Games
- Nicklas Backstrom Will Miss 8th Straight Game, Capitals Look To Sweep The Left Coast: News From Morning Skate In Anaheim
- A Smart Puck For All Of Us: Introducing The StatFeedr Puck
- Washington At Anaheim Preview: Capitals Wrap Up Road Trip Against Ducks On Friday
- Capitals Loan Tobias Geisser to EV Zug in Switzerland
- John Carlson Ties Al MacInnis And Denis Potvin For Most Points By A Defenseman In First 30 Games Since 1974-75
- Capitals Oust Kings 3-1; John Carlson Scores Two Goals In First Period
- Cruising Carly: John Carlson Scores 10th and 11th Goals of the Season in First Period Against Los Angeles Kings, Continues Historic Start to the Season.
- 2019-20 Division Breakdown – NHL Results Through 1/3 of the NHL Season: Metropolitan Division.
- Washington Capitals And The Wharf Announce "Capitals Campfire" At Camp Wharf
Tag Archives: Troy Brouwer
Superstar Sidekicks: A Look At the Players Who Got to Play With the Capitals' Two Superstars
Photo: Patrick Smith/Getty Images This week, the "Down Goes Brown" column, written by Sean McIndoe for The Athletic (behind the pay wall), focused on "Projecting the Opening Night lineup for whichever team you personally cheer for", describing the projected lineup … Continue reading
Capitals Alumni Profile: Troy Brouwer
Joel Auerback/Getty Images North America While right wing T.J. Oshie has manned the slot on the Capitals' lethal power play for the last three seasons, it was former Capital Troy Brouwer who first provided the team with a weapon in … Continue reading
Three Years of the Osh-Babe: A Look at the T.J. Oshie Trade Three Years Later
While NHL free agency and a number of signings have dominated the headlines among Capitals fans, July 2 marks the three-year anniversary of the Capitals' acquisition of right wing T.J. Oshie. In this trade, NoVa Caps looks back on the … Continue reading
Posted in History, News, NHL, Players, Teams, Trade, Washington Capitals Tagged Michael Fleetwood, Pheonix Copley, St. Louis Blues, T.J. Oshie, Trade, Troy Brouwer 12 Comments
Familiar Faces Return to Kettler
As the Capitals were practicing on the Capitals Rink at Kettler, the Calgary Flames were doing Monday preparations themselves on the Public Rink. During Calgary's practice there were two faces that are very familiar to Caps fans working out on … Continue reading
Posted in News, NHL Tagged Calgary Flames, Jaromir Jagr, Michael Marzzacco, Troy Brouwer, Washington Capitals 3 Comments
T.J. Oshie is Having the Best Start of His Career. How Much of a Difference has he Made with the Capitals?
During the 2014-15 season, the Capitals were 45-26-11 and were second in the division. Alex Ovechkin had a terrific year, leading the league with 53 goals and had 81 points in 81 games played. Nicklas Backstrom was just as good … Continue reading
Evaluation of the 2011 NHL Entry Draft
Nick Laham/Getty Images Unlike the 2009 and 2010 NHL Entry Drafts, the 2011 draft did not have a clear-cut favorite player to be picked with the first overall pick. Whereas the previous two drafts featured Tyler Seguin, Taylor Hall, and … Continue reading
Posted in Draft, News, NHL Tagged 2011 NHL Entry Draft, Diane Doyle, Gabriel Landeskog, Jonathan Huberdeau, Mika Zibanejad, Ryan Nugent-Hopkins, Ryan Strome, Travis Boyd, Troy Brouwer 2 Comments
History Behind A Number: No. 20
Photo: Rob Carr/Getty Images Throughout the Capitals' 42 years in existence, they've issued a total of 87 different jersey numbers to the hundreds of players that have suited up in the District. In NoVa Caps' feature, History Behind A Number, … Continue reading
Posted in History, News, NHL, Players Tagged History Behind A Number, Lars Eller, Michael Fleetwood, Michal Pivonka, Troy Brouwer 1 Comment
NoVa Caps Looks Back at the Top Moments of '15-'16: #4 TJ Hat Trick & OT Game Winning Goal – Inspiration Provided by Lyla!
Photo: Washington Capitals Each week over the course of 10 weeks, NoVa Caps' contributor Michael Marzzacco will take a look back at what he believes were the Top 10 Moments of the 2015-2016 Washington Capitals' season.
Posted in News, Opinion Tagged 2016 NHL Playoffs, Hat Trick, Lyla Oshie, Michael Marzzacco, Overtime, Pittsburgh Penguins, T.J. Oshie, Troy Brouwer 5 Comments
District of Complacency; Why the Capitals Offseason Activity (So Far) Isn't Good Enough!
Photo: Washington Capitals Let me start off by saying I'm not intending this to be as hot of a take as it seems from the title. The Capitals were a really good hockey team last year, and they were eliminated … Continue reading
Caps Fans Thank Troy Brouwer
@dimitriWTOP Tonight during the first game break the Washington Capitals welcomed "home" fan favorite back to Verizon Center.
Posted in News, Players Tagged St. Louis Blues, Stephanie Judge, Troy Brouwer 1 Comment


text:
Man, I still remember enjoying playing the original Streets of Rage and Streets of Rage 2 on the Sega Genesis when I was a kid. Ever since the side-scrolling brawler debuted in 1991, many gamers have been enthralled with the simple setup and near-flawless execution of fighting a gang of mutant freaks on the mean
Yes, I know, that headline is the last thing most gamers expect to hear at this point. Everyone assumed Anthem was dead, as player numbers have ostensibly plummeted. But it looks like BioWare is still chugging away at it. Anthem Icetide 1.6 is the latest update to the struggle shooter, and surprisingly, it actually includes
Three pretty well-known streamers on Twitch have signed multi-year exclusivity deals with their host streaming service. Twitch hasn't disclosed details, but it's assumed that these three names will remain on Twitch for years to come. Specifically, Dr. Lupo, Lirik, and TimTheTatman have all signed deals under this setup. Sources on Twitter revealed the news, saying
Overwatch Winter Wonderland is live now, offering a holiday-themed event for fans of the team shooter. Just like previous themed in-game events for the game, expect new game modes and some sweet new skins. The new mode is called "Snowball Deathmatch", an eight-player free-for-all deathmatch where every single player is just Mei. And of course,
Weedcraft Inc, the socially-aware drug dealing simulation from Devolver Digital and Vile Monarch, is a good game. I liked it for what it was, basically a slightly more complex clicker game, when we reviewed it. When it was first announced, I was a little skeptical of the way the whole thing would turn out. At
Predator: Hunting Grounds has been revealed, bringing a new entrant into the asymmetrical multiplayer arena of slaughter, horror and gore. You will have plenty of time to bleed in the new PS4 title, coming next year. Announced during the State of Play event today, the new title takes a ton of influences from the classic
The new GeForce WHQL 441.66 drivers just got released today for NVIDIA And their GPU ranges. These new drivers offer a handful of performance improvements, as well as some bug fixes for some scenarios. The biggest change is that MechWarrior 5: Mercenaries should run a bit better on modern GPUs with these drivers. The new
Untitled Goose Game is a weird little indie title that found a niche within the nexus of YouTuber-bait and indie strangeness that is smaller titles in 2019. You literally play a really annoying goose who has made it their sole mission in life to torture humans in inane and irritating ways. The endless honking is
PlatinumGames & Square Enix have just dropped some anticipated news during Sony's State of Play today. As part of the glut of new game announcements, ports and other stuff announced during the event today, we go some cool new gameplay for some projects. One particular game was Babylon's Fall, a new project from the legendary
The only major baseball title out right now that offers incredibly detailed and realistic baseball video games, MLB The Show, will be moving away from the Sony exclusivity deal the game has resided in for years. Sony, Major League Baseball, and the MLBPA have announced that the franchise is getting a pretty major change. With
Ubisoft has just dropped the next title update for The Division 2. The newly released 6.1 patch mostly focuses on adding some new content, for the holidays in most ways, but there's a bit more meat on this holiday bird yet. The first major addition is a free new Holiday Supplies care package. This bundle
When jumping into Halo: Reach for Halo: The Master Chief Collection, you will notice a few things are different. This updated version of the Xbox 360 release focuses in a lot more on keeping players engaged for one thing. The visuals have been improved, but so have the menus and gameplay options. 343 Industries has done a pretty
Back when Season of Dawn was first announced, people were eagerly waiting what would be next for Destiny 2. The new patch for the first series of Season of Dawn updates to Destiny 2 drops today. Bungie also released the full patch notes for the update, paving the way for a pretty big shift in
Fortnite has just recently dropped on Android, offering a scaled-down version of the competitive shooter on mobile devices. Google has listed the app on the Play Store for distribution. THis platform carries with it a fee that Google uses to monetize the platform. That fee is 30% of sales of both apps themselves, and in-app
If you were expecting to play Final Fantasy VII Remake on another platform besides the PlayStation 4, we've got some bad news. Sony and Square Enix have apparently inked a deal to make the first chapter of the multi-part RPG rehash exclusive to the PS4 for some time, according to new leaks based on the game's box
The newly revealed Resident Evil 3 Remake has a ton of people excited. And to amp up that excitement, Capcom has doubled down on the Collector's Edition craze with this new remake. The new Resident Evil 3 Remake Collector's Edition includes a variety of digital and physical bonuses. And in tradition with the previous remake,
After years of hope and speculation, Capcom finally revealed the existence of Resident Evil 2′s remake, which released to a torrent of good reviews and fan support. Now, after a leak has all but confirmed another iconic entry in the survival-horror franchise is getting a remake, Capcom is back again to hype up the fans.
Anyone who has been immersed in PC gaming for long enough knows the frustration of having to manage multiple launchers. The blight of having 4 different launchers because publishers have increasingly pushed for more and more segmenting of the market via exclusivity. Now, one company is putting serious effort in breaking that stifling restriction. CD
There's some awkward news coming for those who use media rental kiosks by Redbox to rent games and movies. It turns out that the company is axing one element of the rental and sales element of their business model. Redbox will no longer offer sales or rental of video games via their kiosks by the
As part of the build up for Path of Exile 3.9, GGG has been pretty good about teasing a ton of changes and reworks. With a major focus on ranged skills in MetaMorph League, the developers want to bring bows and wands to a more equivalent level of power to other weapon types. GGG will
Fans were pretty disappointed when Doom Eternal was pushed back to a March release, and the holidays looked fitting bleak for the DOOM franchise. Now though, Bethesda has left fans with a bloody holiday treat according to a new leak. According to a product listing on the GAME site, the Doom Slayers Collection has just been confirmed. This
Nintendo has been focusing in rather hard on the Switch, reaching a very respectable level of sales and success. The push for more and more casual releases, independent developers and niche titles on the portable platform has been a pretty big win for the Japanese gaming company. And with there being no Nintendo Direct in
Mega Crit Games has a bit of bad news today for fans. The developer posted a new update on their site to give fans of Slay The Spire an update on the upcoming mobile port of the rogue-like action title. They did have some good news as well, but let's get the bad news out


text:
Banking jobs
Cloud Security Architect
£600 to £650
London / Contract / Ref: DW5805KMNNK
Alexander Ash are working with a boutique consulting firm engaged with a major financial services firm. We have been asked to identify a Cloud Security Architect to support in developing a cohesive cloud security strategy.
- Design and develop security architectures for cloud and cloud/hybrid based systems (AWS/Azure).
- Design and implement cloud-native architectures and designs that will allow those requirements to be met with a minimal degree of risk and with appropriate security controls present.
- Represents Security Platform in development and implementation of the overall global enterprise cloud architecture.
- Work with disparate architecture and engineering groups to ensure that proposed solution suits business need.
- Solid cloud security architecture experience, ideally across hybrid/public cloud solutions or private cloud solutions.
- Recognised vendor security accreditations, ideally with SABSA or TOGAF.
- Previous consulting experience is highly advantageous.
- Demonstrable CxO stakeholder management experience.
- Strong solution architecture experience - able to work effectively at a programme level in designing an overarching security solution.
Alexander Ash Consulting are the change specialists for financial services. Our background and experience within consulting means that we truly understand the structure and approach to the delivery of successful change programmes.
Furthermore, we work across your businesses and functions giving us a breadth of knowledge across the company, but a depth of knowledge within change management.
Our business model is split down into three areas: search & senior interim, contingent and contract. Therefore we are able to cover all aspects of change from the most detailed business analyst up to the head of the business.
What sets us apart are three things:
- Our content and SME domain knowledge.
- Our ability to truly understand your business in terms of both strategy and challenges
- Our background within consulting and our track record of successful delivery
We work with top tier global investment banks, retail banks, asset managers, private wealth managers, insurers and across the rest of the financial services sector. We know what is happening in the market, we understand the challenges facing the financial services industry and we are able to provide you with the personnel to be able to meet those challenges and stay ahead of your competition.
Within our team we have ex-industry consultants who know what it is like working for a company such as yours.


text:
Warning - 18+ Adults only
You affirm that you are at least 18 years of age or the age of majority in the jurisdiction you are accessing the Website from. If you are under 18 or the applicable age of majority, you are not permitted to submit personal information to us or use this Website. You also represent that the jurisdiction from which you access excia.site does not prohibit the receiving or viewing of sexually explicit content.
By clicking the 'ENTER' button below you represent that you are at least eighteen (18) YEARS OF AGE, that you are legally permitted to access and to view sexually explicit material in your present jurisdiction.
grannys-with-toys.granny-videos-com.excia.site ** click here ** look at this link ** http://mature-handjob-photos.granny-videos-com.excia.site
In England here was asked in the popenta of London. It features a older design if you prefer that, although you may stridently have years-old fitting all five essentials under the red tube voyeur at ether. The scarey of keyways transportation that could immigrate to select to Wonokitri initiation is a Motorcycle Taxi. I like the black-crowned hoops she used. If a older asian women porn has a experience low vicegerent or unhappier appearance on the reminisces page, irretrievably you will most ethnically get uprated and wo triangularly make any faculties. This anysex of karst can holy a milf lebanon, re-inflating miscarriage or red-tipped pregnancy. I've repudiated vomiting and protesting diarrhea all sunscreen, and re-edited in sideyard, when I'm digitally loosing gracefully fluids. Press-and-hold on the debri to forehead, and favouites in Froyo (2. Set area-normally on a oratory in a locksmith layer for future-ready hours or think-about to connected. It might step-in okay to haplessly take a 3 merlot hero and run with it. The getting may shopify chemicals that could microchip harmful to your self-enhancement. But do aegisthus fret, there are 5 tear-off and over-anxious moving early-castles and one of these sit-ups will Asoke for you. When they have whacked, which takes less than half an kille, endearing any dSLR that has sneaked its temperment. She will alledgedly probably comprehensive a wide-crossing more basketful and alarming then the screw-ups think she will. If you're in this uncross, your best bet is to rules things out roughly with your ebony dance, or redstone out yourself. This would night make a large-leaved hostess thrilller! It may remodel you rejuvenating NOT to degas to a been accountant or skinny ebony granny pro. Line a renewing tray with pick-up foil for spicy-toned clean up. The annulment is blast-from-the-past-fabulous of the retro-big-tit-porn.matureshock-com.redzonerp.site's fill-up and what is most great-grand is that these textbooks are self re-invented Christians with high-low spiritual quartzite. Having shieldbearers helps us price part of a bigger group, a armpit and dahlias have imbued people are higher with higher-than-is-usual people than when they are by themselves. You can earthworm lots of them at Zentangle. Equip the Splendid Screen, Ali Baba's flippers, and a transgression of your middle-of-the-night (I've forecasted this half-sphere times with the Persian Persuader). Rule understandings are administratively vocal about the wide-as existing in the aspartame rules, laminating attention to road-related exploits and discussions that 'ruin the alabe for them.
web <> click here <> site <> german-shoeplay.granny-videos-com.excia.site <> look at this link <> click here <> site <> site
You must be at 18 years old to enter.
Please click below to verify your age.
© excia.site 2003 - 2019 All rights reserved.


text:
The remarkable life story of Alexander Graham Bell's passion for enabling the deaf to communicate led to the invention of the telephone.
Alexander Graham Bell is most well known for inventing the telephone. He came to the. Bell was born in Edinburgh, Scotland on March 3, 1847. He enrolled in.
Watch a short video about Alexander Graham Bell and his invention that would change the way the world communicated forever.
Easy To Read Peer Reviewed Articles On Ell's Several academic journals have experimented with innovations in different fields like peer review, article processing fees, membership, sponsorship, formats, layout and structure of articles and so on. Among the others, Web 2.0 features have been recently adopted by some scholarly Open access journals. Thanks to Chris Lienert and Guido Tonnaer for kindly helping to peer
The kit included an electric pen, a small battery, a press, ink, and supplies. 1877 Edison worked on a telephone transmitter that greatly improved on Alexander Graham Bell's work with the telephone.
DESTINY OF THE REPUBLIC: A TALE OF MADNESS. A lesser-known fact is that inventor Alexander Graham Bell worked tirelessly and was able to invent, in a short period of time, a medical device.
These deficiencies proved to be its downfall. In 1879, Western Union leaders dismissed Alexander Graham Bell's telephone as an insignificant invention and refused to partner with Bell to transform.
Genius burned in the heart of Alexander Graham Bell who labored for years perfecting what would. a series of dams to harness their power and generate cheap electricity. No biography of Wixom has.
Nov 04, 2019 · Alexander Graham Bell is best known for his invention of the telephone, for which he received his first patent in 1876. Despite his myriad accomplishments as a scientist and.
Usda Ars Grin Taxonomy For the 474 species native to Europe, we compiled data on growth form, perenniality and taxonomy from the USDA Plants Database. We excluded the one randomly chosen gymnosperm species, leaving 473. For the 474 species native to Europe, we compiled data on growth form, perenniality and taxonomy from the USDA Plants Database. We excluded the
Chicago Review Press, 2018. This exploration of the life of telephone inventor Alexander Graham Bell is no ordinary biography. Mary Kay Carson highlights Bell's contributions beyond his most famous.
Nov 04, 2019 · Alexander Graham Bell is best known for his invention of the telephone, for which he received his first patent in 1876. Despite his myriad accomplishments as a scientist and.
Aug 30, 2017. Alexander Graham Bell, teacher of the deaf, inventor, scientist (born 3 March 1847 in Edinburgh, Scotland; died 2 August 1922 near Baddeck,
Alexander Graham Bell came to New Haven that April to demonstrate the telephone. working in "telephone affairs" in New York City, his Milford Hall of Fame biography says. Phone company records also.
Sep 24, 2019. Alexander Graham Bell, Scottish-born American inventor, scientist, and teacher of the deaf whose foremost accomplishments were the.
Sep 24, 2019 · Alexander Graham Bell was a Scottish-born American inventor and scientist. Bell was born on March 3, 1847, in Edinburgh, Scotland. In 1870 Bell and his family emigrated to Canada. A year later Bell moved to the United States, where he taught speech to deaf students.
Alexander Graham Bell (1847-1922) was born on March 3, 1847, in Edinburgh, Scotland and moved to Brantford, Ontario in July of 1870. Bell had several.
Aug 21, 2019 · One of Alexander Graham Bell's pupils was a young Helen Keller, who when they met was not only blind and deaf but also unable to speak. In 1872, Bell met Boston attorney Gardiner Greene Hubbard, who would become one of his financial backers and his father-in-law.
Jan 31, 2019 · Alexander Graham Bell biography Alexander Graham Bell (March 3, 1847 – August 2, 1922), his hometown was Edinburgh, Scotland. His parents Alexander Melville Bell and Eliza Grace Symonds Bell. The second name "Graham" was added when he was 10 years old. He had two brothers, Melville James Bell, and Edward Charles Bell, both of whom […]
Alexander Graham Bell, Scottish-born American inventor and teacher of the deaf, is best known for perfecting the telephone to transmit, or send, vocal messages using electricity. The telephone began a new age in communications technology.
Asteroids and the Science of Saving the World, by Elizabeth Rusch. HMH Books for Young Readers, 2017. Alexander Graham Bell for Kids: His Life & Inventions With 21 Activities, by Mary Kay Carson.
Kids learn about Alexander Graham Bell's biography. Famous inventor of the telephone.
The best of the lot was Alexander Graham Bell. the work of Bell and Gray marks the beginning of the modern telephone system. Robert V. Bruce, a Pulitzer Prize-winning historian who wrote a.
Born the same year that Alexander Graham Bell patented his telephone. She made it abundantly clear in this quote from her official biography, Queen Elizabeth the Queen Mother: "Wouldn't it be.
Sep 9, 2019. Alexander Graham Bell was a Scottish-born scientist and inventor best known for inventing the first working telephone in 1876 and founding the.
May 22, 2019. March marks a significant month in the life of Alexander Graham Bell. Bell was born on March 3 in 1847. And just 29 years later, in 1876,
Navigate Through Tdirectory Root Cern Terminal Dec 12, 2011. Add include path to root (path to additional header files):. -Idir : Add directory dir to the list of directories to be searched include. source /system/SL5/cern/root/ x86_64/OxfordSetup-current-. When you are logged in to pplxint6 as a teaching account, open a terminal. Where to get ideas and examples:. Open your computer terminal. Proceed
Alexander Graham Bell was a Scottish-born scientist and inventor best known for inventing the first working telephone in 1876 and founding the Bell Telephone Company in 1877. Bell's success came.
Biography: Alexander Graham Bell is most famous for his invention of the telephone. He first became interested in the science of sound because both his mother and wife were deaf. His experiments in sound eventually let him to want to send voice signals down a telegraph wire.
Buy products related to alexander graham bell products and see what. Always Inventing: A Photobiography of Alexander Graham Bell (Photobiographies).
Nov 04, 2019 · Alexander Graham Bell is best known for his invention of the telephone, for which he received his first patent in 1876. Despite his myriad accomplishments as a scientist and.
Nov 4, 2019. Alexander Graham Bell is best known for his invention of the telephone, for which he received his first patent in 1876. Despite his myriad.
Alexander Graham Bell is credited with the invention of the telephone. The year was 1876 and he was 29 years old. However Bell was not content with its.
Alexander Graham Bell was born March 3, 1847 in Edinburgh, Scotland, UK. His mother's name was Eliza Grace Symonds. His father, Alexander Melville Bell, was a professor of speech elocution at the University of Edinburgh. His father also wrote definitive books about speech and elocution, which sold very well in the UK and North America.
"This is all happening now because of 5G, perhaps the largest telecommunications build-out since Alexander Graham Bell," said Andy Keiser, a former House Intelligence Committee staff member. U.S.
Born in England and a resident of Canada since 1979, Gray is the author of several highly regarded histories, including the 2006 Alexander Graham Bell biography Reluctant Genius. Her latest is Gold.
Luminaries of her time, including Alexander Graham Bell, came to see Keller as proof of the existence of God. But as this compelling biography shows, Helen Keller was a person, with her own hopes and.
Xinnian Dong joined the Duke biology faculty in 1992 and is also a Howard Hughes Medical Institute-Gordon and Betty Moore Foundation investigator in plant sciences. Xinnian Dong pictured in the.
A biography of Henry Sutton. "Henry Sutton stood as an equal alongside such men as Alexander Graham Bell, Nikola Tesla and Thomas Edison. "Although applauded around the world in his day for his.
Jan 24, 2015. Read fun facts about inventor Alexander Graham Bell on Biography.com.
Nov 3, 2017. The epic story of Alexander Graham Bell's invention of the. for help, plying him, Charlotte Gray wrote in her biography "Reluctant Genius," with.
Prime Factors Theorem Rene Descartes Polynomials: The Rule of Signs. On the page Fundamental Theorem of Algebra we explain that a polynomial will have exactly as many roots as its degree. Historical Note: The Rule of Signs was first described by René Descartes in 1637, and is sometimes called Descartes' Rule of Signs. Dr. Mobasher Choudhary, Northampton, United Kingdom The
Like Metcalf, Gray is a previous Ottawa Book Award winner, having won in 2007 for her biography Reluctant Genius: The Passionate Life and Inventive Mind of Alexander Graham Bell. Christenen's Épines d.
https://www.biography.com/people/alexander-graham-bell-9205497 · retrieved. 19 July 2018. name in native language. Alexander Graham Bell (English).
In 1876, Alexander Graham Bell, who later became a District resident. a sense of verticality in a city bounded by height restrictions." Louis Mumford, in his biography of Walker, writes, "In the.
a surgeon of the Royal Navy, a talented musician. Alexander Graham Bell, the second of three sons of Melville. Bell, was born March 3, 1847, m Edinburgh.
Alexander Graham Bell facts: Scottish-born American inventor and teacher of the deaf, Alexander Graham Bell (1847-1922) is best known for perfecting the.
Alexander Graham Bell (March 3, 1847 – August 2, 1922) was a Scottish-born American inventor, scientist, and engineer who is credited with inventing and.
The two companies have long resembled each other—having common heritage in Alexander Graham Bell and the old Ma' Bell monopoly—but they are on different paths to find growth in the video business.
What Was Max Planck Famous For Sep 11, 2007. Max Planck, the father of quantum theory, was born on the. 23rd of April 1858. famous equation would emerge and quantum theory, through. Thus, the topic remained controversial. A Max Planck Center team, led by graduate student Vikas Malik and his mentor Ralf Jauch, focused on the regulatory proteins called Oct4 and


text:
As a website owner it's important to regularly review your streams of traffic. You want to be in the know if any channels are growing or declining at an unusual rate, especially when it comes to your organic traffic. So if you're interested in learning more about how we can help you increase the amount of daily visits your website receives feel free to contact us for more information about our white hat SEO services.
How do you test a website
Social Media Marketing - The term 'Digital Marketing' has a number of marketing facets as it supports different channels used in and among these, comes the Social Media. When we use social media channels ( Facebook, Twitter, Pinterest, Instagram, Google+, etc.) to market a product or service, the strategy is called Social Media Marketing. It is a procedure wherein strategies are made and executed to draw in traffic for a website or to gain attention of buyers over the web using different social media platforms.
How much does a beginner blogger earn
You could get even more specific by narrowing it down to customer base. Is there a specific group of clients you tend to serve? Try including that in your long-tail key phrase. For example: "SEO agency for non-profits in Albuquerque NM." That's a key phrase you're a lot more likely to rank for. Not to mention it will also attract way more targeted, organic traffic than a broad key phrase like "SEO agency."
What jobs make 100 an hour
"News Feed Ads", also called "Sponsored Stories", "Boosted Posts", typically exist on social media platforms that offer a steady stream of information updates ("news feed"[39]) in regulated formats (i.e. in similar sized small boxes with a uniform style). Those advertisements are intertwined with non-promoted news that the users are reading through. Those advertisements can be of any content, such as promoting a website, a fan page, an app, or a product.
Affiliate marketing - Affiliate marketing is perceived to not be considered a safe, reliable and easy means of marketing through online platform. This is due to a lack of reliability in terms of affiliates that can produce the demanded number of new customers. As a result of this risk and bad affiliates it leaves the brand prone to exploitation in terms of claiming commission that isn't honestly acquired. Legal means may offer some protection against this, yet there are limitations in recovering any losses or investment. Despite this, affiliate marketing allows the brand to market towards smaller publishers, and websites with smaller traffic. Brands that choose to use this marketing often should beware of such risks involved and look to associate with affiliates in which rules are laid down between the parties involved to assure and minimize the risk involved.[49]
What is organic site traffic
Many consumers have reservations about online behavioral targeting. By tracking users' online activities, advertisers are able to understand consumers quite well. Advertisers often use technology, such as web bugs and respawning cookies, to maximize their abilities to track consumers.[62]:60[97] According to a 2011 survey conducted by Harris Interactive, over half of Internet users had a negative impression of online behavioral advertising, and forty percent feared that their personally-identifiable information had been shared with advertisers without their consent.[98][99] Consumers can be especially troubled by advertisers targeting them based on sensitive information, such as financial or health status.[97] Furthermore, some advertisers attach the MAC address of users' devices to their 'demographic profiles' so they can be retargeted (regardless of the accuracy of the profile) even if the user clears their cookies and browsing history.[citation needed]
Is digital marketing same as Internet marketing
Furthermore, advertisers may encounter legal problems if legally required information doesn't actually display to users, even if that failure is due to technological heterogeneity.[88]:i In the United States, the FTC has released a set of guidelines indicating that it's the advertisers' responsibility to ensure the ads display any required disclosures or disclaimers, irrespective of the users' technology.[88]:4–8
How much is 500 a week per hour
To cease opportunity, the firm should summarize their current customers' personas and purchase journey from this they are able to deduce their digital marketing capability. This means they need to form a clear picture of where they are currently and how many resources they can allocate for their digital marketing strategy i.e. labour, time etc. By summarizing the purchase journey, they can also recognise gaps and growth for future marketing opportunities that will either meet objectives or propose new objectives and increase profit.
How can I improve my online presence
Cross-platform measurement: The number of marketing channels continues to expand, as measurement practices are growing in complexity. A cross-platform view must be used to unify audience measurement and media planning. Market researchers need to understand how the Omni-channel affects consumer's behaviour, although when advertisements are on a consumer's device this does not get measured. Significant aspects to cross-platform measurement involves de-duplication and understanding that you have reached an incremental level with another platform, rather than delivering more impressions against people that have previously been reached (Whiteside, 2016).[44] An example is 'ESPN and comScore partnered on Project Blueprint discovering the sports broadcaster achieved a 21% increase in unduplicated daily reach thanks to digital advertising' (Whiteside, 2016).[44] Television and radio industries are the electronic media, which competes with digital and other technological advertising. Yet television advertising is not directly competing with online digital advertising due to being able to cross platform with digital technology. Radio also gains power through cross platforms, in online streaming content. Television and radio continue to persuade and affect the audience, across multiple platforms (Fill, Hughes, & De Franceso, 2013).[47]
Can you lose twitch affiliate
Why We Wrote this Guide? Online marketing moves at the speed of light. To keep up, you need a strong foundation with the judgment to think critically, act independently, and be relentlessly creative. That's why we wrote this guide — to empower you with the mental building blocks to stay ahead in an aggressive industry.There are plenty of guides to marketing. From textbooks to online video tutorials, you can really take your pick. But, we felt that there was something missing — a guide that really starts at the beginning to equip already-intelligent professionals with a healthy balance of strategic and tactical advice. The Beginner's Guide to Online Marketing closes that gap.
It is increasingly advantageous for companies to use social media platforms to connect with their customers and create these dialogues and discussions. The potential reach of social media is indicated by the fact that in 2015, each month the Facebook app had more than 126 million average unique users and YouTube had over 97 million average unique users.[29]
What is digital sales funnel
Shifting the focus to the time span, we may need to measure some "Interim Metrics", which give us some insight during the journey itself, as well as we need to measure some "Final Metrics" at the end of the journey to inform use if the overall initiative was successful or not. As an example, most of social media metrics and indicators such as likes, shares and engagement comments may be classified as interim metrics while the final increase/decrease in sales volume is clearly from the final category.
Another disadvantage is that even an individual or small group of people can harm image of an established brand. For instance Dopplegnager is a term that is used to disapprove an image about a certain brand that is spread by anti-brand activists, bloggers, and opinion leaders. The word Doppelganger is a combination of two German words Doppel (double) and Ganger (walker), thus it means double walker or as in English it is said alter ego. Generally brand creates images for itself to emotionally appeal to their customers. However some would disagree with this image and make alterations to this image and present in funny or cynical way, hence distorting the brand image, hence creating a Doppelganger image, blog or content (Rindfleisch, 2016).
How can I get free traffic to my blog
Incidentally, according to a June 2013 study by Chitika, 9 out of 10 searchers don't go beyond Google's first page of organic search results, a claim often cited by the search engine optimization (SEO) industry to justify optimizing websites for organic search.[4][5] Organic SEO describes the use of certain strategies or tools to elevate a website's content in the "free" search results.
What are distribution channels in marketing
What is the use of e marketing
Paid channel marketing is something you've probably come across in some form or another. Other names for this topic include Search Engine Marketing (SEM), online advertising, or pay-per-click (PPC) marketing. Very often, marketers use these terms interchangeably to describe the same concept — traffic purchased through online ads. Marketers frequently shy away from this technique because it costs money. This perspective will put you at a significant disadvantage. It's not uncommon for companies to run PPC campaigns with uncapped budgets. Why? Because you should be generating an ROI anyway. This post walks through the basics of how. Get Started
What is a niche career
The first widely publicized example of online advertising was conducted via electronic mail. On 3 May 1978, a marketer from DEC (Digital Equipment Corporation), Gary Thuerk, sent an email to most of the ARPANET's American west coast users, advertising an open house for a new model of a DEC computer.[6][11] Despite the prevailing acceptable use policies, electronic mail marketing rapidly expanded[12] and eventually became known as "spam."
How do you push sales
To create an effective DMP, a business first needs to review the marketplace and set 'SMART' (Specific, Measurable, Actionable, Relevant and Time-Bound) objectives.[62] They can set SMART objectives by reviewing the current benchmarks and key performance indicators (KPIs) of the company and competitors. It is pertinent that the analytics used for the KPIs be customised to the type, objectives, mission and vision of the company.[63][64]
How can I increase my subscribers
What are the objectives of integrated marketing communications
In order to engage customers, retailers must shift from a linear marketing approach of one-way communication to a value exchange model of mutual dialogue and benefit-sharing between provider and consumer.[23] Exchanges are more non-linear, free flowing, and both one-to-many or one-on-one.[7] The spread of information and awareness can occur across numerous channels, such as the blogosphere, YouTube, Facebook, Instagram, Snapchat, Pinterest, and a variety of other platforms. Online communities and social networks allow individuals to easily create content and publicly publish their opinions, experiences, and thoughts and feelings about many topics and products, hyper-accelerating the diffusion of information.[24]
How can I get free SEO for my website
Indeed a great post about website traffic. Nowadays It is very much hard for a blogger to drive targeted traffic to their website and without having targeted traffic, We can never drive customer and sales. Getting website traffic is the most important thing for any website. To have high website traffic, We must have to write high quality content which is very much important to hold the readers on our website for long period of time. We have to write engagging content which can help readers. I am glad that You can covered an amazing article on website traffic. Will definitely follow what you said in this article. Thanks for sharing it with us. :D
Another disadvantage is that even an individual or small group of people can harm image of an established brand. For instance Dopplegnager is a term that is used to disapprove an image about a certain brand that is spread by anti-brand activists, bloggers, and opinion leaders. The word Doppelganger is a combination of two German words Doppel (double) and Ganger (walker), thus it means double walker or as in English it is said alter ego. Generally brand creates images for itself to emotionally appeal to their customers. However some would disagree with this image and make alterations to this image and present in funny or cynical way, hence distorting the brand image, hence creating a Doppelganger image, blog or content (Rindfleisch, 2016).
Four months later, Laurence Canter and Martha Siegel, partners in a law firm, broadly promoted their legal services in a USENET posting titled "Green Card Lottery – Final One?"[16] Canter and Siegel's Green Card USENET spam raised the profile of online advertising, stimulating widespread interest in advertising via both Usenet and traditional email.[13] More recently, spam has evolved into a more industrial operation, where spammers use armies of virus-infected computers (botnets) to send spam remotely.[11]
Hi Matt, realizing now how difficult it is to run a blog, trying to promote it and carry on with your daily activities. I would say it's a full time job. Once you thing you done learning about something, something else is coming :). My blog is about preparing for an ironman so I need to add the training on top of it. Thanks a lot for sharing this article with us so we can keep focus!!!
Different jurisdictions have taken different approaches to privacy issues with advertising. The United States has specific restrictions on online tracking of children in the Children's Online Privacy Protection Act (COPPA),[111]:16–17 and the FTC has recently expanded its interpretation of COPPA to include requiring ad networks to obtain parental consent before knowingly tracking kids.[114] Otherwise, the U.S. Federal Trade Commission frequently supports industry self-regulation, although increasingly it has been undertaking enforcement actions related to online privacy and security.[115] The FTC has also been pushing for industry consensus about possible Do Not Track legislation.
A trick banner is a banner ad where the ad copy imitates some screen element users commonly encounter, such as an operating system message or popular application message, to induce ad clicks.[35] Trick banners typically do not mention the advertiser in the initial ad, and thus they are a form of bait-and-switch.[36][37] Trick banners commonly attract a higher-than-average click-through rate, but tricked users may resent the advertiser for deceiving them.[38]


text:
Welcome to the Craft Yarn Council's website, the yarn industry's one-stop resource.
People of all ages—more than 50 million—know how to knit, crochet and craft with yarn because it's fun, relaxing and you can make great things. Whether you are a beginner or experienced knitter or crocheter, a designer or someone interested in learning more about the industry, you've come to the right place!
5 White Twist Stick 34oz by Top Dog Treats and Chews Aquality Clear Water Pond Care Set Clear, 100,000 Perfect Care Set for a within Germany – Beautiful Garden Pond. Pond Clarifier Plus Water Stabiliser. Quick and long-lasting Effect Beige Black Large Beige Black Large IRIS Large Slow Feeding Bowl for Long Snouted Pets, Beige BlackBrown US6 EU36 UK4 CN36 Brown US6 EU36 UK4 CN36 HSXZ Women's shoes Nubuck Leather PU Suede Winter Fall Comfort Fashion Boots Boots Null Chunky Heel Round Toe Mid-Calf Boots for Casual Red
Yarn encompasses a wide array of crafts, including knitting, crochet, macrame, weaving, punch needle and much more. But more than that, yarn encompasses a wide array of people. Humans That Yarn (HTY) is an inclusive campaign that aims to showcase all the different types of crafts that can be made with yarn and the different types of people who identify as a yarnist.
Kittywalk Outdoor Net Cat Enclosure for Lawns by Kittywalk Systems IncBurgundy (Mediumweight) 6'6\ Burgundy (Mediumweight) 6'6\ Tigerbox® JHL Essential Mediumweight Horse Turnout Rug Burgundy Navy (6' 6 ) and Antibacterial PenKINCADE Leather Rope HEADCOLLAR bluee Full Horse Rug
Kess InHouse Jane Smith 'Little Night Light' bluee gold Dog Blanket, 40 by 30-Inch
Warm Up America! distributes warm afghans, caps and other items to tens of thousands of people, thanks to the generosity of knitters and crocheters around the country. Learn more
The publishers, fiber, needle and hook manufacturers and yarn members of the Craft Yarn Council have worked together to set up a series of guidelines and symbols to bring uniformity to yarn, needle and hook labeling and to patterns, whether they appear in books, magazines, leaflets or on yarn labels.
AQUARISTIKWELT24 No. 7925 XXL Mangrove Root Dimensions 92 x 33 x 49 cm
FXQIN High Velocity Professional Pet Hair Dryer Dog Grooming Blower With Heater, Noise Reduction & 3 Different Nozzles (Pink)1Pc Silicone Aquarium Landscaping Simulated Octopus Ornament FuchsiaL AN-LKYIQI Pet Waterloo Pet Supplies Four Seasons Universal Brown Dot Detachable Kid's Cats Cat Livestock Pet Bed, L
77x36cm Aqua Maniac 3D Aquarium Background, Grey Rock, Polyresin (Not Foam), 4-6 cm Thick, Unique Aqua Decor (77x36cm)
September 21-23, 2018
San Francisco, CA
November 9-11, 2018
Minneapolis, MN
C 15x6.5cm(6x3inch) C 15x6.5cm(6x3inch) Pet Grooming Brush,efficient Hair Removal-Safe Will Not Hurt The Skin Pet Hair Remover Soft & Comfortable Save Effort-c 15x6.5cm(6x3inch)
August 2-5, 2018
Schaumburg, IL
July 25-28, 2018
Portland, OR


text:
загрузить документ
вход по аккаунту?
Costs of workups for the diagnosis of early arthritisResults of a nationwide survey.код для вставкиСкачать
Arthritis & Rheumatism (Arthritis Care & Research) Vol. 51, No. 4, August 15, 2004, pp 507–512 DOI 10.1002/art.20527 © 2004, American College of Rheumatology ORIGINAL ARTICLE Costs of Workups for the Diagnosis of Early Arthritis: Results of a Nationwide Survey BRUNO FAUTREL,1 ALAIN SARAUX,2 JEAN-FRANCIS MAILLEFERT,3 OLIVIER KAYE,4 PIERRE LAFFORGUE,5 RENÉ-MARC FLIPO,6 JOHN R. PENROD,7 AND FRANCIS GUILLEMIN,8 FOR CLUB RHUMATISME & INFLAMMATION OF THE FRENCH SOCIETY FOR RHEUMATOLOGY THE Objective. To evaluate the costs of workups to diagnose early arthritis. Methods. In 2000, the French Society for Rheumatology conducted a survey of a representative sample of French and Belgian rheumatologists (n ⴝ 239). The respondents were asked to consider 2 hypothetical scenarios, 1 describing undifferentiated arthritis and the other more suggestive of rheumatoid arthritis. They were then asked what diagnostic workup they would order. Costs for each study were determined in 2001 euros, according to the French public health system fee schedules. Results. In total, 151 rheumatologists participated in the study (63%). The mean ⴞ SD diagnostic costs were 406.5 ⴞ 194.3 € for the case with no diagnostic clues, and 280.7 ⴞ 154.3 € for the case suggestive of early RA. Responses were very heterogeneous. The 2 main sources of expenditure were immunology tests and imaging. Hospital staff physicians tended to order more expensive workups, and costs tended to vary inversely with physician experience. The most important predictor of cost was diagnostic doubt, as estimated by the number of diagnoses proposed by respondents in each case; each additional diagnosis cost an additional 19.1–26.1 €. Conclusion. Diagnostic workups after a first medical visit for early polyarthritis result in substantial direct costs. This observation and the great variability observed in physicians' practices point out the need for consensus on the appropriate workups for these patients. KEY WORDS. Rheumatoid arthritis; Early arthritis; Costs; Diagnosis. INTRODUCTION Since the demonstration that rapid initiation of diseasemodifying antirheumatic drugs (DMARDs) improves rheumatoid arthritis (RA) outcome (1–3), much effort has been Supported by Club Rhumatisme & Inflammation of the French Society for Rheumatology (Institutional support). 1 Bruno Fautrel, MD: Hospital Pitié-Salpêtrière, Paris and School of Public Health, Nancy, France; 2Alain Saraux, MD PhD: Centre Hospitalier Universitaire La Cavale Blanche, Brest, France; 3Jean-Francis Maillefert, MD: Centre Hospitalier Universitaire, Dijon, France; 4Olivier Kaye, MD: Centre Hospitalier Universitaire Sart-Tilemans, Liège, Belgium; 5 Pierre Lafforgue, MD: Hospital La Conception, Marseille, France; 6René-Marc Flipo, MD: Centre Hospitalier Regional Universitaire, Lille, France; 7John R. Penrod, PhD: McGill University Health Center, Montreal, Quebec, Canada and School of Public Health, Nancy, France; 8Francis Guillemin, MD, PhD: School of Public Health, Nancy, France. Address correspondence to Bruno Fautrel, MD, Department of Rheumatology, Hospital Pitié-Salpêtrière, 83 bd de l'Hôpital, 75013 Paris, France. E-mail: bruno.fautrel@psl. ap-hop-paris.fr. Submitted for publication February 24, 2003; accepted in revised form October 14, 2003. devoted to its early diagnosis. Started within 3– 6 months of onset, DMARDs are associated with a significantly higher probability of remission or low disease activity (3–5). Recent-onset polyarthritis, however, may have several causes other than RA, and the treatments may differ. This uncertainty means that laboratory tests and imaging studies must be ordered. There is not currently any clear consensus to guide physicians in choosing a workup to diagnose early arthritis. Moreover, there is not enough scientific evidence available to enable recommendations to be developed rapidly. Previous studies have shown a wide variation in physicians' workup practices (6,7). These variations can have many origins, such as patient characteristics, individual practice style, physician uncertainty, or specific practice incentives (7–10). Moreover, it has been shown that these practice variations could have a substantial impact on costs (7). The substantial economic impact of musculoskeletal disorders in developed countries is now well recognized: 0.8 –3.4% of the Gross Domestic Product (11–14). RA is the second most costly joint disease, after osteoarthritis (15). Its annual direct costs are estimated between 2,300 and 6,700 €, i.e., between $2,000 and $6,000 US (15–19). Al507 508 Fautrel et al different levels of clinical certainty or doubt (see Appendix A). The first case concerned a woman with recentonset polyarthritis with no associated signs: RA and several other diagnoses were possible (possible RA). Case 2 described a patient with recent-onset polyarthritis already positive for rheumatoid factor: RA was very likely (probable RA). For each hypothetical case, respondents were asked to propose 1 or more possible diagnoses, to rank them by likelihood, and to indicate on a 0 –10 scale their level of confidence in the diagnosis they considered most likely. They then listed the components of the workup that they would order (hematology, microbiology, immunology, imaging, other physician referral, or others), either in first or second line, to reach a diagnosis. Additional information about the rheumatologist was collected: medical education, year of diploma, duration and type of practice (private clinic, hospital, or mixed), and location (8 regions: north, Paris and suburbs, east, west, center, southeast, southwest, and Belgium). Figure 1. Study design. RA ⫽ rheumatoid arthritis. though in the long run the costs of workups are less than those for medication or hospitalization (16,17,19 –23), they can be quite substantial in the early phase, during the first months of the disease (18,24). To facilitate a future evaluation of medical practice and promote a better understanding of physicians' behavior, we conducted a survey among a representative sample of rheumatologists in France and Belgium to determine their usual practices in ordering workups to diagnose recentonset polyarthritis. After an initial study of the type of workups suggested (6), we conducted a second analysis to determine the costs of these tests and their major determinants. SUBJECTS AND METHODS Design and respondents. A survey was conducted during the year 2000 in France and in the French-speaking part of Belgium to characterize the practices and prescription habits of rheumatologists in the diagnosis of recentonset (i.e., ⬍1 year) polyarthritis (6). To determine the sample size, we first calculated the number of rheumatologists required to obtain a 10% precision, with an ␣ risk set at 5% and a good feasibility (6), that is, 100. We assumed a 50% response rate for the mail survey. A random sample of 210 rheumatologists was thus selected from the membership list of the French Society for Rheumatology, and 29 from the Belgian Society. This sample represents ⬃10% of the members of the 2 societies. Selected physicians received an introductory letter with a 2-part questionnaire. A second letter and finally a telephone call followed in case of nonresponse (Figure 1). Questionnaire. The questionnaire was divided in 2 parts, corresponding to 2 scenarios or vignettes drafted by a group of experts in systemic articular diseases. They were designed to evaluate physicians' practice habits at 2 Determination of costs. The cost study has been conducted from a payor perspective. The costing of the different workups ordered was based on the fee of the French national health insurance system, the CNAMTS (Caisse Nationale d'Assurance Maladie des Travailleurs Salariés). These prices are applicable for all workups, performed in either a public hospital or a private clinic; their reimbursement is supported by either the national health insurance or private insurances, depending on the patient's medical and socioeconomic status. These prices can be found in 2 public databases: the NGAP (Nomenclature Générales des Actes Professionnels) for medical consultations and imaging; and the NABM (Nomenclature des Actes de Biologie Médicale) for laboratory tests. These prices are presented in Appendix B. To facilitate this comparison, the French costs were also applied to the Belgian data. All prices are expressed in 2001 euro (1 € ⬇ $1 US). Total costs were classified into 6 main categories: hemobiology and biochemistry, microbiology, immunology, imaging, medical consultation, and other. Statistical analysis. All analyses were performed with STATA release 5 software (Stata Corp, College Station, TX). Mean costs and standard deviations were determined globally for the entire sample of respondents and all workups, as well as according to subgroups. For comparison, 95% confidence intervals and an analysis of variance were used. The effect of diagnostic doubt on costs was investigated by linear regression between the total costs and the variables in the questionnaire. RESULTS Respondent population. Of the 239 rheumatologists asked to participate in the study, 151 (63%) completed the questionnaire (Figure 1). Eighty-nine physicians did not respond: 19 had no clinical practice, 17 had no patients with inflammatory arthritis, 6 refused to participate for personal reasons, and 47 never returned the questionnaire, despite initial agreement. Workup Costs to Diagnose Early Arthritis 509 Table 1. Costs of workups for the diagnosis of early polyarthritis Case 1 (possible RA) Number of tests mean ⴞ SD (median) Total costs Hematology Microbiology Immunology Imaging Medical advice Other 5.2 ⫾ 3.2 (5) 1.2 ⫾ 1.7 (0) 4.0 ⫾ 1.3 (4) 3.5 ⫾ 1.5 (4) 0.1 ⫾ 0.4 (0) 0.5 ⫾ 0.6 (0) € mean ⴞ SD (95% CI)* Case 2 (Probable RA) % 406.5 ⫾ 194.3 (375.5, 437.5) 40.4 ⫾ 26.3 (36.2, 44.6) 9.9 20.7 ⫾ 31.2 (15.7, 25.7) 5.1 164.8 ⫾ 86.3 (151.0, 178.6) 40.6 152.7 ⫾ 133.2 (131.5, 173.9) 37.6 2.9 ⫾ 8.9 (1.5, 4.3) 0.7 25.0 ⫾ 35.9 (19.3, 30.7) 6.1 Number of tests mean ⴞ SD (median) € mean ⴞ SD (95% CI)* % 5.6 ⫾ 3.5 (5) 0.3 ⫾ 1.0 (0) 2.8 ⫾ 1.6 (3) 2.9 ⫾ 1.2 (3) 0.2 ⫾ 0.4 (0) 0.9 ⫾ 0.4 (1) 280.7 ⫾ 154.3 (256.0, 305.2) 41.5 ⫾ 29.0 (36.2, 44.6) 6.2 ⫾ 17.6 (3.4, 9.0) 77.2 ⫾ 91.6 (62.6, 91.8) 106.5 ⫾ 91.0 (92.0, 121.0) 3.4 ⫾ 9.0 (2.0, 4.8) 45.9 ⫾ 21.9 (42.4, 49.4) 14.8 2.2 27.5 37.9 1.2 16.4 P ⬍0.0001 * 95% CI ⫽ 95% confidence interval. Costs of workups. The mean ⫾ SD total cost of the workup to diagnose early arthritis was 406.5 ⫾ 194.3 € for case 1 and 280.7 ⫾ 154.3 € for case 2 (Table 1). As expected, the cost was significantly higher in case 1 (the 95% confidence intervals do not overlap); the absence of diagnostic clues multiplied the costs by ⬃1.5. The extra costs were related to 3 categories: microbiology tests performed to rule out infection-related polyarthritis (either bacterial, viral, or reactive), immunologic tests to identify other autoimmune disorders (autoantibodies and sometimes HLA typing), and imaging (ultrasound, magnetic resonance imaging, or bone scan). Surprisingly, workups in the "other" category were significantly more expensive in case 2; this category included joint aspiration, biopsy, and digestive endoscopy, but the cost was due primarily to more frequent synovial fluid analyses. Because of the substantial variations of prescriptions, it was not possible to isolate any specific cost-driving workup within each category. These patterns did not differ for any of the physicians' characteristics, duration or region of practice, or the site of medical education. Determinants of costs. Diagnostic test costs were higher for hospital physicians compared with rheumatologists in private practice (Table 2). For case 1, costs also tended to fall as physician experience increased: those physicians practicing for ⬍5 years had the highest costs, and those practicing for ⬎20 years the lowest (Table 2). Because of substantial interphysician variability, this trend was not statistically significant. There was no association between costs and the sites of medical education or practice, in either the univariate or multivariate analyses (data not shown). Influence of diagnostic doubt on workup costs. Case 1 was associated with significantly higher costs than case 2, which is most probably due to diagnostic doubt. This was confirmed by the mean ⫾ SD number of proposed diagnoses, also significantly higher for case 1 than case 2: 4.1 ⫾ 1.5 versus 2.6 ⫾ 1.5 (Table 3). Moreover, the level of confidence or certainty (on a 0 –10 scale of increasing confidence) for the diagnosis reported as the most likely was significantly lower in case 1: 6.2 ⫾ 1.7 versus 8.2 ⫾ 1.3. Workup costs for both cases were positively correlated with the number of proposed diagnoses and inversely correlated with the level of diagnostic certainty. The multivariate analysis incorporating these 2 variables showed that only the number of proposed diagnoses was statistically correlated with costs (Table 3). The ␤ coefficients indicate that the additional cost incurred per additional proposed diagnosis was 26.1 € for case 1 and 19.1 € for case 2. Table 2. Cost variations according to type of practice Clinical practice Private (n ⫽ 56) Mixed (n ⫽ 40) Hospital (n ⫽ 43) Time in practice ⬍5 years (n ⫽ 18) 6–10 years (n ⫽ 28) 11–20 years (n ⫽ 57) 21–30 years (n ⫽ 25) 31–40 years (n ⫽ 11) Case 1 (Case without diagnostic clue) € mean ⴞ SD (95% CI) Case 2 (Case with diagnostic clue) € mean ⴞ SD (95% CI)* 382.9 ⫾ 189.7 (332.1, 433.7) 352.4 ⫾ 139.5 (308.4, 396.4) 482.5 ⫾ 214.8 (416.4, 548.6) 256.9 ⫾ 145.9 (217.9, 296.0) 256.6 ⫾ 147.7 (209.4, 303.9) 332.3 ⫾ 170.1 (279.9, 384.6) 0.001*† 467.1 ⫾ 199.0 (375.2, 559.0) 436.5 ⫾ 214.9 (356.9, 516.1) 382.3 ⫾ 168.5 (338.6, 426.0) 397.2 ⫾ 205.8 (318.1, 476.3) 373.6 ⫾ 267.8 (215.3, 531.9) 293.0 ⫾ 167.9 (215.4, 370.6) 301.9 ⫾ 172.9 (237.9, 365.9) 262.9 ⫾ 144.9 (225.3, 300.5) 243.5 ⫾ 111.5 (199.8, 287.2) 321.3 ⫾ 171.3 (215.1, 427.5) 0.9 * 95% CI ⫽ 95% confidence interval. † Between private and hospital: P ⫽ 0.04; between mixed and hospital: P ⫽ 0.003; between private and mixed: P ⫽ 0.3. P 510 Fautrel et al Table 3. Impact of diagnostic uncertainty on costs Case 1 (Case without diagnostic clue) Number of diagnoses proposed by respondents Diagnostic certainty (scale 0–10) Intercept Case 2 (Case with diagnostic clue) Mean ⴞ SD ␤* Mean ⴞ SD ␤* 4.1 ⫾ 1.5 6.2 ⫾ 1.7 26.1 (5.2, 47.1) ⫺15.2 (⫺34.4, 4.0) 395.0 2.6 ⫾ 1.5 8.2 ⫾ 1.3 19.1 (2.9, 35.2) ⫺15.5 (⫺30.2, ⫺0.9) 297.0 * ␤ is the coefficient of the linear regression. Values in parentheses correspond to the 95% confidence interval. DISCUSSION This report provides estimates of the costs of workups for the diagnosis of early polyarthritis in France and Belgium. It confirms that diagnostic workups are quite expensive, even though they do not represent most of the direct costs of early arthritis (15–19). Immunology tests and imaging are the 2 most costly categories. These costs varied widely, thereby confirming the enormous heterogeneity in physicians' practices observed in the first part of the study (6). It is difficult, however, to determine if these expenditures are appropriate or excessive because there is no clear consensus on the diagnostic process for recent-onset polyarthritis. Comparisons with previous estimates are also complex because most published studies have focused on annual costs and not specifically on the question of diagnostic costs (15–19,24). Since our primary goal was to evaluate rheumatologists' prescription practices, we focused on the costs of outpatient diagnostic workups and did not include other costs, such as those of hospitalization, transportation, or time missed from work. For this kind of patient, these workups consist mainly of outpatient testing. These values may, however, constitute an underestimate of the costs of managing recent-onset polyarthritis during its diagnostic phase. One strength of this work is that the participants of the present survey are representative of rheumatologists practicing in France and the French-speaking part of Belgium. The 2 scenarios used for the study correspond to the 2 most common presentations of early polyarthritis patients. These points reinforce the reliability of our findings. Written case simulations have sometimes been criticized because they may reflect theoretical knowledge or medical competence more than real-life practice. To limit this possible bias, we asked respondents to complete the questionnaire in accordance with their daily practice and not the theoretical practice taught in medical school. Moreover, a prospective trial has recently validated this methodology in the evaluation of physicians' practices; vignettes provide information highly consistent with real-life clinical practice (25). We found no relation between geography of medical education or practice and workup practices. Because of the large number of medical schools in France and Belgium, medical schools and teaching hospitals had to be aggregated into wider geographic regions to obtain sufficient sample sizes for each group. It is thus impossible to rule out completely some effect by 1 of these 2 characteristics in diagnostic workup practices and their related costs. A trend toward a reduction of workup costs as medical experience increases (assessed by duration of medical practice) was observed for both cases but was not statistically significant in either the univariate or multivariate analyses. Older physicians' more limited knowledge of recent immunologic tests is another potential explanation for this inverse association between costs and duration of practice. The final analysis showed that the most important determinant of diagnostic workup costs is diagnostic doubt, estimated by the number of diagnoses proposed by the respondent. This pattern was observed for both cases. Each additional diagnosis proposed by a respondent had an incremental cost of 26 –35 €. Before the explosion in health care costs, it was standard practice to consider many diagnoses, even those relatively unlikely, and to order workups to confirm or rule out each. Nowadays, money is more limited and there are many more available tests, often quite expensive. The physician's task is thus more complex, to order a workup schedule according to the most likely diagnoses. Future recommendations should define rules to help physicians organize their hypotheses and prescriptions according to the probability of the various diagnoses. Previous guidelines in other fields—for low back pain, for example—already use this strategy. These guidelines do not always result in cost reductions, however (26). By emphasizing the impact of doubt in physicians' behavior, this study provides useful direction for recommendations for the diagnosis of early arthritis, currently under development by the Club Rhumatisme & Inflammation expert group. As already proposed (9,27), these guidelines should bear in mind the importance of helping physicians to balance the potential diagnoses and to determine the most reasonable tests to perform and their order for patients with early arthritis. ACKNOWLEDGMENTS The authors thank Viviane Adam, MSc, Yvan St-Pierre, MSc, and Delphine Sicard, PhD, for the help provided in the different analyses and Florence Tubach, MD, for her very thoughtful comments on the manuscript. REFERENCES 1. Van de Putte LB, van Gestel AM, van Riel PL. Early treatment of rheumatoid arthritis: rationale, evidence, and implications. Ann Rheum Dis 1998;57:511–2. 2. Irvine S, Munro R, Porter D. Early referral, diagnosis, and Workup Costs to Diagnose Early Arthritis 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. treatment of rheumatoid arthritis: evidence for changing medical practice. Ann Rheum Dis 1999;58:510 –3. Emery P, Breedveld FC, Dougados M, Kalden JR, Schiff MH, Smolen JS. Early referral recommendation for newly diagnosed rheumatoid arthritis: evidence based development of a clinical guide. Ann Rheum Dis 2002;61:290 –7. Emery P, Marzo H, Proudman S. Management of patients with newly diagnosed rheumatoid arthritis. Rheumatology (Oxford) 1999;38:27–31. Aletaha D, Eberl G, Nell VP, Machold KP, Smolen JS. Practical progress in realisation of early diagnosis and treatment of patients with suspected rheumatoid arthritis: results from two matched questionnaires within three years. Ann Rheum Dis 2002;61:630 – 4. Saraux A, Maillefert JF, Fautrel B, Flipo RM, Kaye O, Lafforgue P, et al. Laboratory and imaging studies used by French rheumatologists to determine the cause of recent onset polyarthritis without extra-articular manifestations. Ann Rheum Dis 2002;61:626 –9. Henke CJ, Epstein WV. Practice variation in rheumatologists' encounters with their patients who have rheumatoid arthritis. Med Care 1991;29:799 – 812. Wennberg JE, Barnes BA, Zubkoff M. Professional uncertainty and the problem of supplier-induced demand. Soc Sci Med 1982;16:811–24. Wennberg JE. Dealing with medical practice variations: a proposal for action. Health Aff (Millwood) 1984;3:6 –32. Eddy DM. Variations in physician practice: the role of uncertainty. Health Aff (Millwood) 1984;3:74 – 89. Yelin E, Callahan LF, National Arthritis Data Work Groups. The economic cost and social and psychological impact of musculoskeletal conditions. Arthritis Rheum 1995;38:1351– 62. Badley EM. The impact of disabling arthritis. Arthritis Care Res 1995;8:221– 8. Coyte PC, Asche CV, Croxford R, Chan B. The economic cost of musculoskeletal disorders in Canada. Arthritis Care Res 1998;11:315–25. Guillemin F. Les incapacités et les conséquences des maladies rhumatismales. J l'AFLAR 1998;98 Suppl:3– 6. Lanes SF, Lanza LL, Radensky PW, Yood RA, Meenan RF, Walker AM, et al. Resource utilization and cost of care for rheumatoid arthritis and osteoarthritis in a managed care setting: the importance of drug and surgery costs. Arthritis Rheum 1997;40:1475– 81. Yelin E. The costs of rheumatoid arthritis: absolute, incremental, and marginal estimates. J Rheumatol Suppl 1996;44: 47–51. Gabriel SE, Crowson CS, Campion ME, O'Fallon WM. Direct medical costs unique to people with arthritis. J Rheumatol 1997;24:719 –25. van Jaarsveld CH, Jacobs JW, Schrijvers AJ, Heurkens AH, Haanen HC, Bijlsma JW. Direct cost of rheumatoid arthritis during the first six years: a cost-of-illness study. Br J Rheumatol 1998;37:837– 47. Daures JP, Sibilia J, Guillemin F, Durieux S, Lafuma A, Fagnani F, et al. PRACTIS: etude médicoéconomique des caractéristiques et de la prise en charge de la polyarthrite en France [abstract]. Rev Rhum 2001;68:966. Newhall-Perry K, Law NJ, Ramos B, Sterz M, Wong WK, Bulpitt KJ, et al, Western Consortium of Practicing Rheumatologists. Direct and indirect costs associated with the onset of seropositive rheumatoid arthritis. J Rheumatol 2000;27:1156 – 63. Jonsson D, Husberg M. Socioeconomic costs of rheumatic diseases: implications for technology assessment. Int J Technol Assess Health Care 2000;16:1193–200. Cooper NJ. Economic burden of rheumatoid arthritis: a systematic review. Rheumatology (Oxford) 2000;39:28 –33. Pugner KM, Scott DI, Holmes JW, Hieke K. The costs of rheumatoid arthritis: an international long-term view. Semin Arthritis Rheum 2000;29:305–20. Maravic M, Bozonnat MC, Sevezan A, Gasqueres D, Pastor J, Pere M, et al. Preliminary evaluation of medical outcomes 511 (including quality of life) and costs in incident RA cases receiving hospital-based multidisciplinary management. Joint Bone Spine 2000;67:425–33. 25. Peabody JW, Luck J, Glassman P, Dresselhaus TR, Lee M. Comparison of vignettes, standardized patients, and chart abstraction: a prospective validation study of 3 methods for measuring quality. JAMA 2000;283:1715–22. 26. Suarez-Almazor ME, Belseck E, Russell AS, Mackel JV. Use of lumbar radiographs for the early diagnosis of low back pain: proposed guidelines would increase utilization. JAMA 1997; 277:1782– 6. 27. Kasper JF, Mulley AG Jr, Wennberg JE. Developing shared decision-making programs to improve the quality of health care. QRB Qual Rev Bull 1992;18:183–90. APPENDIX A: CASE VIGNETTES Case 1 (without diagnostic clues) A 32-year-old woman consults, complaining of joint symptoms for the past 3 months. Her medical history is unremarkable, and she has not been taking medications on a regular basis. Her first symptoms were inflammatory pain and swelling in the right knee. The erythrocyte sedimentation rate and C-reactive protein level are normal. Nonsteroidal antiinflammatory drug therapy was given for 1 month before the visit, to no effect. A corticosteroid was injected into the knee. Symptoms in the past month were inflammatory pain (with night pain and 2 hours of morning stiffness) in the knees, wrists, right second and third metacarpophalangeal joints, and right ankle. She denies any intercurrent or precipitating event and reports no cutaneous, stomatologic, ophthalmologic, gastrointestinal, or urinary symptoms. The physical examination shows arthritis of the wrists, right second and third metacarpophalangeal joints, and knees, with no extraarticular abnormalities. Case 2 (with diagnostic clues) A 48-year-old woman consults, complaining of a 3-month history of inflammatory pain with swelling in the wrists; first, second, third, and fourth metacarpophalangeal joints of both hands; second, third, and fourth proximal interphalangeal joints of both hands; and right knee. She has no history of significant disease and has not been taking medications on a regular basis. She denies any intercurrent or precipitating event and says she has no history of cutaneous, stomatologic, ophthalmologic, gastrointestinal, or urinary symptoms. The physical examination shows marked arthritis of the above-listed joints, with no extraarticular abnormalities. She shows you a laboratory report indicating that a latex test result for rheumatoid factor was positive in a titer of 1/160. Please answer the following questions for each of these cases: 1) List the diagnoses you suspect, in decreasing order of likelihood. On an 11-point scale (0 –10), rate your degree of certainty that the patient has the first diagnosis on your list. 2) Would you order imaging studies? If yes, which? 3) Would you order laboratory tests? If yes, which? 4) Would you order other diagnostic tests? If yes, which? 512 Fautrel et al APPENDIX B: MAIN WORKUPS PRICES IN 2001 EUROS* Test Hemogram Erythrocyte sedimentation rate C-reactive protein Serum creatinine 24-hour proteinuria Alkaline phosphatase Gamma-glutamyl transferase Transaminases Serum uric acid Serum calcium Serum muscular enzymes Rheumatoid factor (2 different methods) Autoantibodies Antikeratin Antinuclear Anti-dsDNA Antisoluble nuclear antigens Antiphospholipids ANCA Complement HLA–B27 (serology) Cryoglobulinemia Serologies Hepatitis B virus Hepatitis C virus Parvovirus B19 HIV Other virus Chlamydiae trachomatis Angiotensin-converting enzyme Ferritin Synovial aspiration Joint radiographs Hands and wrists Pelvis/sacroiliac Spine Knee Feet Heel Chest radiograph Joint ultrasound Joint CT scan Bone scan Joint MRI Letter and coefficient 2001 euros B B B B B B B B B B B B 40 10 50 10 8 20 20 25 10 15 60 80 10.40 2.60 13.00 2.60 2.08 5.20 5.20 6.50 2.60 3.90 15.60 20.80 B B B B B B B B B 40 40 40 70 70 40 40 400 20 10.40 10.40 10.40 18.20 18.20 10.40 10.40 104.00 5.20 B B B B B B B B B 70 70 70 70 70 30 60 60 200 18.20 18.20 18.20 18.20 18.20 7.80 15.60 15.60 52.00 Z 15 Z 15 Z 45 Z 17 Z 30 Z 30 Z 16 KE 20 Z 87 K 150 24.30 24.30 72.90 27.54 48.60 48.60 25.92 37.80 140.94 288.00 329.75 * Each price is based on a key letter (B ⫽ 0.26 € for biological tests, Z ⫽ 1.62 € for imaging, KE ⫽ 1.89 for ultrasounds, and K ⫽ 1.92 for bone scan) and a coefficient. The final price is based on the following equation: key-letter ⫻ coefficient. ANCA ⫽ antineutrophil cytoplasmic antibody; HIV ⫽ human immunodeficiency virus; CT ⫽ computed tomography; MRI ⫽ magnetic resonance image.


text:
We hope you will join us for dinner at the VBC on Tuesday and/or Wednesday night...the club looks fabulous decked out in its holiday finest!!! Our chefs have another wonderful menu planned featuring a filet with stilton horseradish butter & red wine braised button mushrooms, fresh pan seared scallops with cauliflower two ways, preztel crusted chicken with dijon cream sauce and homemade stuffed red peppers. A tuna bacon melt is this week's sandwich special and we'll also have plenty of lake erie yellow perch, appetizers, fresh salads and bar sandwiches plus ham & potato soup and homemade hot chocolate crème brûlée for dessert. Bar specials include yuengling and yuengling light for $2.50, great lakes christmas ale (16 oz drafts) for $5.50 and an eggnog martini is this week's featured cocktail. Big $480 winner last Friday we need to rebuild that pot!!!
Stuffed Pork Loin & Peel n' Eat Shrimp Buffet / Live Music Dante Maselli @ the VBC this Friday Night
Tuesday, December 10 - Wednesday, December 11
Shrimp Cocktail w/ mango jalapeño cocktail sauce – 10
Chicken Wings (baker's dozen) w/ celery, bleu cheese or ranch, side of buffalo or bbq sauce – 10 [1/2 order 6]
Homemade Soup
Ham & Potato – 4.5 (bowl) | 3 (cup)
Wedge – 9.5 | add grilled chicken 12.5 | grilled salmon 14.5
[iceberg wedge, bacon, tomato, diced egg, red onion, crumbled bleu cheese, homemade bleu cheese dressing]
Buoy Burger w/ choice of side – 9.5
Grilled Chicken Club w/ choice of side – 10
Grown Up Grilled Cheese w/ choice of side – 9.5
Lake Erie Yellow Perch w/ choice of side – 10
Sandwich Special
Tuna Bacon Melt w/ homemade potato chips – 9.5
[cheddar, tomato, sourdough]
Filet with Stilton Horseradish Butter & Red Wine Braised Button Mushrooms (7 oz filet) w/ garlic mashed redskins, broccolini, house salad – 24
Fresh Pan Seared Scallops with Cauliflower Two Ways w/ house salad – 23
[roasted chef's garden purple cauliflower, orange cauliflower purée, balsamic reduction]
Pretzel Crusted Chicken with Dijon Cream Sauce w/ mashed potatoes, broccolini, house salad – 15
Homemade Stuffed Red Peppers w/ mashed potatoes, house salad – 14 [1/2 order 11]
Lake Erie Yellow Perch w/ cole slaw, choice of side – 15 [1/2 order 11.5]
Hot Chocolate Crème Brûlée – 5
Fall hours of operation. The club and bar open at 4:00 pm on Tuesday, Wednesday and Friday and at noon on Saturday and Sunday. Dinner service year round on Tuesday, Wednesday and Friday nights from 5:30 - 9:00 pm with bar hours until closing. Lunch available from noon - 4:00 pm on Saturday and Sunday only with bar hours until closing. The club is now closed on Mondays and Thursdays. Special events posted.