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iNTERACT London is the premier opportunity for private market participants in Europe to connect, learn, and share best practices on portfolio monitoring, data exchange, valuation, analytics and reporting.
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My WA Framework Feedback and Suggestion whistlist
Hello, i made a purchase for this Framework, i found this extension is very potential.. keep up the good work.
however for my first day of test, i found several thing need to improve with this extension
1. It's not support with pure php code.
i create a php file with only <?php echo "TESTING"?> and include the plugin on my test.php. The Result : TESTING is everywhere.. on Title, on Head, on Body.
i hope you can add REGEX filtering, if no <head>..</head> found or no <title>..</title> found.. put everything on Body only.
Because when we assign plugin to a php programmer, it's highly the programmer will create only php code without manual html,head,body tag in it.
2. it Grab <meta http-equiv..>
if i use 8 plugins with simple html, this framework will include 8 <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> on the head tag... this really not necessary
these are for my first hour experience.. i will updating the thread as i gain more experience using WA's framework.. i've been using ADDT since it born as MX Kollection, i build my own simple CMS system with ADDT's Include... I will be happy to port the application to WA's framework...
Great Job

subset: commoncrawl


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SM Home, the retail boutique and winner of the ASID Shooting Star 2008 Excellence Award in Retail Design, offers unique pieces that have been personally curated by Sandra and Laird. You'll find exciting artwork, custom furniture, and a chic assortment of accessories that will add personality and verve to any room.
SM Home is next to our design studio and is open to all customers and clients Monday – Friday 10:00 AM to 5:30 PM, Saturday 11:00 AM to 5:00 PM.
Stylish Vignettes Are Created Daily Throughout the Shop to Inspire You…
Mood Indigo – chic throw pillows to give punch to every room.
Perfect for Entertaining!
Have fun with color, pattern and texture!
Michael Fiedler created a series of oil paintings on paper just for us. They look stunning as stand-alone pieces and powerful when grouped together. Click here to see our current inventory of ALL original art.
Landscape painting by William McCarthy floats above a glamorous, mirrored desk.
A touch of color is added with assorted porcelain vases, in various colors.
One of our SM Home in-store vignettes featured chocolate walls with tangerine decorative accents and lamps.
White Foo Dog lamp sits on an inviting mirrored bar cart with an elegant, antique gold mirror above.
Distressed white architectural bookcase by Bunny Williams in a vignette accented by colorful accessories.
Abstract painting by Penny Putnam above a fluted white chest with marble top and a coral and white hand-painted chevron lamp.
Sophisticated corner with Swedish style carved console table features an abstract gilt mirror reflecting a blue and white Chinese porcelain lamp.


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BY yollanthe On Nov 08, 2018 Strategic
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text: Lovely, self contained 2 level 'mas' (farmhouse), surrounded by garrigue, lavender fields and olive trees, at southernmost point of the department, between the Cèze valley and Ardèche Gorges. Large living room with fitted kitchen area, lounge area, 3 bedrooms (double bed in each), 2 bedrooms (4 single beds) (2 single beds), 3 shower rooms, 2 WCs. Central heating. Covered terrace, garden. Solarium (16 sq.m.) on roof. Private, fully enclosed swimming pool. Near all major sights of Provence, halfway between Vallon Pont d'Arc and Uzès - Pont du Gard. 8km fitness trail around property which can be directly accessed from gîte.


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Risky Business
In 2006, Georgia's information technology systems were a borderline mess. No one was a harsher critic than the man in charge of them. "Our business model...
In 2006, Georgia's information technology systems were a borderline mess. No one was a harsher critic than the man in charge of them. "Our business model and our delivery model were not working for our customers," recalls Patrick Moore, then, as now, executive director of the Georgia Technology Authority. By Moore's measure, the overall reliability of IT services was questionable, whether the job was safeguarding massive amounts of data on government retirees or allowing state police to run license plate numbers quickly during traffic stops. "We weren't keeping up with existing technologies or leveraging resources to make enterprise-wide changes," Moore says.
After weighing whether improvements could be made in-house, Moore, Governor Sonny Perdue and other top state officials decided to turn Georgia's IT systems over to a private vendor to operate--employees and all. From data centers and servers to laptops and printers, the system would be better served, they believed, if it was run by a company steeped in private-sector best practices. In 2007, the state began to woo vendors, with a request for proposal that was one of the largest government technology contracts up for bid at the time. There was a deep pool of potential private-sector talent to take on the task. Moore figured at least a dozen well-known vendors were capable of taking over the state's technology infrastructure. "Whether it's IBM, EDS, Northrop Grumman or CSC," he says, "there were a number of providers qualified to do this work."
In other words, the state had all the ingredients for some lively jostling among vendors to nail down the contract. Except the jostling never happened. One by one, competitors dropped out of the running without even submitting bids. In the end, the state identified three teams of contractors that were qualified to handle the work, and only one, led by IBM, formally responded to Georgia's RFP. Last fall, the state signed an eight-year, $873 million contract to turn over IT for 12 state agencies--representing 80 percent of the state's computing infrastructure--to Big Blue, with Dell and Xerox as subcontractors. A related five-year, $346 million contract to manage the state's computer networks and telephones also went to a different sole bidder--a group led by AT&T--after two other qualified vendor teams dropped out.
In signing a pair of sole-source contracts, Georgia breezed right past at least two yellow flags of caution. One had been raised by the governor himself, just after he came to office in 2003. Perdue's predecessor had put out to bid an even larger version of the same outsourcing plan. And that deal, too, had received only one bid. Killing that contract before it was signed was one of the first things Perdue did as governor. As he explained to the Atlanta Journal-Constitution, the deal would have "put us in a sole-source situation that would not be a good long-term deal for the state." The governor said he wanted to inject "more competitiveness" into the process. Apparently, the competitiveness he desired did not materialize.
The second yellow flag was being waved in Texas. At the very moment Georgia was finalizing its deal with IBM, Texas Governor Rick Perry was temporarily suspending his state's own partnership with that company in a substantially similar type of tech outsourcing contract. A computer crash in the state attorney general's office had destroyed hundreds of critical records, and Texas was accusing IBM of failing to back up important data. Most of the media attention focused on a senior state official's tongue-lashing of IBM and the $900,000 the company was docked for the flub. Hardly anybody noted the circumstances that had led up to the contract between Texas and IBM in the first place: Despite the immense size of the deal--$863 million over seven years--only two vendors had bid on the work. (Northrop Grumman was the other.)
Taken together, the cases of Georgia and Texas raise an important question about how governments are contracting for giant technology deals these days. One of the points of the whole
outsourcing exercise is competition: Governments like to be able to play numerous vendors off each other. For one thing, bidding provides confidence that government is getting the best deal possible. It also lends comfort that the bidders are not being asked to do an impossible task--and that if all else fails, other vendors might be out there to help pick up the pieces. "It is always helpful to have multiple bidders in the process," says Linda Mills, president of the information systems group at Northrop Grumman, which dropped its bid for Georgia's work. "The best situation for states is when they can use the market to help them determine the best value through competition."
But one bidder in Georgia and two in Texas isn't really competition, especially for outsourcing deals of this magnitude. What's going on? Are the states scaring away the vendors they need to stir up healthy bidding for their business? "It's always a concern when you have a just a single bidder," says Douglas Richins, formerly head of procurement for the state of Utah and now a consultant to the Western States Contracting Alliance. In sole-source situations, Richins says, states should be wondering, and perhaps investigating, why obvious contenders dropped out of the running. The winning bidder, too, should be more than a bit worried about why nobody else seems to want the work.
For their part, neither Georgia nor IBM appear to be as concerned as Richins is. GTA spokesman Michael Clark says the state didn't investigate why so many other potential vendors backed out, but the fact that they did "doesn't make us nervous at all." Asked whether he wasn't a little worried about being the only vendor willing to bid on the Georgia job, IBM's general manager of strategic outsourcing, Brian Whitfield, insists he has no concerns. "IBM's experience with our clients," he says, "is they recognize the challenges they face, and understand the difficult task of getting from a decentralized, inefficient infrastructure to a consolidated, resilient and efficient environment."
The whole business of large-scale tech contracting is stunningly complicated, but some simple principles still drive the process. For vendors to pursue contracts, they have to be reasonably certain that they're not being set up for a frustrating tail chase, fiscal pain or outright failure. Yet states seem to be getting stingier about what they're willing to pay for these mega-projects. Texas went so far as to put a ceiling on what it would spend. No doubt, public-sector budgeters like the certainty that goes along with a fixed-price, multiple-year contract. But it also represents a fiscal straitjacket that makes some vendors nervous about getting involved.
At the same time, states have been writing RFPs that put the onus for the performance of these gargantuan efforts almost completely on vendors. The Georgia outsourcing master contract is hundreds of pages long, laying out excruciating detail about vendor responsibilities and performance-level demands. In other words, when glitches come up, responsibility almost always falls on the vendor. That, too, seems comforting from government's point of view. From the perspective of most tech companies, however, it's all the reason they need to take a pass. "Our first responsibility is to our shareholders," says a spokesman for one major firm that looked seriously at the Georgia job, only to back away. "We need to make a profit. And we just can't work in states that want us to accept all the risk."
One major outsourcer that sat out the final bidding in both Georgia and Texas was Texas-based EDS. While declining to comment directly on events in any specific state, Frank Chechile, who heads up the EDS state and local practice, says the company needs to be confident it is moving into an operating environment where it can clearly help a state or locality improve its IT performance. But the bottom line, he says, is the bottom line: EDS (which was purchased last year by HP) needs to make money.
One common thread between the Georgia and Texas contracts is that both states used the same consultant, Technology Partners Inc., to help them write their RFPs and work through the details of the contracts with IBM. Don Flores, head of TPI's state and local practice, says his shop is skeptical of bids that appear "too aggressive"--that is, where vendors seem to be low-balling. Flores also says he speaks up when he thinks clients are being unrealistic about costs. "If a government procurement team has never done something like this before, their normal position is going to be to look at the lowest price, and that's not the right answer," Flores says. "As an adviser, we'll push back on that."
Glenn Davidson sees the situation a bit differently. Davidson heads the public-sector practice of EquaTerra, a company that bid unsuccessfully against TPI for the right to serve as negotiator on the Texas and Georgia consulting jobs. He says executives from some of the large IT companies that dropped out of the running in both Georgia and Texas told him flat-out that "they weren't sure they could make their margin." They also complained that Georgia and Texas were imposing so much risk and liability on vendors that they "feared if something went wrong, they couldn't avoid penalties, and that they would be extreme."
That is exactly what happened in Texas. In addition to the $900,000 that IBM had to credit back to the state for failing to back up data, the company has been docked more than $6 million as of the end of February for failures to provide promised services and meet certain deadlines.
Davidson speculates that IBM may have been willing to agree to contract terms in Texas that other vendors wouldn't accept in order to establish a beachhead in the market for other giant outsourcing contracts from state governments. "IBM really got squeezed on pricing, the solution and the time frame," Davidson says. "They were all too aggressive."
But many industry insiders say IBM has been treated unfairly, both by Texas and by the press. While details of how the attorney general's data vanished remain murky, one person who has worked on both the public- and private-sector sides of large-scale IT consolidations says Texas has to share some of the blame.
Lara Coffer, of the Texas Department of Information Resources, acknowledges that there has been a "communication gap" at times between the state and IBM, and that some agencies have resisted being rolled into the outsourcing deal. IBM's Whitfield concedes that surprises were sure to come up in a project the size of the one in Texas. While the company attempted a "wall-to-wall inventory" of the IT assets it was taking control of, it's inevitable that "you find a batch of servers off somewhere that nobody knew were there."
"When you're dealing with a project that's this large and complex," Whitfield continues, "no matter how comprehensive your contract is, it's not going to cover 100 percent of everything." What seemed certain in the wake of the Texas data dump, however, was that IBM was going to have to accept something like 100 percent of everything when it came to the blame.
Every big tech project comes with a certain amount of risk built into it. What varies is how states choose to handle it. Texas and Georgia, which placed virtually all the risk on the vendor, represent one end of a spectrum. On the other end is the approach taken by Michigan and Missouri, which chose to handle their own massive data-center consolidations in-house. By doing the work themselves, those states absorbed total responsibility in the event anything major went wrong. But they also figured they could absorb as possible savings whatever profits a private vendor stood to make on such a deal. "Whether you're insourcing or outsourcing, consolidation involves a huge amount of risk," says Ken Theis, director of the Michigan Department of Information Technology. "And anything that risky ought to offer a good return on investment."
There are other models for how governments can handle contracting risk on big IT jobs. Pennsylvania, for example, broke up its massive IT consolidation into bite-sized phases. That meant that if any one piece of the project blew up, the damage would be contained. Virginia took an approach that is closer to the Georgia and Texas model, but modified in an important way. The state and its contractor, Northrop Grumman, agreed on a fixed annual price, but also agreed to work closely together on trouble-shooting as the job progressed. Aneesh Chopra, Virginia's technology secretary (and President Obama's pick to be the federal chief technology officer), says there are advantages to the way Virginia structured its deal. The state and the vendor share the risks, as well as the rewards--a profit for Northrop Grumman and efficiencies for Virginia. Chopra acknowledges that the partnership has experienced its own bumps along the way. But looking at the Texas situation, he says, "We're in a much healthier place."
Meanwhile, in Texas, IBM is back to work, having served its time-out and paid its penalty. And in Georgia, the rollover of state staff onto the IBM payroll on April 1 went off smoothly. Officials in both states predict that there will be glitches along the way, but say they are confident that those will be worked out.
Ultimately, it's up to each state to decide how much risk it wants to place on its own shoulders--and how much it wants to make vendors accept. But states need to be careful in the way they go about it. As much as technology vendors need governments as customers, governments need choices among vendors, each of which brings varying forms of expertise to the complicated business that increasingly undergirds just about everything governments do.


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February 1st means one thing here in Cheeky Cheeky land: Valentine's Day is approaching!! As a self proclaimed "single & awesome" girl, you might think I hate this holiday. I definitely will admit I have in the past. I was that girl who grimaced as couples walked by holding hands on their way to their romantic February 14th dinner. I hated when everyone in the office got flowers from their boyfriends. It all made me want to hide under the covers. Well, not anymore! I refuse to let this one holiday become a bummer in my life. I LOVE holidays and I'm reclaiming Valentine's Day for myself. It is now going to be a day of love and happiness in my life. No more snarky comments & feeling sorry for myself. This year, I'm going to spread as much love & happiness on February 14th as I can. Starting with this little blog.
While most women/girls in the blog world tend to have a Mr. or a husby or something, I do not, and am not looking for one right now. I think all of us single bloggers should come together in a group of awesomeness and embrace our single status this month. We can be just as fabulous and beautiful as every other girl on the planet, and wear our "single" badge proud... Or something like that. So instead of sitting at home with a pint of Ben & Jerry's this Valentine's Day, can we all just agree to get off our asses and do something fun? I don't care what it is- just take off the sweatpants, take the scrunchie out of your hair, and get out of the house!! February 14th can be just as fabulous as every other day of the year.
If there's one way to ensure that you will have an amazing Valentine's Day, it's by looking fabulous. I always feel 100% better about life when I feel like I look pretty. Am I right ladies, or am I right?! There's something about getting dressed up & putting effort and energy into my look that makes me super happy. I think you might feel the same. The stars have aligned in fabulousness this Valentine's Day- Rue La La has partnered with Elle to bring tons of gorgeous looks to us this February 14th. They have a few different boutiques geared towards different styles. I'm so all over the place, I have three favorite looks from three favorite boutiques :) Act fast- the boutiques are only open until tomorrow!! {PS- if you aren't a member of Rue La La already, you SO need to be. Discounts are a shopping addict's best friend. Click here to become a member!}
I love all three of these looks for Valentine's Day. Which to pick which to pick... They're all so damn cute!! I'm leaning towards Meet The Parents, even though I'm not meeting ANYONE's parent's this year. A little red dress on Valentine's Day is kind of perfect, right?
So now that you have a fabulous outfit to make you feel nice and pretty, you just have to decide what to do with your single self on this holiday of couples. I tend to favor dinner & drinks with girlfriends at a fancy shmancy restaurant. You really can't beat that. If you plan on drinking a lot, just do everyone a favor and have your friends protect you from drunk texting. Valentine's Day brings out the sappy sentimental beast in all of us. Nothing will make you feel more like throwing up in the morning than realizing you drunk texted your ex at 3AM asking him "what happened to USSSS?!" TRUST ME- leave the phone at home or with your BFF. You won't regret it. If going out isn't your thing, then I vote for a game night with friends or going to the movies. As long as you spend the night with people you love, you'll be juuuust fine :)
Two weeks from now, I hope we're all gearing up for a fabulous night on the town with our besties. It's how every single girl should spend her Valentine's Day. Oh, and maybe pick yourself up some chocolates or something. February 14th only rolls around once a year!


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This holiday season, why not set aside a few moments for family discussion on death?Our guest, emergency room physician Kevin Haselhorst, MD, has witnessed time-and-again needless pain and suffering caused by keeping terminally-ill patients alive. All of us deserve to die in peace on our own terms in complete dignity. Beginning January, 2016, Medicare will pay for end-of-life counseling. Tune in to learn actions you can initiate right away to insure that you and your loved ones pass away in harmony, with your minds at rest. Author Susan B. Mead describes God's divine guidance on her journey from grief to grace following the tragic deaths of both her sister and her son.
Host: Roy Richards


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Toronto -‐ August 25, 2014 – Bodega Premium Blends @BodegaCigars is excited to announce their continued support for MMA fighter Mitch Gagnon @MitchGagnonUFC. With an impressive 11-‐2 record and two UFCTM Fight Bonuses in his last four fights, Mitch is considered, by many, as the top bantamweight in Canada. With a wrestling and grappling background, Mitch's standup talents have impressed fans as of late. His aggressive style makes for exciting fights that rarely make it passed the first two rounds.
Mitch's next opponent will be undefeated fighter Aljamain Sterling at UFC Fight Night 54 in Halifax Canada, on October 4th 2014. This will be Mitch's fifth fight in the OctagonTM. His goal: to make it four wins in a row. "Having Bodega in my corner, during my fights, is a lot more than just having their support. They've become family": declared Gagnon.
"Our partnership with Mitch dates from a few years ago", stated Chief Brand Officer Ron Plante. "Enjoying a Digestivo during the gathering of friends and brothers, at a post fight celebration, is what Bodega Premium Blends is all about" he continued.
"Our commitment to Mitch, to his training plays out usually at After Party events" said Chief Relationship Officer Stephane Barjolin. "It's a natural fit… ReuniónTM of Friends and Bodega Cigars."
Rob Mariani, Chief Strategy Officer, was quoted: "My first live UFCTM event was the Jones/Gustafsson card in Toronto where Mitch was awarded Submission of the night. The adrenaline, the sense of camaraderie I felt was surreal." Rob added: "We hope Mitch has room for us in the future… His star is bright and rising".
CEO, Gino Domanico @Cigar_G added: "Investing in your life's momentsTM isn't just some crafty marketing tagline. We truly believe in contributing to all our friends lives whether it's helping Mitch aspire to greater heights or simply offering new, exciting and premium blends to all our customers."
Bodega Premium Blends is a Boutique Brand focused on offering only Premium, hand rolled Cigars. BPB is proud to invest in your Life's moments.
For further information please visit our website www.bpbcigars.com
Follow us on Twitter Bodega Premium Blends Twitter: @BodegaCigars
Views: 60
Thats pretty rare seeing cigars sponsoring any sport, of any kind. First that I can recall.


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Of the Father's heart begotten,
Ere the world began to be,
Called the Alpha and Omega,
Both the source and end is He
Of all things that are,
that ever have been,
And that future years shall see,
Evermore and evermore!
O that birth forever blessed!
When the Virgin, full of grace,
By the Holy Ghost conceiving,
Bore the Savior of our race;
And the Babe, the world's Redeemer,
First revealed His sacred face,
Evermore and evermore!
O ye heights of Heav'n, adore Him;
Angel hosts, his praises sing;
Pow'rs, dominions, bow before Him,
And extol our God and King;
Let no tongue on earth be silent,
Ev'ry voice in concert ring,
Evermore and evermore!
First upload: 2003? / Update: Dec 17, 2010


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This course emphasizes a brand's ability to simplify customer decision-making, set expectations, and reduce risk. Students gain a deeper understanding of the importance of maintaining, strengthening, and evolving a brand's value over time.
- Describe the main branding challenges and opportunities.
- Explain the criteria and tactics for choosing a brand strategy, and the legal issues surrounding this decision.
- Apply concepts related to planning, implementing and evaluating brand strategy.
- Assemble a basic brand hierarchy.


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- Flowering plants and trees hear when eaten and become defensive to the stimuli is found out in a study
- The plants were made to hear vibrations of a feeding caterpillar and other was just sounds with same acoustics
- The plants listening to caterpillar vibrations showed production of mustard oil which made the caterpillar crawl away
June 23, 2017: Plants and animals can be a source of energy for us but when it comes to defense, plants are not behind. In some cultures and communities, people have started choosing a vegan lifestyle as they are against animal slaughter. The viral videos on how animals are treated in slaughterhouses make people take up the vegan lifestyle. Most people think that plants do not have a conscience but research show otherwise.
Research show that plants do react to external stimuli and some research shows that they also communicate through chemical signals. They grow towards light, compete with other plants for water and nutrients and also signal for help when needed.
In recent news about science, a research published in Oecologia which was conducted in University of Missouri suggests that plants can hear when they are being attacked and can also become defensive from the attack. Heidi Appel (senior research scientist in the Division of Plant Sciences) and Rex Crocoft (professor in the Division of Biological Sciences) carried out the research by conducting experiments in which they placed caterpillars on the flowering plants of cabbage and mustard.
ALSO READ: Find out why Hinduism always emphasizes on being a vegetarian
They put up a piece of reflective material and a laser on a leaf to measure its movement as a response from vibrations of feeding caterpillar and then they recorded the sounds of caterpillar feeding and played them to similar plants and on the other hand, they played sounds with similar acoustics but a different source to other plants.
The results showed that when caterpillars fed on both plants, the plant exposed to vibrations of caterpillars produced more mustard oils as it is unpleasant to caterpillars so they crawled away and those who were played sounds with similar acoustics showed no change in chemical response.
Appel and Crocoft said that more future researches would be upon how the vibrations are sensed by the plants and how plants would react to other vibrations to keep the pests away. Crocoft stated, 'Plants have many ways to detect insect attack, but feeding vibrations are likely the fastest way for distant parts of the plant to perceive the attack and begin to increase their defenses.'
Appel said,' 'This research also opens the window of plant behavior a little wider, showing that plants have many of the same responses to outside influences that animals do, even though the responses look different.'
This research was part funded by National Science Foundation and it could prove to be a useful tool in agriculture!
– by Sumit Balodi of NewsGram. Twitter: @sumit_balodi


text: Please read carefully before you agree! This document instructs you as to when staff is not regularly scheduled at this facility. We are open with treatment staff on the premise 24/7 including ALL major holidays. Exception: We are not actively stafffed with a Veterinarian in this facility after 11pm nightly unti 8am the following morning. Please inquire should you require additional information (*Exceptions listed below) *Exception: We are prepared with proper staff coverage should weather related emergencies arise 365 days a year. I AM AWARE OF THE STAFFING HOURS AT BLUE RIDGE VETERINARY ASSOCIATES AND BLOOD BANK *I understand the above


text:
Friday, October 10, 2008
Also wanted to mention
A bunch of my linking partners with Its All About The Jewels are offering sales or special promotional products where some of the proceeds from the sale of the items will be donated for breast cancer research. It's worth a look! Click on the link below to get to my links page.Some of the companies are Clinique,Vera Bradley & Origins.
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text: Guidelines for the Management of Cardiovascular Risk CONSENSUS OR CONTROVERSY? Brent N. Reed, PharmD, BCPS-AQ Cardiology, FAHA Assistant Professor, Department of Pharmacy Practice and Science University of Maryland School of Pharmacy Headlines from NPR, The New York Times, and Time WHY THE CONTROVERSY? • Significant departure from previous editions • Discrepancies between experts • Evidence-based, but unanswered questions "… not a substitute for clinical judgment, and decisions about care must carefully consider… each individual patient." - JNC8 Guidelines Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials Gordon C S Smith, Jill P Pell "Parachutes reduce the risk of injury after gravitational challenge, but their effectiveness has not been proved with randomized controlled trials" BMJ 2003;327;1459-1461. LEARNING OBJECTIVES • Describe pharmacologic management of blood cholesterol and blood pressure • Summarize evidence responsible for major changes in updated practice guidelines • Recognize where important questions remain GUIDELINES FOR BLOOD CHOLESTEROL Stone NJ, et al. Circulation. 2013. TRIAL DATA Statin vs. Control • SSSS • HPS • ALLIANCE • CARDS • JUPITER • ASCOT-LLA • Post-CABG • WOSCOPS • PROSPER • CARE • LIPID • ASPEN • AURORA • AFCAPS/ TexCAPS • LIPS • GISSI-HF • 4D • ALERT • MEGA • ALLHAT-LLT • GISSI-P More vs. Less Statin • PROVE-IT • TNT • IDEAL • SEARCH • A to Z SECONDARY PREVENTION 5-year absolute benefits per mg/dL LDL-C reduction 30 Event Rate (%) 25 20 15 10 5 0 Major coronary events Outcomes avoided per 1000 (95% CI) 30 (24-37) Coronary revascularization Stroke Major vascular events 27 (20-34) 8 (4-12) 48 (39-57) Adapted from Lancet 2005; 366(9493):1267-78. PRIMARY PREVENTION 5-year absolute benefits per mg/dL LDL-C reduction 30 Event Rate (%) 25 20 15 10 5 0 Major coronary events Outcomes avoided per 1000 (95% CI) 18 (14-23) Coronary revascularization Stroke Major vascular events 12 (9-16) 5 (1-8) 25 (19-31) Adapted from Lancet 2005; 366(9493):1267-78. Baseline LDL-C (mg/dL) < 80 80 - < 100 100 - < 120 120 - < 140 > 140 < 80 80 - < 100 100 - < 120 120 - < 140 > 140 Reduction of vascular events by baseline LDL-C. Adapted from Lancet. 2010 Nov 13;376(9753):1670-81. LDL-C values converted to non-SI units, and rounded to nearest 20 mg/dL. AREAS OF INADEQUATE EVIDENCE • Titration of statin therapy to LDL-C or nonHDL-C targets, or "lower is better" strategy • Adjunct use of non-statin therapies • Symptomatic heart failure (NYHA Class II-IV) or hemodialysis-dependent kidney disease • Age < 40 or > 75 years Adults > 21 years of age and candidate for statin Yes Clinical ASCVD? Yes High-intensity statin (Moderate-intensity if > 75 yo or not candidate for high-intensity statin) No LDL-C > 190 mg/dL? Yes High intensity statin (Moderate-intensity if not candidate for high-intensity) No Diabetes? Yes Moderate-intensity statin Yes Moderate-to-high intensity statin (High-intensity if 10-yr ASCVD risk > 7.5%) No Calculate 10-yr ASCVD risk using Pooled Cohort Equations > 7.5% 10-yr ASCVD risk? No ASCVD prevention benefit less clear, but may be considered STATIN INTENSITY High Intensity (Lowers LDL-C by > 50%) Atorvastatin 40-80 mg Rosuvastatin 20-40 mg Moderate-Intensity (Lowers LDL-C by 30-50%) Atorvastatin 10-20 mg Rosuvastatin 5-10 mg Simvastatin 20-40 mg Pravastatin 40-80 mg Lovastatin 40 mg Fluvastatin 40 mg BID Low-Intensity (Lowers LDL-C by < 30%) Simvastatin 10 mg Pravastatin 10-20 mg Lovastatin 20 mg Fluvastatin 20-40 mg Pitavastatin 1 mg Pitavastatin 2-4 mg Statins and doses listed in italics are approved for use but have not been studied in randomized controlled trials. Adapted from Stone NJ, et al. 2013 ACC/AHA Blood Cholesterol Guideline. RISK FACTORS FOR ADVERSE EVENTS • Multiple or serious comorbidities • History or statin intolerance, muscle disorders • Unexplained ALT elevations > 3 times ULN • Patient characteristics and/or concomitant medications affecting statin metabolism • Age > 75 years STATINS IN PRIMARY PREVENTION • Absolute benefit proportional to baseline risk • Risk reduction proportional to LDL-C lowering • Risk for adverse events must be weighed against risk of catastrophic CVD event • Clear net benefit at 10-year ASCVD risk > 7.5%; less clear at 5 to < 7.5% RISK CALCULATOR Image from ASCVD Risk Calculator App (iTunes). No clinical ASCVD Diabetes or LDL-C > 190 mg/dL? Yes No No 40-75 yo and LDL-C < 190 mg/dL? Yes Calculate 10-yr ASCVD risk using Pooled Cohort Equations < 5% 10-yr ASCVD risk In select individuals, additional factors may be considered to inform treatment decision making 5 to < 7.5% 10yr ASCVD risk > 7.5% 10-yr ASCVD risk Patient discussion regarding ASCVD risk reduction benefits, adverse effects, drug-drug interactions, and patient preferences PRIOR TO STATIN INITIATION • Emphasize heart-healthy lifestyle • Obtain baseline laboratories – Fasting lipid panel – Alanine transaminase (ALT) – Creatinine kinase (CK) if indicated • Exclude secondary causes of dyslipidemia • Evaluate for risk of drug-related adverse effects Assess adherence with fasting lipid panel Yes Expected Response? No No Statin Intolerance? Reinforce medication adherence No Yes Manage Intolerance Expected Response? Reinforce Improved Adherence Increase intensity OR consider addition of non-statin therapy Yes Reinforce continued adherence Follow-up in 3-12 months NON-STATIN THERAPIES Agent Improved Outcomes† Monitoring Niacin • Mortality (all-cause, CV) • Recurrent CV events • • • • Fibrates • Mortality (CV) • Recurrent CV events • Renal function • Triglycerides (for potential benefit if added to statin) • Avoid gemfibrozil/statin combination Bile Acid Sequestrants • Recurrent CV events • Triglycerides (adverse effect) Fish Oil • CV mortality • Intolerance (GI disturbances, skin changes, bleeding) Ezetimibe • None • Hepatic transaminases †In Hepatic transaminases Hgb A1C or FBG Uric acid concentrations Intolerance (flushing) the absence of statin therapy. CV = cardiovascular, FBG = fasting blood glucose, GI = gastrointestinal, Hgb = hemoglobin GUIDELINES FOR BLOOD PRESSURE James PA, et al. JAMA. 2014; 311(5):507-520. MAJOR DIFFERENCES FROM JNC7 Topic Difference in JNC8 Methodology • Systematic search and review process • Standardized protocol for recommendations Definitions • Hypertension, prehypertension not defined Treatment goals • Similar except when trial evidence supported different goals in a specific subgroup Lifestyle • Addressed separately recommendations Drug therapy • ACEi or ARB, CCB, or thiazide • Specific drug in racial or disease subgroups Review process • Expert review from various organizations • No official sponsorship AGE-STRATIFIED GOALS Intention-to-treat Per-protocol Strict vs. Moderate Blood Pressure Control in Older Patients Showing no differences in the primary composite endpoint when a goal of < 140 mmHg (strict) vs. 140-150 mmHg (moderate) was compared. Hypertension. 2010;56:196-202. CHRONIC KIDNEY DISEASE • No improvement in cardiovascular outcomes at lower BP goals (i.e., < 130 / 80 mmHg) • Some improvement in kidney-related outcomes in post-hoc analyses but results inconsistent Lancet. 2005;365(9463):939-946. JAMA. 2002;288(19):2421-2431. N Engl J Med. 1994;330(13):877-884. DIABETES MELLITUS Systolic Blood Pressure Goals in Diabetes Mellitus Showing no differences in the primary composite endpoint and cardiovascular death when a goal SBP of < 140 mmHg vs. < 120 mmHg was compared. N Engl J Med. 2010;362(17):1575-1585. SELECTION OF INITIAL THERAPY • Non-blacks: similar improvements with ACEi or ARB, calcium channel blockers, or thiazides • Blacks: calcium channel blockers or thiazides prior to ACEi or ARB • Not impacted by presence of diabetes • ACEi or ARB recommended as initial therapy in chronic kidney disease JAMA. 1991;265(24):3255-3264. JAMA. 1979;242(23):2562-2571. JAMA. 1970;213(7):1143-1152. JAMA. 2002;288(23):2981-2997. JAMA. 2002;288(19):2421-2431. Adults > 18 years with hypertension No No Age < 60 y? < 150 / 90 mm Hg DM or CKD? Yes < 140 / 90 mm Hg Yes CKD? Yes No < 140 / 90 mm Hg Acceptable if < 140/90 mm Hg achieved safely No Thiazide, ACEi, ARB or CCB Black? Yes Thiazide or CCB ACEi or ARB Optimize by up-titrating and/or adding thiazide, ACEi or ARB, or CCB. For refractory patients, may add from an additional class (e.g., beta blocker, aldosterone antagonist) ANTIHYPERTENSIVE STRATEGIES Strategy A B C Description Start with one drug, titrate to maximum dose, then add a second drug Add second drug before achieving a maximum dose of first drug Begin two drugs at same time either as separate pills or combination pill • Select ACEi or ARB, CCB, or thiazide first • Avoid ACEi / ARB combination therapy • Consider Strategy C if BP > 160/100 or if SBP is > 20 over goal and DBP is > 10 over goal (mm Hg) Class ACEi ARB CCB Thiazide diuretic Initial Daily Dose (mg) Target Daily Dose (mg) Doses/day Captopril 50 150-200 twice Enalapril 5 20 once to twice Lisinopril 10 40 once Candesartan 4 12-32 once Losartan 50 100 once to twice Valsartan 40-80 160-320 once Irbesartan 75 300 once Amlodipine 2.5 10 once 120-180 360 once 12.5 12.5-25 once 12.5-25 25-100 once to twice Medication Diltiazem ER Chlorthalidone Hydrochlorothiazide ACEi = ACE inhibitor, ARB = angiotensin receptor blocker, CCB = calcium channel blocker. International drugs omitted from table. Adapted from James PA, et al. JAMA 2014;311(5):507-520. EVIDENCE FOR RECOMMENDATIONS Group Recommendation Grade Age > 60 y Goal < 150 / 90 mmHg A (Strong) Age < 60 y Goal < 140 / 90 mmHg E (Expert opinion) (SBP) A (Strong) (DBP) CKD Goal < 140 / 90 mmHg E (Expert opinion) DM Goal < 140 / 90 mmHg E (Expert opinion) Non-blacks Thiazide, ACEi/ARB, or CCB B (Moderate) Blacks Initial: CCB or thiazide B (Moderate) (non-DM) C (Weak) (DM) CKD Initial ACEi or ARB B (Moderate) All Strategies for achieving goal E (Expert opinion) REMAINING QUESTIONS Blood Cholesterol Blood Pressure • Primary prevention in older populations • Goals for older patients with high-risk features • Alternate strategies for reducing ASCVD risk • Goals in younger patients • Non-statin therapies added to low-dose statin • Diabetes risks • New therapies vs. statins • Non-hypertensive populations (e.g., HF) • Which optimization strategy is best? Guidelines for the Management of Cardiovascular Risk CONSENSUS OR CONTROVERSY? Brent N. Reed, PharmD, BCPS-AQ Cardiology, FAHA Assistant Professor, Department of Pharmacy Practice and Science University of Maryland School of Pharmacy


text:
After careful study of otherworldly environments, you can quickly evaluate how an outsider reacts in its home surroundings. You can use your knowledge of the outsider's native environment to guide your attacks and overcome the outsider's natural resistances.
Prerequisite(s): Knowledge (planes) 5 ranks, favored terrain (any plane) class feature.
Benefit(s): When you are on one of the planes you've selected as a favored terrain, you gain a +2 bonus on weapon attack rolls against outsiders native to that plane. You also ignore up to 5 points of damage reduction when making weapon attacks against outsiders native to that plane, except for damage reduction without a type (such as DR 10/—). In addition, you gain this bonus against extraplanar creatures you encounter and identify as being from one of your planar favored terrains, such as with a successful Knowledge (planes) check, regardless of what plane you or they are on.
Special: You may select this feat multiple times. Each time you take it, you apply it to a different qualifying favored terrain.
Pathfinder Player Companion: Champions of Balance © 2014, Paizo Publishing, LLC; Authors: Matt Goodall, Ron Lundeen, Philip Minchin, Patrick Renie, Jason Ridler, and David Schwartz.


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Old men sat on the benches in front of the country store and whittled. Some just whittled on a stick, others were whittling something in particular. It gave them something to do with their hands while they sat and talked. In the hot dry summers of the depression era there was a lot of time when there wasn't work for men to do in rural north Louisiana.
Groceries came in boxes and crates and barrels and cloth sacks. Much of it was shipped on the train. The apple boxes had ends that were perfect for whittling and almost every person had a knife.
Boys might start out with a rusty old cast-off, but as they got older they would find a shiny new knife in the Christmas stocking. A girl might get a tiny knife an inch long with a pearl handle. She was expected to take care of this and use it to sharpen her pencil and keep her fingernails clean.
On a farm a pocketknife was useful. It also provided the pleasant pastime of whittling. Toys and whistles could be made for the children, duck decoys and pencil boxes if you were more talented. The root of the tupelo gum was good for carving.
Someone cut dice out of wood - smooth cubes as large as a woman's thumbnail. A letter was printed on each side of the dice and several sets of dice were made. At Christmastime the letters spelled "St. Nick." At Valentine's Day "Hearts." Young people worked out a system of scoring. As long as you were spelling part of the words you continued to throw the dice. This made a good party game in cold weather. You could set up several card tables. This mixed up the young people and gave everyone a chance to talk to the others.
Gypsy Damaris Boston
Shreveport, Louisiana
Back in 1955 a call went out from the editors of the then Capper's Weekly asking for readers to send in articles on true pioneers. Hundreds of letters came pouring in from early settlers and their children, many now in their 80s and 90s, and from grandchildren of settlers, all with tales to tell. So many articles were received that a decision was made to create a book, and in 1956, the first My Folks title – My Folks Came in a Covered Wagon – hit the shelves. Nine other books have since been published in the My Folks series, all filled to the brim with true tales from Capper's readers, and we are proud to make those stories available to our growing online community.


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INSURANCE REGULATORS MEET: The National Association of Insurance Commissioners opens its annual meeting in Seattle Thursday.
The NAIC is tasked with helping define many insurance reform requirements, and it has a busy agenda to go over: http://bit.ly/96CfrY
On the menu for Thursday: Adoption of the new forms submitted by insurance companies to report quarterly and annual financial information to regulators, updated to take into consideration changes from the healthcare reform law.
Read The Hill's earlier story: http://bit.ly/dhbhzc
GLOBAL HEALTH: The Council on Foreign Relations announces its new interactive guide on global health policy: http://bit.ly/a7bkQ1
The guide examines the deficiencies in global health governance and offers concrete solutions for improvement. This is the latest component of the council's Global Governance Monitor after previous guides on climate change, nuclear nonproliferation, finance and oceans governance.
STATE IMPLEMENTATION: Maine launches website to explain health reform and Maine's plan for implementation: http://bit.ly/d2lvmi
HEALTH REFORM'S HIDDEN COSTS: Health insurers will face "debilitating impacts to their bottom lines" to meet the healthcare reform law's medical loss ratio requirements if their investment incomes decline significantly, according to Weiss Ratings.
Read the report: http://bit.ly/cdG3zE
NEW INSURANCE GROUP FORMED: The States Alliance for Balanced Insurance Regulation officially launched Wednesday to promote continued state regulation of insurance.
Read the press release: http://bit.ly/9Ls6Cs
MINE SAFETY: Federal Mine Safety and Health Review Commission hears mine safety cases: http://bit.ly/aaHqfg


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So, this weekend offered me some free time, so I took every opportunity to enjoy myself. I beat BioShock on Survivor difficulty; a feat I've never accomplished before, so I was proud of that. It honestly wasn't too bad. It's pretty normal for BioShock titles to be tougher in the beginning and Survivor mode was no exception. I then beat the challenge room DLC for BioShock, and nabbed all of those trophies, so I can now say that BioShock is 100% complete for me. The challenge rooms were neat and made you think in a new way, which I really liked.
I'm now working on the Protector Trials DLC for BioShock 2; I have them all done except two bonus trials, and I have to say, I'm a really big fan of this DLC. You pretty much are given an area from the story that's been fixed up into an arena, and you have to protect your Little Sister through a gathering session for a decent amount of time. The twist is that each area is a challenge, restricting you to certain weapons and Plasmids, so it's kind of like a puzzle. The longer she gathers unhindered by Splicers, the more Adam you get. If you get an A or A+, you get one to three stars, and those stars unlock scrapped animations and concept art and stuff like that. It's really cool. Once I clear those last two rooms, I can consider BioShock 2 100% complete too. Then it's on to 1999 mode in Infinite.
In Final Fantasy Tactics, I'm starting to fill up my party with story characters. I think I'm only two or three battles away from the next chapter.
Finally, I finished Cowboy Bebop this weekend. What a great show. Despite having the ending already spoiled for me, it still hit me really hard; that last scene is really beautiful. What makes Cowboy Bebop especially great, to me, is the characters. All of the characters are believable, and each episode that gives you back story for them only gives you a bit at a time, result in you wanting to watch more to learn about the characters, but you end up really appreciating the stand alone episodes too. Episode 23, Brain Scratch, was probably my favorite stand alone episode in the series, and I was surprised how hard Hard Luck Woman (I think episode 24) hit me as well. What a great series with great characters. I'm going to watch the movie next. Honestly, it's just a well rounded series. The music is great and jazzy, the characters are believable, lovable, and avoid being tropey for the most part, and I really felt like I was a member of the Bebop by the end of the show. Have I mentioned the interactions between the characters? So good. If you haven't seen Cowboy Bebop, you're missing out.
Did you know that Cyberphile has a Facebook page? Feel free to swing by and get our new posts in your newsfeed.
These "What'cha Doin'?" posts are designed to spark discussion, so feel free to post in the comments what you've been playin', watchin', or listenin' to lately.


text: Gorilla grow tents Lite Line is engineered to increase the plant production, health, and quality of indoor gardening efforts. Grow Tents Plus specialize in a variety of large grow tents that are available in a wide range of sizes and heights that allow for custom installations in very large spaces such as a basement or a garage. No plastic anywhere, with biggest zippers on the market, plus diamond reflection technology. Gorilla grow tents Lite Line are for experts and perfect for beginners.


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There are twelve animals in the story. Which one is your favourite? Tell us about it!
MissInternetEarth replied on United Kingdom (Great Britain) Permalink
You can download an printable activity that goes with the story, by clicking on 'print an activity for the story'.
LearnEnglish Kids team
SkiingBaseballBull replied on Vietnam Permalink
My Chinese Zodiac is the monkey.
KindGem9000 replied on Philippines Permalink
cool story great race
KindGem9000 replied on Philippines Permalink
My birthday date is 2005, my chinese zodiac is the rooster and i will invite my friend i have lots of friend
RedJeans99 replied on India Permalink
A wonderful story....
PrinceWhite4 replied on Saudi Arabia Permalink
great race
CaptainIslandSoccer replied on Vietnam Permalink
I like this story
CoolThunderSinger replied on China Permalink
I Love China is very much. there are good country!
KingSnowPlanet replied on Permalink
I like this .
PrinceWhite4 replied on Saudi Arabia Permalink
- i love races they're my favourite


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The empirical evidence of EMDR's effectiveness as a treatment for post traumatic stress disorder has been acknowledged by several organizations including the International Society for Traumatic Stress Studies (Foa, Keane, & Friedman, 2001), American Psychological Association (Chambless et al.,1998), United Kingdom's Dept. of Health.
In several direct comparisons with cognitive behavioral therapy, EMDR appears to be equivalent in effect and to work more quickly, often with less distress for clients. (Vaughan et al., 1994; Rogers et al., 1999; Lee et al., in press: Ironson et al., inpress; Power et al., 2000).
EMDR has an impact on intrusive, numbing and hyperarousal symptoms of PTSD as well as on the grief and depression, which often follow traumatic events. Many studies show a 70-90% decrease in the number of individuals meeting diagnostic criteria for PTSD after 3-6 sessions. (Shapiro, 2001)
With little modification, EMDR has been used successfully in response to a variety of mass casualty events. It can be integrated with other modalities such as supportive counseling or debriefing. (Solomon, 1998)
The efficacy of EMDR in the treatment of those impacted by natural disasters has been demonstrated in controlled studies. (Chemtob et al., in press; Grainger et al., 1997).
EMDR has been used successfully in the treatment of war and terrorism trauma. (Silver & Rogers, 1996; Puk & Silver, 1997; Carlson et al., 1998; Silver & Rogers, in press)
EMDR Humanitarian Assistance Programs (EMDR-HAP) is a non-profit organization, which coordinates direct intervention for trauma survivors and training in EMDR for therapists treating them. This network of professionals has worked internationally in cooperation with relief organizations such as the Red Cross, UNICEF and Catholic Relief Services. EMDR-HAP has set up the Disaster Mental Health Recovery Network to respond to the New York City/Washington D.C. terrorist attacks.
The Disaster Mental Health Recovery Network can be accessed through:
Phone: (800) 531 3640 or (215) 862-4310
Fax: (215) 862-4312
In NYC Please call (917) 626-9117


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July 13, 2011: The Lord's Pantry Food Bank of Shinnston will hold the second annual Music Festival July 22-23, 2011 at the auditorium of Lincoln High School. Here is their Press Release:
The Lord's Pantry of Shinnston and Tenmile is sponsoring its 2nd annual Lord's Pantry Music Festival on Friday, July 22nd, and Saturday, July 23rd, at Lincoln High School. The Friday hours are from 6 – 10 p.m. The Saturday hours are from 1 – 4 p.m. and 6 – 10 p.m. This is guaranteed to be a great weekend of Christian music.
The cost of tickets is: one day – $10.00 and two days – $15.00. Children 5 and under are FREE. Tickets will be sold at: Tolley's Bible Book Store in Eastpoint Shopping Plaza in Bridgeport and Dola Dairy Mart in Dola. In Lumberport, tickets can be purchased at Melissa's Hair Salon, United Methodist Church and the Baptist Church. In the Shinnston area, tickets can be purchased at Shinnston Shop 'n Save, Jewel City Church, All Season's Florist, Shinnston First United Methodist Church, Shinnston Plumbing, CLK Financial, and Shinnston First Baptist Church. Tickets will also be available at Bice's Greenhouse & Florist in Enterprise.
Featured groups and singers include: New Prophets, Millie Tate, Susie Sigmon, Ron Shamblin, the Goodwins, the Sandy Family, and New Journey. Appearing on Saturday: Josh Oldaker at 1:00 p.m., JP Miller at 7:00 p.m., Taj Rohr at 8:00 p.m. and the Anointed Trio.
Nonperishable food or money donations will be accepted.
Food vendors will be present.
Please attend to enjoy God's word in song and help to alleviate hunger.
For more information, call 304-592-0637 (Sandra Haggerty) or 304-783-4601 (Kathy Burr).
Tags: Lincoln High School, Lord's Pantry, Music, Music FestivaL, Shinnston


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How to Raise Kids With Dogs
Explore this Article Prepare Dogs for New Babies Prepare Children for Dogs Ask a Question Related Articles References
When your household contains both children and dogs, there are methods you can demonstrate and practice with both parties to achieve the best possible levels of safety and companionship. Sometimes the behavior of your children may indirectly bother your dog, although your children may not be trying to bother them on purpose. Regardless of whether you have your dogs before your kids, or vice versa, there are steps you can take to ease both kids and dogs into a healthy relationship. When you raise kids with dogs, you must teach them to be respectful of one another to achieve the healthiest environment possible for the entire family.
Prepare Dogs for New Babies
1Allow your dog to enter the nursery. This will help your dog become accustomed to new furniture, new smells, and a new environment.
2Apply baby products to yourself or your dog's toys. The smells of baby lotion or baby shampoo will allow your dog to become familiar with your baby's smell before they arrive in your home.
3Play tapes or videos of babies crying on a regular basis. This will help familiarize your dog with a crying baby so they can adjust to the extra noise when the baby arrives.
4Introduce your dog to your baby when it arrives at home.
- Tell your partner or family member to hold your dog as you slowly approach the dog with the baby. This will allow your dog to sniff and inspect the baby.
5Establish companionship instead of competition between your dog and the baby.
- Bring your baby along when you take your dog for walks. If your dog enjoys going on walks, they will begin to associate this pleasurable activity with the baby.
- Give your dog a special treat when you are required to pay more attention to the baby. This may calm and satisfy your dog when you have to nurse your baby or change their diaper.
Prepare Children for Dogs
1Show your kid how to pet the dog in a nice manner. This may prevent your kid from patting your dog too hard or hurting them unintentionally.
- Take hold of your child's hand, then use it to gently pet the dog. This will help your child better understand the petting process.
2Show your kid how to play fetch with your dog.
- Have your kid throw toys and balls away from the dog instead of at the dog. Your kid will understand how to play fetch when the dog begins to chase the object, then brings it back for additional play.
3Teach your child to stay away from your dog while your dog sleeps and eats. Your dog may become irritable and angry with your child if your child pesters them during sleeping and eating.
4Scold your child if they tease your dog for an extended period of time. Your dog may become upset and uncomfortable with certain types of roughhousing behavior; such as ear-pulling or jumping onto the dog while they are resting.
5Allow your children to maintain the dog on a regular basis. This will help establish a trusting, friendly relationship between your children and the dog.
- Engage your children in bathing or combing your dog, or providing them with food and water on a regular basis.
Community Q&A
- Reward your dog with a special treat if they have endured behavior from your children that may have made them uncomfortable; such as if the children played with the dog's food or poked the dog repeatedly with a finger.
- If you already have a child and are considering adding a dog to your family, choose a breed that copes well with children; such as golden retrievers or labradors. You may also want to speak to a pet store representative or veterinarian for additional recommendations on dogs that get along well with children.
- Do not leave your babies or young children alone with your dog at any time, even if you feel your dog is well-behaved. Your dog may exhibit violent behavior or your child could unintentionally hurt your dog.
Article Info
Categories: Raising Children


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It is a dense read with fewer "cognitive party tricks" than the pages of so many other popular books on the subject, but it's fascinating, even as I'm only halfway through it.
Since I've recently sold some positions and also have some new clients, I have the "high class problem" of having capital to put to work. So the book arrived just as I'm searching for new ideas and as a result, the aspect of the book that's come into sharpest focus is the relative nature of observations and its relationship to decision making.
We all know that colors have a relative nature, changing depending on the background. And we all know there is a relative nature to sound, to speed, to taste, to time, etc.
Concurrently, the book also introduced to me the concept of "bounded rationality", which describes our tendency to frame things in a specific way, then solve for the problem within that arbitrary frame. For example, my wife often poses questions at me along the lines of "would you rather do this or that?" as if those are the only two options available, and without articulating the problem she's trying to solve. (I'll acknowledge the difficulty of being married to an over-analytical spouse when all she wants to do is go out for dinner).
Reflecting on these aspects of decision making is critical for the obvious reason that ours is a decision making business and few people do it well consistently. Though the first year of my firm provides a good start, consistency is measured in years not months, and I still have a lot to prove.
Furthermore, the returns we put up isn't some theoretical experience; I have a fiduciary obligation and professional responsibility to grow my client's capital and avoid losses on their hard earned money. It's important to get it right and I better not screw it up!
So with these new insights into the relative nature of observations, it comes to mind that the search I've been conducting for new ideas may be rife with biases I'd never before considered. Here I am reading Q's and K's, learning about businesses, screening, modelling, reading, reviewing ... and saying "no" over and over ... and up percolates an emotional experience, let's call it "frustration", about not finding good ideas.
Frustration can lead to impatience ... and then perhaps the relative nature of observations takes over ... and I'm suddenly comparing the next idea to the last idea instead of to an objective benchmark. Each idea is independent of the other - and I should be more eager to preserve cash for the right idea than rush into the wrong one - but what if I'm suddenly framing them relative to each other and thus distorting the analysis?
The problem with all this is twofold: First, the potential lack of awareness that fatigue and relativity can drive decisions. Second, because most of the stocks I tend to buy are lonely trades where validation can be incredibly delayed, I might not know whether I'm "right or wrong" about a stock for months, if not years. I'd rather hold cash than be wrong ... but I'd like to not miss opportunities to be right.
All of a sudden the obvious and well discussed theories behind deep value investing are crystalized: If you buy companies for less than its asset value, you don't have to worry so much about the future. It's an easy philosophy on paper but less so in practice, because some "deep value" businesses absolutely suck and the good ones don't trade for below their asset values for long. Value, as we all know, is infrequently obvious.
"It would be convenient to say that adherence to value investing permits investors to avoid conjecture about the future and that growth investing consists only of conjecture about the future, but that would be a considerable exaggeration. After all, establishing the current value of a business requires an opinion regarding its future, and that in turn must take into account the likely macro-economic environment, competitive developments and technological advances. Even a promising net- net investment can be doomed if the company's assets are squandered on money- losing operations or unwise acquisitions.
There's no bright-line distinction between value and growth; both require us to deal with the future. Value investors think about the company's potential for growth, and the "growth at a reasonable price" school pays explicit homage to value. It's all a matter of degree. However, I think it can fairly be said that growth investing is about the future, whereas value investing emphasizes current day considerations but can't escape dealing with the future."
The future, the fact that nobody knows it, and the risks associated with its possible outcomes are important considerations in all investments. One I've been considering - Invuity - which makes lighted surgical equipment for the operating room, recently sold off b/c of weaker than expected guidance for 2017 (the near future), but I think it may represent a compelling long term opportunity.
At $6.00, Invuity (ticker: IVTY) has a $100M market cap and is trading at ~2.5x 2017 sales guidance of $40M-$42M, a future that implies 35% topline growth. This is - I believe - a "capitulation price" for a company innovating in an overlooked and undervalued area of the surgical equipment market and in an industry where stocks tend to trade in the range of 2x-10x sales.
The company's core product is an engineered piece of plastic that delivers cool bright light with a wide field and few shadows directly into the cavity of a surgical "field". This piece of plastic – for simplicity sake let's just call it a widget for now – either clips onto a reusable retractor that the company sells or is built into the company's version of ubiquitous operating room tools like "yankauers" and "bovies".
The company has two types of sales; a "capital" sale - an expensive piece of reusable equipment - and a "disposable" sale (ie recurring) via the handheld equipment and clip on widget. These products together improve visualization - a surgeon's ability to see - in non-laproscopic / non-robotic procedures.
The company currently markets these products into four narrow verticals: Breast oncology, orthopedic surgeries, thoracic and spine procedures. Some procedures like "nipple sparing masectomies" and "anterior hip arthroplasties" are particularly well suited for the device as they are fairly technical and involve smaller incisions for open surgery, making "visualization" difficult.
These procedures benefit the patients via less scarring and/or faster recovery times so the concurrence of the new procedure's acceptance and the improved equipment may help grow their use and thus demand for the equipment, etc. (Note that despite the negative bias towards the anterior approach in this link, it acknowledges speedier recovery for the anterior approach as well as the greater difficulty with visualization).
B/c of the NSM procedure the company has had the greatest traction with breast oncology - about 40% of sales - but has under-penetrated the more lucrative spine and orthopedic procedures.
This is still a small company - not just in market cap but in actual size - selling just a few products into a few narrow verticals. At 3Q16, the most recent quarter, the company had 65 salespeople, many of them with the company for less than a year, selling into 700 accounts. Small, yes, but on a relative basis, compared with last year, this reflects 25% growth in salespeople, 50% growth in accounts, and a 63% increase in procedures per quarter, to 26,000 from 16,000 in 3Q15.
It is worth noting here that IVTY's head of R&D, Paul Davison, was the head of R&D at PEAK Surgical, before it was acquired by Medtronic in 2011. At the time of the 2011 acquisition, PEAK had $20M in sales and was acquired for a 6x sales multiple.
So what don't we know?
I have talked to a number of doctor's about the product for qualitative background. One, whom I respect and admire greatly, insists on caution with the investment. "They're not the first to try to do this," he says. "There've been people trying to come up with better lights on surgical tools for more than 30-years."
My response: "That's proof it's a problem searching for a solution."
Several other doctors I talked with expressed enthusiasm for the product; "Tt would be awesome if it did what they say it does" but they all universally blanched at the price.
And price is an issue. The company charges a huge 10x premium for their lighted product. Their disposable yankauers and bovies as well as the clip on widgets (called "waveguides") cost $250 to $300 compared to non-lighted versions of the same products, which cost under $25.
In a market with thin margins for hospitals and risk that ACA will disappear, it seems ridiculous to think hospitals will pay this much for disposable plastic. The product pricing is the first of many obvious reasons why this company fails.
Yet, despite the premium and all the other obvious reasons, the company is on track to sell $24M of these disposable plastic products in '16 (and $8M in reusable products that the widgets clip into), all at +70% gross profit margins. And these are pure cost to the hospital; there is no CPT code that allows the hospital to get reimbursed for its use.
The reasons for the company's potential success are less obvious. Again, this investment depends on a future. But experience indicates that it takes time – and costs money - to introduce a new premium product to the market and for the market to adopt it. It takes time for a salesperson to "mature" and an account to "mature". It takes time for doctors to see the light and press a hospital Value Analysis Committee to buy for them a premium priced piece of equipment.
And yes, the costs of selling currently exceed the revenues, but perhaps there is overlooked promise in the early operating evidence, particularly with the recurring revenue disposable widgets and most particularly at 3Q16, where the ratio of incremental sales to incremental marketing spend reached an inflection point and increased to 48%.
Management expects to keep sales staff flat into 2017 and focus on going "deeper" into existing accounts and were this to happen, we would see continued revenue scaling and then perhaps we are just now seeing the inflection and impact of more salespeople and more accounts on revenues.
Yet, the market is most skeptical as signs of success are improving. That skepticism, which underlies the low multiple, is driven by a variety of issues I'll lay out below:
1. The proximate issue with the recent decline in the stock price was a guidance shortfall. On the 3Q16 earnings call, mgmt guided to 35% topline growth in 2017 down from expectations of 50% growth, and this led to the stock's capitulation. The stock was trading towards $13 heading into the quarter and hit $4.50 on the earnings release.
The 3Q16 sell-off reflected the market's focus on the weak guidance. Through the lens of a DCF model, such a response makes total sense: If T+1 income is lower, the whole valuation declines. But from a qualitative perspective, there should be no point in investing in this company at any price – regardless of what the DCF says - nor under any circumstance without the belief that IVTY's usefulness to its customers will grow over time, along with its sales and eventually profits.
What drives long term growth of a company – qualitatively - is a problem identified and solved at a price the customer can afford. We see evidence in the operations that the company's illumination products are indeed solving a problem and they are generating traction on the valuable recurring revenue side of the business. But ...
2. Price seems to be a major issue.
A former employee I talked with said cost is the single biggest obstacle with "going deeper". This person said as they "get deeper" into accounts and sell more into each hospital, eventually the invoices roll up to the CFO who pushes back.
In addition, every doctor I talked with - bar none - expressed shock at the cost.
A former employee I talked with said cost is the single biggest obstacle with "going deeper". This person said as they "get deeper" into accounts and sell more into each hospital, eventually the invoices roll up to the CFO who pushes back.
In addition, every doctor I talked with - bar none - expressed shock at the cost.
The company says the better lighting enables doctors to perform surgeries faster and therefore do 1-2 more per day. A response I got from another doctor was polite laughter: "If I were to make a list of items that slows down my [thoracic] surgeries, lighting would be like item 1,700."
The company also said interestingly, "when we show up on the CFO's desk, it means we're doing something right." Reminds me of the old saying: "Salesmanship begins when the customer says no."
3. In addition to being high priced, there's no CPT code for the product, so hospitals don't get reimbursed for their use. And hospitals aren't rolling in cash to spend on expensive equipment.
4. And recently there seems to be a lot of salesperson turnover.
5. And surgical procedures are supposedly moving away from open towards laproscopic and robotic
My response on these four items is that these issues are not "new".
A brief look at a scuttlebutt message board for pharma sales reps shows people talking about the high product pricing, employee turnover, competition, etc. since at least 2014. In the interim, sales have grown from $14M to $32M.
Meanwhile, the cost / benefit analysis of robotic surgeries doesn't appear to be compelling (though as long as insurance covers it, hospitals will do it).
More broadly, product price is a solvable problem. They can continue down the path of a $250-$300 ASP, scratching for sales within the four narrow verticals and with the new product expected to come out in 1H17, they can offer bundled pricing.
Or, they can lower prices. These products are cheap to make and if the product is desired, the potential for ubiquitous access across all hospital channels at a lower price is an attractive investment option, though even more attractive at the higher price.
6. Ultimately though, the skepticism is bound - like life itself - by the limits of time. The company is unprofitable, running at losses of $40M in 2016 on sales of $32M and gross profit margins +70%. It also has $14.5M of outstanding debt at 12.5% interest, held by Healthcare Royalty Partners, a medspace investment firm that also owns 5% of the stock. And although the company has $34M in net cash on the balance sheet, it is still cash flow negative so at some point, there will be a future dilution event.
This is no walk in the park, but startups with losses and debt are not unusual, and this isn't the first rodeo for the management team - lead by CEO Phil Sawyer and CFO Jim Mackaness - who have prior experience running growth distribution businesses.
Nobody knows the future, but at ~2x 2017 sales, the stock market appears skeptical about the prospects due to losses, debt, the recent guidance shortfall, and issues that are not new.
That skepticism overlooks what appears to be some traction in the recurring revenue business and the traction is new, the evidence of success is new, the favorable relationship between the sales and cost curves are new and trending in the right direction.
Sure, my biases and frustrations, hubris about my successes, shame about my losses, all may have contributed to this idea floating up to a level of thinking that ... maybe it's totally irrational. A yankauer for $250? A plastic widget with some special light? Hospitals spending money on stuff they don't get reimbursed for?
Maybe I've talked myself into a bad idea ... but when the market is already valuing this as a bad idea ... and the evidence suggests that its not failing ... it seems to offer a favorable possibility for those armed with information and an uncommon perspective.


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The school does not have electricity at the moment however it should be back on by 6pm tonight. We will update you in the morning to confirm this is the case. Fingers crossed we are all in tomorrow!
Front Page news >
Front Page news >
Updateposted 13 Feb 2014, 08:51 by Hayley Rogers [ updated 13 Feb 2014, 08:52 ]


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so dreamy I die
The Weekly Leibovitz: Disney - Year of a Million Dreams
Posted by Tigerlilly Quinn at 14:26
Labels: annie leibovitz, beautiful photography, disney
2 comments:
- Nicole Alesi said...
Incredible photos! Thanks for posting!
- 6 December 2010 at 14:33
- the secret tea party said...
i love this set of images, i remember when they first came out and i was like wowww. lovely posts my dear x x
- 6 December 2010 at 19:21
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The Salvation Army Providing Critical Services in North Texas Following Severe Weather
Press Release
May 11, 2015 – 3:51 PM EDT
Philip Burn
(214) 956-6243
Dallas, TX (May 11, 2015) – After a weekend of damaging weather in North Texas, including tornadoes, severe thunderstorms, high winds and flash flooding, The Salvation Army is providing assistance in several communities and stands ready to respond across the state. The State Operations Center in Austin has been activated and a Salvation Army Liaison has been available to coordinate with other State Agencies and Voluntary Agencies in multiple response efforts.
Sunday, May 10, saw response from Salvation Army disaster teams in Abilene, Corsicana, and Tyler. The Abilene Corps was called to provide assistance in Cisco, Texas by the local emergency management agency at 9:00 AM. Staff provided emotional and spiritual care, meals, hydration and snacks to first responders and survivors. The disaster canteen (mobile kitchen) remained on the scene on Monday morning and will stay as long as necessary.
In Corsicana, The Salvation Army was requested to open an emergency shelter by the local Fire Chief at 10:00 PM. The Corsicana Corps provided shelter, snacks and emotional and spiritual care for 16 people following extensive flooding in the area and remain on stand by for this evening. "We opened up the Fellowship Hall as a shelter after receiving the call to help," said Sgt. Toby Romack, Corps Officer in Corsicana. "There were a number of stranded motorists who had been caught on flooded roads and several other people who were flooded out of their homes and had nowhere else to go. The Salvation Army is here to provide help to those in our community when they need us most."
A tornado struck the East Texas city of Van late on Sunday evening destroying several homes and forcing some residents to evacuate due to a gas leak. The Salvation Army in nearby Tyler has activated its mobile kitchen and is providing support to first responders and survivors in Van.
With the continued threat of severe weather forecast for the upcoming week The Salvation Army remains on standby and ready to respond where needed.
If you are interested in learning more about The Salvation Army Emergency Disaster Services (EDS) in Texas, or to become a local disaster volunteer, please visit: www.disaster.salvationarmyusa.org.
For the most up-to-date emergency disaster services news from The Salvation Army in Texas, please visit: www.disaster.salvationarmyusa.org and follow latest updates on Twitter @SalArmyTXEDS and Facebook at www.facebook.com/SalArmyTXEDS.
About The Salvation Army Emergency Disaster Services:
"The Salvation Army, an international movement, is an evangelical part of the universal Christian church. Its message is based on the Bible. Its ministry is motivated by the love of God. Its mission is to preach the gospel of Jesus Christ and to meet human needs in His name without discrimination." While every disaster is unique and creates its own special needs, the core of The Salvation Army's disaster program consists of several basic services. And while these services address many of the typical needs of a disaster survivor, Salvation Army disaster relief is also flexible. Our services are adapted to the specific needs of individuals and communities and scalable according to the magnitude of the disaster.