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An autumn iris: 'Eternal Bliss'
I know I promised some veg posts this week but they will have to wait another day because one of the new iris is in bloom. I planted a big selection last autumn and they mostly did well this year. Among them were a few remontant (reblooming) iris. These are standard bearded iris that have the potential, if conditions are right, to produce spikes in late summer, autumn and early winter, depending on the variety and the season. I met my first remontant many years ago and became very interested in them. I went to California to see Monty Byers in the late 80s and was further inspired. He was the greatest producer of remontants, as well as space agers, and many of his introductions have stood the test of time. So here I have his 'Eternal Bliss', introduced in 1988.
It is not the biggest or most spectacular iris but it is a lovely thing. The flowers of remontants often vary a little according to when the flowers open and the autumn blooms are often deeper in colour than the spring blooms. 'Eternal Bliss' is basically white with a pale violet suffusion and a tangerine beard. I think the colour is a bit more violet in these autumn blooms though the sun we have had has faded them to almost white. The blooms are nicely ruffled with a little lace and they are nicely scented. When the whole bed is in bloom in May I don't really appreciate the scent of the iris enough but right now, the perfume from just these few flowers is delightful.
Geoff's rating 9/10
Garden rating 7/10


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Cold and Flu Season Etiquette
The weather is giving us a little break in this area of the country, and it's starting to feel like (ahhhhh!) SPRING! Though we know better in the Midwest than to think Winter is done with us, the hope is certainly there. But one thing is for sure, the colds aren't gone just yet!
I sat down to talk with the lovely host of Better Kansas City to talk about cold and flu season etiquette. Can you avoid shaking hands for the benefit of attempting to stay healthy? What do you do with a guest who is clearly under the weather? We tackled all of this and more in our segment. Below are a few quick Do's to help you stay safe AND civil during cold and flu season!
DO Shake Hands! The damage you can do by avoiding or refusing a hand shake, especially in a business situation, may be detrimental. Etiquette is all about building relationships, and properly greeting someone is an important part of that. Shake hands and then, if needed, discretely excuse yourself and wash your hands.
DO Stay Home! If you've been invited to do something with others (let's say a dinner party...) and you are feeling under the weather, be considerate of the other guests and don't bring your ailment to the party. On the show, we talked about the reverse - What if you have a guest who is clearly under the weather in attendance? Do you ask him/her to go home? Your good manners would never do such a thing, just be the gracious host you are and don't bring attention to it.
DO Hold The Door For Others! Keep your gracious manners in mind and continue to grab and hold that door for others. With everyone scurrying inside quickly to get out of the cold, this is such a simple way to show consideration and respect for others.
DO Excuse Yourself! Don't forget that some things have no place at the table. If you need to blow your nose or manage a prolonged cough, do excuse yourself from the table to the restroom. Your fellow companions will appreciate it!
And one last one that I selfishly include - please DO wipe down the exercise equipment after each use:)
Hang in there! Spring is just around the corner!

subset: commoncrawl


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Category: Family
Day 324/365 A Warm Pocket
It has been happening bit by bit…this change… My soon to be twelve-year-old daughter has one tentative foot into her adolescence, and one foot still carefully positioned in the land of childhood. Her dirty converse high tops straddle them both, not entirely belonging in either…existing in the in-between. The metaphor I so readily conjure is that of a butterfly… The green and gold chrysalis … Read More Day 324/365 A Warm Pocket
Day 322/365 This Wild and Precious Life
As many of you know, my family has been taking the same spring trip together for over twenty years. If you have been an avid reader of this blog, you may have, in a sense, taken the trip with us last year. Coming just five months after my father's death, it was hard. I tearfully joked that I felt we should have purchased an … Read More Day 322/365 This Wild and Precious Life
Day 301/365 Braving The Rapids
I was twelve years old when I first understood that my mother would do anything for her children, without hesitation. In fact, she would drown. The creek, which was often completely dry, sometimes offered a gentle current into which we could dip our toes… But on this day, it was raging. I had never seen it that way before, nor have I ever since. … Read More Day 301/365 Braving The Rapids
Day 294/365 (You Don't Have To) Do It Yourself (This Time)
When my mother was diagnosed with cancer, she was caught completely by surprise. She had not felt the least bit ill. It was odd explaining to my daughters that their Nana is sick. She certainly didn't look sick. As time went on, the chemo treatments did what the cancer had not – they made her feel incredibly ill. It's surreal, watching the nurses don … Read More Day 294/365 (You Don't Have To) Do It Yourself (This Time)
Day 287/365 F*ck That
I knew she was feeling better when she sweetly suggested I put a sign outside her door telling the priest making rounds to Fuck Off. I howled laughing. You have to understand, this is a woman who didn't give herself permission to curse in front of me until I was about 40 years old. I still find her use of the word "fuck" entirely … Read More Day 287/365 F*ck That
Day 279/365 Recline, then Bloom
Maybe it's because she's always hated reclining chairs. My mother has impeccable taste, both in her home and on her person. Owning a reclining chair was, for many years, tantamount to wearing sweatpants… It's just something she would never do. I'm not really sure how the (very tasteful) recliner ended up in my parents' den, but I imagine it had something to do with … Read More Day 279/365 Recline, then Bloom
Day 256/365 How We Got Here
Mom and I are having our weekly date at the infusion center. I thought today I would write about how we ended up here. Maybe it'll impact someone. In the summer of 2016 I had a mammogram. Shortly afterward I received a letter from Newport Hospital, stating that while nothing had come up on the images, because of my "dense breasts" they could not guarantee … Read More Day 256/365 How We Got Here
Day 247/365 A Bundle of Gratitude
I have always been adamantly opposed to putting up a Christmas tree in November. This year, though, I really wanted to decorate for Christmas early. "Bring on the shine and the joy!" I thought. We went and picked out a tree yesterday. As a single woman, lugging the tree off of the top of my car and carrying it into the house myself brings … Read More Day 247/365 A Bundle of Gratitude
Day 245/365 Like the Stars at Noon
"Yet that light is always present, like the stars at noon." – Peter Matthiessen, "The Snow Leopard" Depression and grief have been frustrating emotions for me. They are hollowing, damp and heavy emotions, and being IN them is hard in and of itself, but for me the hardest part has been knowing these emotions are not my true nature. I know the lightness of which … Read More Day 245/365 Like the Stars at Noon
Day 244/365 Choose Your Own Adventure
"You should come with me," he said. "I just booked a flight this morning." It was Eric on the phone, a week ago. (Shockingly) I burst into tears. Being that spontaneous was not something I thought I could do. Not right now. After all, I take my mom to chemo on Fridays. I'd also have to make arrangements for the girls to spend a … Read More Day 244/365 Choose Your Own Adventure
Day 238/365 The Elephant Revealed
"…and so I start chemo next week," she said, exhaling. My heart started racing the moment she told me I should sit down. Then it all became a blur of words like "tumors" and "biopsies". I struggled to bring this information into focus – to process what she was saying. She has cancer. She'd known for a month. She'd gone to all the tests … Read More Day 238/365 The Elephant Revealed


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Enjoy for 3 ore 7 days 26 excursion destinations.
We have something extra special for our Osttirol friends, fans, and guests: the memory-function on our website.
While riding in East Tyrol without fail there is one saying which you will surely adopt from the good old vernacular – 'Happiness on this earth is being on horse-back.' Anyone who has ever been on a horse in East Tyrol, or been in a horse-drawn carriage, will be able to confirm this saying emphatically and loud and clear. Not literally loudly, quite the contrary – very peacefully. Since a carriage ride is something which you could describe as being very romantic. The winter landscape all around you, the sound of the snow, everything is quieter. You can enjoy this very special experience in Ausservillgraten and in Strassen too. Preferably by moonlight, to bring the romance level up a notch further.
Walder Gottfried
Price: up to 6 persons € 60,-; each more person € 10,-; max. 10 persons; children 50% discount
Tel. +43 (0)664 4949171
Ingo Führhaupter
Price: up to 5 persons € 50,-; each more person € 10,-; max. 11 persons;
Tel. +43 (0)4843 5188
St. Jakob
Walter Ladstätter
Price: up to 2 persons € 55,-; each more person € 10,-;
Tel. +43 (0)487351039
Matrei i.O.
Steiner Andreas
Price: up to 4 persons € 50,-; each more person € 10,-; max. 8 persons;
Tel. +43 (0)699 118 383 81
Anyone who wants to have a try at horse-riding and look for this happiness on horse-back, and doubtless find it too. There are opportunities to enjoy guided rides and you can even swap your horse for a pony. Meggie the pony would certainly look forward to a little ride. There is so many other riding activities – professional escorts and instruction, relationship training, riding lessons, taking part in rides and and. You can even bring your own horse on holiday to East Tyrol if you like! So you see, there is plenty on offer for horse lovers in East Tyrol. So you don't have to be without a horse during a holiday in East Tyrol.
Prägraten am Großvenediger
Family Kratzer, Bobojach 4
Tel. +43 664 279 55 13
Check out our latest brochures or look up online.
3 nights incl. halfboard and day tickets for fishing
from € 405,00 p.P.Info/Inquiry
3 nights incl. halfboard and day tickets for fishing
from € 405,00 p.P.more information


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Photovoltaic Safety for Firefighters Courses Location: Shaftsbury Fire Station Date: Monday, May 22, 2017 Application deadline: Monday, May 8, 2017 Time: 1830 - 2200 Location: West Dover Fire Station Date: Wednesday, May 24, 2017 Application deadline: Wednesday, May 10, 2017 Time: 1830 - 2200 Register by submitting a General Admission Application to the Vermont Fire Academy by the deadline indicated above. Solar Photovoltaic (PV) systems are becoming more common on homes and businesses across Vermont. Building mounted PV systems present special considerations for firefighters when handling emergencies within these buildings and around these systems. This course will provide the participants with information about what firefighters need to know to safely deal with fires in buildings equipped with PV systems and other emergencies that occur around ground mounted PV equipment. Topics include an introduction to photovoltaics and electrical theory, recognition of PV systems and components, general PV system operation, common safety labeling, tactical considerations, disconnecting means, fire suppression and ventilation issues, and the hazards associated with fire service operations in the area of a PV system. Emergency Vehicle Driver Training
Location: Springfield Fire Station Classroom - May 31 & June 1 (1800 - 2200) Practical - June 4 ( 0800 - until finished) Student Minimum: 15 Student Maximum: 24 Application deadline: May 17, 2017 Please apply by submitting a general admission application to the Vermont Fire Academy by the Application deadline listed above. This program was developed by VFIS, to teach the emergency vehicle operator proper driving technique, the mental as well as the physical aspects of the driving task. The program points out the long term impact of an accident involving an emergency vehicle on the operator, the emergency service organization and the community in which they serve. Includes both classroom and practical driving course. Minimum class size is 15 students, maximum class size is 24 students. Prerequisites: Valid vehicle operator's license. Water Rescue Safety and Awareness
Location: Hartland Fire Station When: Saturday, July 22 Time: 0800 - 1200 Application Deadline: Friday, July 7 Course Minimum: 15 students Please apply by submitting a general admission application to the Vermont Fire Academy by the Application deadline listed above The Water Rescue Safety and Awareness course is part of a series of courses designed to develop and enhance your skills as a rescuer. These programs are delivered both in the field and as residential offerings at the Vermont Fire Academy to allow you the opportunity to continue your education and training as a rescuer. This course is designed to introduce Firefighters and EMS personnel to water rescue at the awareness level of response. The course is an informational course with no hands on training component; it is not intended to provide instruction in water rescue skills. To be able to perform water rescues, personal should obtain hands on training such the Water Rescue Operations or Swift- Water Technician level courses. The overall objective of this course is to enhance the safety of the first responders at water rescue incidents by increasing their knowledge of the hazards of water rescue and the techniques and equipment needed to manage those hazards. At the completion of this course, the student shall have: an awareness of the risks in water incidents, the ability to recognize hazards at water incidents, knowledge of the VFA water rescue training program, the ability to identify local water rescue resources, the ability to identify basic shore based rescue techniques, the ability to identify water rescue equipment, and an awareness of the risks in water incidents.


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Living Room. Friday , October 19th , 2018 - 07:20:42 AM
Quote from elegant living room furniture set :
The living area is the very happening area of this home as all Our guests are entertained . Can it be a little family get together or a massive celebration, living area is a significant section of our home and so needs to pay particular attention to if decorating.
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Protect its value...
Regular servicing and inspection will not only extend the life of your vehicle, but also protect its market value.
Three Point Four are the leading De Tomaso restorers in the UK. Our specialist mechanics and technicians undertake full vehicle inspections, including mechanical, interior, bodywork and chassis checks. We will work with you to agree a maintenance and repair programme to keep your vehicle safe and at the pinnacle of condition.
Contact us today and we will be happy to discuss these expert services with you.


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The Download's Swap Meet: "You got some junk that you think is worth something?"
It's Wednesday night so that means it's time for the Swap Meet sponsored by Wolff's Flea Market! Greg Flamm aka The DuPage Picker is here to evaluate your old collectibles. Want to find out how much that 1985 commemorative Bears poster is worth? How about Ron Santo's rookie baseball card? What about those old Ronald McDonald dinner plates from late 70s? You have the questions and Greg has the answers! It's "The Swap Meet!"
Follow Justin on Twitter and give him a like on Facebook. The Download with Justin Kaufmann airs Monday through Friday from 7 pm. to 11 pm on @WGNRadio


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Incidence Of Low Back Pain
Incidence Of Low Back Pain
- 79.2% of Australians Suffer Low Back Pain at some point in their life. (J Manipulative Physiol Ther. 2004 May;27(4):238-44.)
- 67.6% suffer mild low back pain in any 12 month period
- In any 6 month period around 10% suffer significant disability from low back pain
- Most frequently seen musculoskeletal condition in general practice.


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In an increasingly complex, unpredictable world it can be difficult to find clarity in your thoughts and peace of mind. Simplifying your behavioural patterns, removing unnecessary responsibilities and organising and streamlining possessions has been shown to reduce anxiety, stress and indecision.
A cluttered environment and mind greatly reduces our ability to focus and concentrate. By learning to identify and remove unneeded mental and material possessions, productivity can be boosted and creativity can take flight.
Reclaim space & time
Reclaim physical and psychological space with fewer responsibilities to consider and maintain, providing you with more time, space and energy to focus on the pursuits which really matter.
Ambi Mistry is a Social Psychologist and Life Coach who specialises in helping clients let go of their excess material possessions and mental clutter to live happily with less.
She is a graduate of the London School of Economic's Department of Psychological and Behavioural Science, where her research focussed on Consumer Psychology and culminated in the UK's first report on the rise of the Minimalist movement.
Using a dynamic framework tailored to individual needs, Ambi has developed a unique, blended approach to helping her clients live happily with less.
Book a free 45 minute consultation to learn more and explore if letting go could bring greater clarity, productivity and space to your life.
Press & Speaking Opportunities
Ambi is available for interview and speaking opportunities on matters concerning her research and coaching, including:
- Consumer psychology
- Behavioural psychology
- The psychology of decluttering and letting go
- Minimalist lifestyles
- The psychology of creativity and innovation


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Two Young Buck Deer Playing
Close-up of two young white-tail buck deer play fighting in a grassy field, shot through the trees in early fall.
Canon EOS Rebel T6i 1/250s, f 6.3, ISO 1600, 600 mm
License: CC0 Public Domain
Note: If you intend to use an image you find here for commercial use, please be aware that some photos do require a model or property release. Pictures featuring products should be used with care.
268,454 free pictures
2,202 users online
Public Domain Pictures.net created by Bobek Ltd. Copyright 2007 - 2019 by Bobek Ltd. Registered in England and Wales No. 5951382


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The Copyright Licensing Agency (CLA) has partnered with KYOCERA Document Solutions UK to create a new app that collects information about school copying, thereby reducing the burden of administration for schools.
'CopyScanPublications' is a free app that can be installed on the school copiers and scanners to collect the copying data that is required by CLA to make royalty payments to authors, visual artists and publishers. The app captures copying done by staff of any articles, chapters or other extracts from publications that they use for teaching.


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Learnings from SlideShare – How to get to 75MN monthly visitors on a zero marketing budget!
Happened on :Duration : 60 Minutes
Consumer internet companies like Facebook, Twitter, YouTube, SlideShare have grown large user bases without explicitly spending money on marketing activities. They have used their products' inherent virality to achieve mass distribution on the web.
Join us in this webinar with Amit Ranjan, CoFounder of SlideShare to learn about the concept of virality and how you can utilize it for your business. Key takeaways from the webinar would be:
- Virality as a concept
- How is virality different from marketing, buzz, word-of-mouth
- Depth v/s width strategies
- Viral coefficient & the maths behind it
- Viral strategies used by Facebook, YouTube, LinkedIn, Skype, SlideShare
- How to design and optimize viral loops
- SlideShare case study – how it used virality for growth
Webinar Leader
Amit Ranjan
Co-founder, SlideShare


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Frequently Asked Questions
Here are some of the more frequent and common questions asked prior to both Breast Augmentation and Facelift and Neck Lift procedures. Anything question not answered here, will be covered off in your personal cosmetic surgery consultation with Mr Riaz.
What is a Breast Implant? . . .
A breast implant consists of an outer shell and a filling material which is most often silicone gel or sometimes salt water (referred to as saline). Some implants are round and others are shaped more like a natural breast, referred to as tear drop or anatomical implants. Either can give excellent results. The manufacturers life expectancy of breast implants is 10 or more years, although implants can stay in without problems for a much longer time.
How safe is Breast Augmentation? . . .
Breast augmentation has for many years been the most common cosmetic procedure in the UK which is testimony to its safety and ability to achieve a satisfying outcome in most patients. However no surgical procedure is without risk and understanding these risks as well as having a realistic expectation is essential.
Is Silicone Safe? . . .
Whatever the filling of the implant, the outer layer is made of silicone which is a firm type of material referred to as silicone elastomer. Silicon is a naturally occurring element which becomes silicone when it is combined with carbon hydrogen and oxygen. Silicone is manufactured into many items including cosmetics, foods and medical implants. Many studies have been conducted to establish whether silicone breast implants cause certain diseases.
How long does a facelift last? . . .
This is one of the questions most frequently asked by patients. The answer is that this type of surgery puts back the ageing clock by seven to ten years, but of course, cannot stop it from ticking. Ten years after the surgery you will of course look older but will always appear 7-10 years younger than you would have looked without surgery.
How to ensure a natural look with a Facelift? . . .
Most patients like to have a natural look without any stigma or signs of surgery. Mr Riaz will show you some before and after clinical photographs and will also point out the one which is matches yourself, as far as age related changes are concerned.
Can Facelift scars be hidden? . . .
Most of the scars after facial rejuvenation surgery are in the skin creases and settle down very nicely in the majority of patients. The most popular technique used these days leave a scar around the sideburn, which is the most prominent scar on the face after facial rejuvenation and neck lift. The scar in front of the ear is usually in the crease but part of the scar can be placed inside the ear canal. The scar behind the ear is usually in the crease. The scar over the bone behind the ear and at the hairline again settles down very nicely. Sometimes these scars can stretch and become prominent. The risk of really very prominent and hypertrophic scarring is in a very small percentage of patients. Mr Riaz likes to use absorbable deep sutures and usually there are no sutures to be removed after a face and neck lift and certainly we do not use any skin staples.
How soon can one have another face lift? . . .
About one third of the total patients coming for facial rejuvenation come for a second procedure. The choice of a second procedure depends on the type of primary procedure and also depends on the changes on the face in the years after the primary procedure. These changes are dependent on the quality of skin. Some of these patients just require skin excision only to give them a fresher appearance and other patients require a full procedure on the face and neck. Most of the patients coming back for a second operation are the ones who had a primary procedure performed 7-10 years previously. It is very rare for patients to come back within five years to have further surgery on their face or neck. Repeating the facelift which was performed seven years before is usually straightforward as there will be further laxity of soft tissue and skin as the result of the ageing process so a further lift is technically feasible. It is believed that one can have up to three facelifts before the tissues become very scarred and difficult to operate on. Secondary face lifting for unhappiness with scarring or residual signs of ageing is more demanding, as to remove unwanted scars requires the patient to have enough laxity in the skin for adequate excision and repositioning of the scars in a more favourable line. Mr Riaz will discuss with you about the appropriateness of different procedures or techniques and also about the timing of the surgery as and when suitable for you.
What type of anaesthesia will be used? . . .
Facelift surgery is carried out under general anaesthesia, so you will be asleep through the whole procedure. Mr Riaz employs the services of a skilled consultant anaesthetist who specialises in anaesthesia for facial aesthetic surgery since there is no doubt that this makes the procedure very much safer and improves the outcome.


text: Blessed with superb tone, Higgs' soundworld on his own compositions exist in Claus Ogerman-meets-Mark Isham-like musical situations, as they're highly romantic, melodic and communicative. But if someone set words to 'Clocks', it would be perfect for a singer such as Christopher Cross. You won't however find big improvisational flights of fancy or extended solos here as that's not the point although there is a jazz sensibility at play. 'Shadows and Desire' is my pick of the tunes with its Metheny-esque Secret Story-like atmosphere, and the album may well also appeal to listeners who dip in and out of light classical music as much as they do styles of jazz that have their compass set firmly from the example of the early balladic side of Miles Davis onwards. The exposition of the themes, very strong movie-quality ones at that, and their decorative interpretation, is the preferred approach, whether it's heard in the light classical style of 'Crystalline' or the sentimental 'The Glow of Evening.' SG


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Rail to the Canadian Rockies & Ice Festival
You'll be awed by the majestic peaks of the Canadian Rockies and the incredible International Ice Festival.
Tour Description
Our snowy mountain holiday begins as we board a motorcoach from Seattle to Vancouver and then VIA Rail for a stunning train trip into the Canadian Rockies. Enjoy sleeping accommodations, fabulous food and first-class service as our train winds past the ice-choked Thompson River, the tallest peak in the Canadian Rockies and mountain vistas. Watch for large concentrations of elk, bighorn sheep, and mountain goats as we enter the Park boundaries. Disembark for Jasper on board a deluxe motorcoach for one of the world's most scenic drives. Spend two nights at the Chateau Lake Louise, one of Canada's most beautiful landmark hotels. During the festival, 20 teams from around the world will have 53 hours to create ice masterpieces which will last until April. Next, we're off to Banff. You'll see a castle at the base of Mt. Rundle - our hotel for one night. See the sites of the charming town of Banff and live like royalty at the Banff Springs Hotel before departing to Jasper for our return rail trip to Vancouver. Here we board our motorcoach to Seattle.
Highlights and Inclusions
- Section on VIA Rail train with upper & lower berth, and shared bath
- 2 nights train accommodation onboard VIA Rail
- 2 nights' accommodations Lake Louise
- 1 night accommodations Banff
- 2 full breakfasts & 2 dinners
- Deluxe motorcoach transportation
- Fully escorted and narrated, so you won't miss a thing!
Day 1 - Seattle - Vancouver - VIA Rail
Our mountain holiday begins as we head north of the border by deluxe motorcoach to Vancouver, BC. Enjoy dinner before transferring to the VIA Rail station. Sit back and relax as your Tour Director shows you the sights along the way. First class treatment awaits as our Service Manager welcomes you aboard the VIA train. After settling in, our group will gather in the Glass Dome Car to watch the sparkling Vancouver skyline as we journey north. Nothing could be finer. (D)
Day 2 - Lake Louise
Good Morning! Awaken to freshly brewed coffee and the morning paper. When you look out the window, you will see the rolling hills surrounding the ranching community of Kamloops, BC. A hearty breakfast awaits onboard. The winter scenery is incredible as we wind our way along the shores of the mighty ice-choked Thompson River and past Mt. Robson, the tallest peak in the Canadian Rockies. In the mid-morning, we will arrive in the snowy little mountain town of Jasper, Alberta. All aboard our motorcoach as we sightsee on the way to Lake Louise, our home away from home for the next 2 nights. (B)
Day 3 - Lake Louise
This morning after breakfast on your own, enjoy Lake Louise. Here you will immerse yourself in the coolest (literally) celebration in Canada, the International Ice Festival. Up to 20 teams battled the ice to create masterpieces, which will last until April. Enjoy the festivities and check out the master's work.
Day 4 - Banff
After breakfast, you will have time to explore Banff on your own. Banff is a resort town and one Canada's most popular tourist destinations known for its mountainous surroundings and hot springs. As a UNESCO World Heritage Site, Banff offers rugged beauty, unspoiled landscapes, and pristine mountain ranges. Experience an unrivaled alpine escape at 'The World's Finest National Park.'
Day 5 - Jasper - VIA Rail
Enjoy breakfast on your own before boarding our motorcoach bound for Jasper, Alberta. In the late afternoon, board VIA Rail for an overnight trip to Vancouver, BC. Enjoy dinner in the diner. (D)
Day 6 - Vancouver - Seattle
Enjoy breakfast on board the train before arriving in Vancouver. We bid our train staff a fond farewell before boarding our motorcoach bound for Seattle. Welcome home! (B)
Train and Hotel Accommodations
Fairmont Chateau Lake Louise
The Chateau has an indoor pool, hot tub, fitness center, spa, game room, horseback riding stables, concierge service, gift shops, business center, several restaurants, lounge, room service, and Afternoon Tea.
Fairmont Banff Springs Hotel
For over a century, "The Castle in the Rockies" has been providing luxury in the heart of the Canadian Rockies. This historic hotel is located in Banff National Park, a UNESCO World Heritage Site. The hotel offers several restaurant choices as well as relaxing lounges, Afternoon Tea, and room service. The property has a 27-hole golf course, spa, tennis courts, indoor and outdoor pool, hot tub, horseback riding, business center, gift shops, convenience store, and concierge service.
Click here to view testimonials for Rail to the Canadian Rockies & Ice Festival.
The scenery was spectacular. It was a once in a lifetime excursion.
Dates & Prices
Select from the packages below to view prices for this tour.
|Departure Date
|24th January 2020
|Book Now
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: Departs 24th January 2020 ($2,399)
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Enter your details below if you would like to be notified when 2021 dates and prices are available for Rail to the Canadian Rockies & Ice Festival.


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The VW Motor has released preview of their future SUV 2021 Volkswagen Golf 8, The The Volkswagen Golf is rather perhaps one of the most prominent hatchbacks ever before generated. The Golf 8 have actually been a symbol of ability to move, portable layout as well as efficiency. For 7 generations, it has actually surprised motorists and also admirers alike.
The prominent warm hatch will obtain a significant upgrade with its brand-new launch. The 8th generation of this vehicle will be launched in the type of the 2021 Volkswagen Golf 8. The brand-new variation will preserve the renowned form and also the shape of the existing version. Nevertheless, the front fascia will get a renovation motivated by the golf versions from days passed. With a broader body as well as significant upgrades on the inside also, this golf variation will be profoundly pleasing for vehicle drivers and also residents alike.
2021 Golf 8 Design Preview
Minimalism is stressed in the external look of the 2021 Volkswagen Golf 8. The auto includes a lost weight front bumper. It likewise has an air-intake inside story throughout the size of this area. A set of haze lights are mounted at both ends of the bumper. They are divided from the remainder of the attribute by slim, elegant intermediaries. The radiator grille is barely noticeable many thanks to the reduced, diving hood. In addition, the fronts lights are lost weight and also attribute formed LED light bulbs.
The hood is identified by some moving wind resistant lines that bring about the side mirrors. Lost weight also, they are set down on the A-pillar and also provide a continuous line down the vehicle's body. The sides likewise have some toned lines that include personality to the auto.
The back area is equally as remarkable as the front. The taillights are wedge-shaped and also styled to look advanced. In addition, the trail entrance is smooth throughout. An eye-catching function of this automobile is that the exhaust pointers are snuggled within chrome intermediaries in the back bumper. A set of red reflectors are located right over these intermediaries and also finish the vivid back side of the automobile.
Technology & Inside Improvement
Additionally called the Golf 8, the 2021 Volkswagen Golf 8 has a captivating inside. Convenience is made the most of with the products that are made use of within the automobile. Moreover, the control panel is created such that the guiding wheel is close to the handles as well as dials which are important for regulating the different systems of the automobile.
Specifically, the guiding wheel has a 3-spoke layout. It additionally has some controls after it which the motorist could utilize to control the infomercial system, A/c (Air Conditioning) as well as a phone without taking their hands off the wheel.
The inside could be cushioned in natural leather or material depending upon the selection of the motorist. Moreover, an 8-inch display rests on top of the facility pile. Located right under some air-vents, it gives the owners of the auto with info concerning enjoyment, navigating as well as the auto's Air Conditioning setups. This Volkswagen Golf could seat 5 individuals rather conveniently. Along with that, it enables multimedia connection since it works with Bluetooth and also MP3 gamers.
2021 Volkswagen Golf 8 Capability
The 2021 Volkswagen Golf 8 will be offered with both gas as well as diesel motor. The base trim of this automobile will have a 1.0-litre engine. The Costs cut will have a 2.0 liter, in-line 4 engine. The last will probably be made use of in the GTi variation of the vehicle.
For the Sports series of the Golf 8, there will be a 3.0-litre V6 engine. The producer has actually likewise shown that there might be a crossbreed engine in the jobs too. Along with this, the auto will be readily available with both fronts as well as back wheel drivetrains. Chauffeurs will have the selection to choose from among these.
The brand-new Volkswagen Golf will be readily available with 2 transmission variations. The very first of these is a 6-speed guidebook transmission. The automobile will likewise be offered with a 7-speed transmission system. The last will have a double clutch system. This warm hatchback will have the ability to release from 0 to 60 miles per hour in just 7.3 secs. Moreover, it will have a gas mileage of around 24 mpg in the city, 33 on the freeway as well as 28 incorporated.
Launching & Price of 2021 Volkswagen Golf 8
The brand-new 2021 Volkswagen Golf 8 will be offered in the worldwide market in late 2019. In the U.S.A., it will be released in 2020. The base trim of this cars and truck will set you back $20, 715 while the leading trim referred to as the Golf R will set you back $40, 195.
Competitors For 2021 Volkswagen Golf 8
- Honda Civic
- Chevrolet Cruze
- Subaru WRX STI
- Ford Focus
- Mazda CX-3
Other People Come with This Keyword to this Article, Maybe You can Try too:
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If visitors saw each dog through a volunteer's eyes…the shelters would be EMPTY.
Take a look at Titan, available at The Humane Society of Sheboygan County. Titan is a fun loving energetic dog that would keep anyone active. Titan will always be ready to play and will greet you at the door when you come home with a playful smile.
Titan is a volunteer favorite and will make a phenomenal dog for the right family. He has been waiting a while because he, like many other shelter dogs, doesn't show well in his kennel. Please don't judge a shelter dog by your first impression of him or her behind a kennel door. Ask to meet with them in a yard or a quiet room. You won't regret it.
Titan would like to be your one and only pet AND his adoption fee has been sponsored!!!


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Naval Consulting & Management AS, NaCoM, is a privately held company and was founded in 1995. Offering marine engineering services, project management as well as personnel with key competence within military diciplines, mainly to support the Royal Norwegian Navy in executing complex material procurements.
During the summer of 2005 NaCoMs Energy division was established at Ågotnes. Offering engineering support and design of process solutions for the Oil & Gas industry. Offering it´s customers better services, better project management and taylor-made solutions.
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We at NaCoM Energy know that finding the right engineers to contribute to your projects, is a choice not to be taken lightly. That is why we offer free consultations to walk you through your needs, the scope of your goals, and your budget.


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Articles tagged "amateur sleuth"
Thriller Thursday (4/12/18 Edition)
We're thrilled to have 2 finalists for the 2018 ITW Thriller Awards!
Best Hardcover Novel
THE BREAKDOWN by B.A. Paris
Best Young Adult Novel
PROOF OF LIES by Diana Rodriguez Wallach
The winners will be announced at ThrillerFest XIII on July 14, 2018 at the Grand Hyatt, NYC.
And now for today's #ThrillerThursday reads:
A DEATH OF NO IMPORTANCE by Mariah Fredericks
Two starred reviews! Fredericks' compelling adult debut novel follows Jane Prescott, a ladies' maid in an upper-crust 1910 NYC household, after her mistress's playboy fiancé is gruesomely murdered. "The novel's voice, plotting, pace, characterization, and historical background are all expertly crafted, while the resolution—which feels both surprising and convincing—will leave readers hungry for more." — Publishers Weekly, starred review
INQUISITION by David Gibbins
Archaeologist Jack Howard and his team are excavating a 17th-century shipwreck off Cornwall in England when they find clues that lead to the fabled Holy Grail—and the present-day inheritors of the Inquisition. "Steve Berry fans eager for an intelligent blend of suspense and reality, including some horrific contemporary developments, will be rewarded." — Publishers Weekly, starred review
DATE WITH MALICE by Julia Chapman
The second book in the Samson and Delilah mystery series set in the Yorkshire Dales has the investigators looking into several disturbing incidents at the local retirement community. "Mystery readers who love to escape to Louise Penny's village of Three Pines will enjoy becoming acquainted with the Dales town of Bruncliffe and its quirky residents. The ongoing suspenseful story line will keep series fans hooked." — Library Journal, starred review readmoreremove
RT Book Reviews 2017 Reviewer's Choice Awards
Congratulations to the 28 Macmillan titles nominated for Romantic Times Book Reviews' 2017 Reviewer's Choice Awards!
Best Mainstream Fiction Protagonist
I LIKED MY LIFE by Abby Fabiaschi
Best Contemporary Mystery
A DARKNESS ABSOLUTE by Kelley Armstrong
BLUE LIGHT YOKOHAMA by Nicolas Obregon
Best Suspense
SHATTERED by Allison Brennan
Best Thriller
THE LOST ORDER by Steve Berry
LOOK BEHIND YOU by Iris Johansen and Roy Johansen
Best Amateur Sleuth
STICKS AND BONES by Carolyn Haines
Best Historical Mystery
DEATH IN ST. PETERSBURG by Tasha Alexander
THE DAUGHTER OF SHERLOCK HOLMES by Leonard Goldberg
THE ORPHAN OF FLORENCE by Jeanne Kalogridis
Best Romantic Suspense
THE WOMAN WHO COULDN'T SCREAM by Christina Dodd
Best Paranormal Romantic Suspense
STORMCHASER by Cherry Adair
Best Historical Romance
THE SCOT BEDS HIS WIFE by Kerrigan Byrne
Best Historical Love & Laughter
I DARED THE DUKE by Anna Bennett
Best First Historical Romance/ Historical Fiction
THE WARDROBE MISTRESS by Meghan Masterson
Best Erotic Romance
THE BILLIONAIRES: The Bosses by Calista Fox
Best Futuristic Romance
BORN OF VENGEANCE by Sherrilyn Kenyon
Best Urban Fantasy
ALL THOSE EXPLOSIONS WERE SOMEONE ELSE'S FAULT by James Alan Gardner
Best Fantasy
DUSK OR DARK OR DAWN OR DAY by Seanan McGuire
WINTER TIDE by Ruthanna Emrys
WITHIN THE SANCTUARY OF WINGS by Marie Brennan readmoreremove
Thriller Thursday (2/23/17 Edition)
Sleuths from 16th century England to the present abound in our #ThrillerThursday picks:
THE CROW TRAP by Ann Cleeves (also available in trade paperback)
DI Vera Stanhope investigates a murder that rips through a group of women conducting an environmental survey. "Published in the UK in 1998 and just now released in the United States, this first book in Cleeves's 'Vera Stanhope' series (which also inspired a popular television show) demonstrates exactly why the curmudgeonly Northumberland police detective gets results. It would be foolish to discount Vera because she doesn't dress smartly-she can outfox even the wiliest of criminals, while wearing whatever she pleases, and readers will delight in getting the chance to see how such a quirky character evolved. " — Library Journal
A CAST OF VULTURES by Judith Flanders
In this third series entry, book editor and amateur sleuth Samantha Clair finds herself entangled in an elaborate saga of missing neighbors, suspected arson and an odd, unidentified body. "Flanders adroitly avoids chick-lit clichés, opting for nuanced, multidimensional characters… Readers will look forward to seeing more of smart, successful, self-deprecating Sam. " — Publishers Weekly readmoreremove
#ThrillerThursday: The Softer Side (11/13/14 Edition)
Victorian England's amateur sleuth Charles Lenox has been compared to Sherlock Holmes and Dorothy L. Sayers's Lord Peter Wimsey — his creator, Charles Finch, has been compared to Agatha Christie and Anne Perry. My dear librarian, why haven't you dipped into this delightful series, yet?
"Vividly capturing the essence of Victorian England, Finch presents us with a unique sleuth who combines the deductive powers of Sherlock Holmes with the people skills of Thomas Pitt. A sparkling achievement."–Library Journal (starred review)
"Even the most astute reader will be guessing to the end. Another triumph." —Library Journal (starred review)
"A beguiling Victorian mystery [with] an amiable gentleman sleuth cut from the same fine English broadcloth as Dorothy L. Sayers's Lord Peter Wimsey."–Marilyn Stasio, The New York Times Book Review
"Readers of Anne Perry should be snatching up Finch's books and clamoring for more."–Library Journal (starred review)
"Agatha Christie meets Patrick O'Brian in Finch's accomplished fifth whodunit set in Victorian England … the best in the series to date."–Publishers Weekly (starred Review)


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28 girls are looking for a partner for Erotic Watch
Erotic literature comprises fictional and/or factual stories and accounts of human sexual relationships which have the power to or are intended to arouse the.
Hi guys Kaley Age: 18. Exclusive Playmate and international luxury companion available only for VIP! If you are looking for the absolutely top companion enjoy the most luxury and discreet companionship with a italian playmate! I'm glad I've caught your eyeMy sensuality leads us to my other gift, the gift of pleasing my chosen gentleman.I'm Hayley years old, fitness model and also avid travelerI'm looking for a cool guy to hang with
Category:Erotic short stories
Pages in category "Erotic literature". The following 17 pages are in this category, out of 17 total. This list may not reflect recent changes (learn more).
Description:In ancient Sumer, a whole cycle of poems revolved around the erotic lovemaking between the goddess Inanna and her consort Dumuzid the Shepherd. The Seven Beauties Persian: This poem is a part of the Nizami's Khamsa. This was the original method of circulation for the Sonnets of William Shakespeare , who also wrote the erotic poems Venus and Adonis and The Rape of Lucrece.


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A restaurant and function centre overlooking Lake Macquarie in the NSW Hunter region has been destroyed in a large blaze overnight with 20 motel guests being evacuated.
Ten fire crews raced to the Squid's Ink Motel in Belmont at 1.20am on Monday to find the top floor of the hotel well alight with crews working for an hour to extinguish the blaze, a Fire & Rescue spokesman told AAP.
No one was injured, said police, who are appealing for witnesses to the blaze which has caused an estimated $2 million in damage.


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To examine the cross-sectional association between obstructive sleep apnea (OSA) risk and atrial fibrillation (AF) in the REasons for Geographic And Racial Differences in Stroke (REGARDS), a cohort of black and white adults.
Using REGARDS data from subjects recruited between 2003–2007, we assessed 20,351 participants for OSA status. High OSA risk was determined if the participant met at least two criteria from the Berlin Sleep Questionnaire (persistent snoring, frequent sleepiness, high blood pressure, or obesity). AF was defined as a self-reported history of a previous physician diagnosis or presence of AF on electrocardiogram. Logistic regression was used to determine odds ratio and 95% confidence interval for the association between OSA status and AF with subgroup analysis to examine effect modification by age, race, sex, and geographical region.
The prevalence of AF was 7% (n = 1,079/14,992) and 9% (n = 482/5,359) in participants at low and high risk of OSA, respectively (P < .0001). Persons at high risk of OSA had greater prevalence of diabetes and stroke history, and were more likely to be obese and taking sleep medications. In a multivariable analysis adjusted for demographics, cardiovascular risk factors, and potential confounders, high risk for OSA was associated with an increased odds of AF compared to low risk for OSA (odds ratio = 1.27, 95% confidence interval = 1.13, 1.44). This association differed significantly only by race (P for interaction = .0003). For blacks, there was a significant 58% increase in odds of AF in participants at high risk versus low risk of OSA, compared to a nonsignificant 12% increase in odds in whites. We were limited by self-reported variables, inability to adjust for obesity, and the cross-sectional nature of our study.
High risk of OSA is associated with prevalent AF among blacks but not whites.
A commentary on this article appears in this issue on page 1459.
Ghazi L, Bennett A, Petrov ME, Howard VJ, Safford MM, Soliman EZ, Glasser SP. Race, sex, age and regional differences in the association of obstructive sleep apnea with atrial fibrillation: reasons for geographic and racial differences in stroke study. J Clin Sleep Med. 2018;14(9):1485–1493.
Current Knowledge/Study Rationale: Obstructive sleep apnea (OSA) is prevalent among 32% to 49% of patients with atrial fibrillation (AF) and has been associated with increased cardiovascular risk including several AF risk factors; this association may differ by race, sex, age, and region. We explored the association between AF and OSA risk in the REGARDS cohort and assessed whether this association differed by race, sex, age, or region.
Study Impact: Individuals at high risk for OSA have increased prevalence of AF and after multivariable adjustment this association remained significant in blacks but not in whites. This study showed that this association did not differ by sex, region, or age as previously presumed; understanding this association will be key to reducing the burden of AF.
Atrial fibrillation (AF) is the most common chronic cardiac arrhythmia in adults and is associated with significant morbidity and mortality,1,2 Epidemiological studies have consistently found an increased prevalence of AF with age,1,3 less prevalence among blacks,4 and greater age-adjusted prevalence in European and North American men than women.5 No regional differences in the prevalence of AF between the stroke belt and other regions in the United States have been observed.6 Prevalence of AF is expected to increase from 2.3 million Americans currently to 5.6 million Americans by the year 2050 and thereby will require more health care utilization irrespective of sex or race.1,7
Obstructive sleep apnea (OSA), or the periodic collapse of the upper airway during sleep, is a common but underdiagnosed sleep disorder; 13% of men and 6% of women have moderate to severe sleep.8 In a recent meta-analysis, OSA was shown to be more prevalent and severe in blacks than whites, as measured by the respiratory disturbance index, the apnea-hypopnea index, and the oxygen desaturation index of 4%.9 Furthermore, OSA is associated with increased cardiovascular risk and several AF risk factors including heart failure (HF), diabetes, coronary heart disease (CHD), myocardial infarction, and hypertension.10 Overall OSA prevalence with AF is 32% to 49%.11 In the Sleep Heart Health Study (SHHS), 4.8% of patients with OSA had AF versus 0.9% without OSA.12
There is also an increased risk of AF in patients with untreated OSA, and the 12-month recurrence of AF in patients after cardioversion is greatest (82%) among those with untreated OSA, compared to 53% without OSA and 42% for those with OSA managed with continuous positive airway pressure.13 Several studies have previously assessed OSA as a predictor of AF in special populations including patients who have undergone cardiac surgery, ablation, electrical cardioversion, coronary artery bypass patients, or those with underlying congestive heart failure.14–16 Risk factors such as age, race, and sex are common for OSA and AF. Previous investigations have shown an independent association between OSA and AF. In SHHS, a prospective community-based cohort (7% black patients), central sleep apnea but not OSA was associated with incident AF after adjustment for cardiovascular risk factors.17 In the cross-sectional analysis of outcomes of sleep disorders in older men, increased severity of sleep-disordered breathing (SDB) was associated with increased odds of AF, and in the unadjusted analysis OSA severity was associated with AF.18 However, the quality of the published data was limited because some studies examined only specific patient populations,12,19 and in a case-control study the association of sleep apnea with AF could not be verified.20,21
The REasons for Geographic And Racial Differences in Stroke (REGARDS) study, a large, biracial, and national cohort, provides a unique opportunity to study this association and offers the advantage of examining race-specific associations. Therefore, we examined the cross-sectional association between OSA risk and AF in the REGARDS study, and evaluated whether differences exist by race, age, or sex. Given the REGARDS cohorts' unique geographical distribution, we also explored whether geographical regional disparities altered this association. It is well known that geographical disparities in cardiovascular disease exist,22 but no data exist on the OSA and AF interplay.
The REGARDS study is an ongoing nationwide large, biracial (blacks and whites) prospective cohort study of adults age 45 years or older. The aim of the study is to assess factors that increase risk of vascular events with emphasis on racial and regional disparities. Details of the study have been published previously.23 Between 2003–2007, the study recruited 30,239 participants through postal mailing and telephone calls. The study oversampled blacks and individuals residing in the stroke belt (North Carolina, South Carolina, Georgia, Alabama, Mississippi, Tennessee, Arkansas, and Louisiana). Demographic information and medical history were obtained at baseline by a trained interviewer using a computer-assisted telephone interview (CATI) system. Additional information was obtained 3 to 4 weeks later during an in-home visit, including blood pressure (BP) measurements, electrocardiogram (ECG) recording, recording of information on medications, and collection of blood and urine samples. Participants are followed by CATI every 6 months to obtain information on potential stroke hospitalizations and change in cognitive function.
Between September 2008–2010, a series of sleep questions were added to the 6-month follow-up phone calls such that all active participants were asked questions about sleep, including OSA risk. The sleep assessment included the Berlin Sleep Questionnaire (BSQ),24 sleep medication use, and previous sleep apnea diagnosis and treatment.
We excluded participants who did not complete the sleep questionnaire (n = 6,264), were missing AF status (n = 501), had data anomalies (n = 56), or had missing covariates (n = 3,067). The remaining 20,351 participants were included in the analysis (Figure 1).
Exclusion cascade.
(more ...)
OSA status was determined by the BSQ,24 which was part of the sleep assessment (2008–2010). BSQ uses three symptom categories of risk for OSA including: (1) snoring (5 items), (2) daytime sleepiness (3 items), and (3) high blood pressure (BP) and body mass index (BMI) (2 items). BMI was calculated from measured height and weight from the baseline in-home visit. Hypertension (high BP) was defined as systolic BP (SBP) ≥ 140 mmHg or diastolic BP (DBP) ≥ 90 mmHg or self-reported use of antihypertensive medications obtained using the CATI system. Participants were placed into two categories based on their response: high risk for OSA diagnosis and low risk for OSA diagnosis per standard protocol.24,25 Participants were considered high risk for OSA if they met criteria in two of the three symptom categories, that is, ≥ 2 affirmative responses in symptom category 1, ≥ 2 in category 2, and ≥ 1 in category 3 (or a BMI ≥ 30 kg/m2). Participants were considered low risk for OSA if they met criteria in none or only one of the symptom categories. BSQ is a widely used tool in screening for OSA, and its validity may vary in different populations. BSQ in a population-based setting has been shown to have a high negative predictive value (96.3%) and good sensitivity (76.9%) in ruling out OSA and has moderate sensitivity (58.8%) and moderately high negative predictive value (82.9%) in predicting apnea-hypopnea index ≥ 15 (moderate OSA).26–28
The presence of AF was determined by ECG evidence obtained during the in-home visit or self-reported history of a physician diagnosis of AF during the initial telephone survey (2003–2007). Self-reported history of AF was assessed by a positive response to the question: "Has a physician or a health professional ever told you that you had atrial fibrillation?"29 The ECGs were read at a central reading center by trained ECG technicians who were blinded to all other participant data (Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States). A 7-lead ECG recording acquired by applying the standard 4 limb electrodes and a midsternal electrode was done on the first 8,459 REGARDS study participants; the remaining participants underwent standard 12-lead ECG recording. The ability to detect AF is not affected whether a participant underwent a 7-lead or 12-lead ECG.30,31
Demographic characteristics and socioeconomic factors included self-reported age, race (black or white), sex, income (less than $20,000, $20,000–$34,000, $35,000–$74,000, $75,000 and higher, refused), education (less than high school, high school graduate, some college, college graduate and above), geographic region (stroke belt, stroke buckle, non-belt or buckle23), alcohol habits, and smoking status. Alcohol use was classified as heavy (> 2 drinks/d for men and > 1 drink/d for women), moderate (1 to 2 drinks/d for men and 1 drink/d for women), and none.32 Smoking was categorized into never, past (at least 100 cigarettes during a patient's lifetime), and current. Pulse pressure was calculated as the difference between SBP and DBP. History of stroke/transient ischemic attack (TIA) was considered affirmative if participants reported a history of physician verified stroke, or ministroke or TIA during the telephone interview.33 Other medical conditions consisted of CHD (self-reported history of myocardial infarction, coronary artery bypass grafting, coronary angioplasty or stenting, or evidence of myocardial infarction on the baseline ECG), left ventricular hypertrophy [LVH] (Sokolow–Lyon Criteria34), and diabetes (fasting glucose level ≥ 126 mg/dL, non-fasting glucose ≥ 200 mg/dL, or a history of taking diabetes medications). We assessed digoxin use at baseline as proxy for HF similar to other REGARDS publications. Current clinical indications for use of digoxin include HF and AF, and digoxin use has 28% sensitivity and 99% specificity in diagnosing HF.35 Physiological markers included albumin:creatinine ratio (> 30 mg/g was considered as renal dysfunction36), levels of total cholesterol, high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein. Sleeping pill usage was self-reported and measured with the questions, "How many days/nights in the last month have you used prescription sleeping pills?" and "How many days/nights in the last month have you used non-prescription, or over the counter sleeping pills?" Sleep medication use was then categorized as any (prescription or over the counter) versus none.
We compared baseline characteristics between those with low risk versus high risk for OSA. Categorical variables were reported as percentages and frequencies, continuous variables as mean ± standard deviation. Logistic regression was used to test the association between OSA categories and baseline AF. We computed odds ratio (OR) and 95% confidence interval (CI). A sequential adjusted logistic regression was performed as follows: model 0 unadjusted model, model 1 adjusted for pulse pressure. Pulse pressure has been associated with new-onset AF independent of other measures of arterial pressure and other previously recognized AF risk factors and therefore was included in model 1.37,38 Model 2 included model 1 covariates with the addition of age, sex, race, region, and socioeconomic status (income category and education level); model 3 included model 2 with the addition of all previous medical conditions (eg, diabetes, CHD, HF, LVH, stroke); model 4 included model 3 as well as physiological markers and health behaviors (albumin:creatinine ratio, total cholesterol, high-density lipoprotein, C-reactive protein, smoking, alcohol use, and prescribed and over-the-counter sleep medications [frequency]). Additionally, a test for interaction and stratified analysis was performed to examine effect modification by race, sex, age (younger than 75 years and 75 years or older; based on the cutoff used by the AF risk stratification CHADS(2) score [congestive heart failure, hypertension, age 75 years or older, diabetes, prior stroke/transient ischemic attack]39), and region. Evidence of effect modification was demonstrated by a value of P < .10 for the interaction term. We conducted a sensitivity analysis looking into the association of OSA and AF with different methods of AF ascertainment: self-reported AF, ECG reported AF, and AF detected by self-reports and ECG reports. SAS, version 9.4 (SAS, Cary, North Carolina, United States), was used for all the analyses.
Of the 20,351 participants included in the analysis 14,992 (73.7%) were at low risk for OSA and 5,359 (26.3%) were at high risk for OSA. Baseline characteristics of study participants categorized by OSA risk are shown in Table 1. Of those at low risk for OSA, AF was present in 1,077/14,992 (7.2%) and of those at high risk for OSA, AF was present in 482/5,359 (9%). Similar AF prevalence using only self-reported AF was reported in low- (1,023/14,992; 6.8%) and high-risk (467/5,359; 8.7%) OSA participants (Table S1 in the supplemental material). Participants at high versus low risk for OSA had greater prevalence of CHD, LVH, diabetes, and history of stroke/TIA; they were also more likely to be obese and were more likely to use over-the-counter/prescription sleep medications.
Baseline characteristics of REGARDS patients by OSA risk (n = 20,351).
In the main unadjusted model, compared to those at low risk of OSA, those at high risk of OSA had increased odds of AF (OR = 1.27, 95% CI = 1.14, 1.43). After adjustment for demographics, cardiovascular risk factors, physiological markers, and other potential confounders, high risk for OSA remained significantly associated with a 27% increased odds of AF compared to low risk for OSA (OR = 1.27, 95% CI = 1.13–1.44) (Table 2). When self-report was considered as method of AF ascertainment, odds of AF for high risk compared to low-risk OSA remained fairly similar to that observed using self-report or ECG reported (OR = 1.28, 95% CI = 1.13–1.44) (Table S2 in the supplemental material). The association between OSA risk and AF did not differ by age (P for interaction = .61, sex (P for interaction = .47), or geographic region (P for interaction = .48) (Tables S3–S5 in the supplemental material). However, the association between OSA risk and AF differed significantly by race (P for interaction = .0003) (Table 3). For blacks, high risk for OSA remained significantly associated with AF in the fully adjusted model (OR = 1.58, 95% CI = 1.30–1.93). This association was not observed in whites (OR = 1.12, 95% CI = 0.96–1.31).
Association of atrial fibrillation with obstructive sleep apnea.
Atrial fibrillation by OSA among whites versus blacks.
In this large diverse cohort, we found that high risk of OSA was associated with an increased prevalence of AF and this did not vary by age, sex, or geographical region. However, the association between AF and OSA risk differed significantly by race. For blacks, there was a significant 58% increase in odds of AF in high-risk OSA versus low-risk OSA, compared to a nonsignificant 12% increase in odds in whites after adjusting for sociodemographic factors, medical conditions and physiological markers.
Previous studies have mostly focused on the frequency of OSA in patients with AF; however, few studies have assessed the frequency of AF in OSA. Moreover, several studies assessed specific subgroup populations focusing on postsurgical events.13–15,19,40 REGARDS provided a unique opportunity to assess this association in a large national cohort of blacks and whites where high-risk OSA was associated with a 27% increased prevalence of AF after multivariable adjustment. The prevalence of AF is age specific; 3.6% among those age 66–69 years and 16.3% among those age 85–89 years.41 In our study, AF was prevalent in 9% of high-risk OSA participants, and our cohort consisted of younger individuals with mean age of 64.3 ± 9.1 and had higher rates of AF for both high and low risk of OSA (Table 1). This may indicate that AF is more common than we expected in individuals age 60–70 years. However, we found no difference in the association between OSA risk and AF when comparing patients younger than 75 years and those age 75 years and older (Table S3).
We speculate that using self-reported AF might provide sufficient information on the OSA-AF association as does ascertainment of AF using self-reported or ECG reported AF (Table S1 and Table S2); this might be especially useful in cases where ECG data are unavailable. Similarly, in the REGARDS study, self-reported AF was found to be a strong predictor of incident stroke and could be used interchangeably or in combination with ECG-reported AF.29 We had a relatively small number of participants with AF in high-risk and low-risk OSA using ECG reports alone or using both ECG and self-reports; thus, we are unable to make any conclusions about differences between these two methods of AF ascertainment.
Others have reported an association between OSA and AF and this interplay differed in some cases by OSA severity. A study following 121 consecutive patients from time of coronary artery bypass grafting surgery until hospital discharge found a higher risk of AF in patients with OSA, assessed by polysomnography (PSG), compared to those without OSA (OR = 2.8; 95% CI = 1.2, 6.8).14 Another analysis of 566 participants from the SHHS found that among individuals with SDB, odds of AF was 4 times greater than in participants without SDB as verified by PSG (OR = 4.02, 95% CI = 1.03, 15.74) after adjusting for age, sex, BMI, and prevalent CHD, and there was no dose-response relationship between risk of AF with severe to very severe SDB.12 In a recent study, among patients being investigated for suspected OSA by manually estimating sleep index from respiratory recordings, AF was common (13/170 = 7.6%) and the prevalence increased with OSA severity; however, all subjects with OSA were men.42 In our study, we relied on the BSQ to determine OSA risk and we found that individuals at high risk of OSA compared to those at low risk had greater prevalence of AF. This association was lower than observed in the SHHS (OR = 4.02, 95% CI = 1.03, 15.74)12 and this may be due to differences in cohort characteristics, study design, and method of measurement of OSA risk. The relationship between OSA and AF could be explained by several pathological mechanisms, such as oxidative stress, inflammation, sympathetic activation, atrial remodeling, intrathoracic pressure shifts, apnea-induced hypoxia, sympathovagal imbalance, and intrathoracic pressure shift, but discussing these mechanisms are beyond the scope of the current analyses.43
Despite OSA being a significant public health burden, it remains poorly diagnosed especially in blacks.44,45 Racial differences have been observed in the association between OSA and cardiovascular disease.46 However, most studies have been conducted in predominantly non-black populations, therefore limiting the generalizability of these findings.46 The Jackson Heart Study, a study of black participants only, found a high prevalence of sleep symptoms, risk of OSA, and sleep burden, and these differed by sex.47 Sleep symptoms (ie, snoring, stop breathing in sleep, fall asleep during the day) were associated with obesity, stress, and poor perceived health. The Multi-Ethnic Study of Atherosclerosis, or MESA < is a multisite prospective cohort study that included white, black, Hispanic, and Chinese patients aged 45–84 from six United States communities. MESA using PSG found that blacks had higher odds of sleep apnea even after adjustment for age, sex, and study site (OR = 1.78, 95% CI = 1.20, 2.63).48 Risk factors for AF are race (black), OSA, obesity, and metabolic syndrome.49 A previous analysis in the REGARDS study found that the association of smoking and AF differed by race, with smoking being associated with AF only in blacks. There was no differential association of AF with other risk factors, such as sex, diabetes, dyslipidemia, or income among races. However, population-attributable fractions of hypertension, obesity, and smoking were higher in blacks than whites.50 In the Southern Community Cohort Study, hypertension and diabetes were significantly associated with AF in whites and not blacks. However, age, male sex, obesity, and CHD were similarly associated with AF between races.51 Race is a common risk factor for OSA and AF, and race also modifies the association between AF and other predictors and outcomes. Because in our study we also found a differential association of OSA with AF by race, further studies to understand these racial disparities are warranted.
For OSA, black race also serves as a risk factor for the development of OSA both in adults and children even after adjustment for confounders.44,52,53 The community-based SHHS, however, did not find a difference in OSA prevalence by race after adjusting for age, sex, and BMI, but this study included only 5% black participants.54
In the community-based study in Olmsted County, Minnesota, OSA and its severity predicted 5-year incidence of AF (hazard ratio = 2.18, 95% CI = 1.54, 3.54) and a decrease in nocturnal oxygen was predictive of AF only in those younger than 65 years; however, race was not included in the analysis.55 In MESA, physician-diagnosed sleep apnea (based on a self-administered sleep history questionnaire) was associated with AF incidence in the multivariable analysis (hazard ratio = 1.76, 95% CI = 1.03, 3.02). However, unlike our study no significant interaction between racial/ethnic groups was observed.56 Given the contradictory data and limited longitudinal studies that include adequate representation of races, further longitudinal studies are needed to examine the temporal association of AF with OSA. Current AF and OSA guidelines do not differentiate between races as far as screening, management, or treatment and there are no specific recommendations for AF screening in patients with OSA and vice versa.57,58 Further studies examining the benefit of screening for AF in patients with OSA and patients with OSA and AF in a large diverse cohort would be beneficial.
Our results, however, should be interpreted with caution. Several baseline characteristics were self-reported (eg, smoking, sleep medications pills); thus, they may be subject to recall bias and misclassification. We were unable to report the class and dosages of sleep medications. Because we relied only on BSQ and not on PSG data to determine OSA risk, the association between OSA and AF might have been attenuated. Relying on BSQ to assess OSA risk might have introduced false-positive results, which could have influenced our analyses. We were unable to identify the degree of hypoxemia or identify central SDB; therefore, we only identified participants as having high or low risk OSA. Also, BSQ has low specificity and modest to high sensitivity in identifying OSA in the general population and in patients with cardiovascular or cerebrovascular disease,59–61 and this may affect the generalizability of our results. Using digoxin usage as the basis of diagnosing HF is also a limitation of the study. Obesity is an independent risk factor for AF and increases OSA risk.62,63 However, we were unable to adjust for BMI in the model because BMI was used to determine OSA risk. We were unable to test whether BMI modifies the association between OSA risk and AF because BMI was part of OSA risk determination. We have included stratified models based on BMI ≥ 30 kg/m2 and BMI < 30 kg/m2 in Table S6 in the supplemental material. Because BMI was used to calculate OSA risk, the stratified models of BMI are not directly comparable. We found that among participants with low BMI (< 30 kg/m2), OSA risk (participants reporting snoring and daytime sleepiness) is significantly greater than having no symptoms and this association remained significant even after adjusting for demographic and clinical characteristics. In high BMI strata (BMI ≥ 30 kg/m2), OSA risk, whether participants had snoring or daytime sleepiness, compared to having no factors was not significant. Furthermore, because AF was established at baseline from participant self-report or ECG ascertainment, we likely missed some cases of paroxysmal AF and misclassification of AF could occur, which could skew our risk estimates. Also, incident cases of AF that could have occurred between the baseline visit and the sleep apnea module administration, and/or misclassified AF could have underestimated the prevalence of AF. Additionally, we were limited by the cross-sectional nature of the analysis, so we were not able to establish the temporal relationship between OSA risk and AF. There was some time discrepancy, as data on covariates were collected before BSQ was administered. However, in the setting of the large and diverse REGARDS cohort and with most covariates measured, we were able to explore the association of AF with OSA, which we believe is the significant contribution of this analysis. Longitudinal analyses, using REGARDS data, could be used to expand on the association between OSA and AF, once these data are available.
In conclusion, we have shown with the REGARDS cohort that OSA risk is associated with prevalent AF and persons at high risk of OSA have a 27% increased prevalence of AF compared to low risk after adjustment. This association varies by race, with blacks having a stronger association. Further research and longitudinal studies are needed to determine whether OSA can be a predictor of incident AF, and the potential for race interaction.
All authors have seen and approved the manuscript. The authors report no conflicts of interest. This research project is supported by a cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke or the National Institutes of Health. We are also supported by K24: 1K24HL111154 and REGARDS: R01HL080477. Representatives of the funding agency have been involved in the review of the article but not directly involved in the collection, management, analysis, or interpretation of the data.
atrial fibrillation
body mass index
blood pressure
Berlin Sleep Questionnaire
computer-assisted telephone interview
coronary heart disease
confidence interval
diastolic blood pressure
heart failure
left ventricular hypertrophy
Multi-Ethnic Study of Atherosclerosis
odds ratio
obstructive sleep apnea
REasons for Geographic And Racial Differences in Stroke
systolic blood pressure
Southern Community Cohort Study
sleep-disordered breathing
Sleep Heart Health Study
The authors thank the other investigators, the staff, and the participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions can be found at http://www.regardsstudy.org.
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May 1, 2019
Justice for Child Victims of Sexual Abuse By Jess J. Araujo There are some injuries that are so extreme and severe that no perfect remedy is available to adequately compensate the victim or to remove the permanent effects of the harm suffered. Such is the case with child victims of sexual abuse and rape. These […]Read More


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Here are the squares I've been making over the last 3 weeks:
Week 8: When I was looking at my blanket, I realised that I needed a few more 'solid' looking squares so here's one in blue to celebrate the beautiful spring sky that can be seen now the rain has mostly stopped.
Week 9: Inspired by the spring flowers that are popping up all over the place.
Week 10: I enjoyed the flower square so much decided to make another one 🙂
And on that note, this is what I've been working on over the last few days:
I loved the pattern for the flower squares so much that I'm going to make a flower granny square lap blanket for Little Miss.


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9/24/2017 0 Comments
Brief History of CBD and Hemp Oil
Cannabidiol (CBD) has been enjoying increasing amounts of attention as people find out more about its incredible possibilities as a supplement. With so many articles and research studies being discussing CBD, you might think that consumable is just a recent discovery. It is true that many of the CBD extraction and packaging methods use cutting-edge technologies but the utilization of CBD in its hemp oil form extends back farther than a lot of people realize.
In the 2010's the general public began to see just what a profound effect CBD oil may have treating a number of life threatening aliments, especially in children. A primary exemplory instance of this can be a young family from Missoula Montana, using CBD oil to treat their 20 month old son, Cash Hyde, who had been identified as having brain cancer in 2010. Hyde's condition was worsening and his tumor inoperable. After exhausting every treatment option, including 30 rounds of intensive radiation, Ketamine, Methadone and Morphine treatments, the Hyde family had hit their limit. Nothing had worked. In an effort to provide his small child some relief, his father did what was considered to be "crazy"during the time, and gave him a very concentrated cannabis extract, unsure what else to do. After the very first treatment, Hyde's State IV brain tumor had shrunk. Though it was considered unorthodox, Mike Hyde was applauded by medical professionals and even spoke with the press in hopes of shedding the light on how CBD oil generally is a lifesaver. Cash Hyde lived for another two and a half years, passing away after the State of Montana made a big change in legislation that impaired the household from easily accessing the cannabis oil their son needed.
Probably the most prolific case of CBD oil and it's success is the 2013 story that achieved national press. Charolette Figi is just a 3 year old Colorado girl who suffered 300 grand mal seizures every week. Such as the wholesale cbd oil europe family, her parents thought they had tried everything, including much regime of pharmaceutical drugs and painful procedures that still did not ease her condition. Her parents had watched a documentary of among the first medical marijuana dispensaries in California centered around testing their strains of CBD and other cannaboid content. The California center testing was one of the first public assertions that cannabis was safe to ingest and use for many different medical purposes. CBD rich oil could treat 99% of the girls seizures, and CNN aired a 2013 special on marijuana and it medicinal effects.
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