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If you have been struggling with SEO on your own, it's time to hand the reins to the professionals. You could actually be doing more harm than good in running your own SEO campaigns. Business owners usually spend hours, weeks and months running their own SEO only to find the results for their website traffic failed to improve, or even worse, it got reduced. You might spend so much time on SEO that your business actually starts to fail.
Don't take the risk. Hire a good web marketing company to take care of your website optimization and social media marketing for you. With so many SEO companies trading today you can't say you don't have help available. So why is it that so many SEO companies are unreliable?
The problem with SEO is that it's a relatively new marketing process. The Internet marketing boom caused many so-called professionals to jump on the bandwagon. Very often, they have no experience in SEO and attempt to con companies into signing up for their SEO packages. As with any industry, there are many scam companies out there, but it's easy to avoid these when you know what to look for and how to read between the lines.
It's quite a good idea to learn a little about SEO, so that you can ask relevant and pertinent questions before making a decision about who to hire. Many scam companies will promise to get you on the first page of Google within a couple of days. There is NO WAY they could ever do this. It would take a couple of days alone (at the very least) to analyze your traffic and to work out a suitable strategy to get your website noticed.
Tips for Choosing the Right web marketing Company
• If a company promises to rank number in Google, don't simply take their word for it. Nobody can guarantee a number 1 ranking, but if a company says they can get you in the top 10 spots that's good reason to hire them.
• Get recommendations from business associates, friends and family. An SEO company with good word of mouth recommendations is one not to be ignored.
• Ask around in online forums. There are many forums for webmasters and online professionals and it's easy to get advice about which SEO company to use. However, owners of SEO companies also hang out in these forums so be sure to ask more questions before you hire a company.
• Turn to Google – You can Google the company name to make sure the company exists and it's not simply a fly by night setup. If the company is scamming their clients, then you will probably find complaints from past users on the web. However, the lack of negative comments doesn't mean the company is good. It could simply mean they are trading under a different name or that they haven't had many customers. Look for a company that has lots of positive comments and testimonials.
• If you are looking for a local SEO company, search for them on Google – not by name, just as you would search for any local company in your area. Only use an SEO company that is ranking well in Google. You need to use a company that has its own SEO house in order after all!
• Ask a company you are interested in hiring for examples of websites they have worked on. Any company worth its salt will be more than happy to give you details of past successes. Most genuine companies will have details of testimonials on their websites. If a company rejects your request for testimonials for confidential reasons, this should set alarm bells ringing. Even if some clients have requested confidentiality about their details, the SEO company should still have some testimonials to show you.
• Ask them what keywords they are ranking their own website for. If they don't rank well for these keywords then it makes you wonder how good their services are.
• Do they use automated submissions to build links? This practice is frowned upon by the search engines and could get your website banned from page ranking. Steer clear!


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Christ Is Risen!
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Why does it seem like evil is so much more powerful than good?
Why not try to ask one question at a time? I don't know where to start.
Also look at it this way; in order for us to be deified, God had to grant us freedom--which includes the potential for evil. God Himself--in order to deify His creations--had to make the potential for evilness accessible. Our deification is dependent upon the existence and potential for evil. God had to use the potential for evil to make us capable of deification. If evil did not exist then we could not be deified. Goodness itself is dependent on evilness. Evilness appears supreme almost.
...this world...It's already lost...
Quote from: Kerdy on September 29, 2012, 05:37:52 AM...this world...It's already lost...Then evil has prevailed. Evil won. It's as simple as that. Evil drive God into a retreat where now God had to create a new world because He lost the first one.
James, people have a sinful nature, which IMO means humans are not inherently good, rather we are inherently bad. Some disagree with me, but I see this being why the evil way is more appealing. In our sinful state, our nature is to seek that which pleases the flesh and those things which come easy.
Why does it seem like evil is so much more powerful than good? I mean, in almost any dilemma the evil option is always much easier than the righteous option. If humans are supposed to be inherently good, then why does evil come to us so easily and why is it so much easier to perform opposed to goodness which requires a lifetime of hard work, sacrifice and toil? Whereas one single basic, in-the-moment act of evilness can easily ruin years of goodness? Likewise, goodness requires a lifetime of work and toil to remain eternal within a person, whereas a single act of evilness can easily--in many cases--have a lifetime of affects? It appears that evil laughs and spits in the face of goodness. Yet, as Christians we are told that ultimately goodness will prevail. I don't get it. Goodness is obviously the losing side; yet goodness is supposed to be the side God is on. I don't know how I can have faith that goodness will prevail when goodness has its back against the wall and is constantly -censored- slapped by evilness. Why do we always have to be on the losing side? Why does anything involving God or goodness always have to be harder? For once why can't the right thing freaking be easy?! Maybe good and evil do not even exist. And how can evil really be 'evil' if evilness is usually just the result of our natural tendencies and instincts as humans whereas goodness seems unnatural, like it is always trying to suppress or alter our natural state of being?--the state of being that God allowed us to be in. The world is a gloomy place :-(
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A man who was abducted and taken to Mexico more than 30 years ago may soon be reunited with his long-lost mother.
David Amaya, 37, was recently discovered crossing the border into San Diego. David said his father took him to Mexico as a toddler, leaving him with no idea his mother in the United States had been looking for him all this time.
David and Kathy Amaya, now living in Wisconsin, spoke for the first time over the phone last weekend. However, neither of them have the means to meet in person.
U.S. & World
But that could change because of the kindness of strangers.
Santee father and son Fotios and Dino Tsimboukakis saw David's story on NBC7.com and contacted our station. Fotios is now working with the church where David is staying and has pledged about $450 for a plane ticket so mother and son can be reunited.
"Everybody deserves a chance to be next to their mother, and a mother deserves to spend it with her child," Fotios said.
When David found out the news, he said through a translator: "I'm very happy, excited."
"I am going to meet my mother after all."
However, there was still one hurdle: David didn't have identification and would need ID to board a plane.
On Tuesday, David took his U.S. birth certificate to the DMV and started the process of getting an ID card.
David had this message for his donors: "My thanks. I'm very grateful."
But Fotios and Dino say they're more than happy to help.
"Every kid deserves to see their mom," Dino said.
"[Kathy] didn't get to see her kid play around. She didn't get to see him ride a bike," Fotios said. "You know what, it's never too late."


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- Home
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Rock and Mineral Receivers
NESTA arranges for a local person to receive your shipment and see that the raffle specimens arrive safely at the NESTA Rock Raffle. Be sure to allow enough time for shipping.
Receiver for NSTA Reno Area Conference (Oct 2015):
Receiver of materials shipped for this conference:
Jodie Harnden
Sunridge Middle School
700 SW Runnion Ave
Pendleton, OR 97801
Receiver for NSTA Philadelphia Area Conference (Nov 2015)
Peter Dorofy
Palmyra Cove Nature Park
1300 Route 73 North
PO Box 6
Palmyra, NJ 08065
(856)-829-1900 x1263
[Note: There is no Rock Raffle scheduled for the Kansas City Area Conference.]
We are still seeking a Receiver for NSTA 2016 National Nashville Rock and Mineral Raffle .
Parker Pennington IV email@example.com
If you are personally bringing the specimens to the conference please contact Parker Pennington IV at email@example.com to arrange on site delivery. It is also VERY important for Parker to know what is coming so he can adjust what he prepares.


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This morning it was sunny and warm again, and now it's snowing... I kind of hope it snows all night and all day tomorrow. Because of the snow, we didn't drive to Grand Lake for the sleigh ride I've started dreaming about... Funny, though, while it's cold and snowy now, the resort said that their trails are actually a little sparse of snow at the moment because of the mild winter we've had so far. Hopefully we'll be able to head up there soon, though.
Last night, Jamie went out to watch a football game with some friends. I could have gone, too - the girls were having dinner together while the guys watched the game- but I still felt kind of blah and icky and tired. So tired that when I took a shower after work, I started to rinse the conditioner out of my hair, when I realized that I hadn't put conditioner in it, and in fact, hadn't even washed it yet. I must have been distracted, thinking about a world in which legs are always smooth and shaving is a thing of the past. Also, I'd just gotten my copy of the second book in The Hunger Games series, and couldn't wait to start reading it.
We were going to make Margherita pizza, but with Jamie going out, we decided to wait to make that tonight. And I really didn't feel like cooking anyway. Yes, even I get burned out sometimes and need a night off of cooking.
Salad, strawberries and a leftover muffin sounded just right to me. The salad was fresh and simple and quick to make - thinly sliced zucchini, squash and asparagus, on a bed of greens, and a little boiled potato to give it more substance. A non-fat lemon yogurt dressing drizzled over the vegetables added a bright, creamy touch.
Speaking of lemon and yogurt, I just tried for the first time the Lemon-flavored non-fat Chobani Greek yogurt, and fell in love with it! I think I'll be buying a lot of that, now.
And the strawberries, soaked in a little honey and balsamic vinegar, topped with some goat cheese, were sweet and delicious. Even though it's not strawberry season, I eat them whenever I feel like it. And the sight of those bright red strawberries on a pale blue plate just made me feel better.
Guess what? I even went to the grocery store without a stitch of makeup on and in my PJs (although I did have a winter coat over the PJs...). Because, just sometimes, you have to not care what others think. As long as no one nominates me for What Not to Wear...
Squash, zucchini, Asparagus and Potato Salad with Lemon Yogurt Dressing
printable recipe
- 1 cup greens (spinach, watercress, chopped romaine, etc...)
- 1/3 zucchini, thinly sliced
- 1/3 yellow squash, thinly sliced
- 4-6 stalks asparagus, ends trimmed, thinly sliced on the bias
- 2 white mushrooms, sliced
- 1 small red potato, boiled until tender and cut into bite-sized pieces
- 1 tablespoon chopped fresh basil
- 3 tablespoons non-fat Greek yogurt
- 2 teaspoons fresh lemon juice
- 1 tablespoon honey
- 1 teaspoon lemon zest
- salt and pepper
Serves 1, if eaten as a meal, or 2 servings, if eaten on the side.


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Merry Christmas from Topdown and from Automobili Lamborghini S.p.A. in Sant' Agata Bolognese, Italy, where they will soon be making the Lamborghini Huracán LP 610-4, a car every boy and girl should want under their Christmas trees. But, noooo, not for this Christmas. It will be ready, however, for Christmas 2014 and I suggest you immediately place it on your wish list.
What you'll get, once Santa Claus (no relation to Sant' Agata) forks over an estimated $300,000, is a low-slung coupe with a 5.2-liter V10 engine sporting 610 horsepower. They say it will do zero to 60 in 3.2 seconds and hit a top speed of 202 mph. Lamborghini will reportedly release the car some time in the second half of 2014.
The Huracán feature I like is the fact that the car will come standard with four-wheel-drive, that soothing mechanical balm that makes every driver feel impervious to Mother Nature's harshest offerings. I write this blog item less than an hour after driving cautiously down a nasty, glazed road in rural Maine, where a brutal ice storm has been pummeling the state for the past two days. I have this wonderful image of the four-wheel-drive Huracán zipping around in the ice storm, its four-wheeliness nimbly avoiding the ice-encrusted limbs that have fallen willy-nilly onto the gnarly roads. Zoom….. there goes the Lambo, smartly passing that Subaru (the national car of New England), and about to swoop around that big, slow Maine DOT salt-and-sand truck. Now, what about that oncoming Chevy Silverado 2500 pickup with a humongous snowplow attached to the front? Oops, where'd the Lamborghini go?
More about this wondrous toy in this Autoweek piece.


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Discussion in 'Info and Announcements' started by Cyrilshark, Mar 23, 2011.
Apparently I am logged in agian?
I like the new update a lot I hate the old GT which is why I am just recently active, as soon as I saw update I was like Yes
Yeah they were due for a face lift for sure.
Maybe now they will have some better spamblockware setup too.
The reCaptcha is a good start.
That Captcha thing can easily be bypassed by a bot, it would require a human to either Enter it once and Check log me on Auto each time, and then they are good...
But usually a bot (here atleast)
Writes 2-5 posts and then he dies...
Yep, that is really it
Great site for checking bots
Url Win!
I know. I got shown that on GIMP Forums and have been using it ever since
SpamBuster... too the tune of ghostbusters!
Make sure when you do use it though add the spammer to the database too.
We have been using that site for Gimp Chats spammers for a great while now and have added many emails and ips to the mix.It helps everyone when you add them.
That's GREAT News!
down again..
It's their shared server.They need to get a dedicated one.
I have downloaded 10+ gigs of tutorials in case they go down for good.
There is just way too much interference with data streaming due to many sites being hosted on the one server most likely. :\
Separate names with a comma.


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We were dubious when we first heard about David O. Russell directing an underdog sports movie, so we'll give Mark Wahlberg the benefit of the doubt as a former mental patient trying to piece his life back together.
Russell and Wahlberg are reuniting for an adaptation of Matthew Quick's "The Silver Lining Playbook," reported Variety.
Here's the synopsis for "Silver Linings" from Barnes & Noble:
U.S. & World
During the years he spends in a neural health facility, Pat Peoples formulates a theory about silver linings: he believes his life is a movie produced by God, his mission is to become physically fit and emotionally supportive, and his happy ending will be the return of his estranged wife, Nikki. When Pat goes to live with his parents, everything seems changed: no one will talk to him about Nikki; his old friends are saddled with families; the Philadelphia Eagles keep losing, making his father moody; and his new therapist seems to be recommending adultery as a form of therapy.
When Pat meets the tragically widowed and clinically depressed Tiffany, she offers to act as a liaison between him and his wife, if only he will give up watching football, agree to perform in this year's Dance Away Depression competition, and promise not to tell anyone about their "contract." All the while, Pat keeps searching for his silver lining.
Russell and Wahlberg have made two excellent films together--"The Fighter" and "Three Kings"--and Russell teased out of Wahlberg the best performance of his career in the otherwise dreadful "I (Heart) Huckabees." Until they turn in an unqualified dog, they've got our attention--no matter how dubious the project sounds.


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The Donatello is the mid-range oven from Cuppone and is a more controllable version of the Tiepolo oven, perfect for restaurants, takeaways and gastro-pubs. These ovens have a highly energy effcient digital control panel which allows controllability of the heating elements and also has an acoustic cooking timer. Other features include a glass door and internal lights to check the progress of your pizzas, and a stone cooking base which guarantees authentic Italian pizza cooking. Pizzas can be cooked in around 3-6 minutes. The Donatello has a revolutionary heat regeneration system so when the oven door is opened it immediately circulates the heat back inside to minimise heat-loss. The doors are fitted with a heat seal between the door and the cooking chamber to retain the heat when the doors are closed. These ovens can be supplied with a stand and a fully operational extraction hood which should be vented out of the building.
|External Height
|437 mm
|External Width
|1155 mm
|External Depth
|1050 mm
|Internal Height
|150 mm
|Internal Width
|720 mm
|Internal Depth
|720 mm
|Electrical Power Rating
|5.3 kW
|Net Weight
|106 Kg
|Electrical Connection
|Hard Wired
|2 Years Parts & 1 Year Labour
|Single Deck
|Pizza Capacity on Base
|4 x 14 Inch Pizzas
|Pizza Capacity in Pans
|4 x 12 Inch Pizzas
This product has not been reviewed yet.
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WHITE CITY, Ore. (AP) – Nike bolts out of his dog box and instantly bounces around like a 4-year-old on a sugar high of diabetic proportions.
The large and powerful black Labrador retriever spins and twirls while his trainer, Paul Foster, tries unsuccessfully to get a red collar around the dog's neck.
"Sometimes the hardest part of training him is getting his collar on," says Foster, of Medford.
Foster clips the collar together, and with one word – "heel" – Nike becomes nothing but business.
Minutes later, three ducks thrown into the Denman Wildlife Area brush for Nike to fetch lay at Foster's feet, all perfectly marked and retrieved from more than 200 yards in near perfection.
"See that intensity?" Foster says. "It's all part of our routine."
This same work ethic that gets violinists to Carnegie Hall has Nike and Foster at the pinnacle of the retrieving world.
The pair won Top Amateur Retriever for 2012, winning an astounding seven American Kennel Club-sanctioned field trials as a 3-year-old en route to the third-highest seasonal finish in the history of national amateur retriever competitions.
For his accomplishments, Nike will be honored by Purina during the company's annual awards banquet today in Medford in conjunction with the Rogue Valley Retriever Club's annual field trials.
"I've had dogs before with seven wins, but it took a lifetime," says Foster, a retired physician. "He did it in one year.
"He has intensity, drive, but his strong point is he sees where the birds go down and knows exactly where they are," Foster says. "I trust him better than I trust myself."
The pair trust each other enough to best a field of hundreds of Labradors trained and handled by nonprofessionals like Foster, despite Nike being a relative newcomer to the field-trial world.
"This is a very big deal in the retriever world," says Dean Reinke, Purina's area manager for breeder enthusiast groups who oversees the competition and awards. "At 3 years old, to be that consistent is amazing.
"Dogs don't usually come into their own until they're ages 5 to 7," Reinke says. "It'll be interesting to see where he goes from here."
Nike could become a fixture in the amateur category for years to come because he'll retain amateur status as long as Foster and his wife, Sally, handle him. Nike slips out of amateur status only when a professional handles him in the field, and Foster has no intention of doing that.
Foster says he believes he and Nike have another five or six years together, "if he stays healthy."
Which is a problem, because Nike has a penchant for more than winning field trials. He eats rocks – one of which had to be surgically removed this winter.
"The only thing that seems to hold him back is injury – eating those rocks," Reinke says.
Nike had a different sort of rocky start in 1999 when the Fosters bought a puppy from a litter bred from two prestigious retrievers. They registered him as "Rockliffs Justdoit" in homage to The Swoosh's famous slogan and dubbed him Nike for short.
He was an underachiever as a pup, with apparently little innate ability to find or "mark" downed birds and follow direct trajectories to retrieve them.
From 6 months on, however, his intensity, drive and desire kicked in during training sessions with Foster. On his first birthday, he won a derby contest. By the time he was 2 years old, he had racked up enough top finishes to garner 32 points in the derby world.
Field trials entail handlers getting their labs to see three birds thrown into the air for them to fetch from as far as 400 yards away over marsh, fields and ponds. The birds must be picked up in succession, with the dog losing points for everything from lackadaisical runs or lack of direct runs from the handler to the bird and back.
Nike's well-honed skill of finding and remembering where the birds land led to last year's breakout year, putting him within 8 points of the all-time amateur record for a single year on the circuit.
Foster decided to hit the last few trials intent upon setting a record.
"The minute I stopped letting it happen and got intense about it, he stunk it up," Foster says.
Nike failed to garner any more points, then stalled his defense of his title after his latest and most expensive rock-eating escapade to date landed him in surgery between stints as a now-famous sire who fetches fetching stud fees.
"He hasn't earned a point yet," Foster says. "The only thing he's done this spring is make puppies.
"If he keeps eating rocks, we might come out even," he says.


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Information For Authors
- Manuscript Submission Guidelines
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Lymphatic Research and Biology is a quarterly, peer-reviewed journal which will provide an interdisciplinary forum for the world's leading biomedical investigators to discuss current and anticipated developments in lymphatic biology and pathology.
The Journal features fundamental scientific research of relevance to the lymphatic system and publishes original work from a variety of investigative disciplines, including genetics, biochemistry and biophysics, cellular and molecular biology, physiology and pharmacology, anatomy, developmental biology, and pathology. The Journal also encourages the submission of state-of-the-art reviews in focus areas such as vasculogenesis and angiogenesis, the genetics of lymphatic disorders, muscle cell biology, interstitial signaling mechanisms, and others.
Each figure should be submitted in a separate TIFF or EPS file. (See below.) References must be part of the manuscript text and not embedded through a separate program, such as EndNote. Authors with questions should address them to the Editorial Office at (516) 625-9675 or by e-mail to email@example.com
Manuscript Submission
All submitting authors are required to complete their submissions using an ORCID identifier. Please visit the ORCID website for more information, or to register.
Manuscripts must be submitted online using the following URL:
Submissions should be formatted in Word. The main text file of the manuscript must include a title page, abstract, disclosure statement(s), and reference section. Figures, legends, and tables should not be embedded in the text. See below for more instructions.
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2. Cite references, figures, and tables in numeric order. If any material has been published previously (figures, tables, etc), provide written permission from the copyright holder to use such material.
3. Consult the American Medical Association Manual of Style, 9th ed, Baltimore, MD, Williams; Wilkins, 1998, for style.
4. Assemble the manuscript in this order: Title page, abstracts, text, acknowledgments, references, figure legends, tables, and figures.
5. The title page (page 1) should contain these elements: Full title. Running title (not to exceed 50 characters,including spaces). Authors' names, academic degrees, and affiliations. Name and complete address for correspondence (include street name and address as well as PO box) and address for reprints if different from correspondence. Fax number, telephone number, and E-mail address. Sources of support that require acknowledgment.
Please supply a structured abstract of not more than 250 words, which should be self-explanatory without reference to the text. Do not cite references in the abstract. Limit use of acronyms and abbreviations. Define at first use with acronym or abbreviation in parentheses. Use the following headings: Background (rationale for study), Methods and Results (brief presentation of methods and presentation of significant results; note that both categories are included under one heading), and Conclusions (succinct statement of data interpretation). Include a condensed abstract of not more than 100 words for use in the annotated table of contents. It need not adhere to the structured format.
The body of the manuscript should consist of the following sections in this order: 1) Introduction, 2) Materials and Methods, 3) Results, 4) Conclusions.
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When reporting experiments on human subjects, authors should indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. If doubt exists whether the research was conducted in accordance with the Helsinki Declaration, the authors must explain the rationale for their approach and demonstrate that the institutional review body explicitly approved the doubtful aspects of the study. When reporting experiments on animals, authors should indicate whether the institutional and national guide for the care and use of laboratory animals was followed.
*This portion of the Instructions for Authors has been quoted directly from the Uniform Requirements for Manuscripts Submitted to Biomedical Journals website. For more information, visit www.icmje.org/ethical_6protection.html
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Prepare each table with its title on a separate page in Microsoft word. Each table must stand alone and contain all necessary information in the legend. The table itself must be comprehensible independently from the text. Details of experimental conditions should be included in the table footnotes. Information that appears in the text should not be repeated in a table, and tables should not contain data that can be supplied within one or two sentences in the text.
Figures must be submitted as either TIFF or EPS files and labeled as Figure 1, Figure 2 and so on. Color figures and halftones must be at a minimum 300 DPI resolution.
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A list of figure legends should be supplied at the end of the manuscript, double-spaced in Microsoft word. Magnifications should be included when appropriate. Illustrations can be printed in color with a subsidy from the author and are encouraged. Contact the publisher for details.
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Immediately following the Acknowledgments section, include a section entitled "Author Disclosure Statement." In this portion of the paper, authors must disclose any commercial associations that might create a conflict of interest in connection with submitted manuscripts. This statement should include appropriate information for EACH author, thereby representing that competing financial interests of all authors have been appropriately disclosed according to the policy of the Journal. It is important that all conflicts of interest, whether they are actual or potential, be disclosed. This information will remain confidential while the paper is being reviewed and will not influence the editorial decision. Please see the Uniform Requirements for Manuscripts Submitted to Biomedical Journals at http://www.icmje.org/index.html#conflicts for further guidance.
If no conflicts exist, the authors must state "No competing financial interests exist."
When naming your figure files, please label them with your manuscript number, followed by a period (.), and then list the figure number. Ex: MET-2008-0123.Fig1. Label figures and tables inside the files in addition to naming the file with the figure or table number. (ie: When figures or table files are opened, the figure or table number should appear inside the file.)
Please upload individual files of all manuscript material — do NOT upload a single PDF file containing all text, figure, and table files of your paper. Once all individual files are uploaded on to Manuscript Central, the system will automatically create a single PDF proof for you and the peer-review process.
If no conflicts exist, the authors must state "No competing financial interests exist."
References should be presented using the order of citation method. Please place a numerical superior in the text that corresponds to the number in the reference list. Below are examples of references in the reference list:
Journal articles
Jeltsch M., Kaipainen A., Joukov V., Meng X., Lakso M., Rauvala H., Swartz M., Fukumura D., Jain R.K., Alitalo K., Hyperplasia of lymphatic vessels in VEGF-C transgenic mice. Science. 1997; 276: 1423-5
Book chapters Ferrara N., Gerber H., The Vascular Endothelial Growth Factor Family. In: Ware J.A., Simons M. eds. Angiogenesis and Cardiovascular Disease. New York: Oxford University Press; 1999: 101-27.
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Frontline Spot-On Flea & Tick Treatment Dog 10-20 Kg - 6 Pack
Frontline Spot-on Medium Dog 10-20kg is for the treatment and prevention of flea and tick infestations in dogs.
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Frontline Spot-on Medium Dog 10-20kg [6 pack] is for the treatment and prevention of flea and tick infestations in dogs and as part of a treatment strategy for flea allergy dermatitis where this has been previously diagnosed by a veterinary surgeon. Also for the control of infestations of biting lice on dogs. Frontline Spot-on Medium Dog contains Fipronil 134mg Easy to use pipette containing 1.34ml solution to be applied topically to the skin on the back of the neck 1 pipette per 10-20kg bodyweight For the treatment and prevention of fleas use every two months. For the treatment and prevention of ticks, and if part of treatment for flea allergy dermatitis use every 4 weeks. Can be used in puppies over the age of 8 weeks/and or weighing over 2kg.
To view the most up to date information about this product please read the Summary of Product Characteristics (SPC) found on the Veterinary Medicine Directorates (VMD) Product Information Database
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(Or "The Achars are coming")
First, there is IHH expected to list in July. Intetegrated Healthcare Holdings is the healthcare arm of Malaysia's state investor. Its assets include Turkish hospital group, Singapore's Parkway Holdings, India's Apollo Hospitals Enterprise and Malaysia's Pantai Hospitals and International Medical University. It presses all the right buttons: Turkey, India, M'sia and S'pore.
The listing of IHH in Singapore and Malaysia is expected to be the fourth-biggest initial public offering in S'pore's history and Malaysia's second-largest this year after the planned listing of Malaysian plantation group Felda Global Venture Holdings.
International Financial Corp, part of the World Bank Group, is planning to take part in the planned US$1.5 billion listing of IHH. Another cornerstone investor is the Pru's Asian funds arm. UK's Pru or the US Pru. I'm sure GIC or Temasek will be another cornerstone investor.
For those interested in Indian healthcare and yield there will be Religare Health Trust. India's Fortis Healthcare, which is seeking to expand its clinical operations and cut debt, plans to raise about 20bn rupees (S$459m) by listing its hospital business in Singapore. Its listing is expected to be later than that of IHH.
"We are looking at this listing to de-leverage the balance sheet," its CEO said anning the IPO last week. Fortis, which has about 15 hospitals and clinics that are part of this business, has a consolidated net debt of 50bn rupees, the CEO said. The company is looking to add about 2,500 hospital beds in three to four years, he added. Fortis, India's No 2 hospitals chain after Apollo Hospitals Enterprise, said consolidated net profit jumped 41.34% to 415.4bn in its fiscal fourth quarter ended March.
Religare Health Trust has a mandate to invest in medical and healthcare assets and services in Asia, Australasia and emerging markets.
The IPO would be the second by an Indian company in Singapore after Indiabulls Properties Investment Trust raised US$165m (S$210.8m) in 2009. This has been a dog of a stock.
Reliance Communications is also planning to raise US$1 billion through a Singapore listing of its undersea cable business.


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Which is the dinosaur egg? main content.
The specimen on the lower right is an approximately 80 million-year-old fossil dinosaur egg from the Late Cretaceous Djadochta Formation of Shahbarakh Usu, Mongolia. It was collected by A. F. Johnson on 17 July 1923 as one of a group of 3 weathered oviraptorid eggs.
The object on the upper left is a water-worn rock, most likely from a river. Its resemblance to an egg is merely accidental.
River-rounded rocks are commonly mistaken for fossil eggs. This is just one method by which nature produces rocks that resemble eggs. Sedimentary concretions are another common imposter. Concretions often form when some object acts as a "seed" for the deposition and cementation of sequential layers of sediment. On occasion, the matter that initiates the concretion, the "seed," can be a fossil. To find this out requires cracking or cutting open the concretion.
Genuine fossil eggs usually have an easily identifiable shell which differs significantly from the enclosed sediments either by having a fine surface ornamentation (the smoother the "shell," the less likely it is to be a non-bird dinosaur egg) or a specific type of crystalline structure in cross-section. Also, because eggshell tends to be brittle, the shell is almost always heavily cracked with clear shifting of the eggshell bits. Ironically, one strong indication against a dinosaur egg identification is a very egg-shaped specimen: most fossil eggs are not "egg-shaped" because most fossil eggs come from non-avian dinosaurs and are everything from spherical to torpedo-shaped.
Additionally, the thickness of the "shell" can rule out an egg ID. Embryos in hard-shelled terrestrial eggs need shells through which they can conduct gas exchange—basically so they can breathe. Past a certain thickness, this becomes impossible.
And don't forget, if a chicken egg were included in the photo, it, like the oviraptorid egg would be properly identified as a dinosaur egg.


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|Photo: Allen Partridge
One that I have thought about quite a bit. I thought others might enjoy reading my reply – and it might make for an excellent conversation starter. It's worth noting that we were talking about motivation in the specific context of learners using Adobe's LMS (Adobe Captivate Prime.)
Below you'll find my response:
1. Communicate relevance:
Use the announcement system to invite people to explore a bit of content that benefits them. For example – a course designed to boost sales, or a common tech problem explained, perhaps some particularly video heavy or short form piece to start. You can also use alternative company channels to communicate the purpose / relevance of the training- market your initiative based on it's alignment to the company business objectives. Don't be shy about branding it, and explaining how the project can help the organization meet important goals.
Read more...
Source: Adobe eLearning Community


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sometimes i am quite confused about whether to use "in" or "for", i hope someone would help me clear my confusion.. this is very important to me... (i am an Eng tutor in fact, but non-native) thanks
for example... in this case, let's talk ONLY about grammar but not the meaning.
A. " the machine will be sold for $3000"
or B "the machine will be sold in $3000"
i am not sure if both, either or neither of these two sentences is grammatically correct..
i think A should be correct, and it means " i will pay $3000 exact to get the machine..."
and I think B is also correct , but it will mean " i will pay $3000 exact or less than $3000 to get the machine...
ok, but i am not sure if my thought is correct. i hope someone would correct..
i know " i will get it in one day ..." that mean i will get it in the very near future, not more than 24 hours..."
but i don't know if this applies to money too.
Only A is correct.
As this is a forum for people interested in learning English, please use capital letters for the first person pronoun and the first word of a sentence. Thank you.


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Web Solutions is pleased to announce their recent acquisition of Who Is The Old Guy, a fellow Connecticut-based web design agency.
After collaborating to ensure the smoothest possible transition, the Who Is The Old Guy client base is now integrated with Web Solutions. Three full-time staff members of Who Is The Old Guy have joined the Web Solutions team, which will now serve all former Who Is The Old Guy clients.
"We're very excited to welcome former Who Is The Old Guy clients to the Web Solutions family," said Tom Barton, Principal of Web Solutions. "They'll be able to retain the account managers whom they know and trust, and as a full-service marketing agency, we'll be able to provide a more cohesive level of support."
Like Web Solutions, Who Is The Old Guy was formed in 1996, growing steadily throughout the years and providing services including web design, hosting, search engine optimization, social media and email marketing. The company was playfully named for the former owner's great-great-grandfather, a lifelong business owner and source of inspiration. But it was their similar client base – both large and small organizations in a variety of industries – that attracted Web Solutions to the acquisition.


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The Jeff Banks Luxury collection draws its influence from the traditions of British tailoring. It is designed with the sophisticated man in mind who appreciates superior attire and a flattering silhouette. The shoulders are cut quite square and the waist, chest and seat measurement are slightly relaxed for a regular fit. This blue check is made from a wool cloth, the luxury tailoring jacket has two button single breasted fastening, four button cuffs and notch lapels.
100% Wool


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BCH recycling need leads to partnership with disabled workers
Cindy Sutter
Daily Camera
Kai Abelkis was working on a tough problem.
As sustainability coordinator of Boulder Community Health, he is working to reach zero waste in the Boulder hospitals. The job is complex, finding solutions to the waste problems that hoteliers and food service providers face. And then there's the medical stuff, much of which is not the hazardous material most people imagine but, rather, packaging for instruments and all the various items used in medical care.
The problem was particularly acute in operating rooms, where equipment is wrapped in a thick, perforated plastic called blue wrap and sent through the autoclave to be sterilized. Abelkis could not find a recycler willing to take the blue wrap, which often had tape on it and was frequently mixed with other packaging.
"After a while it adds up," Abelkis says. "It generates a lot of waste."
Geoff Davis also was working on a problem.
As Day Program team leader at North Metro Community Services in Westminster, his job is working with cognitively disabled adults in what's known as pre-vocational services. That means getting people ready for "real world" jobs by working on skills such as promptness and working hard at a job. North Metro already does cardboard recycling, runs a shredding business and also supplies jobs that involve disassembling computers and taking out the usable parts to be recycled.
Davis approached Abelkis, hoping he had computers for Davis' team to recycle. Abelkis happily agreed to let Davis handle BCH's old computers.
A few months later, after talking to a peer in a Portland hospital who had found a way to recycle the blue wrap, Abelkis contacted Davis to see if he could help with BCH's blue wrap problem.
The hospital had operating room personnel eager to do some preliminary sorting by placing certain items in certain carts. But what Abelkis needed was someone to sort the materials more specifically and find an end user willing to take the blue wrap material once it was separated.
Davis did some research and found a company, Alpine Waste, in Denver, willing to take the blue wrap waste if it was bundled in large quantities. The next step was putting together work crews to sort through operating room packaging to separate out the blue wrap and take tape off it.
Fast-forward to today.
Twice a week, two North Metro "blue crews" pick up operating room waste at BCH, Longmont United, Exempla and Children's hospitals and sort through it in the facilities at North Metro. The two crews employ 10 people, who work Monday through Thursday and are paid minimum wage for their sorting work.
The job provides valuable experience, teaching them to interact with others, since they pick up the materials from the hospitals, in addition to doing the actual sorting.
Davis says blue crew members have a lot of pride in their work.
"They know that non-disabled people on the outside are doing the same tasks," he says, adding that the workers also get the enviromental piece, that they are helping to keep the blue wrap out of landfills.
Every now and then, a piece of surgical equipment shows up in the blue wrap. That is donated to a nonprofit in Centennial that sends medical equipment to developing countries. The workers call the bin where the equipment is placed the Africa basket.
Blue Crew member Shawn Davidson, 34, of Thornton, says she enjoys meeting new people when crew members pick up the blue wrap.
"I like all of them," she says.
She adds: "I like helping people."


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Message Board
Wendy Wasserstein Message Board
Talk about the novels, new and used books that Wasserstein has written!
Author Wasserstein's Book Reviews
Elements of Style
Although Frankie is intelligent, she is not a perfect size two and does not wear Manolas. She is always the extra dinner guest seated next to the artsy afficinado, who leaves her at her door when he escorts her home. The New York Brahmins and the nouveau riche have thier own clashes and Frankie is caught in the middle. The married couples interchange partners-always looking for the ultimate experience. Their world is filled with private jets, Aspen holi...


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Power Supplies >
12 Volt Power Supplies > Preferred Power Products P3DC12-4-3W
4 Camera 12VDC 3 Amp Power Supply
The P3DC12-4-3W is a CCTV power center engineered to manage remote camera and accessory power requirements in a NEMA 4X weatherproof enclosure. The P3DC12-4-3W distribution module is designed with 4 individually fused output for powering up to 4 CCTV camera or accessory.
It will provide 12Volts DC via distribution to four fused output with a total of 3.0 Amps continuous supply current.
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Study: For Blacks in America, Home Ownership Does Not Mitigate Residential Segregation
Home ownership has long been a symbol of the American dream, but blacks owning homes may not reap the same benefits as whites and other minorities in metropolitan America, a UAlbany study finds.
In a study published in August in the journal Demography, sociologist Samantha Friedman finds that while blacks have had steadily increasing success in achieving home ownership, it has not been enough for them to gain proximity to whites and attendant opportunities to accrue wealth.
The analyses reveal that the segregation of black renters relative to whites is significantly lower than the segregation of black owners from whites, all other factors being equal. However, this is not the case for Hispanics and Asians. The segregation of Hispanic and Asian renters from whites is greater than that of Hispanic and Asian owners from whites.
Home ownership is one of the primary ways through which families accumulate wealth, particularly for blacks and Hispanics. According to the 2002 U.S. Census Bureau, black and Hispanic households invested 61.1 percent and 58.5 percent of their net worth, respectively, in the ownership of their homes; for non-Hispanic whites and Asians, the rates were 41.7 percent and 42.7 percent, respectively.
According to the same census-based report, in 2002, the median net worth of U.S. households with a non-Hispanic white householder was $87,056, more than 15 times the median net worth of households with a black householder ($5,446), more than 10 times that of Hispanics ($7,590), and nearly 1.5 times that of Asians ($59,292). Moreover, a report from the Pew Hispanic Center found that between 2005 and 2009, the median wealth of Hispanic and black households fell by 66 percent and 53 percent, respectively, but for whites it fell by only 16 percent.
"The disparity in wealth between minorities and whites persists as one of the most salient fault lines in the United States," said Friedman. "Contrary to the notion that home ownership represents an endpoint in the residential assimilation process, for blacks it does not necessarily accompany a decline in residential segregation. This obviously has significant and immediate implications for the future of racial and ethnic inequality in American society."
It is likely, Friedman says, that discrimination in the mortgage market -- and in particular, the fact that blacks have been more likely than whites to acquire subprime loans -- has contributed to this pattern.
For more news, subscribe to UAlbany's RSS headline feeds
About the University at Albany
A comprehensive public research university, the University at Albany offers more than 120 undergraduate majors and minors and 125 master's, doctoral, and graduate certificate programs. UAlbany is a leader among all New York State colleges and universities in such diverse fields as atmospheric and environmental sciences, business, criminal justice, emergency preparedness, engineering and applied sciences, informatics, public administration, social welfare, and sociology taught by an extensive roster of faculty experts. It also offers expanded academic and research opportunities for students through an affiliation with Albany Law School. With a curriculum enhanced by 600 study-abroad opportunities, UAlbany launches great careers.


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Premium Package,Exclusive Package,Lighting Package,Intelligent Drive Package,Dark Ash Wood Trim (Open-Pore),Climate Comfort Seats,Windshield Heater,Heated Rear Seats,Wireless Phone Charging,Black Fabric Roof Liner
Mercedes-Benz London is a new and pre-owned London, ON Mercedes-Benz dealer. We proudly serve and ship to Southwestern Ontario. In our online showroom, you'll find an outstanding selection of new Mercedes-Benz vehicles in London, ON and Mercedes-AMG vehicles you might not find so easily elsewhere. Or perhaps you're in the market for Mercedes-Benz vans or vehicles from our Corporate Fleet Program? We can help you with that too. We offer comprehensive service here at Mercedes-Benz London!
New vehicle pricing includes all offers. Tax, Title and Tags not included in vehicle prices shown and must be paid by the purchaser. While great effort is made to ensure the accuracy of the information on this site, errors do occur so please verify information with a customer service rep. This is easily done by calling us at (519) 937-1603 or by visiting us at the dealership.
**With approved credit. Terms may vary. Monthly payments are only estimates derived from the vehicle price with a 72 month term, 5.9% interest and 20% downpayment.
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Welcome to the website of Think Driving School, we offer driving lessons lead by experienced, professional, DSA Checked and tested instructors. For more information on our Learning to Drive please browse our site or for more information and please dont hesitate to Contact Us if you have any questions. In addition to Driving Lessons for beginners we also provide full driving instructor training, B+E Training, Pass Plus, Motorway Driving Lessons, Driving Instructor Teaching Plans and Driver Confidence boost sessions.
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Palau profile in the solid waste and recycling sector
This Pacific Country/Territory Profile in the solid waste and recycling sector was published in 2018 as part of a compendium of fifteen individual country profiles that seek to identify and quantify the opportunity to improve the resource recovery of fifteen common commodities1 present in the solid waste stream. The research study was commissioned by PRIF in 2017 – the 'Regional Resource Circulation and Recycling Network' – to address the challenges faced in the Pacific region in providing sustainable management systems for an increasing and diversifying range of waste materials, driven mainly by changing urbanisation patterns, globalised markets, wealth redistribution and the resultant changing lifestyles. The compendium document is also available here
Other individual profile reports are linked here:
Cook Islands, Fiji, Federated States of Micronesia (FSM), Guam, Kiribati, ,New Caledonia, Papua New Guinea (PNG), Republic of the Marshall Islands (RMI), Samoa, Solomon Islands, Timor-Leste, Tonga, Tuvalu, Vanuatu.
The Country and Territory Profiles were prepared detailing country-specific information which was used to inform other elements of the research. The first phase of the study conducted a material flow analysis of imports and exports, estimated the available materials for recovery and quantified the expected increase in commodities based on various policy interventions. The study also identified waste disposal infrastructure and service provision, reviewed current institutional frameworks, identified port infrastructure and shipping logistics and estimated plastic marine debris in the Pacific nations. The study examined further the potential to establish a regional network to improve the recovery, and where feasible, recycling of solid waste, in a manner that meets economic, social and environmental objectives.
The research was conducted by Anne Prince and Debra Mackeen, following desktop data analysis, extensive consultations and visits to Fiji, Palau, Samoa and American Samoa, Solomon Islands and Vanuatu. The project is managed by Jack Whelan, Secretariat Manager, PRIF Coordination Office, guided by a technical implementation committee including specialists from PRIF member agencies and in partnership with the Secretariat of the Pacific Regional Environment Programme (SPREP).
1 PET (plastic) beverage containers; Glass bottles; Steel cans; Aluminium cans; Paper and cardboard; Electronic 'E-waste'; White goods; Used oil; Used lead-acid batteries; Lithium batteries; Scrap steel, ferrous and non-ferrous metals; Tyres; End-of-life vehicles; End-of-life renewable energy equipment, for example, solar panels and inverters; plastic shopping bags


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Compare cheap flights to Osaka
When is the cheapest time to fly to Osaka?
What to do in Osaka
Osaka is the third biggest city in Japan, and it's the country's best place to eat, drink, and party. Osaka is filled with historical sites, authentic Japanese restaurants that serve Osaka cuisine, gorgeous scenery made by man and nature, and incredible festivals. This Japanese city is worthy to be anyone's top travel destination, and it should be yours too.
Start your Osaka adventure by hopping on a train to Osaka Castle and learn more about Japanese culture. Enjoy a picnic at the Naniwa Palace Site Park. Visit the Osaka Science Museum and the Osaka Museum of History.
Stop by Sumiyoshi Shrine and Shitennoji Temple next. Bring your camera to Tsutenkaku and the Japan Mint. Don't forget to visit the iconic Peace Osaka too.
After all that walking around, taste the best of Osaka and go on a food trip. To help you plan your foodie adventure, here's an 12 things to eat in Osaka and a guide to the weird and must try foods of Osaka too.
Enjoy a fun day at one of the world's biggest aquariums, Kaiyukan. Spend a day having endless amounts of fun at Universal Studios Japan. Then enjoy pampering yourself at Spa World.
Join Osaka's biggest events and experience the city like a local, like the Tenjin Festival in July. Be dazzled by the Nakanoshima West Winter Tale, as well as the Terraced Paddy Fields Light-up and Harvest Festival.
Complete your Osaka trip by going to the Umeda Sky Building, where you can have access to an observatory for amazing views of Osaka.
So what are you waiting for, mate? Start planning your Osaka adventure now and check out this Osaka travel guide.
When to visit Osaka
The best time to visit Osaka is during the high season in spring (March-May), when you can enjoy pleasant weather and the bloom of Japan's cherry blossoms. Autumn (September-November) is also a lovely time to visit Osaka, so you can see the red hues of the city. You can enjoy discounted airfare in November too, because it's the cheapest time to fly to Osaka.
Banzai! Australians like you can fly to Japan and visit Osaka visa-free for up to 90 days as a tourist. Make sure that your passport is valid for at least six months on your return date to Australia. Visit Smartraveller for more info.
Travelling to and around Osaka
You will reach Osaka through the Kansai International Airport. From there, you can reach the city by rail, taxi, or airport limousine buses. Begin your Osaka adventures by taking the subway, train, taxi, waterbus, and ferry.
Airlines that offer cheap flights to Tokyo from Australia include:
- Japan Airlines
- Asiana Airlines
- Singapore Airlines
- Qantas
- Thai Airways
- Jetstar
- China Southern Airlines
It's time you have some fun in Japan by choosing Osaka! Go book your Osaka flights with Skiddoo today.
Today's currency rate
Temperature average in July
Rainfall average in July
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Cheapest time to fly to Osaka (KIX)
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I've got this irritating discomfort in the back of my jaw that just showed up a couple of days ago, so I've had to make a dental appointment. This is a problem, because deep within my mature and balanced psyche lies the pain threshold of a four-year-old girl.
But at least I'm in good company. Here's an excerpt from a paper delivered by Dr. William Harper De Ford to the Pennsylvania State Dental Society on June 11, 1912 and published in The Dentists' Record later that same year:
Dr. Wolf of Washington, D. C., told me that on one occasion, a tall, gawky, raw-boned, awkward specimen of humanity came to his ofiice for the extraction of a tooth. He placed him in the chair, procured a forceps, and just as he was about to operate, the patient said, "Just a moment, please," drew from his pocket a small bottle, and took several inhalations. "Now you may proceed," he said, and opened his mouth. The tooth was extracted painlessly. The bottle contained chloroform. The patient was Abraham Lincoln, then president of the United States.
He knew from personal experience that you'd better prepare for the worst when having your mouth worked on. Years earlier, another dentist had torn off part of Lincoln's jawbone while extracting a tooth…and without any anesthesia. I hope I have better luck than he did.


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Do you feel like your kids are outgrowing their clothes faster than you can buy them? If so, you're not alone! I know many people sell their used children's clothing via online auction sites, yard sales, etc. But I know more who simply give them away. Don't get me wrong – I'm all for helping someone else, donating to a good cause, etc. However, oftentimes that can leave you short on cash to buy the replacement items you need.
I was reading Walmart's All You Magazine recently and found an interesting article about some websites where you can swap kids clothing. Unfortunately the actual article I read is not in their online magazine that I could find, but there was this article that talks about 10 tips to spend less on kids clothing. They mention some different websites where you can send in your gently used kids clothing for points which you can then redeem for other items you want. What I really liked is that they determine if the clothing is of good enough quality to pass along or not. It gives me confidence that I would get quality items in return. It certainly seems easy enough and wouldn't take much effort. If you decide to try one of these, be sure to check out their quality standards before sending items in for credit.
Here are the links to the sites:
I hope you find those useful!
Now for some other good stuff!
All You Magazine March 2012 Coupon List – Deal Seeking Mom has been kind enough to provide a list of coupons that are in Walmart's All You Magazine for April. You can check it out here to see if you want to stop by and pick up a copy. I believe it retails for $2.49 per issue if you buy it at Walmart, but you can get a subscription for $1.66 per issue here. However, I will tell you that sometimes the subscription version has fewer coupons than the newsstand version.
Walmart Deals – If you're a Walmart shopper, I highly recommend checking out Iheartthemart.com for the best deals.
For local calendar events:
For Delray Beach, click here.
For Boynton Beach, click here.
For Boca Raton, click here.
Now, on to the deals this week!
Know the Lingo
BOGO – Buy one, get one free
SS – Smart Source (coupon inserts in Sunday's papers)
RP – Red Plum (coupon inserts in Sunday's papers)
PG – Proctor & Gamble (coupon inserts in Sunday's papers)
GM – General Mills (occasional coupon inserts in Sunday's papers)
Blinkie – coupon dispensers in stores
Peelie – coupons found on products that you peel off
Hangtag – coupons found hanging on bottles
All You – Magazine sold at Walmart or via subscription
Whole Foods: Click here for their coupons. If you prefer to shop at Publix, they should accept these as competitor coupons.
Publix Greenwise: Click here for their weekly ads.
Many thanks to IHeartPublix.com for their great tips on shopping at Publix!
For Publix "super deals" list for 3/22-3/28/12, please click here.
For Publix full sale list with coupon match-ups for 3/22-3/28/2012, please clickhere
Renita's Favorite Money-Saving Sites
E-Book now available!
I'm excited to tell you that my book is now available as an e-book! So, you can save money while you learn to save even more money by purchasing an e-book instead of a traditionally bound book! For more information, please click here.
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My book is now available for the Kindle! Please click here!
Renita is a resident of Palm Beach County, and author of "Wow! You Saved How Much?" For more information, visit her website athttp://wowyousavedhowmuch.com.
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Wednesday, June 25, 2008
Food For Thought
Wedging a little update, for public interest, between my previous and tomorrow's (final?) post, I thought I'd mention a meeting I had recently. Some readers will recall I said I'm considering resuming, part-time, my surgical hospitalist gig. In discussing details, some interesting issues came up which go to themes about which I and other bloggers have written severally: namely, the changes going on in training programs and the products thereof.
I talked with two surgeons; one was of my era, the other much younger but having finished training just before the invasion of the eighty-hour work week. They have big concerns. Having just hired a couple of the recently minted, they are finding the need to establish a mentoring program, because the newbies seem neither to have the skills nor knowledge to manage completely on their own, despite looking great on paper. This, of course, is exactly what I've written about. In fact, I've suggested such a mentoring program will need and ought to be a formalized requirement of all new trainees, given their limited experience compared to those much decried days of yore (and myre.)
The ramifications are many. For me personally, and others like me, it might suggest a future premium: who better to mentor the fresh faces than the old and grizzled and recently retired? And for me personally, and for you, let's hope we never need surgery. At least until the full effects of the recent changes are realized and dealt with. Which would be, oh, another couple of decades. So good luck with that.
The warnings are out there, in this blog and comments thereon, and in many others, as well as in a trickle of papers on the subject. I've been saying there's trouble ahead; it may or may not be as bad as my worst fears. I'm certain there are highly-qualified people being cranked out. The questions are, how many, qualified for what, and willing to do how much? And how to separate the sheep from the goats.
Meanwhile, were I to finalize the job arrangements (not yet certain), there might be food for further thoughts down the road.
24 comments:
- scalpel said...
How does the newbies feel about the need for mentoring?
- Sid Schwab said...
Good question, to which I don't have a specific answer. From the discussion I inferred it wasn't unwelcome. Having done some mentoring not too long ago for a person just out of training (actually just before the 80 hour week), I can say in that case at least it was appreciated; mutually, in fact, in that I enjoyed imparting a few tricks and being told "wow, that was really slick!"
- rlbates said...
Seems like that would give you many new stories to tell us. :)
Peer-to-Peer mentoring is always a great idea, but can I take it a notch?
Expand on it. Make it a group effort. Experienced O.R. RNs and surgical technicians can be an invaluable source of information, tips and techniques.
The Former OR RN who was known to send new Residents scrambling for "sterile fallopian tubes, STAT!!". =)
You mentioned that 2 surgeons hired the "newly minted" doctors. Is this a physician owned facility? Otherwise, I would imagine that most new doctors are hired by hospital recruiters who are trained in business, not medicine. Without the insight and concerns expressed by the doctors in your example, it would seem that most hospital recruiters would feel free to award surgical automomy to these new doctors based solely on "what looks great on paper".
Pity the poor patient who unwittingly becomes a stepping stone for the new surgeon's climb to practical proficiency.
- Sid Schwab said...
kristi: excellent point, and I agree entirely. All it takes is for the young hands to realize the great source of info they have; swallow their egos a bit. I used to think how many times I went from bottom to top and bottom again: grade school, big eighth grader; freshman in hs to senior; freshman in college to senior; first year med school to fourth; intern to chief resident. The pinnacle. Then, new kid on the block. It takes getting used to.
mary: I'd say it's still the case that most docs are hired privately and not by a hospital. I can't say for sure, nationwide.
Since you already mentor right here on the blog and through your other writing, I think you'll be pleasantly surprised at how much you enjoy it back in the clinical setting. The new kids, I'm guessing, will be extremely appreciative, as this isn't a fellowship or residency with a set endpoint.
I used to love to mentor grad students because they came with their own agendas, were licensed and practicing under their own credentials, and so, we engaged on subjects of mutual interest. All of the fun without most of the headaches.
I'm happy for you and hope that it provides you with what you enjoy: patient contact, surgerizing, teaching and stories (to tell us, I hope)!
- shadowfax said...
Ha! I'll be bummed if you stop blogging, but hey, if I get to consult you in the ER, that's a win for the home team as far as I am concerned!
The new crop of interns started orientation today. They look very young, very excited, and not scared enough. I always thought a good sense of fear of screwing up was a helpful thing to have during residency (and now!)
- Sid Schwab said...
shadowfax: not that we know where you work. Wink, wink.
anonymous: fear (sense of your own limits and warning bells not to exceed them) is the essence of a safe doctor; and, given the potential harm surgeons can do, it explains, in my opinion, at least some of the more harrowing aspects of (at least old-style) surgical training. Having those sense of limits and of responsibility and commitment is imperative. Traditionally, part of the method was haranguing. I can't say other ways wouldn't be as good; but when the stakes are as high as they are for surgeons, I felt, in the main, it was justified.
- Unknown said...
Perhaps if we take the focus off of, well, everything (publishing papers, doing research, volunteering. . .etc.) we would be better able to focus on what we really care about. You know how it goes - "Jack of all trades. . ."
- Patrick Bageant said...
And for me personally, and for you, let's hope we never need surgery. At least until the full effects of the recent changes are realized and dealt with. Which would be, oh, another couple of decades. So good luck with that.
Umm, gee. Thanks for the good luck bidding. I think.
Let's assume for the sake of discussion that maybe some of us don't care to rely too much on luck, and would prefer to stack the deck in our (or our loved ones') favor. If you were asked to produce a list of things that you think a patient should look for when choosing a surgeon, what would be on that list?
(And while we are assuming, let's ignore the trauma patient, since the only factor patient should be concerned with is proximity.)
- Sid Schwab said...
Patrick: I get asked that a lot, both on the blog and in other face-to-face situations. (Like when I did readings of my book.) Back then part of the answer was the usual: where did you train? Are you board certified or eligible; are you a member of the American College of Surgeons. Where a person trains is probably not really revelatory, as is true with lawyers: my dad went to a night law school; my brother, to your locums. The memberships are perhaps more important. Nowadays I guess I'd wonder how recently trained, and if in the eighty-hour era, I'd consider risking insult by asking if there was or is any mentoring since. But mainly I always say this, partly because it's an artful dodge, and partly because I think it's sensible: if you trust your primary care doctor, then you have to trust that he/she would send you to someone competent. Transfer the trust from the one to the other. Or, even, ask your doc if the surgeon is the one he/she would have do the same operation on him/herself or family.
- Patrick Bageant said...
Your answer seems fair. And and artful dodge.
Most states/communities have a listing of the "best lawyers," where best is determined by polls of practicing attorneys. While a high ranking may indicate professional ability, or it may indicate something else (like, networking ability) it seems like a pretty good bet that the nit-wit density on those lists is pretty low. Is there a comparable listing or publication for docs? I'm guessing the answer is no. Y'all seem pretty tight-lipped outside the club.
Also, there is one hell of a sentence inside your comment at 8:25, Sid.
It features a colon, a semi-colon, plus the words "locums" and "revelatory" . . . AND it makes a point.
If I wasn't convinced before that they don't make surgeons the way they used to, I am now.
- Sid Schwab said...
There are some such ratings for doctors. I can't claim familiarity with them all. One with which I am familiar listed me as one of America's Top Surgeons. The first year it was done, it actually WAS based on a survey of physicians, asking them to whom they'd go themselves or refer family for various specialties. I considered it a mild honor; but the deck was a little stacked. I was in a large clinic; other local docs were on their own. Plus there's no saying who responded and why or why not. A very similar one has come out every year since: same look of the book, same notification to those mentioned in it, with an offer of a nice plaque for two or three hundred bucks. Since that first time they abandoned the peer criteria and use who knows what. Since I'm still listed as a "top surgeon," and since I haven't practiced for several years, one can only assume it's completely bogus. And, indeed, it is. I wrote about it here.
- Bongi said...
in my country we don't have the different levels of certification like board eligible and board certified. if you qualify in out country you're on the roll which means you are fully qualified. if you qualified in another country you may have so called limited registration meaning you can only work in a state hospital. you then need to write our finals to become fully qualified. many of the cubans who defected from their contract did write these exams and are now fully qualified.
we're a bit behind you but there is a strong human rights move to make surgery training easier. it doesn't help that we have a shortage of general surgeons. they want to churn them our, despite quality. and they will be fully qualified so there will be no clear differentiation between the old style and new style surgeons.
recently i've seen and heard some things that really shock me. my master plan is to not get sick in my old age. otherwise i'm screwed.
Hey Sid, before you sign off forever, Did you ever scratch your ass during a case and neglect to reglove? I saw a Surgeon wipe his brow once and then go back to work sewing in an Aortic Valve...
- Chrysalis said...
I would think the mentoring would be appreciated. It isn't like you walk out of training knowing everything there is to know about everything. You would probably be perfect for this type of thing.
I hope there will be no final post for a long time!
- Sid Schwab said...
Frank: I do recall a wayward scratch once in a rare while, but never without realizing it in time to reglove. And there's the grabbing of the light handle that isn't there...
how do you do this mentoring, particularly by non-physicians without undermining the authority of the new hires?
it seems like you are asking for trouble. it is one thing for a grizzled veteran to throw a couple pearls every now and then. it is completely another to establish a formal program to review competency rather than to inspire excellence. it creates an aura of mistrust rather than team, in my experience. rather like another residency/ fellowship for these guys. don't be surprised when they move on. after the first few months they will be insulted.
- Sid Schwab said...
anonymous: your inferences have nothing to do with how it actually works. "Non physicians"? Who suggested that??? "couple of pearls now and then"??? What gave you that idea? "review competency rather than inspire excellence"?? We are so not on the same page. Can't imagine where you got your concepts...
- Andrew Tan, M.D. said...
There are a few lists of "best doctors." I just saw the one for Honolulu, the town where I work. Some of the choices I would judge reasonable. Some, not so much.
Personally, I think the best doctor is the one that gets out of bed and drives to the hospital to see you at 3 AM when the intern calls because she thinks something is wrong.
Somebody that does great technical operations, but only when the sun is up, probably isn't the right person for me.
I've also always thought that a good surgeon should be as interested in NOT operating on you as he/she is on operating on you. Just because you are sent to a surgeon should not mean you need or get an operation. I've seen more than a few cases done for fairly dubious indications.
I am always amazed that patients meet me, have about 20-30 (clinic is slow) minutes to talk to me about their hernia/gallbladder/etc, and then are booked for an operation if needed. There's a lot of trust that is put in you (me) and I'm constantly awed that it happens like that.
- Sid Schwab said...
andrew: I agree completely and I've written as much here several times. It's an amazing thing that people entrust us with so much, with so little real information. I'd also add that the great surgeon is the one who knows how to avoid trouble in the first place (which also includes knowing when not to operate) rather than the one who is always making a great "save." As I said in my book, it's like the great outfielder who knows the pitch count, the game situation, and positions himself always to make an "easy" catch, as opposed to the one making a diving catch. That can't always be avoided; but more often than people recognize, it can.
- SnowLite said...
- This comment has been removed by the author.


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The holidays are a special time for many, but for some celebrities, there was even more to celebrate this year.
Kate Winslet revealed she had married beau Ned Rocknroll in a super-secret ceremony. Janet Jackson's boyfriend reportedly put a ring on it. Several famous names also announced new or upcoming additions to their family, such as Jessica Simpson's adorable Christmas Day Twitter picture that confirmed her long-rumored second pregnancy. Sadly, however, the holidays also brought the loss of several beloved celebrities, including The Odd Couple's Jack Klugman and memorable character actor Charles Durning.
Remember when Justin Timberlake had curls? Check out the most dramatic celebrity makeovers
To see which stories you might have missed, check out the links below.
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Friday Night Lights' Zach Gilford Weds The Glades' Kiele Sanchez
Boy Meets World's Rider Strong Gets Engaged
Kate Winslet Weds in Secret Ceremony
Brandy Gets Engaged to Ryan Press
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Western Character Actor Harry Carey Jr. Dies at 91
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Thunderbirds Creator Gerry Anderson Dies
Oscar-Nominated Character Actor Charles Durning Dies at 89
Jack Klugman, The Odd Couple and Quincy, M.E. Star, Dies at 90
Iron Butterfly Bassist Lee Dorman Dies at 70
Jack Hanlon, Child Actor in Our Gang Movies, Dies at 96
See more of the stars we lost this year.


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The Europa Jagellonica exhibition has recently finished its run, closing at the third venue, in Potsdam. I had a chance to see the show in Kutná Hora, as well as in Warsaw, and have seen all the publications accompanying it. In the following, I will provide a brief overview and review of this major European project.
As the website of the project informs, the international exhibition EUROPA JAGELLONICA is a joint Czech-Polish-German project and the first exhibition on the European dynasty of the Jagiellonians during the period around 1500, which was of great significance for Europe.
This project has been in the making for a long time. Organized by the Centre for History and Culture of East Central Europe at the University of Leipzig (GWZO), the basis for this project was the interdisciplinary and international research project, "The Significance of the Jagiellonian Dynasty in Art and Culture of Central Europe 1454–1572", which was carried out from 2000 to 2005. Dr. Jiří Fajt (GWZO) is the chief curator of the project, and Dr. Susanne Jaeger (GWZO) is responsible for the coordination. After several unsuccessful attempts, the exhibition finally got the green light as well as European funds, and was realized together by the Czech Republic, Poland and Germany. Hungary - which was originally supposed to have been part of project - did not become an organizing partner and a venue in the end, but contributed several loans to the exhibition.
|Detail of the exhibition at Kutná Hora
"The time frame covered by the exhibition starts with the coronation of Jogaila (Władysław Jagiełło) in 1386 as King of Poland. Thanks to prudent political alliances, the Jagiellons ascended to the thrones of Bohemia and Silesia in 1471 and of Hungary in 1490. The resulting commonwealth of nations – Europa Jagellonica – spanned vast territories with a total area surpassing two million square kilometres, from the Baltic to the Black and Adriatic Seas. At the same time, strategic marital unions arranged for Polish princesses expanded the family's influence to include the Reich states – Brandenburg, Braunschweig, Bavaria and Saxony. This unique amalgamation in Central Europe left its mark on not only the political atmosphere there but on the economies of the individual nations, the intellectual culture and social mentality of the day, and the arts. [The exhibition] will highlight the period's unique circumstance of cultural diversity amidst unity – the coexistence of regional cultures and the formation of a common tradition. From such a perspective, the old Jagiellonian commonwealth becomes a fascinating reference point for reflections on modern times."
Further information about the project is available at several sites, first of all on the website of GWZO. Various flyers of the exhibition - including one in English - are available online from here. The original central websites of the project - www.europajagellonica.com and www.europajagellonica.eu - are no longer online, however, the www.europajagellonica.de provides information on the project. The websites of the various venues also provide information and photos of the exhibition: GASK in Kutná Hora, the Royal Castle and the National Museum (MNW) in Warsaw and the Haus der Brandenburgisch-Preußischen Geschichte in Potsdam all have some information.
Kutná Hora exhibition
The exhibition was the most complete in Kutná Hora. Organized at a perfect venue, the Gallery of the Central Bohemian district (GASK), located in the former Jesuit monastery right next to the church of St. Barbara, the whole town was in effect part of the exhibition. The newly renovated building provided a great location for the exhibition, and it was comfortable to walk through the exhibition. The full list of the sections of the exhibition were unfolded here, which was easy to follow - although contained a few repetitions in my opinion.


text:
Astigmatism is an abnormal curvature of the clear outer covering of
the eye (cornea), causing blurry vision.
The cornea directs light rays into the eye and focuses them on the
light-sensitive retina at the back of the eye. If the surface of the cornea is
irregular, light rays may not focus properly on the back of the eye.
Vision problems caused by astigmatism can be treated with
eyeglasses, contact lenses, or surgery.
Last Revised:
June 24, 2011
Healthwise Staff
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Kathleen Romito, MD - Family Medicine & Christopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology
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