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Pam Green
We have happily returned to Switzerland after spending 2 weeks in Armenia and Georgia. Arara travel agency in Armenia organized the whole tour for us starting from airport pick-up when we arrived. I can now say that everything was thoroughly taken care of, every detail was well-thought.
We stayed at the nicest hotels with professional staff and amazing views. Most of all we loved the atmosphere and breakfasts at Tufenkian Yerevan and Dilijan hotels. Gino Wellness Rabath in Akaltsikhe was another highlight of the trip. We enjoyed the spa there at its finest.
We had 2 amazing guides in 2 countries – Ara in Armenia, and Tazo in Georgia. Both of them were passionate fans of their countries and could give all the feels to us. They were quite punctual and took good care of us. We also tried this delicious fish near Sevan lake which Ara recommended.
Overall we are satisfied with the trip and will surely recommend Arara to our friends.
Lisa Martin
Me and my husband traveled to Armenia for a short trekking trip, the main highlight of which was Aragats Mt. Thank you Arara for making our lifetime trip happen! Conquering Aragats was on our wish list for a long time.
Sati did an amazing job during our whole stay in Armenia. Our guide Antuan was a perfect match for us. A professional hiking guide with many years of experience in the whole region. He was very flexible with our needs and made the tour pace suit us. We are not such an experienced hikers, but the hiking level is quite moderate and available to everyone with a wish to climb Aragats mount. The camping conditions were also satisfactory, everything was neat and clean.
We have already recommended your company to everyone we know and will come back to you sometime in the future for a tour to Georgia or Central Asia as discussed with Sati.
Paul H.
The trip was just fabulous! So much to mention, I don't even know where to start. Our guide Haikui and driver Robert were very caring and attentive. Haikui is very energetic, knowledgeable and full of love towards her country. Her engaging way of transferring the information was so interesting and pleasant. And Robert was a safe and professional driver, we really appreciated that.
We liked almost all the hotels included in the tour. Actually we prefer small and cozy hotels more like Armenia guesthouse in Dilijan, that is why some big chain hotels were of less preference. Though they had professional staff and all the facilities inside, this was quite convenient.
Armenia turned out to be an astonishing country with so much to offer! During our trip we were happy to visit many regions which let us catch the unique atmosphere of the country. Ah, and we met so many hospitable locals. They were always so friendly and kind. These experiences were always the best during every trip we had.
We are back to the UK with warmest memories about Armenia and hope to be back to this beautiful part of the world one day. Will recommend Arara to our friends, relatives and anyone interested in visiting Armenia!
Amy Peacock
I did the 14-day tour to Armenia with Arara. The sightseeing spots included in the tour were amazing and so captivating. The program was very well structured to cover most of Armenia. The team did a great job from beginning till the end. The email correspondence with Tatev went smoothly, she was quick in responding and very flexible during the communication process. I had this professional and experienced guide Arthur, who was amazing in every aspect. I am rather an experienced traveler and have met many tour guides throughout my trips. And I can confidently say that Arthur in Armenia is one of the best. I highly recommend Arara tours and once again want to thank Tatev and the team for making this happen!
Norma Norton
The trip was amazing! We were planning this tour for 2 years already, and were so happy to finally make it. The tour title tells it all – Uncover Armenia. We feel like we have really uncovered this amazing country. The program was very well-designed, so that we don't get tired and have time to explore the cities also on our own each day. Our tour had lunches included – a real delight for us to try something new every single day. The dishes were amazing; the Armenian barbeque became our favorite. We do hope to make it the way Khoren – the nicest chef made it for us in Dilijan!
Traveling during covid era is not an easy thing to do. I want to emphasize the importance of feeling protected and safe when traveling. Arara staff gave us that feeling of secureness. Our guide Arthur was vaccinated, which was great. He also disinfected his car every day before the tour started; it was very professional of him. Hotels were also perfect in terms of safety, our rooms being thoroughly cleaned every day.
Making this trip was a dream come true for three friends! We will always be grateful to Arara for making this a reality.
Cynthia Slater
We had booked the 17-day tour to Azerbaijan, Georgia and Armenia. Naturally, we couldn't make the trip last year because of Covid19 pandemic. That is why we were so happy and excited to finally be able to travel after getting fully vaccinated this spring. This trip was one of a kind to remember. Though we hoped to travel to all the 3 Caucasus countries, Azerbaijan didn't reopen its borders by our travel time. Our travel manager Tatev modified our tour program in such a professional and flexible way, that we didn't feel to have lost anything. We really got a full coverage of Armenia and Georgia, 2 beautiful countries with unbelievable nature, delicious national cuisine and such an interesting history to get acquainted with.
Our guide Ara was such a nice guy, he was always very polite and punctual and took really good care of us. He was always open to new suggestions during the trip and some unplanned changes if we needed them. He really did a great job!!
Though we are vaccinated, I would like to mention the safest environment we were in during the whole tour. The hotels were first of all very clean, which made us feel safe and secure. The restaurants Tatev and Ara recommended were also keeping all the sanitary measures. We cannot complain in any of these aspects.
Thank you once again Tatev and the whole Arara team for making out time so special. We really needed that after more than a year of fear, lockdown and restrictions. Will recommend Arara to our friends and colleagues!
Janice Powell
Hi Tatev, we have successfully reached home. What an amazing time we spent in your region. We will truly remember our hiking to Armenia and Georgia. Thank you for arranging our trip. Also, thank our guide Vardan for taking care of us. He was very polite and always provided hand sanitizers and face masks, although you gave us a bunch as well! We really enjoyed our hiking in Georgia too, the lakes were very beautiful, as you mentioned, so thank you for suggesting us having that hike. Overall, we really enjoyed our trip and have already passed your contact details to our friends, so check your email for new bookings!
Bobbie Bishop
This was our second visit to Caucasus region and this time we travelled only in Armenia as the Covid situation here was the calmest. We weren't sure if the trip will take place till we arrived to Yerevan. But luckily, everything went perfect. Our travel agent Sati made sure that we have all the details about covid requirements and restrictions. We were provided a bottle of hand sanitizer, masks and other necessary stuff to be protected throughout the trip. Arara has managed to provide excellent service for us. Our guide Haykuhi was very thoughtful and made sure we were feeling great throughout the trip. We visited a lot of places but the most favorite one was Noravank Monastery. Everyone should visit this magical place when coming here. Armenia is a great place to travel to and we will never get tired of being here.
TSORAPi Emilia
Very good tour with variety of things to do and professional guides with good knowledge of the places and willing to help.
Charlotte Gallaher
Dear Rima, As promised, I am sending you my feedback on the Silk Road Tour. We had an amazingly organized tour. You were supper helpful with your informative and follow up emails. Guides and drivers were ok, we did not have any issues with them, the same is with hotels. They were nice and clean with delicious breakfast. Please tell Arthur who was our guide one more time that we enjoyed our time with him. I am sure this was right choice of a tour package in terms of days and countries included in it. We have seen many monasteries, mosques, churches and fortresses. We experienced cultures, cuisines, which trust me is quite delicious. I recommend Arara tour to anyone who is looking for a company that can organize a vacation perfectly. With Love Charlotte.
Cedric & Family
Hello, my family wants to thank Arara tour and especially Eduard who was our tour manager for organizing this amazing trip to Caucasus and Central Asia. Hotels were nice and clean, especially cascade hotel in Yerevan. Please also thank our guide Arnur in Kazakhstan, we are glad to be accompanied by him. What a beautiful countries Tajikistan and Kyrgyzstan are, culture, colorful mosques, architecture, traditions and of course food were life changing. Drivers were also professional and well organized. The funniest part for us was taking part in master classes. The wine tunnel in Georgia was shocking, I will never forget the panoramic view from Tatev Monastery, Bishkek city with its white houses and big Almaty lake was amazingly beautiful. One more time I want to thank and definitely will use your services again. I have sent you a small present, hope you will like it. Cedric & Family


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Thousand Oaks, CAHome Menu
Calendar List View
Cursive for Kids
- Date: 09/22/2022 3:30 PM - 4:00 PM
- Location: Grant R. Brimhall Library Children's Program Room
1401 E Janss Road
Thousand Oaks, California 91362
- Introduction: Cursive for Kids is a program for students to practice cursive handwriting with the help of an interactive volunteer. *Location changed - this week only.
Return to full list >>
Register here: http://libcal.tolibrary.org/kids
This series breaks down cursive handwriting into alphabetical areas. This series breaks down cursive handwriting into 3 main areas; the alphabet, connecting letters in simple words, and sentences.
Please note that all programs are subject to change or cancellation without prior notice.


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Created for: The Sims 4 Creator Terms of Use
Hi! I hope you will like this hair! It is inspired by Anya Taylor-Joy's hair in the movie Last Night in Soho!
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Weed Control Means Improved Alfalfa Yield And Higher-Quality Hay
Farmers who grow alfalfa now have a new way of controlling weeds and increasing yield: a breakthrough technology that delivers unsurpassed weed control and crop safety, while providing growers with an easy, flexible way to raise more higher-quality alfalfa.
Roundup Ready Alfalfa was developed by Monsanto in cooperation with Forage Genetics, Inc. Research shows that using Roundup® agricultural herbicides with Roundup Ready Alfalfa allows improved management practices that lead to better-quality hay. Benefits to growers and dairy operators include:
• Fewer Weeds. In trials against competitive herbicide systems, Roundup Ready Alfalfa had more consistent, high-quality hay.
• Better Feed. The system can help eliminate potentially toxic and low-quality weeds, producing a better feed product.
• Superior Crop Safety. Built-in tolerance means less potential crop injury when sprayed with Roundup agricultural herbicides compared with other herbicide systems.
• Trusted Brands. Use of an environmentally responsible weed-control system and an herbicide with a 30-year history of safe use.
"Stand establishment is critical for successful alfalfa production," explained Chris Peterson, Monsanto's marketing manager for Roundup Ready Alfalfa. "An early application of Roundup will provide excellent weed control, which will maximize stand establishment. This enables growers to produce cleaner, higher-quality forage with Roundup Ready Alfalfa, so they get more alfalfa yield."
In addition, the system provides growers with a wider application window than conventional herbicides, to allow more flexibility in their weed management practices.
"The introduction of Roundup Ready Alfalfa offers a great opportunity for growers-both those who currently use herbicides and those who don't," said Mark McCaslin, president of Forage Genetics, Inc. "The Roundup Ready Alfalfa system provides improved weed control, increased flexibility in timing of herbicide application and increased crop safety compared with alternative weed control strategies."
The United States regulatory agencies granted full approval to alfalfa containing the Roundup Ready trait for commerce within the United States, including approval for marketing and consumption as food, food ingredients and feed for livestock. These products also now have the necessary import approvals in Japan, Mexico and Canada.
Regulatory approval is still pending in Korea. As a result, exporters should avoid shipment of Roundup Ready Alfalfa hay or processed products to Korea. Test kits for hay, leaf and seed can be purchased from Strategic Diagnostics, Inc. (www.sdix.com or 800-544-8881) or from Enviro Logix (www.envirologix.com or 866-408-4597).
Monsanto Company (NYSE: MON) is a leading global provider of technology-based solutions and agricultural products that improve farm productivity and food quality. For more information, visit www.monsanto.com.
Forage Genetics, Inc. is a world leader in the development, production and marketing of value-added proprietary alfalfa germ plasm and traits.
Farmers may soon find that new technology in weed control could help improve crop yield and result in a higher quality of alfalfa hay.
Roundup Ready Alfalfa is for sale and distribution by authorized seed companies or their dealers in the United States only. This seed may not be planted outside of the United States, or for the production of sprouts or seed. Any product produced from a Roundup Ready Alfalfa crop or seed, including hay and hay products, may only be used, exported to, processed or sold in countries where regulatory approvals have been granted. It is a violation of national and international law to move material containing biotech traits across boundaries into nations where import is not permitted.
Not all Roundup® agricultural herbicides are approved for use over-the-top of Roundup Ready Alfalfa. Check with your Monsanto representative for the herbicide registration status in your state.
Always read and follow pesticide label directions. Roundup Ready® crops contain genes that confer tolerance to glyphosate, the active ingredient in Roundup® agricultural herbicides. Roundup® agricultural herbicides will kill crops that are not glyphosate tolerant. Roundup® and Roundup Ready® are registered trademarks of Monsanto Technology LLC. ©2006 Monsanto Company.


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Public Records in Other Counties
Other Records in Tama County
Public Records in Tama County, IA
Tama County, IA, provides public access to property records, marriage licenses, and criminal records. You can search these records in the office of the Treasurer of Tama County, as well as other offices. You can also view maps, sketches, and photographs of properties. If you're interested in military discharges, you can also look up their records, but you need to register. Fortunately, the information on Tama County Public Documents is frequently updated, so you can always count on reliable information.
Tama County's Clerk of Court's Office is the place to look for vital records for a number of reasons. It has an old homestead book that you can consult, but it is no longer in use. If you're interested in a birth or death record, you'll need to check with the Tama County Courthouse. This office does accept requests, but it does not have 1921-1941 records. If you're interested in a marriage or death record, you can also look in the county's Courthouse for a birth, death, or marriage certificate.
Tama County's Clerk of Court is responsible for maintaining public records. As part of this role, she provides access to these records for the public and supports local government elections. The duties of a county clerk are governed by state and federal statutes, ordinances, and charters. The Recorder's Office is able to provide these documents to people who need them. If you're interested in researching your family history, this office's records are one place to start.
Tama County's Clerk of Court maintains public records for the county. She also helps the public access these records and provides assistance with local elections. The recorder's office is responsible for a variety of responsibilities. These include recording birth, marriage, and death certificates. In addition to these duties, she's also responsible for maintaining a database of public documents for the community. So, if you're interested in learning more about the people in your community, visit the Tama County Clerk's website.
Besides vital records, the Tama County Clerk's office also has access to the county's first book of deeds. This is likely the place where you'll find a birth, death, and marriage records, but it may not have all of them. If you want to search a homestead record, you'll need to travel to the Tama County courthouse. You can find the first book of Benton County deeds at the Courthouse.
The recorder/registrar also holds records related to real estate. These records are important for genealogy. The Tama County Clerk is responsible for maintaining public records in the county. If you want to find a copy of a vital record, you'll need to visit the Tama County Courthouse. The office does not maintain 1921-1941 deeds. Regardless of your purpose, you'll find a Tama County clerk's office to be your best source of information.


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Valentine's day gifts are widely in search these days, you must also be looking for a gift idea to make your loved one more loved. One can shop from number of websites but if you are in UAE, we have best options for you to choose from. Let me first give you an idea about […]Read More
1) Herbal Tea: Herbal tea is not a professionally true tea, as it does not develop from the Camellia sinensis plant. Herbal tea is an infusion or blend of several types of leaves, fruits, bark, roots, or flowers belonging to about any edible, non-tea plant. Herbal teas also called as herbal infusions and less often called […]Read More
The National Day of UAE is celebrated on December 2nd of every year in the United Arab Emirates. The UAE was established under the fanciful leadership of the late Sheikh Zayed bin Sultan Al Nahyan, known as the father of the nation. The National Day of UAE marks the celebration of joining of the 7 emirates on Dec […]Read More
The "Black Friday" celebrates globally but it originated in Philadelphia, dating back to at least 1961. Black Friday is celebrated on the day after Thanksgiving where shop owners give steep discounts on their products. It is the perfect occasion to shop and has now become a tradition globally. Black Friday is celebrated a day after Thanksgiving […]Read More
Mobile phone: A mobile phone is potable telephone that can make receive calls over a radio frequency link while the user is moving within a service area. A mobile phone sometimes called cellular phone, cell phone, hand-phone, sometimes short ended to simply mobile. There are variety of mobile phone like simple mobile phone, smart phone, […]Read More
There are 31 supermarket and hypermarket chains in UAE. Top market in UAE as follows: Al maya Lal's Supermarket/AlMaya The headquarters of Al Maya Group is in Dubai Marina, UAE. The main source of business consists of distribution of Food and Non-Food products, Al Maya Group settled in 1982, by a pioneering and inspiring businessman Mr. […]Read More
The Restaurant Delivery Apps to Make Your Life a Little easy and quickest. Whenever you click 5 top-rated restaurant food Delivery Apps in UAE, you can find the apps as follows: Talabat: Talabat is the number one online food ordering service that helps customers find restaurants in their area and offers services through mobile apps […]Read More
Noon has numerous watch brands and Lacoste is one of them which comes with wide variety of stylist watches for men, women, boys, and girls. All type of watches has attractive dial color band color and band closure. Band closure consists of buckle clasp and hook N loop type and band material fond in stainless […]Read More
The iPhone 13 Pro Max is a 5th generation iPhone with 5-core GPU and reactive Super XDR Display. Which boots speed to run the advanced display with ProMotion, and designed at A15 ultrafast bionic chip. Previous camera system modified for dramatic possibilities. And has fast enough for multiplayer gaming and more, a chip with the […]Read More
This is where grocery-shopping tips come handy, especially the ones that also save us money. Clubbed offers are a great way to save money when you're buying groceries. Keep an eye out on deals such as two for the price of one on spices, cereals, flours, and other household goods that you are familiar with. You're […]Read More


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One of hip-hops most underrated lyricists Young M.A. has returned with her all new EP, Red Flu following last year's debut album Herstory in the Making, which peaked at No. 16 on the U.S. Billboard 200.
M.A has also dropped the first visual from the EP, "Savage Mode," shot by ShotByCisco. The clip finds the Brooklyn rapper in traffic with her crew whipping a few foreign cars.
Aside from music, M.A. recently announced that she'd purchased her first home. It looks like the independent route is working well for the 28-year-old who garnered international fame with her 2016 smash single, "Ooouuu," which was certified 4x platinum by the RIAA.
Salute to M.A. You can stream her latest video and EP below.


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District Health Society Rajkot Recruitment For Medical Officer, Staff Nurse, FHW Posts 2021 District Health Society Rajkot has published an notification for the Pharmacist -RBSK, Lab Technician NHM, NUHM, Staff Nurse HNM,CMTC, Female health Worker, HNM, NUHM Posts. Eligible Candidates advised to read to the official notification and apply for this post. You can find … Read more
Category: district health society
District Health Society, Rajkot Recruitment for RBSK Medical Officer Posts 2020
District Health Society, Rajkot Recruitment for RBSK Medical Officer Posts 2020 DHS, Rajkot Recruitment 2020 – District Health Society, Rajkot has published an Advertisement for the RBSK Medical Officer and Ayush Medical Officer Posts. Eligible Candidates are advised to refer to the official advertisement and apply for Medical Officer & Ayush Medical Officer post. You can find … Read more
DHS Recruitment 2020 – NHM, Palanpur Recruitment for Various Posts 2020
DHS Recruitment 2020:-District health society has Announced a Job Notification for the Post of Female Health Worker, Staff Nurse, Pharmacist, Lab Technician, which is updated on 07 Aug 2020. As per District Health Society Recruitment, there were about DHS vacancies. The Jobseekers who wish to grab the Central Govt Job the DHS is the Great … Read more


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We know D.C. Get our free newsletter to stay in the know.
D.C. native Jermaine Fowler has been on quite the career-winning streak as of late. Apart from his busy schedule touring nationwide performing stand-up—his current tour brings him back home to D.C. for a headlining show at Black Cat tonight—he's also prepping for the Dec. 11th airing of his very first comedy special. Shot late last year at the DC Improv, the hour-long special, Jermaine Fowler: Give `Em Hell Kid, will debut on Showtime.
And it doesn't stop there: Fowler also has an untitled CBS comedy project that he's currently writing the pilot for. Largely inspired by his life growing up in Hyattsville as a son of teenaged parents, the 27-year-old will play a character largely based on his dad's experience raising children who are nearly tweens while in his twenties. Fowler frequently uses his childhood experiences in his stand-up material. Reached by phone earlier this week, the second oldest of four (he has a twin) admitted that he feels most comfortable sticking with his life as source material.
Unlike Richard Pryor—one of his comedy idols—he stays away from overtly political material. Rather, his experiences being teased by family members and peers for liking "nerdy shit," as he calls it, provides a large portion of his core comedic narrative. He's able to find the humor in those experiences now, but they weren't funny at the time.
"I would just stay in my room and listen to Bone Thugs and cry," Fowler says. Of course, he would eventually find friends with similar interests, and they'd laugh at how weird his family viewed him. But the comedy bug didn't bite him until high school. It was then, at Northwestern High School, that his friends encouraged him to try comedy. "I've always liked making people laugh, at school," he says, "just being a terror to substitute teachers and stuff—making their lives miserable."
It was watching Eddie Murphy's classic concert film Raw, in the 12th grade, that finally provided the spark that made him want to actually pursue a career in comedy. Shortly after graduating, Fowler played the comedy club circuit here in the District, before predictably heading off to New York City at the tender age of 20. After a few years of auditioning for television pilots and commercials, he took matters into his own hands by creating a viral hit series on YouTube called Homo Thugs, along with his friend and fellow comedian Kevin Barnett. Homo Thugs was a three-episode comedy web series that originally ran back in 2012, which followed the lives of two closeted gay "thugs."
"That's the thing that kind of blew everything up for me," Fowler says. "After that, things started happening a little more quickly… People just loved it. It was well written and acted. That's the thing that I credit my success to."
So now the actor-comedian, who primarily resides in NYC when not pursuing television work in L.A., is amongst a sizable lineage of successful comedians to emerge out of D.C. He mentions the likes of Dave Chappelle, Tommy Davidson, and Martin Lawrence as examples. Fowler even makes the case for D.C. as the number one market for discovering new comedic talent.
"Boston, D.C., and Chicago are like some of the best comedy scenes in the world. They've made so many people who are just fuckin' great―really funny people…D.C. might be tied at number one with Chicago." I feign surprise upon hearing that. "Yeah man, D.C.'s the shit…"
Jermaine Fowler performs tonight, Oct. 23, at Black Cat, 1811 14th St. NW, with Will Hessler and Jamel Johnson. Hosted by Martin Amini. $15.


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The initiative called the Eleventh Impact Justice 2 Judicial Circuit Criminal Mental Health Project (CMHP) includes a pre-booking, post-booking jail diversion program. The pre-booking diversion follows the Crisis Intervention Team model where people arrested for minor offenses are diverted to crisis units to receive treatment and police officers go through 40 hour training to de-escalate potentially violent incidents, and how to recognize the signs of mental illness. It concludes the importance of replicating the program in other communities.
Home / Archives for The New England Journal of Medicine


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preliminary report! President Recep Tayyip Erdogan is particularly pleased to welcome Turkey's strategic partner and ally, Polish President Andrzej Duda, at a joint press conference held after meeting with Polish President Andrzej Duda at the Chankaya Presidential Palace. He said he was.
Prime Minister Erdogan announced that he had discussed relations between Turkey and Poland, especially at both the bilateral meeting and the lengthy supper that followed, and during the official visit to Duda in May last year, relations were held in all areas. He said he had a strong discussion about his will to develop.
Prime Minister Erdogan said today's actual visit to Duda was a concrete sign of this will, and they discussed developments and bilateral relations primarily in the context of Ukraine and Russia.
Prime Minister Erdogan pointed out that the two NATO allies had a detailed exchange of views, saying, "The NATO summit will be held on the 24th. At this summit, we will find an opportunity to continue discussions from where it was interrupted. Yes. The process between Russia and Ukraine continues. What can we do as two NATO allies? We will have the opportunity to reassess what steps we can take. "He said. Said.
Erdogan explained that he and Duda shared an assessment of European security, saying:
"We have agreed that diplomatic efforts should be accelerated to end the war. Turkey is continuing its efforts to achieve a ceasefire. In fact, my foreign minister is in talks in Moscow today. He will travel to Turkey tomorrow. Maintain strong shuttle diplomacy. In the process, we will also discuss with Poland. We will continue to discuss and cooperate. As you know, the NATO extraordinary summit will be on March 24th. Will be held in Moscow on the day. ""
Prime Minister Erdogan said Poland is taking an exemplary position by opening the door to nearly two million refugees fleeing the war.
President Recep Tayyip Erdogan met with Polish President Andrzej Duda at the Chankaya Presidential Palace.
Congratulations to Duda for this hosting, but this is beyond all gratitude, Erdogan said:
"Turkey has the best understanding of the challenges facing Poland as the country that has accepted the most refugees in the world in eight years. Take this opportunity to encourage Polish authorities to evacuate and Ukraine. It is commendable that their support across the borders of the citizens of the country reaches our customers. At our conference, we also establish a high-level strategic cooperation council and our strategy. We discussed the idea of crowning a strategic partnership. We strive to hold our first council in Warsaw later this year. Our trade volume is 28 despite the epidemic situation. % Increased. It reached $ 3 billion. We are very close to our $ 10 billion target. We are also pleased with the development of relationships in the field of defense industry. "
Prime Minister Erdogan has expressed close cooperation with Poland on regional issues and multilateral platforms and believes that the constructive attitude and support of Polish friends will continue to advance Turkey-EU relations. I emphasized that I am. Prime Minister Erdogan hoped the meeting would be beneficial.
Explanation from Duda
Polish President Andrzej Duda said Russia had attacked Poland's neighbor, an independent country, and that the most important issue in the meeting with Prime Minister Erdogan was to stop the war between the two countries.
"I thanked (to Erdogan). I know how hard you worked for peace (in Ukraine)." Duda said that Turkey, like Poland, has peace between Ukraine and Russia. He said he hopes to be established as soon as possible.
Duda said, "Turkey plays a very important role in ensuring peace in the region as a geographically and politically important country. Thank you. We agree. " He said.
The Russians emphasized that they should stop attacking, killing and bombing civilians as soon as possible, and in his contribution to stop even the painful images first seen since World War II. I thank Erdogan for that.
"We have begun a very good cooperation in the field of defense."
Duda said he wants military cooperation to continue as well as economic cooperation between Poland and Turkey.
The visiting president said:
"Last year (with Turkey) we had a very good partnership in the field of defense. We will continue to develop this partnership. We hope that the mutual benefit with the President will exceed $ 10 billion. As you know. Very well, Poland and Turkey in this area. The potential for cooperation is very strong and large capacity. "


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Yesterday was a day, nothing special. I did stop at the original Hodgepodge coffee shop for an afternoon pick-me-up. I'm always amazed how many people are in coffee shops during my normal work hours.
Once again I'm in the office before 6:00am because it's warm out and I couldn't sleep. Initially I was going to visit the Waschsalon this morning, oh yeah I saw that East Atlanta's only lavanderia has now closed, but I didn't want to wait around until its 7:00am opening.
If ITP-Reader (a callback to the olden days around here) Bonnie reads today's post she's either doing so via in-flight WiFi, or because she has jet lag; either way, I hope that you had a marvelous trip and I missed hashing with you.


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Hands-on examples and best practices about how companies can drive high adoption rates for their Employee Communication and Engagement Platform – at the initial launch and for ongoing success.
In this demo, you will learn how to ramp your new hires faster and more effectively to increase engagement, performance, and retention throughout the employee lifecycle.
JetBlue's Doug McGraw explains how the airline uses Dynamic Signal to keep a dispersed workforce informed, engaged.
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1. Department of Orthopaedic Surgery, University Hospital of Heraklion, Heraklion, Crete, Greece
2. 4th TO.M.Y., Heraklion, Crete, Greece
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Background: The use of patient-reported outcome measures (PROMs) constitutes a valuable tool in evaluating the quality of care offered in orthopaedic surgery. The aim of this review is to identify the PROMs that have been translated into and validated in the Greek language, summarise their measurement properties, and evaluate their methodological quality according to the COSMIN Risk of Bias Checklist. Methods: A structured literature search was conducted using the databases PubMED/MEDLINE, Embase, Scopus, and the Cochrane Library in order to identify PROMs relevant to musculoskeletal conditions translated and validated in the Greek language. The methodological quality of the studies was assessed according to the COSMIN Risk of Bias Checklist, and the quality of measurement properties according to the COMSIN criteria. Results: Literature search yielded 6743 articles. After removal of duplicates and screening of the articles, 32 studies including PROMs related to musculoskeletal conditions were identified. The studies included 31 PROMs and reported 171 measurement properties. Methodological quality was adequate for 81 of them (47.3%). The most commonly reported measurement properties were internal consistency, reliability, construct validity and responsiveness. Conclusion: The majority of PROMs translated into Greek involves the lower extremity and especially knee pathologies. The search revealed that there are areas of Musculoskeletal Medicine such as skeletal trauma, musculoskeletal oncology, and paediatric orthopaedics in which patient reported-outcome measures have not been translated into Greek. Translation and validation of new outcome measures is encouraged, using studies designed in compliance with the COSMIN guidelines, and further validation of the translated instruments.
Cite this article as: Daskalakis I, Sperelakis I, Sidiropoulou B, Kontakis G, Tosounidis T. Patient-Reported Outcome Measures (PROMs) Relevant to Musculoskeletal Conditions Translated and Validated in the Greek Language: A COSMIN-Based Systematic Review of Measurement Properties. Mediterr J Rheumatol 2021;200-17.
Article Submitted: 25 Feb 2021; Revised Form: 25 May 2021; Article Accepted: 10 Jun 2021; Available Online: 30 Sep 2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
©Daskalakis I, Sperelakis I, Sidiropoulou B, Kontakis G, Tosounidis T.


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In the smallest province of the country folklore is breathed in each of its colonial corners. Tasting its famous handmade bread or admiring its unmissable clay handicrafts is only comparable to the joy of its carnivals and festivals.
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Top 5 Crucial Moments in life to use hand sanitizers
Usually, in our normal routine, we touch hundreds of hard surfaces whether traveling on a bus or train, entering coffee shops or making transactions via ATM. We could never know how many bacteria and germs these surfaces contain. There is a possibility that diseased persons may touch the same objects in public settings, if we also accidently come in contact with that object, it has a high probability that we may get infected by the disease.
Five Crucial Moments to use Hand Sanitizers
It is important to spread awareness about hand hygiene as an individual responsibility to keep ourselves and others safe. Since the breakout of Coronavirus, hand sanitizers have become an initial part of our daily routine. The need for proper hygiene is now playing a vital role in keeping the harmful viruses and bacteria away. The alcohol concentrated sanitizers are 60% to 90% more effective in killing germs. Let's discuss the crucial moments where use of hand sanitizers becomes inevitable.
Shopping is a need of time and an important component of our lives but while shopping we may touch many items which would have already come in contact with others so we should use hand sanitizers before and after we are done buying stuff in order to minimize the risk of getting infected. It is necessary to use hand sanitizers as we can get dozens of germs or viruses if we do not wear gloves.
When we go out and travel by public transport, it is advised to be careful where you touch i.e. door handles of cars or buses. After taking transport, we should properly apply hand sanitizers. Since we are not aware how many bacteria have been spread as various people may touch or have set in the same spot as you. You should avoid putting hands on various surfaces but it is wise to apply sanitizer gel before you get on and off the transport.
You need to be attentive while working as well. In order to keep all the employees safe and sound, clean your office settings by spraying liquid forms of sanitizers. You should always follow the standard protocols provided by the government at all places like maintaining social distance, coming in contact with desks, tables and shaking hands. Regular use of gloves and hand sanitizers can limit these infections.
Prior to eating, we should wash and rinse our hands with soap or sanitize our hands. It is a common habit to eat snacks without washing hands, but it is very detrimental. It is a healthy practice to wash hands before and after eating food at any place. Hand hygiene should be prioritized in every condition.
It is a vital observation that many people tend to touch their faces before applying sanitizer gel, it is the most harmful action, you can do to yourself as this is an unnoticeable action. Before touching your nose, lips, ears, or any part of your face, apply hand sanitizer as it is a necessary measure.
Final Thoughts
Touching hard surfaces while shopping, provides a high risk of getting sick. In simple words, we rub our eyes or come in contact with our faces frequently in our day-to-day routine. The use of hand sanitizers is the most portable and effective solution in order to ensure our health safety as well as to protect our loved ones from getting infected.


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|Effect of cardiac rehabilitation with exercise training on fasting plasma glucose and HbA1c in patients with chronic heart failure
|STEVENS, An
HANSEN, Dominique
OP 'T EIJNDE, Bert
DENDALE, Paul
BERGER, Jan
|Issue Date:
|EuroPRevent 2012, Dublin, Ireland, 3-5 May 2012
|Purpose: It has long been recognized that chronic heart failure (CHF) and glucose abnormalities are linked. However, the effect of physical exercise training on glucose metabolism in CHF has not been extensively investigated. The aim of the presented analysis is to describe a large cohort of CHF patients that engaged in rehabilitation in terms of exercise tolerance, fasting plasma glucose and HbA1c. Methods: Data concerning cardiopulmonary exercise testing, blood analysis and training were extracted from medical files. Maximal exercise testing with gas analysis was performed on a bicycle ergometer, venous blood samples were taken in a fasting state at the start and after 6 weeks of rehabilitation. Result: In total, 124 CHF patients were included in rehabilitation, of which 38 (31%) dropped out of the programme before the second exercise test after 6 weeks of training. The dropouts did not differ significantly in terms of age, left ventricular ejection fraction and percentage of predicted peak oxygen uptake. The prevalence of diagnosed diabetes was 10% in the dropout group (vs 23%). Nevertheless, baseline glucose (113 ± 39 vs 103 ± 18) and HbA1c (6.07 ± 1.07 vs 5.91 ± 0.66) tended to be higher in the dropout group, although the difference was not statistically significant. Eighty-six patients finished a second exercise test after 6 weeks, of which 20 patients had diagnosed diabetes (table 1). The diabetic group did not differ significantly in terms of age (66.4 ± 9.7 years vs 62 ± 12.3 years, p=.101), left ventricular ejection fraction (29 ± 13% vs 32 ± 13%, p=.422) and body mass index (28.1 ± 5.2 kg/m2 vs 27.1 ± 5.5 kg/m2, p=.48). Although both groups had a significant increase in peak oxygen uptake (+8.3 ± 8.1 % predicted in diabetics, p<.001 vs +9.45 ± 14.3 % predicted in non-diabetics, p<.0001), this was significantly lower at both tests in the diabetic group (p<.05). Fasting plasma glucose in the diabetic group was unaltered after training (-0.1 ± 41.5 mg/dL, p=.935), but tended to increase in the non-diabetic group (+4.1 ± 18.7, p=.222). HbA1c tended to decrease after training in both groups (-0.28 ± 0.47, p=.091 in the diabetic group vs -0.08 ± 0.29, p=.239 in the nondiabetic group). Conclusions: The prevalence of diabetes is considerable in a CHF population engaged in rehabilitation. Patients without diagnosed diabetes also showed high fasting plasma glucose, which did not decrease after exercise training. Further study will show what is the role of cardiac rehabilitation in improving glycemic control and what would be the best method to detect changes in glycemic control after intervention.
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Why choose Achieve Balance Chiropractic?
Chiropractic care is a non-invasive, drug free way to treat issues in your body.
By using targeted adjustments and gentle manipulations of the joints, manual chiropractic can be a solution to moderate pain, severe pain, or simply wellness reasons.
Each individual presents us with a new challenge to task ourselves with.
We are experienced with a growing variety of symptoms. This allows us to be able to help you because we possess a large understanding of conditions in the human anatomy. Learning is a part of our daily jobs. This means we approach your care with an analytical, and comprehensive mindset so that we are ready to handle every case that we are presented with.
Since your central nervous system is made up of your brain and spinal cord, it is imperative that your spine and joints are taken care of so that there are no obstructions to halt your nerves from running their commands correctly.
For example, if you were to experience a head injury such as whiplash which would also misalign the spinal segments in your neck, it could also cause you to feel sick, simply unwell, or your body could function in a different manner than usual which can be a signifying note that something is going on.
Each adjustment is chosen to provide you with lasting results. Your doctor will go through your case and familiarize themselves with your condition.
Disorders, allergies and illnesses have a possibility to be fixed due to Chiropractic. A wide spectrum of pain can be resolved due to Chiropractic.
Each case that we are presented with is always individually assessed.
Ready To Live Pain Free?
No assumptions are made that your case will be the exact same as someone else's case.
No matter what, big or small, painful or not, we are here to help you get on track or stay on track with a healthy lifestyle that you want to be living. Chiropractic care can provide a base for your body to heal from or help you manage the symptoms of your case.
All of our doctors have been appropriately trained and licensed as certified Doctors of Chiropractic so that we are able to take care of you in the best possible way.


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Inflationary increases in groceries and household items are among the most notable increases hitting stores, and although consumers are only just starting to feel it, logistics companies have been grappling with the issues for some time. behind some of these price increases.
The prices of ingredients and raw materials have increased significantly over the past year due to higher wholesale costs, particularly in the consumer packaged goods sector. At the same time, transport costs are also high, in part due to high fuel prices, which reduce the margins of freight transporters.
"Transportation costs are definitely increasing. With fuel prices and a shortage of truckers, it's getting harder than ever to ship goods," said Campbell Smith, account manager at PTV groupsaid.
Although many factors are beyond their control, fleets have been able to better control their transportation spend by using PTV Route OptimizerThe functionality of is designed to meet specific last mile delivery logistics needs for CPG items. By using the tool, savings of 17% or more are not uncommon, according to the PTV Group website.
Even in times of relative stability, the delivery of consumer packaged goods comes with its own unique set of day-to-day challenges, which have only intensified in recent years with the popularity of e-commerce and the increase in population in urban areas.
"We see a lot of challenges with moving certain types of vehicles into certain specific urban regions," Smith said.
Due to the nature of the goods transported – such as dry, refrigerated and frozen goods – and their varying requirements, route planners have already spent hours trying to figure out which goods can be transported in which trucks. Vehicle types, capacity availability, and size and weight attributes also influence this load and route planning.
These factors, combined with the fact that goods are delivered over the last mile through densely populated areas, further complicate the planning process due to legal restrictions, traffic patterns and construction zone considerations. With PTV Route Optimizer, this planning process has never been easier.
Route planners manage many trucks at once and using PTV Route Optimizer they can easily assign loads to all their assets and vehicle types at once and find the best routes while considering these considerations.
This means lowering transport costs by minimizing unnecessary miles along inefficient routes, reducing fuel consumption and vehicle wear and tear, all in all adding up to serious savings every year.
At the same time, route optimization allows fleets to fulfill more orders in the same amount of time, which further increases revenue and frees up the capacity to accept more orders as demand for CPG items and e-commerce products remains an essential component of consumer spending. habits.
With PTV Route Optimizer, carriers are able to avoid arduous planning time, freeing up more time for other productive tasks.
"Nothing is theoretical. It is something very pragmatic. So, in the end, it allows on the one hand to reduce costs and on the other hand to increase the reliability of the services you provide", said Matthias Hormuth, president of product management logistics at PTV Group.
PTV Group plans to launch its tracking visibility tools soon, which will allow drivers to notify customers of their estimated time of arrival, strengthening relationships with the other side of the supply chain.
Find out how PTV Route Optimizer can help CPG carriers reduce transportation costs by clicking here.


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Girls hoops roundup: Manchester stays hot in divisional play
Manchester remains undefeated in division, Toms River North's Ashley Tutzauer scored 31, and Holmdel's Jen Inman also dropped 30
Manchester continued its strong divisional play, remaining undefeated in the Shore Conference Class B South after defeating Donovan Catholic, 38-32, on Tuesday night.
Anissia Fucci scored a team-high 13 points and pulled down 10 rebounds. Lyric Green also had five points, 11 rebounds and four assist for the Hawks.
Dakota Adams had a good game in the paint for Manchester, pulling down 10 rebounds along with seven points.
Manchester head coach David Beauchemin credits the victory to another strong defensive performance, as the Hawks trailed Donovan heading into the fourth quarter.
"We didn't make any drastic adjustments, we just stayed the course," Beauchemin said. "They came out strong in the fourth, and we were able to hit our foul shots and close it out."
The Hawks finished the fourth quarter with a 17-8 advantage.
Molly Collins scored a team-high 11 points for Donovan.
Manchester will look to pick up another divisional win when it hosts Jackson Liberty on Friday.
Girls Basketball: This week's Top 10 through 1/9
Southern 38, Toms River East 33: Gabby Davis scored a team-high 12 points leading the Rams over the Raiders in a Class B South game. Bianca Nicolini also netted eight points for the Rams in the win. Kaitlin Lister scored a team-high 13 points for Toms River East.
Toms River North 73, Brick Memorial 68: Ashley Tutzauer had a huge day for the Mariners, finishing with a game-high 31 points, leading her team to the Shore Conference Class A South win over the Mustangs. Brielle Bisogno also added 18 points for Toms River North.
Central 47, Pinelands 36: Rachel Rice scored a team-high 19 points leading the Golden Eagles over the Wildcats in Class B South action. Sam Wilbur added eight points for Central.
Holmdel 66, Manalapan 53: Jen Inman erupted for a game-high 30 points leading the Hornets over the Braves in a nondivisonal game. Sydney Coffaro added 11 points for the Hornets. Erin Rotondo scored a team-high 18 points for Manalapan.
Matawan 51, Freehold 42: Tracey Brereton scored a team-high 15 points, and Khoryn Bannis added 12 more, as the Huskies defeated the Colonials in a nondivisonal game.
Henry Hudson 54, Asbury Park 47: Kam Hubney scored a team-high 16 points leading the Admirals over the Blue Bishops in a Shore Conference Class B Central game. Devon Adams and Emma Curry each scored 13 points for Henry Hudson. Kiara Wood scored a game-high 21 points for Asbury Park.
Keansburg 48, Point Beach 37: Alison Florenzo scored a team-high 18 points leading the Titans over the Garnet Gulls in a B Central divisional game. Cheyenne Lyons added 13 points for Keansburg. Cameron Barnes scored a team-high 10 points for Point Beach.


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On Nov. 5 — actually, before then, since early voting is now the law here — New Yorkers will get to say yay or nay to five potential changes to the City Charter, which is Gotham's foundational legal document. We hereby give our blessing to the most important of those reforms: ranked-choice voting for local primaries and special elections.
The way municipal office elections work now is that voters go to the polls in June to choose who will be the standard-bearer for their party. Since this is almost exclusively a one-party town, those primaries are decisive. Turnout is typically low; just one in five Democrats showed up in 2013; in 2009, just 12% did.
In primaries for mayor, controller or public advocate, winning candidates must get above a 40% legal threshold. If not, the top two finishers advance to a runoff, where turnout is inevitably even more pitiful; in 2009′s, just 10% of eligible voters turned out.
In primaries for borough president and Council and in special elections — like the clown-car 17 candidate contest picking a new public advocate earlier this year — there's no 40% threshold. The top finisher wins, even if that candidate winds up with 13% of 5% turnout.
A better way is on the ballot, called ranked-choice or instant-runoff voting. Voters don't pick just one candidate; they can rank up to five choices, in order. If nobody in an all-comers primary gets 40%, the counters look to the second-place votes of the losing candidates, redistributing those to the top two contenders.
The result includes more voters' preferences, encourages turnout and, at least in theory, fosters a more constructive style of campaigning.
Last year, we scoffed at this Charter Revision Commission, doubting they'd produce anything useful. We were wrong. It happens.


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Till a few years ago, breastfeeding was a taboo topic. New moms had their mothers, mothers-in-law, aunts or elder siblings to guide them when it came to breastfeeding the child. Many would give up on breastfeeding or also add formula milk if told by elders that their child was looking lean. But Breastfeeding Support for Indian Mothers (BSIM), a Facebook group started by Adhunika Prakash, has changed the lives and the way women look at breastfeeding for better.
The group with more than 95,000 members from India and abroad, motivates women to exclusively breastfeed their child for six months, then continue breastfeeding along with appropriate complementary foods for two years, breaks myths and clears doubts about the most beautiful bond between a mother and her child. The members also motivate each other to nurse in public because breastfeeding is the most natural thing to do.
Prakash, an MBA graduate from Symbiosis University, is mother to a son and a daughter, aged six and two respectively. A certified lactation educator and counsellor, Prakash is happy that the group has reached a large number of women.
She was selected as one of the top five Community Leaders in Residence by Facebook and the group was selected to receive up to $1 million to fund their community initiative.
The launch of BSIM
Prakash says that it was in June 2013, when her son was 11 months-old and still being breastfed that the idea struck her. "He would need breast milk a lot and very often. Nobody had told me that breastfeeding would be so hard, and more than that something that society still doesn't acknowledge and appreciate. I wondered why was it that the fascinating facts about breastfeeding were not known to most?," she says.
Keeping that in mind, she set up a Facebook group to connect with other women and make them feel less lonely. "I would post everyday about lesser-known facts about breastfeeding, about how women can decipher if they're making enough milk for their child or not," she adds.
Changing outlook of first time mothers
The first thing that the group has managed to do is to convince mothers that they should ask for help if they are struggling, rather than giving up on their goals. "It is a mother's right to breastfeed and nobody can take it away from her. The sisterhood is there to guide moms and help them in their breastfeeding journey. While simple queries get answered pretty much immediately, for more complex queries, they can get help from lactation consultants," she says. "The group has normalised breastfeeding, growth spurts and sleepless nights for first-time mothers. Nursing in public is difficult for many mothers. The group has helped them understand that it is common and that they should not be locked up inside the four walls of a house, just because they are breastfeeding."
According to Prakash, the notion that breastfeeding and being employed outside the house don't go together, is gone. "We have lots of mothers who have gone back to work and continued to breastfeed their babies well beyond the two-year mark. The changes in the body do not happen because of breastfeeding but because of pregnancy. If anything breastfeeding makes, it positively changes a mother's body and mind," she insists.
Women are thankful
She happily shares that every week, they see a handful of testimonials from first-time mothers about how the group has been helpful to them. "We mostly get positive and happy responses and that keeps the team going. Over the years, the 'thank you' messages have changed from 'thanks for supporting our breastfeeding journey for the past six months' to 'thank you for supporting us through the past few years.' We see more and more toddlers being breastfed. We get 'thank you' messages from mothers of premature babies too. We have even supported mothers with adopted babies through induced lactation," she says, adding, "The support is extended to exclusively pumping mothers, mothers who work, mothers who want to transition from formula feed, mothers with specific illnesses, mothers of babies with specific illnesses and so on. Each time we help a mother to break through one of the many constraints to reach their goals, the testimonial posts show how happy and thankful they are to the group and the team."
A happy journey
In almost six years, the group is 95,000+ members strong, which Prakash says is itself a huge milestone. "I spoke at the Mashable Social Good Summit (in partnership with United Nations) at New York about the positive impact social media can play in the lives of people. In addition to that, we launched the #FreedomtoNurse campaign when a nursing mother was asked to nurse her baby in a toilet in a mall in Kolkata," says Prakash who also received the Web Wonder Woman award from the Ministry of Women and Child Development in March 2019.


text:
- Janic, P.
- Abstract:
- The purpose of this article is to describe the modern methods of making models of quarry using the latest technologies such as laser scanning, land and air photogrammetry using Unmanned Aerial Vehicles (UAV) and their subsequent use in the planning of technological processes in the quarry. The first part of the article is dedicated to the creation of models with a focus on data collection and processing, compatibility of each format, the very creation of the model as well as the possibility of using the created model for creating realistic physical models using 3D printing. The emphasis is on creating the optimum method of data processing and the creation of a model with a focus on the cheapest solution with the maximum use of free available software tools to make such a model quarry also available for smaller sites and companies. The second part of the article describes the options thus create a model for planning the various processes of mining in the quarry, such as blasting, optimizing transport to the quarry, planning process and scheduling by specialized software.
- SGEM Research areas:
- Year:
- 2017
- Type of Publication:
- In Proceedings
- Keywords:
- modeling; UAV; quarry; mining; 3D print; planning; optimization
- Volume:
- 17
- SGEM Book title:
- 17th International Multidisciplinary Scientific GeoConference SGEM 2017
- Book number:
- 13
- SGEM Series:
- International Multidisciplinary Scientific GeoConference-SGEM
- Pages:
- 11-18
- Publisher address:
- 51 Alexander Malinov blvd, Sofia, 1712, Bulgaria
- SGEM supporters:
- Bulgarian Acad Sci; Acad Sci Czech Republ; Latvian Acad Sci; Polish Acad Sci; Russian Acad Sci; Serbian Acad Sci & Arts; Slovak Acad Sci; Natl Acad Sci Ukraine; Natl Acad Sci Armenia; Sci Council Japan; World Acad Sci; European Acad Sci, Arts & Letters; Ac
- Period:
- 29 June - 5 July, 2017
- 978-619-7105-00-1
- 1314-2704
- Conference:
- 17th International Multidisciplinary Scientific GeoConference SGEM 2017, 29 June - 5 July, 2017
- 10.5593/sgem2017/13/S03.002
Hits: 1226


text:
There are 36 Equine Services in Colorado, serving a population of 5,436,519 people in an area of 103,614 square miles. There is 1 Equine Service per 151,014 people, and 1 Equine Service per 2,878 square miles.
The state of Colorado is ranked 10th in Equine Services per capita, and 29th in Equine Services per square mile.


text:
Adam's Heart Valve Surgery Blog – Page 54
After 57 Cardiac Rehab Sessions, Charles Feels Very Fortunate
By Adam Pick on May 31, 2009
When talking with patients and caregivers about heart surgery recovery, I can never say enough about cardiac rehabilitation programs. I hear from patients over-and-over-and-over-and-over again about how valuable cardiac rehabilitation programs are for their physical, social and mental well-being after heart surgery.
Here's a quick note I just received from Charles Harrall, an active 65-year old businessman from Nevada, about cardiac rehab, goal setting and medication management. Charles writes:
Hi Adam,
I am one year past my aortic valve replacement, mitral valve repair and a triple bypass.
Patient At Cardiac Rehabilitation – On Treadmill
Mitral Valve Prolapse And Panic Attacks?
By Adam Pick on May 31, 2009
Janice has a question about mitral valve prolapse and panic attacks.
She writes to me, "Hi Adam – I'm curious to know if you've come across patients that have panic attacks and mitral valve prolapse? I've looked up the symptoms of mitral valve prolapse and I don't see "panic attack" listed there, just anxiety. The reason I ask is my 59-year old husband was diagnosed with moderate-to-severe mitral regurgitation and I've noticed a very unusual, very anxious side to him lately. Is there any connection between this valve disease and panic attacks? Thanks, Janice"
So you know, Janice isn't alone. I receive this question every once-and-a-while from patients and caregivers. Initially, my research did not suggest a direct connection between mitral valve prolapse and panic attacks. However, during the past few years more research about this co-occurrence has forced some members of the medical community to take a position on this condition.
At 73, Sylvia Woolworth Was Physically And Mentally Fit For Heart Valve Surgery
By Adam Pick on May 27, 2009
Here is a fantastic patient success story from 73-year old, Sylvia Woolworth, of New Jersey. As you can read below, Sylvia's preparation for heart valve surgery was… extra-ordinary!
Hi Adam,
Five weeks ago, I had aortic valve replacement surgery. I was diagnosed with severe aortic stenosis although I had no symptoms except a heart murmur.
Thankfully, before my procedure, I read your book which greatly helped me prepare for surgery. My doctor, John M. Brown III, Chief Thoracic Surgeon at Morristown Memorial Hospital in Morristown, New Jersey, also prepared me during our face-to-face appointments.
I wanted to be in the best physical and mental condition for the operation. So, during the past twelve months, I lost 35 pounds. I went to the YMCA four-to-five days a week and I joined Weight Watchers to learn better eating habits.
Jenny Garth Reveals Leaky Heart Valve Diagnosis
By Adam Pick on May 27, 2009
It seems like 2009 could be "The Year Of The Celebrity Heart Valve Patient".
In February, Barbara Bush had aortic valve replacement. Then, in March, Robin Williams had aortic valve replacement with a bovine valve and a mitral repair. Later that month, Aaron Boone, professional baseball player with the Houston Astros, had aortic valve repair.
Yesterday, we learned that actress Jenny Garth was diagnosed with a leaky heart valve over seven years ago.
Farmer & Triathlete, John O'Neill, Shares Inspirational Heart Valve Surgery Story
By Adam Pick on May 24, 2009
There is nothing better than waking up, kissing Ethan (my 6-week old son), turning on my computer, and opening an incredible email from one of my readers.
That said, I thought you might like to read this inspirational note from John O'Neill. As you can see, John discusses many of the experiences common to heart valve surgery patients – including symptoms, diagnosis, surgical care, genetics, recovery, cardiac rehab, Coumadin, etc. So, with John's permission, I am posting his email below:
John O'Neill – Bicuspid Valve Replacement Patient
"Did Your Heart Pound Like Crazy After Valve Surgery?" Asks Josh
By Adam Pick on May 21, 2009
Josh just asked me an important, post-operative question about elevated heartbeat sensations after heart valve surgery and aneurysm repair. I responded below but, if you are a former patient, maybe you can help Josh by leaving a comment as well? Here is what he writes:
Can You Get Life Insurance After Heart Valve Surgery?
By Adam Pick on May 19, 2009
I'm not sure if you remember… But, I have been trying to get life insurance after my heart valve surgery for a lonnnnnnnnnnnnnng time.
During this process, I have been denied, even auto-denied, by some of the largest insurance carriers as soon as they learn that I had my aortic and pulmonary valves replaced.
Well… I have some good news to report!!!
The 'Other Side' Of Patient & Caregiver Fear
By Adam Pick on May 18, 2009
I receive many each day about heart valve surgery, from both patients and caregivers. Unfortunately, many of these emails begin with opening statements like:
- "Hi Adam – I am scared out of my mind right now, I was just diagnosed with severe aortic stenosis…"
- "Hi Adam – After monitoring my my mitral prolapse for 10 years, I need surgery. Needless to say I'm a wreck…"
- "Help Adam! My husband is going in for aortic valve replacement tomorrow. I can't sleep I'm so scared…"
As you can tell, fear is the fundamental emotion expressed in these types of emails.
In the past, we have talked about fear on many occasions. We have turned it into an acronym as F.E.A.R. or Fantasized Experiences Appearing Real. And, I have posted clinical research to illustrate how to dispel your fear of heart surgery.
This morning, I read a wonderful quote from best-selling author, John Roger, that addresses this very common issue among patients and caregivers. Here is the quote:
You may be surprised to learn that negative conditions can actually lead to a positive place.
On the other side of loneliness is a beautiful place called solitude.
On the other side of rejection is the simply powerful place of acceptance.
I loved how this quote could be directly applied to the negative condition of fear. I even thought about how we could add one more line to this quote about heart valve surgery. It might read like this:
On the other side of heart surgery fear is courage, strength and, among all things, healthy hearts.
If you are fearful about an upcoming surgery or if you are struggling through your recovery, please remember that the odds are with you. As my mom said to me, "You can turn a heart valve lemon into heart valve lemonade."
Keep on tickin!
Off-Topic: At 5 Weeks, Baby Ethan Is Yummy!
By Adam Pick on May 12, 2009
Thank you for all the wonderful notes regarding the birth of our son, Ethan.
Robyn (my wife) and I wanted to give you a quick update… Ethan is doing great!!! On Saturday, Ethan entered his fifth week of life. And, on Sunday, we celebrated Robyn's first Mother's Day.
As Ethan is our first child, we have quickly learned how wonderful it is to be parents. Yes, Robyn and I are very tired. Yes, we're pee'd on regularly. Yes, he's pooped on us. And… Yes, I've had the joy of "spit-up" splattering the side of my face several times. But, all it takes is one look from Ethan and all that discomfort becomes comfortable.
Here are some of the latest pictures we've taken of our little man.
"How Long Were You In The Intensive Care Unit After Heart Surgery?" Asks Cindy
By Adam Pick on May 9, 2009
Cindy, from Illinois, just asked me a fantastic question about heart valve surgery and the intensive care unit (ICU).
Her email reads, "Adam – The time is finally here. After suffering from aortic stenosis for the past twelve months, I'm going in for heart valve replacement next week. Yes, I'm nervous. Yes, I'm anxious. Anyways, I have a question for you about the ICU. How long were you (and other patients) in the intensive care unit? I want to know what to expect and I want to make sure my family knows what to expect. Thanks, Cindy."
To start, I want to acknowledge Cindy for asking an excellent question. In my opinion, expectation management is critical for patients and their caregivers. That said, I'd like to publicly say, "Great job Cindy!"
Me (Adam) In The Intensive Care Unit
"Is Constipation After Heart Surgery Normal?" Asks Dahlia
By Adam Pick on May 6, 2009
I just received a very important question from Dahlia about constipation and heart surgery.
She writes, "Adam – I'm quite embarrassed to be writing you about this but I just had mitral valve replacement surgery due to prolapse and leaky mitral valve. It's been two weeks since my surgery and I'm incredibly constipated. Is constipation after heart surgery normal? Do you have any advice? Thanks, Dahlia"
Dahlia has ab-sooooooo-lutely nothing to be embarrassed about. So you know, it is very common for patients to experience constipation… And, it can be quite dangerous.
"Do All Heart Valve Surgery Patients Go To Cardiac Rehab?" Asks Eva
By Adam Pick on May 4, 2009
In response to a recent blog titled, "Do I Have Cardiac Depression?", I just received a follow-up question from Eva. She writes, "Adam: Does every heart valve surgery patient go to cardiac rehabilitation?"
Specific to the recovery from heart surgery, I believe this is a great question for both patients (and their caregivers) to consider. That said, I asked this exact question to 75+ heart surgery patients, during a recent survey, to evaluate whether-or-not cardiac rehab was common among recovering heart surgery patients.
As you can see below, my research indicates that only 51% of patients surveyed did participate in a cardiac rehab program. So you know, I have a problem with that statistic. In my opinion, that survey result is wayyyyyyyyyy tooooooooo low.
Mitral Regurgitation Forces Malaysian Sultan Into Heart Valve Repair Surgery
By Adam Pick on May 4, 2009
The Sultan of Selangor, Sultan Sharafuddin Idris Shah, is in stable condition after a 10-hour open-heart surgery on Saturday at the Stanford University Medical Centre in Palo Alto, California.
The sultan's private aide, Kelvin Ong, said in statement here today that Sultan Sharafuddin, 63, was now recovering in the Intensive Care Unit of the medical centre after undergoing repair of a leaking valve for "mitral regurgitation".
He said mitral valve regurgitation (leaking heart valve) surgery was recommended when a person's ejection fraction — a measurement of the heart's efficiency — dropped below 60 per cent and/or the left ventricle was larger than 40mm at rest. The ejection fraction could be used to estimate the function of the left ventricle, which pumps blood to the rest of the body, he said.
"What Are The Signs And Symptoms Of Heart Valve Problems?" Asks Donna
By Adam Pick on April 26, 2009
I just received an interesting email from Donna about the signs and symptoms of heart valve problems.
Donna writes, "Adam – I was diagnosed with moderate mitral regurgitation over five years ago. Since then, I have annual check-ups to make sure the valve doesn't get any worse. The strange part is that I've had no symptoms since diagnosis. Yesterday, however, I lost my breath while walking up a hill during my weekly hike. As I'm 63-years young, I'm curious to know if this is a sign or symptom that my heart valve problem is getting worse. Any thoughts? Donna"
Like Donna, I was primarily asymptomatic prior to my double heart valve surgery. I only experienced one symptom related to my problematic heart valve disorder. That said, it is critical for all patients to continuously monitor their heart valve problems through annual echocardiograms. While heart valve problems can be identified via stethoscopes, the echocardiogram is the medical standard for evaluating valve disease over time.
After Bicuspid Valve Replacement And Root Repair, It's Softball Season For Kevin
By Adam Pick on April 25, 2009
Anyone interested in a patient success story that smells of 100% inspiration?
If so, read this wonderful story about Kevin Hains which addresses soooooooo many patient issues specific to heart valve surgery. Here is what Kevin wrote to me:
I am 39-years old and had aortic valve replacement and aortic root repair surgery on October 27, 2008. I had a heavily calcified bicuspid valve.
Due to my age, I opted for a mechanical valve. My adjustment to Coumadin has been very smooth. It is amazing what the body will endure! After surgery, I spent 2 1/2 months in Cardiac Rehab and I have been at the gym four to five days a week since. I am in law enforcement, am an active athlete and have played sports my entire life.
Kevin Hains – Heart Valve Surgery Patient
"Close To My Heart" Project Looking For Female Heart Surgery Patients
By Adam Pick on April 25, 2009
I just received this very unique request from Angelica Hoyos. Is anyone interested?
Here is what Angelica writes, "I am a photographer in Los Angeles and I am currently working on a project which consists of creating artistic portraits of women who have had heart surgery under the age of 40. The purpose of the project is to leave women feeling that the scar on their chest is nothing to be ashamed about. I am working in collaboration with the American Heart Association."
If you would like to learn more, please call Angelica at 954.665.3850, or visit http://soclosetomyheart.wordpress.com.
Keep on tickin!
How Does Blood Flow Through The Heart?
By Adam Pick on April 24, 2009
Have you ever wondered how blood flows through the heart and body?
Have you ever wondered how your heart valves help manage the flow of blood through your heart?
If so, click the play button on this educational video to learn (i) how blood flows through the heart and (ii) how each heart valve (aortic valve, mitral valve, tricuspid valve and pulmonary valve) ensure the flow of blood in one direction through the body. Please remember to have the sound on your computer turned on.
To learn more about the topics referenced in this video, please click the hyperlinks below:
I hope you enjoyed this video about blood flow through the heart.
Keep on tickin!
After Valve Surgery, Infection And Coma, Steve Hits 175 Miles Per Hour… Once Again!
By Adam Pick on April 22, 2009
I've said it before and I will say it again…
There is nothing better than turning on my computer, opening my email inbox and reading an inspirational, patient success story from one of my readers. This morning, I learned about Steve's recovery from heart valve replacement surgery which was complicated by an infection and six days in a coma.
Steve Returns To Racing After Heart Valve Replacement
Here is what Steve writes:
Hi Adam – I do not know whether this will actually get to you but thank you for your book and blog. I received a homograft aortic valve in early 2006 due to a post-Hurricane Katrina contracted infection. I am from New Orleans, Louisiana.
Heart Surgery, Pregnancy, Labor And Baby Delivery… Can You Help Shannon?
By Adam Pick on April 22, 2009
I recently received a very interesting email from Shannon about heart surgery, pregnancy, labor and baby delivery. In her note to me, Shannon asks for help from other patients about delivering a baby after heart valve surgery. Can you help her?
Off-Topic: A Mayonnaise Jar & Two Beers
By Adam Pick on April 22, 2009
Every once-in-a-while I receive a forwarded email that resets my focus on life.
Earlier today, my sister, Monica, sent me an email titled, "A Mayonnaise Jar & Two Beers". Given the nature of this website, I found the fundamental message of this story to be very appropriate for those dealing with the stress of heart valve surgery.
So, without further ado, I offer you "A Mayonnaise Jar & Two Beers":
When things in your life seem almost too much to handle, when 24 hours in a day are not enough, remember the mayonnaise jar and the two beers.
A professor stood before his philosophy class and had some items in front of him.
When the class began, he wordlessly picked up a very large and empty mayonnaise jar and proceeded to fill it with golf balls.
He then asked the students if the jar was full.


text:
Flawless and seamless kanjivaram wine saree with a distinguished border. This saree gives you an amazing and soothing look. Drape yourself the beauty of the south and embrace yourself.
Fabric: Blended Silk.
Style: Zari Butta.
Colour: All Colors same as the Photo.
Type: Kanjivaram Saree.
Saree Length: 5.50 Meters.
Blouse Length: 0.80 Meters[Unstitched].
Package Contents: 1 Saree and 1 Blouse Piece[Unstitched].
Zari Colour: Silver and Gold.
Washing Instructions: Dry Clean for the first wash, thereafter Hand Wash. Wash with like colors.
Note :
1. The shades may Vary Slightly from the Colors displayed on your screen.
2. There might be slight color variation due to lightings & flash while photo shoot.
Description :
The color and designs of the body and the pallu are quite different, weavers weave both of them separately and eventually join them. You can spot a zig-zag pattern where the body meets the pallu. It is also quite a common practice to weave the border of the saree separately and then join the three together. The joining of the three is done with such precision that even if the saree tears, the border will not detach.
Kanchipuram silk sarees are woven from pure mulberry silk. While the silk belongs to South India, the pure gold and silver zari comes from Gujarat. The silk thread that is used to weave the sarees dipped in rice water and sun-dried before it is used to increase both, its thickness and stiffness. The silk thread is then interlocked with a thin silver wire and woven through after which a golden thread is used to complete the procedure.


text:
Tina Olah
2 games reviewed
Are you Tina Olah? If so, email [email protected] to claim this critic page.
Sep 26, 2018
A great Sierra-style mystery game. Very enjoyable despite the lack of some major point-and-click gameplay features.
Aug 19, 2018
A simple top-down adventure game with a very perplexing narrative that unfortunately fails to deliver.


text:
Bring the kids and discover fun for the whole family in the Hamptons and North Fork this weekend, July 23-26, 2021, with our top five local family events and activities, and some great places always worth a visit.
Top 5 family events to discover this week:
Deconstructed rainbows
Friday July 23, 3 p.m.
Kids ages 6-9 will love this opportunity to create bright and colorful collages inspired by artist Frank Stella. Early registration on the East Hampton Library website is required.
153 Main Street, East Hampton. 631-324-0222, Easthamptonlibrary.org
Storytime at Amber Waves Farm
Saturday July 24, 10 a.m.
Story time on the farm is free and open to children of all ages. While you're there, your kids can enjoy fresh produce and sweets at the market and cafe.
367 Main Street, Amagansett. 631-267-5664, amberwavesfarm.org
Introduction to Ukulele for Grades 4-6
Saturday July 24 noon
Learn to play the ukulele in a fabulous setting in a small group. Students will learn chords and maybe even a song by the end of this session at the Neighborhood House Community Learning Center.
92 Three Mile Harbor Road, East Hampton. 631-655-4586, [email protected], projectmost.org
Princess tea
Sunday July 25, 10:30 a.m., 12:30 p.m. & 3 p.m.
Head to the Long Island Aquarium with your little princess for this party that includes white glove service and finger sandwiches. Reserve a spot in advance and get ready for plenty of photo ops.
431 Main Street East, Riverhead. 631-208-9200, [email protected], longislandaquarium.com
ICAMP STEAM Day Camp
Monday to Friday, July 26 to 30, 9 a.m. to 3 p.m.
Develop your little one's mind and keep their fingers occupied while you enjoy the much-needed adult time. Older campers will learn about drones, 3D printing, and game design. Toddlers ages 3-4 will enjoy exploring music, art and nature.
60 Mill Stone Road, Bridgehampton. 631-466-5298, icamp.com
Fun family attractions to check out this week
Amagansett Beach and Biking
Toddler pedal enthusiasts will love the opportunity to rent bikes with their families for half days, days, or even weeks at a time. Children's bicycles, baby seats and baskets are available.
1 Cross the road, Amagansett. 631-267-6325, amagansettbeachco.com
Coopers Beach
While many Hamptons beaches are known for their clean, uncrowded charm, Coopers Beach deserves rave reviews from parents and toddlers. A snack bar, picnic tables, and lifeguards dot the vivid blue landscape and you can stay to watch the sun go down with great shows.
298 Meadow Lane, Southampton. 631-287-3450
Estia's little kitchen
The little ones who love a delicious breakfast will eat the morning scene here. They can dine on favorites like chocolate chip pancakes and eggs while adults enjoy more interesting options like breakfast tacos. And your kids can run around the garden while waiting to be seated.
1615 Sag Harbor Turnpike, Sag Harbor. 631-725-1020, estias.com
The Fudge Company
Kids with a sweet tooth will love this opportunity to sample homemade fudge, saltwater taffy and delicious penny candy. You can also order frozen yogurt, ice cream, and a variety of refreshing toppings.
67 Main Street, Southampton. 631-283-8108, Southamptonfudgecompany.com
Greenport Carousel
Have family fun in Greenport with this century-old carousel for just $ 2 each way. During the Labor Day weekend, you can visit the attraction every day from 9 a.m. to 8 p.m.
115 Front Street, Greenport. 631-477-2200, villageofgreenport.org
Harbes Family Farm
This time of year, adults can sample the vineyard while the little ones can enjoy farm stand options like sweet corn, tomatoes and peaches. Farm animals and flower fields are also part of the summer entertainment.
715, avenue du son, Mattituck. 631-482-7641, harbesfamilyfarm.com
Herrick Park
This local outdoor getaway is a favorite with parents and kids. It is known for its beautiful, pristine playground, tennis courts and restrooms.
67 Newton Lane, East Hampton. 631-324-4150, easthamptonvillage.org
Moo Moo's East Hampton Ice Cream
Enjoy hand-dipped ice cream and whimsical toppings at this charming Hamptons family favorite. You can't go wrong with flavors like the Caramel Cheesecake Cookie Monster and you can even give the kids a basket of candy to take home.
69 Main Street North, East Hampton. 631-604-2382, easthamptonicecream.com
Southampton Golf Course
Discover this 18-hole mini-golf course with batting cages and a driving range. You can also stop by the snack bar for classic burgers and fries.
699 County Road 39, Southampton. 631-283-2158, facebook.com/southamptongolfrange
Whale tale
The ferry ride to Shelter Island is an adventure in itself for some kids, but Whale's Tale is also the perfect day trip to the Hamptons for families. Enjoy a lighted 18-hole mini golf course, indoor games and an ice cream parlor. Meanwhile, parents can relax with espresso, chai tea, or smoothies.
3 Ram Island Road, Shelter Island. 631-749-1839, refugeislandwhalestale.com
Find other exciting Hamptons, North Fork and family events happening this weekend and beyond (or list your own event) at DansPapers.com/Events.