text:
Mediators of Inflammation
Volume 2013, Article ID 850714, 7 pages
Prognostic Value of Inflammatory Mediators in 1-Year Outcome of Acute Ischemic Stroke with Middle Cerebral Artery Stenosis
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, China
2Division of Neurology, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
Received 22 February 2013; Revised 10 July 2013; Accepted 15 July 2013
Academic Editor: Dennis D. Taub
Copyright © 2013 Xiping Gong et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background and Purpose. Inflammation exists in inception, progression, and reperfusion of acute ischemic stroke. Insightful understanding of correlation in inflammatory mediators and stroke severity with intracranial artery stenosis may improve rational stroke therapy. Methods. We prospectively recruited 977 patients with acute noncardioembolic ischemic stroke with MCA stenosis by MRA as none to mild (<50%), moderate (50–69%), severe (70–99%), or occlusive (100%). The peripheral levels of WBC, homocysteine (HCY), and high sensitivity C-reactive protein (hs-CRP) were recorded. All patients were assessed of 1-year outcome by mRS as favorable (0–2) or poor (3–6). Results. The levels of WBC, HCY, and hs-CRP had no significant differences in patients with categorized MCA stenosis (all . Higher levels of WBC, HCY, and hs-CRP were found in patients with 1-year poor outcome (all , but only hs-CRP is an independent predictor (OR 1.06, 95% CI 1.027–1.093, . The combination of any two of increased hs-CRP (>3 mg/L), WBC (>6.91 × 109/L), and HCY (>15 μmol/L) had higher power in predicting 1-year poor outcome than the single elevated mediator. Conclusions. Elevated hs-CRP independently predicts 1-year poor outcome in acute stroke. The combination of increased hs-CRP, WBC, or HCY had a stronger predictive value in poor outcome than individual elevated mediator.
1. Introduction
Inflammation potentially contributes to destruction of cerebral tissue during the stage of acute ischemic stroke. Originally, inflammation acts as the fundamental part in the process of atherosclerosis [1–4] which is the most common cause of ischemic stroke by arterial thrombosis or embolism. Subsequently, focal acute ischemia will trigger a series of inflammatory cascades which are different from atherosclerotic progression, causing more damage to ischemic cerebral tissues [5]. Moreover, even in the phase of ischemia-reperfusion, inflammatory mediators are also implicated, which can result in further neuronal injury [6, 7]. Accordingly, inflammation exists in all stages of acute ischemic stroke, from its inception through the progression and the final salvageable brain tissues repairing.
The recognition of inflammation in acute ischemic stroke spawned the application of inflammatory biomarkers to extend the investigation on stroke pathogenesis and prognosis as well as improvement on clinical therapeutics, especially by the concentration of peripheral inflammatory markers because of the conveniently operational availability and repeatability. Raised levels of markers of the acute inflammatory response after stroke are associated with poor outcomes [8]. Extensive studies demonstrated that the peripheral levels of white blood cell (WBC) [9–11], homocysteine (HCY) [12–15], and C-reactive protein [14, 16–18] strongly correlate with stroke severity and independently predict mortality and stroke recurrence in acute ischemic stroke patients. However, the effect of these biomarkers on intracranial stenosis is unsubstantial, despite significant attribution of intracranial stenoocclusion to stroke severity. In addition, as a complicated process, inflammation usually involves multiple mediators, but the cooperative actions of these markers in acute ischemic stroke remained uncertain.
A better understanding of the significance of inflammatory mediators in intracranial stenosis and stroke severity in acute ischemic stroke would assist in the advanced therapeutic strategies. The aim of the present study was to clarify the contribution of inflammatory mediator level, including WBC, HCY, and high sensitivity C-reactive protein (hs-CRP), to categorized middle cerebral artery (MCA) stenosis as well as stroke severity by means of 1-year modified Rankin Scale (mRS).
2. Methods
2.1. Study Design and Participants
Institutional review board of Beijing Tiantan Hospital approved the study, and each participant provided an informed consent. From October 2007 to June 2009, we approached consecutive adult patients who presented with acute ischemic stroke or transient ischemic attack (TIA) with symptom onset within 7 days. We excluded the patients with atrial fibrillation or mRS > 2 before admission. We also excluded the patients who were clinically unstable or required close monitoring or were moribund, as well as physically or subjectively unable to comply with magnetic resonance examination or had severe comorbidity.
We recorded participants' demographics and risk factors (history of previous stroke, hypertension, diabetes mellitus (DM), hyperlipidemia, concurrent smoking, moderate-to-heavy drinking, and ischemic heart disease). Each patient underwent magnetic resonance imaging (MRI) and three-dimensional time of flight magnetic resonance angiography (3D TOF MRA) for the cerebral circulation. All patients underwent detailed clinical evaluation, for example, laboratory tests, National Institute of Health Stroke Scale (NIHSS) scores on admission or at discharge.
2.2. Imaging Evaluation
All patients underwent conventional MRI and MRA on a 3.0 T magnetic resonance scanner. Two stroke neurologists blind to subjects' clinical information reviewed the images. Disagreements of greater than 10% were further reviewed by a third reader who decided the final value.
Stenosis of MCA (M1/M2) was measured by WASID criteria [19] with Wiha DigiMax Digital Calipers 6′ (Germany) with a resolution of 0.01–0.03 mm for 0–100 mm and was classified as none or mild (<50%), moderate (50–69%), severe (70–99%), and occlusive (100%). If two or more stenoses were revealed, the stenotic severity of MCA would be identified by the most severe segment.
2.3. Follow-Up
All patients were assessed at 1 year after disease onset for clinical outcome by mRS (favorable (mRS = 1-2), poor (mRS = 3–6)) and recurrent stroke. Stroke recurrence was defined as functional deterioration in neurological status or a new sudden focal neurological deficit of vascular origin lasting more than 24 h, including recurrent ischemia or hemorrhage. Trained research personnel followed up patients over the telephone, using standard scripts to collect study data at the follow-up center.
2.4. Statistical Analysis
Continuous variables were summarized as mean ± SD or median (interquartile range, (IQR)). Categorical variables as gender and vascular risk factors were presented as (%). Independent-samples -test or Wilcoxon test was used for comparison of continuous variables. Comparison of categorical variables was analyzed by test. In a multivariable analysis, stepwise logistic regression was used to evaluate the association of possible determinants and categorized MCA stenosis or 1-year mRS. Variables with a value < 0.10 were included in the multivariate regression analysis.
All analyses were done with SAS software version 9.1 (SAS Institute Inc., Cary, NC, USA). For all tests, statistical significance was considered at the two-sided 5% level.
3. Results
From October 2007 to June 2009, a total of 1101 patients with acute ischemic stroke were admitted and 977 patients met the inclusion criteria. The clinical features of the patients are summarized in Table 1. The mean age was years, and 73.29% of the patients were men. The peripheral levels of inflammatory mediators were expressed by mean WBC ( /L), HCY ( μm mo/L), and median hs-CRP (2.6 mg/L, IQR (0.9–8.2)).
Table 2 presented patients' characteristics and inflammatory mediators by categorized MCA stenosis. In terms of peripheral level of inflammatory mediators, no significant differences were found between these four groups. The multivariate logistic regression analysis showed that none of these mediators predicted MCA stenoocclusion (not shown in table).
Of all the 977 patients, 952 completed 1-year follow-up and 25 cases (nearly 2.6%) were lost because of unable to contact. Patients with poor outcome had more MCA stenosis of ≥70% (13.71% versus 8.52%), more recurrent stroke (6.45% versus 2.27%), and higher levels of WBC, HCY, and hs-CRP. The variables with a value < 0.10 were included in the stepwise multivariate regression analysis. In terms of inflammatory mediators, only hs-CRP was an independent predictive factor (OR 1.06, 95% CI 1.027–1.093, ). We performed multivariate analyses with hs-CRP (<1 mg/L, 1–3 mg/L and >3 mg/L), HCY (≤15 μmol/L and >15 μmol/L), and WBC (expressed by mean value, ≤6.91 × 109/L and >6.91 × 109/L) as categorical variable (not shown in table) and got the same results as shown in Table 3.
We assessed the correlation of increased hs-CRP combined with elevated HCY or WBC with 1-year mRS. The patients were divided into three groups according to hs-CRP level (<1 mg/L, 1–3 mg/L and >3 mg/L). Furthermore, based on different combinations of peripheral HCY levels (≤15 μmol/L and >15 μmol/L) or WBC concentration (expressed by mean value, ≤6.91 × 109/L and >6.91 × 109/L), the patients were divided into 6 groups (Table 4). Adjusted by age, gender, history of DM and current smoking, NIHSS score on both admission and discharge, and the level of HDL, multivariate logistic regression model suggested a stronger correlation in poor outcome with combination of increased hs-CRP (>3 mg/L) and higher HCY (>15 μmol/L) (OR 4.487, 95% CI 1.994–10.098, ) or higher WBC (>6.91 × 109/L) (OR 3.174, 95% CI 1.713–5.884, ), compared to those combined with lower HCY (≤15 μmol/L) (OR 3.116, 95% CI 1.361–7.137, ) or lower WBC (≤6.91 × 109/L) (OR 2.381, 95% CI 1.284–4.415, ), respectively. We also found that, although the individual elevated level of WBC and HCY could not predict poor outcome, the combination of increased HCY (>15 μmol/L) and WBC (>6.91 × 109/L) dramatically independently predicts 1-year poor outcome (OR 1.879, 95% CI 1.158–3.05, ) (not shown in table).
4. Discussion
In this hospital-based, prospective, cohort study, we found three major contributions of inflammatory mediators to acute ischemic stroke. First, the peripheral levels of WBC, HCY and hs-CRP were comparable in patients with categorized MCA stenoocclusion. Second, patients with 1-year poor outcome had higher levels of WBC, HCY, and hs-CRP, but only hs-CRP is an independent predictor for unfavorable outcome. Third, the combination of any two of the increased hs-CRP, WBC, or HCY would have a stronger predictive value in poor outcome than individual elevated mediator.
Atherosclerosis is attributed to inflammation [1–4] and is commonly manifested as intracranial stenosis [20], so that it is necessary to investigate the potential interaction of inflammation with arterial stenosis. According to the first contribution described earlier, the inflammatory marker level did not parallel MCA stenotic severity which suggested a negative prognostic impact of inflammatory mediators on MCA stenosis. There may be several reasons underlying the negative correlation. Atherosclerosis, as a complex and systemic disease, may unequally induce intracranial stenosis [20], as well as the limitation of particular inflammatory mediator in describing atherosclerosis [2]. Moreover, history of previous stroke implied the usage of medicines for stroke prevention. We found that patients with MCA severe stenosis had the higher frequency accompanied with relative lower inflammatory mediator level, suggesting the possible effects of medicines for stroke prevention in biomarker level. Consistently, studies reported that medicines for stroke prevention may decrease inflammatory mediator, for example, aspirin [21, 22], clopidogrel [23], statins [24], folic acid [25], and vitamins B6 and B12 [25]. Accordingly, regardless of the fluctuated level of peripheral inflammatory markers, comprehensive information of interaction of inflammation with intracranial stenosis may be more critical by targeting patients with first-ever stroke.
By the second finding mentioned above, an increase of admission hs-CRP independently predicts 1-year poor outcome in acute ischemic stroke, which was consistent with prior studies [26, 27]. These results suggested the potential benefit of neuroprotective therapeutics by anti-inflammation in acute ischemic stroke. Unfortunately, secondary prevention of cardiovascular disease by neuroprotection against adverse clinical outcomes was still uncertain [25, 28, 29]. Interestingly, we found the predictive value of increased PLT level in 1-year poor outcome of acute ischemic stroke. As known to us, circulating platelet mass (PLT count × mean platelet volume (MPV)) is normally kept constant [30], and prior reports indicated predictive value of high MPV in ischemic stroke [31, 32]. These pieces of information implied reasonable possibility of decrease instead of increase of PLT level in patients with poor outcome. For the inconsistency, further information by dynamic monitoring of PLT level in ischemic stroke is necessary.
In recent years, inflammatory mediators have been individually investigated intensively in patients with ischemic stroke. However, there has been little attention given to the cooperative role of these markers. Based on the third contribution, we observed the cooperative impact of increased WBC, HCY, and hs-CRP on clinical outcome by stronger association of any two increased mediators, instead of individual elevated mediator, with 1-year poor outcome. One possible reason was that, in the complex process of inflammation, multiple mediators may be dependent on inflammation-related mechanisms in the course of acute cerebral ischemia, which was described in a prior study by small sample size [33]. In the treatment strategy of cerebrovascular disease, whether lowering the mediator level reduces the risk of cardiovascular events was controversial [25, 28]. Based on the observation of the superimposed effect of inflammatory markers, we suspected that detection and intervention of multiple inflammatory markers might have greater significance than single one in stroke mechanism and treatment formulation in neuroprotection. However, there was no standard for the prespecified targets in inflammatory mediators according to current guidelines in stroke prevention, which suggested that further study should be conducted for detailed information on cooperative inflammatory impact on ischemic stroke.
We had a few limitations in this study. First, we used 3D TOF MRA to evaluate MCA stenosis. Although MRA is not the gold standard for assessing intracranial stenosis, hierarchical evaluation instead of detailed value of stenotic severity improved the measuring accuracy to some extent. Second, functional outcome might be associated with not only MCA but also with other intracranial large arteries stenosis, which possibly generated an analysis bias. Third, because of the fluctuant levels of inflammatory markers, one-time examination of plasma level might confound the mediator concentration. Finally, medicines given to patients for stroke prevention might affect inflammatory mediator level and disturb the analysis of the inflammatory impact on MCA stenosis.
5. Conclusion
The prognostic value of increased hs-CRP, especially the combination of increased inflammatory markers in predicting 1-year poor outcome in acute ischemic stroke, might provide insight information into stroke mechanism and treatment strategy, particularly in neuroprotection, for acute ischemic stroke.
Authors' Contribution
Xiping Gong and Xinying Zou contributed equally to this paper.
Conflict of Interests
The authors declared that there was no conflict of interests relevant to what they wrote.
- A. Tuttolomondo, D. Di Raimondo, R. Pecoraro, V. Arnao, A. Pinto, and G. Licata, "Atherosclerosis as an inflammatory disease," Current Pharmaceutical Design, vol. 18, pp. 4266–4288, 2012. View at Google Scholar
- M. T. Montero-Vega, "The inflammatory process underlying atherosclerosis," Critical Reviews in Immunology, vol. 32, pp. 373–462, 2012. View at Google Scholar
- A. Anogeianaki, D. Angelucci, E. Cianchetti et al., "Atherosclerosis: a classic inflammatory disease," International Journal of Immunopathology and Pharmacology, vol. 24, no. 4, pp. 817–825, 2011. View at Google Scholar · View at Scopus
- P. Libby, "Inflammation in atherosclerosis," Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 32, pp. 2045–2051, 2012. View at Google Scholar
- J. M. Simard, T. A. Kent, M. Chen, K. V. Tarasov, and V. Gerzanich, "Brain oedema in focal ischaemia: molecular pathophysiology and theoretical implications," Lancet Neurology, vol. 6, no. 3, pp. 258–268, 2007. View at Publisher · View at Google Scholar · View at Scopus
- J. E. Jung, G. S. Kim, H. Chen et al., "Reperfusion and neurovascular dysfunction in stroke: from basic mechanisms to potential strategies for neuroprotection," Molecular Neurobiology, vol. 41, no. 2-3, pp. 172–179, 2010. View at Publisher · View at Google Scholar · View at Scopus
- J. N. Stankowski and R. Gupta, "Therapeutic targets for neuroprotection in acute ischemic stroke: lost in translation?" Antioxidants and Redox Signaling, vol. 14, no. 10, pp. 1841–1851, 2011. View at Publisher · View at Google Scholar · View at Scopus
- W. Whiteley, C. Jackson, S. Lewis et al., "Inflammatory markers and poor outcome after stroke: a prospective cohort study and systematic review of interleukin-6," PLoS Medicine, vol. 6, no. 9, Article ID e1000145, 2009. View at Publisher · View at Google Scholar · View at Scopus
- T. H. Wu, K. L. Chien, H. J. Lin et al., "Total white blood cell count or neutrophil count predict ischemic stroke events among adult Taiwanese: report from a community-based cohort study," BMC Neurology, vol. 13, article 7, 2013. View at Google Scholar
- R. Kazmierski, P. Guzik, W. Ambrosius, A. Ciesielska, J. Moskal, and W. Kozubski, "Predictive value of white blood cell count on admission for in-hospital mortality in acute stroke patients," Clinical Neurology and Neurosurgery, vol. 107, no. 1, pp. 38–43, 2004. View at Publisher · View at Google Scholar · View at Scopus
- A. J. Grau, A. W. Boddy, D. A. Dukovic et al., "Leukocyte count as an independent predictor of recurrent ischemic events," Stroke, vol. 35, no. 5, pp. 1147–1152, 2004. View at Publisher · View at Google Scholar · View at Scopus
- W. Zhang, K. Sun, J. Chen et al., "High plasma homocysteine levels contribute to the risk of stroke recurrence and all-cause mortality in a large prospective stroke population," Clinical Science, vol. 118, no. 3, pp. 187–194, 2010. View at Publisher · View at Google Scholar · View at Scopus
- R. Cui, Y. Moriyama, K. A. Koike et al., "Serum total homocysteine concentrations and risk of mortality from stroke and coronary heart disease in Japanese: The JACC study," Atherosclerosis, vol. 198, no. 2, pp. 412–418, 2008. View at Publisher · View at Google Scholar · View at Scopus
- J. Yan, J. K. Liao, and D. Wang, "Elevated homocysteine and C-reactive protein levels independently predict worsening prognosis after stroke in Chinese patients," Journal of Huazhong University of Science and Technology, vol. 30, pp. 643–647, 2010. View at Google Scholar
- X. Q. Wu, J. Ding, A. Y. Ge, F. F. Liu, X. Wang, and W. Fan, "Acute phase homocysteine related to severity and outcome of atherothrombotic stroke," European Journal of Internal Medicine, vol. 24, pp. 362–367, 2013. View at Google Scholar
- H. M. Den Hertog, J. A. Van Rossum, H. B. Van Der Worp et al., "C-reactive protein in the very early phase of acute ischemic stroke: association with poor outcome and death," Journal of Neurology, vol. 256, no. 12, pp. 2003–2008, 2009. View at Publisher · View at Google Scholar · View at Scopus
- S. Shantikumar, P. J. Grant, A. J. Catto, J. M. Bamford, and A. M. Carter, "Elevated C-reactive protein and long-term mortality after ischaemic stroke relationship with markers of endothelial cell and platelet activation," Stroke, vol. 40, no. 3, pp. 977–979, 2009. View at Publisher · View at Google Scholar · View at Scopus
- M. Di Napoli, F. Papa, and V. Bocola, "C-reactive protein in ischemic stroke an independent prognostic factor," Stroke, vol. 32, no. 4, pp. 917–924, 2001. View at Google Scholar · View at Scopus
- O. B. Samuels, G. J. Joseph, M. J. Lynn, H. A. Smith, and M. I. Chimowitz, "A standardized method for measuring intracranial arterial stenosis," American Journal of Neuroradiology, vol. 21, no. 4, pp. 643–646, 2000. View at Google Scholar · View at Scopus
- P. T. Akins, T. K. Pilgram, D. T. Cross 3rd, and C. J. Moran, "Natural history of stenosis from intracranial atherosclerosis by serial angiography," Stroke, vol. 29, no. 2, pp. 433–438, 1998. View at Google Scholar · View at Scopus
- L. Mannini, R. Marcucci, R. Paniccia et al., "Erythrocyte deformability and white blood cell count are associated with aspirin resistance in high-risk vascular patients," Clinical Hemorheology and Microcirculation, vol. 35, no. 1-2, pp. 175–181, 2006. View at Google Scholar · View at Scopus
- E. Grad, M. Golomb, N. Koroukhov et al., "Aspirin reduces the prothrombotic activity of C-reactive protein," Journal of Thrombosis and Haemostasis, vol. 7, no. 8, pp. 1393–1400, 2009. View at Publisher · View at Google Scholar · View at Scopus
- M. W. McCarthy, D. Kockler, J. F. Feliú, and J. Kaiser, "Clopidogrel-associated leukopenia," Annals of Pharmacotherapy, vol. 37, no. 2, pp. 216–219, 2003. View at Google Scholar · View at Scopus
- M. A. Albert, E. Danielson, N. Rifai, and P. M. Ridker, "Effect of statin therapy on C-reactive protein levels: the pravastatin inflammation/CRP evaluation (PRINCE): A randomized trial and cohort study," Journal of the American Medical Association, vol. 286, no. 1, pp. 64–70, 2001. View at Google Scholar · View at Scopus
- E. Lonn, S. Yusuf, M. J. Arnold et al., "Homocysteine lowering with folic acid and B vitamins in vascular disease," The New England Journal of Medicine, vol. 354, no. 15, pp. 1567–1577, 2006. View at Publisher · View at Google Scholar · View at Scopus
- S. Kaptoge, E. Di Angelantonio, G. Lowe et al., "C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis," The Lancet, vol. 375, pp. 132–140, 2010. View at Google Scholar
- K. Winbeck, H. Poppert, T. Etgen, B. Conrad, and D. Sander, "Prognostic relevance of early serial C-reactive protein measurements after first ischemic stroke," Stroke, vol. 33, no. 10, pp. 2459–2464, 2002. View at Publisher · View at Google Scholar · View at Scopus
- K. H. Bønaa, I. Njølstad, P. M. Ueland et al., "Homocysteine lowering and cardiovascular events after acute myocardial infarction," The New England Journal of Medicine, vol. 354, no. 15, pp. 1578–1588, 2006. View at Publisher · View at Google Scholar · View at Scopus
- M. Ebbing, Ø. Bleie, P. M. Ueland et al., "Mortality and cardiovascular events in patients treated with homocysteine-lowering B vitamins after coronary angiography: A randomized controlled trial," Journal of the American Medical Association, vol. 300, no. 7, pp. 795–804, 2008. View at Publisher · View at Google Scholar · View at Scopus
- J. A. Jakubowski, C. B. Thompson, and R. Vaillancourt, "Arachidonic acid metabolism by platelets of differing size," British Journal of Haematology, vol. 53, no. 3, pp. 503–511, 1983. View at Google Scholar · View at Scopus
- J. C. Arevalo-Lorido, J. Carretero-Gomez, A. Alvarez-Oliva, C. Gutierrez-Montano, J. M. Fernandez-Recio, and F. Najarro-Diez, "Mean platelet volume in acute phase of ischemic stroke, as predictor of mortality and functional outcome after 1 year," Journal of Stroke and Cerebrovascular Diseases, vol. 22, no. 4, pp. 297–303, 2013. View at Publisher · View at Google Scholar
- S. Greisenegger, G. Endler, K. Hsieh, S. Tentschert, C. Mannhalter, and W. Lalouschek, "Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebrovascular events?" Stroke, vol. 35, no. 7, pp. 1688–1691, 2004. View at Publisher · View at Google Scholar · View at Scopus
- M. Y. Z. Youssef, O. A. Mojiminiyi, and N. A. Abdella, "Plasma concentrations of C-reactive protein and total homocysteine in relation to the severity and risk factors for cerebrovascular disease," Translational Research, vol. 150, no. 3, pp. 158–163, 2007. View at Publisher · View at Google Scholar · View at Scopus


text:
Sigitas Tamulevicius
Prof, Kaunas University of Technology
Prof., Dr. Habil. Sigitas Tamulevičius (male) is Director of Institute of Materials Science, KTU and Professor at Department of Physics, Faculty of Mathematics and Natural Sciences, KTU. He graduated from Moscow Engineering Institute of Physics, Russia (former USSR) with the diploma of physicist – engineer in 1979. He received a doctoral degree in Physics from Vilnius University, Lithuania in 1984. In 1994 he received the degree of doctor habilitus from KTU in the field of Materials Science. In 1990-1991 he was Fellow of Swedish Institute and Visiting Scientist at Royal Institute of Technology, Sweden, in 1993 Recipient of Soros Foundation Research Grant, Fellow of Fulbright Program and Research Scholar at Massachusetts Institute of Technology, in 1994. In 2000 he was awarded the National Award for Science. He is full Member of the Lithuanian Academy of Sciences (since 2002), Editor in Chief of Scientific Journal "Materials Science (Medžiagotyra)", Member of Editorial Board of "Materials Research express" (IOPScience), Member of the European Materials Research Society, Peer reviewer of the Institute of Physics and IOP Publishing Ltd (UK), Elsevier. He was acting as expert in the projects evaluation for the European Commission Framework Programmes, COST and Eureka research and development (since 2000). He was a national representative in FP7 programme 'Nanosciences, nanotechnologies, materials and new production technologies'. He headed multiple research projects funded by COST, Eureka, NorForsk, Lithuanian State Foundation for Research and Studies, the Research Council, as well as Science and Innovation Agency of Lithuania. He is author and co-author of more than 180 articles (Hirsh index in the Web of Science data base is 15). 12 PhD theses were defended under his guidance. His research fields of interest include condensed matter physics, thin films, vacuum and plasma technologies, optical measurements, surface and interface phenomena, micro and nanotechnologies, electronics, photonics, biomaterials, biosensing.

subset: commoncrawl


text:
Fire Marshal Division
The Johnston County Fire Marshal's Office provides support to all Johnston County Fire Departments in several different areas as requested. Such areas include but not limited to conducting fire origin and cause investigations, fire district/insurance district mapping, NC Fire Rating Inspections, and incident fire reporting. The FMO also conducts fire inspections at all Johnston County Public Schools. FMO is also responsible for issuing burn permits and investigating illegal burning in the county.
For further information please contact:
|© 2018 Johnston County Government


text:
Got any suggestions on how to improve Oriel Web or this chat facility? All feedback welcomed here!
Moderators: Duffman, Colin Gallagher
2 posts • Page 1 of 1
- Duffman
- 1st Team Regular
- Posts: 3800
- Joined: Mon Dec 02, 2002 8:18 pm
- Location: Dundalk
- Has thanked: 64 times
- Been thanked: 2 times
- Contact:
On the cusp of member 600 joining the site looks as good as it ever did. Took me a while at the beginning to get used to the format but couldn't ever go back. Another site that I frequent, www.roversrearguard.com shows how bad these fora can be.
2 posts • Page 1 of 1
Return to "Site Feedback/Suggestions"
Who is online
Users browsing this forum: No registered users and 1 guest


text:
Brookdale Leesburg Memory Care
710 South Lake Street Leesburg FL 34748
for a local advisor
Socialize with friends outside in our courtyard, read a good book on our lovely front porch or pamper yourself in our beauty/barber shop, at Brookdale Leesburg there is something for everyone to enjoy. We offer a variety of amenities and activities, including:
- Putting
- Horse shoes
- Jukebox tunes
- Art class
- Bowling
Our community has a private suites and companion suites, making it easy for residents to find the perfect place to call home.
At Brookdale Leesburg our staff is dedicated to going above and beyond to ensure our residents every need is being met. We create personalized care plans with every resident that we regularly review to ensure that as needs change we are there to provide care and support. Residents and families can rest assured knowing that at Brookdale Leesburg we consider ourselves a family and care for each other in that manner.
Pricing at Brookdale Leesburg Memory Care
We value your privacy. By clicking Unlock All Pricing, you agree to our Privacy Policy. You also consent to our reaching out to you using a system that can auto-dial number; you do not need to consent to use our service.
*Prices quoted are monthly rental charges and are provided by the communities themselves. Actual prices may differ due to one-time fees, timing and care services required. Speak with your Senior Living Advisor to learn more.
Community Details at Brookdale Leesburg Memory Care
Senior Housing Types Provided at Brookdale Leesburg Memory Care
The features and amenities that are displayed on this page contain marketing information provided by the community. A Place for Mom has not confirmed the completeness of the provided information, and cannot guarantee its accuracy.
To conduct a complete investigation, seniors and their families should:
- Tour any listed location to confirm the accuracy of the community description;
- Confirm that the community offers services that are required for the senior's specific needs and budget; and
- Check additional licensing and state audit information.
If you become aware of any information that should be updated or noted, please contact A Place for Mom.


text:
Program News
The Federation of Canadian Municipalities works with partners around the world to promote local economic development, empower local governments and local government associations, and facilitate post-disaster reconstruction efforts. We also work closely with our international counterparts to ensure the crucial role local governments play in development cooperation is recognized worldwide.
Visit this page regularly for the latest news and updates on the activities and initiatives of our International programs.
FCM launches partnership to strengthen South African municipalities (30/11/2016)The Federation of Canadian Municipalities (FCM) has launched a $5.8 million, five-year initiative to support green infrastructure, trade and economic growth in South Africa's municipalities.
FCM partners with Global Affairs Canada to support municipalities in Jordan hosting Syrian refugees (31/10/2016)The Federation of Canadian Municipalities (FCM), with funding from Global Affairs Canada, has launched a $20.7-million five-year initiative to assist municipalities in Jordan struggling to manage the influx of displaced Syrians.
2016 Recipients of FCM Awards of Excellence for International Programs Announced (11/02/2016)FCM celebrates contribution of municipal experts to international programs
Statement from FCM President on today's announcement by the Minister of Immigration, Refugees and Citizenship (09/12/2015)Getting it right for these refugees and investing in more social and affordable housing now will help all Canadians in the long run.
Canada's municipalities establish unified response to Syrian Refugee Crisis (30/09/2015)The Federation of Canadian Municipalities (FCM) has released details on the membership of the Task Force on Syrian Refugee Resettlement.
Emergency recommendation on Syrian refugee crisis passed at FCM Board Meeting (12/09/2015)During a week-long meeting, FCM Board members unanimously pass an Emergency Recommendation; and take steps to ensure municipal issues remain front and centre in the remaining five weeks of the campaign.
Cities mobilize for action on Syrian refugee crisis (04/09/2015)Canada's big city mayors are mobilizing support to address the continuing humanitarian crisis
FCM announces recipients of 2015 awards of excellence (08/06/2015)The Federation of Canadian Municipalities (FCM) announced its 2015 Awards of Excellence during FCM's Annual Conference and Trade Show in Edmonton.
FCM launches Roadmap to Stronger Cities and Communities (08/06/2015)The Roadmap presents practical solutions to the challenges Canadians face every day. It points the way towards reducing commute times, safer roads and bridges, cleaner water and more affordable housing.
Stronger local government, better future for communities in Ukraine (28/04/2015)Federation of Canadian Municipalities works with localgovernments in Ukraine to support democracy and prosperity.
Stronger local government better future for mining communities in Peru (01/04/2015)Federation of Canadian Municipalities works with local governments in South America to better manage impacts and benefits of mining operations.
Stronger local government, better future for mining communities in Colombia (26/03/2015)Federation of Canadian Municipalities works with local governments in South America to better manage impacts and benefits of mining operations.
FCM announces new strategic partnership with federal government on international development (02/03/2015)A new Memorandum of Understanding between FCM and Foreign Affairs, Trade and Development Canada (DFATD) will ensure greater collaboration between the Government of Canada and Canadian municipalities on questions related to international development.
Recipients of 2015 FCM International Awards of Excellence Announced (13/02/2015)Through these awards, FCM recognizes Canadian municipal experts, both staff and elected officials, who have made an outstanding contribution to FCM's international programs.
The Maison des collectivités territoriales opens in Haiti (10/12/2014)By bringing the country's three largest federations of elected officials together under one roof, the Maison is poised to become a hub for both tackling the issues affecting Haiti's municipalities and supporting the efforts being made to coordinate and decentralize these municipalities.
FCM First Vice-President joins Ukraine's local democratic leaders to discuss importance of Open Government in economic development (31/03/2014)Federation of Canadian Municipalities (FCM) First Vice-President and Mayor of Fredericton Brad Woodside travelled to Ukraine last week to join local government leaders in discussing the importance of Open Government in local economic development, as the country moves towards greater integration with the European Union.
Partners launch second phase of the Haiti/Canada Municipal Cooperation program (13/03/2014)The Municipal Cooperation Project is a joint initiative of the Federation of Canadian Municipalities (FCM), the Union des municipalités du Québec (UMQ) and the City of Montreal. The program's second phase will build on the achievements of the past three years, continuing to strengthen the institutional capacities of five Haitian territorial communities (the city of Port-au-Prince and the municipalities of Gressier, Léogâne, Grand-Goâve, and Petit-Goâve in the Palmes region), the national federations of local elected officials (FENAMH and FENACAH) and the Ministry of the Interior and Territorial Communities (MICT).
Canada supports Haitian communities to improve transparency, effectiveness, and economic growth (17/02/2014)Technical support for municipalities will lead to better delivery of services to citizens.
FCM Announces 2014 International Awards of Excellence Recipients in Celebration of International Development Week (05/02/2014)The Federation of Canadian Municipalities (FCM) today announced the individual recipients of this year's International Awards of Excellence in celebration of International Development Week (IDW).
Page Updated: 01/05/2018


text:
Friday and Saturday the local Scouts will be distributing door hangers for the SCOUTING FOR FOOD program. They will start at 9 a.m. on Saturday, November 15, and distribute door hangers reminding people that they will pick up food on November 22. This food drive will benefit the Food Bank at the Wesley United Methodist Church.
Article Categories
- News (8,117)
- Obituaries (1,470)
- Special Interest (76)
- Sports (3,092)
- Tyrone Daily Herald Archives (2,963)
- TyronePA News (10)


text:
UAE claims it has taken coastal city from Yemen's Houthis
The United Arab Emirates (UAE)'s armed forces have captured the coastal city of Al-Khokha in Yemen's western Hudeidah province from the Houthi militia, the UAE's official WAM news agency reported on Thursday.
The news agency quoted an unnamed military source as saying that Al-Khokha had been "completely liberated from the Iran-backed Houthi militia".
"Yemeni resistance fighters, backed by UAE forces operating within the framework of the [Saudi-led] Arab coalition staged an advance early Wednesday and liberated the coastal area from the grip of the Houthis," WAM reported.
It did not provide any additional details on the military operation or whether it had resulted in any casualties.
Houthi officials, for their part, have yet to comment on the UAE's claims.
The UAE is a leading member of a Saudi-led Arab coalition that has been fighting the Houthis since 2015.
Yemen has remained in chaos since 2014, when the Shia Houthi militia group overran much of the country, including capital Sanaa.
Since 2015, Saudi Arabia and its Arab allies have waged a devastating military campaign aimed at reversing the Houthis' territorial gains and shoring up Yemen's pro-Saudi government.


text:
We stayed in Minas studios for a week Aug 29th - Sept 5th 2006 and were very happy with our accomodation. We had room 2 which had a beautiful sea view (see pic) and over looked the garden with palm & olive trees. Rooms were immaculatly clean and tidy and very spacious for studio apartments. Cleaners were polite and would wait for you to go out before coming in to clean. Fab pool at the Marianna, 2 mins away and Antonio beach a 7 min walk, absoloutly gorgeous! You can hire a fan for 1 euro a day from Lassi supermarket (Hi Stan) - opposite Marianna, and get all your bits and pieces there...fresh bread, bottled water, papers etc. Our favourite tavernas were Mystic Gusto and Zorbas, both of whom do good Greek nights, Zorbas esp! If your looking for a quiet beach holiday and be spoilt for choice of where to eat then Lassi is the place! Its more for families and older couples who really want to chill.....youngsters beware....no nightclubs, takeaways etc.....thank god!!! Definatly take a trip to Argostoli the capital, a 20 min walk away - we ate at La Gondola which was lovely but more pricey than eateries in Lassi. Overall Lassi is not typically Greek to look at, just a resort of hotels and apartments but locals are friendly and beaches are fab, too many to chose from! Gutted that they are not listed in First Choice 2007 brochure!Loved it so much, going back in 2007.....to live!
Meant to say gutted that Minas studios are not listed in First Choice 2007 brochure, dont know why????


text:
Related Expert Areas
water distribution system
Experts Only
Join our distinguished experts for biofilm jobs, projects and consulting opportunities.
Expert in Microbiology, Biocides, Biotechnology, Renewable Chemicals, BioremediationExpert is a microbiologist with expertise in microbiology and biotechnology with 7 years of consulting experience advising large and small industrial clients as well as venture capitalists and investment groups on emerging technologies in areas such as ... See full profile
Georgia (GA), USA
Expert in Industrial Microbial Control using Speciality Biocides. European Regulations for Biocides. MicrobialExpert has experience of a range of industry sectors including oil; paper; food; paint; textiles; leather; mineral extraction and processing; adhesives; coatings and water treatment. Areas of Expertise � Education and Training, both in the laboratory ... See full profile
West Midlands, United Kingdom
Expert in GMP Compliance EPCMV of BioPharmaceutical Process, Clean Utilities, Systems, Facilities EngineeringHe is a Health Canada Expert (in 2007) and a Senior BioProcess Engineer & Project Manager Consultant; He acquired more than 21 years' experience with various BioPharma Industries & Consulting companies (SNC Lavalin Pharma), where more than 50 projects ... See full profile
Qu�bec, Canada
Expert in Acute Wound Healing, Animal Models, Re-epithelization, Wound Infection, Burn Wound Healing, BacteriaExpert and her mentor, David Taplin were the first to identify flower water as a potential source of hospital acquired bacterial infections. She also worked on and helped develop a medium that has a color indicator to detect dermatophytes. See full profile
Florida (FL), USA
Expert in QC/QA, Sterility Assurance, Aseptic, Pharmaceutical, Biotech, Device Manufacturing & TestingEnvironmental Monitoring Operations, EM Trends Reports, EM Remediation and Investigation. Cleanroom Contamination Control Practices, Behaviors, Personnel, Gowning, Cleanroom Traffic Guidelines, Process/Personnel and Product Flows. See full profile
California (CA), USA
Expert in Brewhouse Operations and Process Maximization, Fermenting Operations, and Stratified FermentationExpert has continuously improved a large scale brewhouse operation, generating savings of up to 566,000 lbs of grain per month through increases in extraction efficiency, going from 88.5% to 92.5%. During this effort Expert and his team increased the brew ... See full profile
Idaho (ID), USA
Expert in Microbiological Contamination ControlA principal with his eponymous consulting firm, Expert has amassed 30 years of experience in academia, industry, and consulting. The majority of his research and consulting work has been in the area of microbiological contamination detection and ... See full profile
Massachusetts (MA), USA
Expert in Life Support and Low-Temperature PlasmaExpert has expertise in life support systems for humans in space. He has extensive experience in physico-chemical approaches to recycling water and oxygen in space, oxygen storage, and processing solid wastes. See full profile
Expert in Diving Accident InvestigationBob notes that corrosion is a major problem that affects many industries. Bob has spent over forty years studying and solving corrosion problems in the construction, aerospace, defense, petroleum, utility and related industries. He was also the technical ... See full profile
New York (NY), USA
Expert in High Risk Pregnancy, Obstetrics and Gynecology, Perinatal Medicine, and Fetal MedicineExpert is board certified by the American Board of Obstetrics and Gynecology (FACOG) and was a practicing Obstetrician Gynecologist for 6 years before returning to academics to complete a Maternal Fetal Medicine Fellowship. See full profile
Expert in Natural and Processed Cheeses, Spray Drying, Food Processing and Packaging, R&D, and SanitationExpert has a BS degree in Dairy Manufacturing with a minor in chemistry, an MS degree in Food Science, and a Ph.D. in Food Science with a minor in Biochemistry. He was also trained as a Dairy products judge. He has conducted research on cheese ... See full profile
Kentucky (KY), USA
Expert in Water and Wastewater Treatment, Nanofiber and Nanotube synthesis, Waste To EnergyHas 16 issued patents in the field of water and wastewater treatment, including membrane, electrochemistry, ion exchange, softening, adsorption, zero discharge, chromatographic separation of mixed metal wastes. Also has multiple pending patents in ... See full profile
Expert in Corrosion and Metallurgical Failure AnalysisExpert notes that corrosion is a major problem that affects many industries. Expert has spent over forty years studying and solving corrosion problems in the construction, aerospace, defense, petroleum, utility and related industries. He was also the technical ... See full profile
Expert in Bioenergy, Renwable Energy, Bioproducts, Agricultural Biotechnology, Waste to Energy, Competitive Intelligence, Bio-Based Products, Commercialization, Technology ScoutExpert is an expert in bioenergy, renewable energy and biobased products that works with companies and investment managers to evaluate and commercialize technology, identify new markets and to optimize R&D programs. Areas where Expert can be ... See full profile
South Carolina (SC), USA
Expert in Infectious Disease, Immune Deficiencies, Molds, Toxins, Acupuncture and Integrative MedicineExpert's expertise as an internist combines Internal Medicine and Infectious Disease with Medical Nutrition. As such, she is well equipped to recognize and manage challenging medical conditions, especially in those with different types and ... See full profile
Expert in Biotechnology, Biochemistry, Molecular Biology: Enzymology, Protein Biochemistry, IndustryAs a researcher in plant molecular biology, he published scientific data relevant for genetic modification of crops. He generated and characterized genetically modified plants, and published these data in peer-reviewed scientific journals. See full profile
Virginia (VA), USA
Expert in Molecular Biology, Molecular Pathology, Polymerase Chain Reaction TechnologyExpert has expertise in the adaptation and development of molecular biological techniques to answer medical questions of human genetics, differential gene expression, diagnostics, epidemiology, and pathogenesis, particularly in regard to infectious agents ... See full profile
Pennsylvania (PA), USA
Expert in orthopedic R&D, regulated (GLP) nonclinical trials, large animal models, surgery, vet medExpert is the Director of the Comparative Orthopaedic Research Laboratory in the Department of Clinical Studies at the University Of Pennsylvania School Of Veterinary Medicine. Expert trained in both human and veterinary medicine, and ... See full profile
Need the right expert in biofilm? We can help!
Intota is now ORC Expert Advisory Services


text:
Good luck, but I sure hope that my heart does not have 700+ species living in it
mikejapan wrote:It's a "big puddlle" (less than 6 letters/more than 6 letters - your spelling isn't very good) that was outside your house last Tuesday.
The formation of the puddlle was caused by lots of rain drops - that ceased to be when they created the puddlle. Also they flowed together to form it.
The puddlle is part of the entity of rainfall.
It's evaporated now so we can't touch it and it was wetter at the beginning than at the end.
It had a life ie; formed, existed then evaporated
It has been scientifically proven that approx 700 forms of life inhabit the average puddlle ranging from microbes and small insects to fish and hippopotami.
My beginning is the ending of others.
My beginning is the ending of others.
underquark in "Help with particular puzzles" wrote:This puzzle looks more like a caecum than an appendix (which, incidentally, isn't the
beginning of the large intestine as that honour goes to the ileocaecal valve with the
appendix being an add-on, an afterthought as it were at the end of the cul-de-sac of
the bowel, but never mind, I'm not bitter).
Loren G. Martin, professor of physiology at Oklahoma State University, replies:
"For years, the appendix was credited with very little physiological function.
We now know, however, that the appendix serves an important role in the fetus
and in young adults. Endocrine cells appear in the appendix of the human fetus
at around the 11th week of development. These endocrine cells of the fetal
appendix have been shown to produce various biogenic amines and peptide hormones,
compounds that assist with various biological control (homeostatic) mechanisms.
There had been little prior evidence of this or any other role of the appendix
in animal research, because the appendix does not exist in domestic mammals.
"Among adult humans, the appendix is now thought to be involved primarily in
immune functions. Lymphoid tissue begins to accumulate in the appendix shortly
after birth and reaches a peak between the second and third decades of life,
decreasing rapidly thereafter and practically disappearing after the age of 60.
During the early years of development, however, the appendix has been shown to
function as a lymphoid organ, assisting with the maturation of B lymphocytes
(one variety of white blood cell) and in the production of the class of antibodies
known as immunoglobulin A (IgA) antibodies. Researchers have also shown that
the appendix is involved in the production of molecules that help to direct
the movement of lymphocytes to various other locations in the body.
"In this context, the function of the appendix appears to be to expose white
blood cells to the wide variety of antigens, or foreign substances, present in
the gastrointestinal tract. Thus, the appendix probably helps to suppress
potentially destructive humoral (blood- and lymph-borne) antibody responses
while promoting local immunity. The appendix--like the tiny structures called
Peyer's patches in other areas of the gastrointestinal tract--takes up antigens
from the contents of the intestines and reacts to these contents. This local
immune system plays a vital role in the physiological immune response and in
the control of food, drug, microbial or viral antigens. The connection between
these local immune reactions and inflammatory bowel diseases, as well as autoimmune
reactions in which the individual's own tissues are attacked by the immune system,
is currently under investigation.
"In the past, the appendix was often routinely removed and discarded during other
abdominal surgeries to prevent any possibility of a later attack of appendicitis;
the appendix is now spared in case it is needed later for reconstructive surgery
if the urinary bladder is removed. In such surgery, a section of the intestine is
formed into a replacement bladder, and the appendix is used to re-create a
'sphincter muscle' so that the patient remains continent (able to retain urine).
In addition, the appendix has been successfully fashioned into a makeshift replacement
for a diseased ureter, allowing urine to flow from the kidneys to the bladder. As
a result, the appendix, once regarded as a nonfunctional tissue, is now regarded
as an important 'back-up' that can be used in a variety of reconstructive surgical
techniques. It is no longer routinely removed and discarded if it is healthy.
October 21, 1999
Vic Reeves wrote:88.2% of statistics are made up on the spot.
underquark wrote:...This argument is unwinnable, by the way, as medical literature is awash with conflicting views, many with cast-iron, statistically full-proof evidence. The half-life of medical knowledge (the time taken for half of what a doctor knows to be absolute, true fact to be proven to actually be rubbish) has been estimated at 4½ years.Vic Reeves wrote:88.2% of statistics are made up on the spot.


text:
No, this may not be about hiring the coach from Bryant (a Wilton, CT native) or negotiations with a coach at Yale or Quinnipiac, but the Stags have once again gone to the cupboard to recruit a highly-talented local product. The Norwalk Citizen-News has the story.
Seems as if Brett Adams gave up playing football for a D-I or D-I AA school to play lacrosse at Fairfield. And, as the article shows from the outset, he's got a pretty sweet family pedigree... for lacrosse, that is.
More to come on the coaching search tonight.
Tuesday, July 22, 2008
The Connecticut Lax Pipeline
Posted by Keith Connors at 5:36 PM
No comments:
Subscribe to: Post Comments (Atom)


text:
Three labour workers killed in boiler explosion
FAISALABAD: Three labour workers were killed and 15 others were injured when a boiler exploded in a factory here at Sargodha Road on Friday, ARY News reports.
According to rescue officials, a boiler of a garments factory exploded in which 35 year old Sohail Ahmed and 40 year old Zahoor were killed on the spot whereas injured Usman succumbed to his injuries during treatment.
The injured were shifted to Allied Hospital in which three are in critical condition.


text:
Authentic tasty Caribbean cuisine, our Caribbean caterers cover all of London, Buckinghamshire, Berkshire, Bedfordshire, Gloucestershire, Hampshire, Hertfordshire, Midlands, Northamptonshire, Oxfordshire and Surrey. Other national locations are covered, so please contact us.
Preferred Supplier
Book award winner Mwah! Catering for mouth watering and fresh cuisine. An approved wedding caterer for Three Rivers Golf Club and Quex Museum House & Gardens. Try before you buy with our FREE TASTER.
One of the Premier Caterers In the Southeast
Established in 1985, we have since built up an excellent reputation, hard to be matched by any other caterer. Our policy is to buy the best, produce the best, and to present and serve the best to you, our customer, at the best possible price.
Purple Potato. What sets us apart? Like our name, we are a successful mix of the unusual but down-to-earth. Imaginative, contemporary but also reassuringly traditional, we aim at providing our clients with precisely what they want.


text:
Previously and more dully known as The Station, Marvin Kren's Blood Glacier begins with audience-goosing title cards about climate change and melting icecaps. It's a gratuitously self-serious ignition button for a lame Thing knockoff that pits a bunch of research scientists in the German Alps against wildlife made rabid by a micro-organism that leaks out of a, yes, glacier soaked in blood. As the scientists try and wrap their minds around why the contaminant's index case, a fox, would ever bite a dog, and sarcastically wonder if the surreptitious critter shares their public-relations ambitions, unfortunate parallels to a certain ubiquitous viral hit from Norway arise. The plot becomes increasingly overstuffed with the introduction of parallel threads involving one of the scientist's ex, Taja (Edita Malovčić), who's none too subtle about having aborted their child, and a Random Blonde seen running from a prehistoric-seeming bird whose razor-sharp tail takes out one of the guides for a bunch of elderly hikers in the region. Everyone's hysteric paths cross at one of the scientific research stations, which gets an intermittent pummeling from freakazoid animals that suggest botched Rick Baker creations. And as it programmatically works its way toward the unexpected but doggedly stupid resolution to Janek (Gerhard Liebmann) and Taja's personal travails, Blood Glacier straddles a very awkward line between creature feature, conspiracy thriller, and domestic drama, all without novelty or suspense. One caveat: As Ministerin Bodicek, actress Brigitte Kren mines a delicious bit of camp from this atonal pulp-o-matic when her absurdly fascist granny verbally assaults a travel companion with the demand that she "stop eating that banana while you're crying!"
Film Comment Selects runs from February 17—27.


text:
Do you want out of your timeshare contract? We have a unique process to get you out of your contract - for good. Pay a one-time cancellation fee, fairly based on the negative value of your timeshare contract. We guarantee success, if we can't cancel your contract for good - we'll refund your money 100%, no questions asked. What are you waiting for? Let's cancel your contract.
Fortis Law Group is a full service firm led by seasoned legal professionals who are committed to preserving the interests of its clients. Stop by our site Cancel My Timeshare Contract today and learn how we can help you get your freedom back. http://www.cancel-my-timeshare-contract.com


text:
There are times when it is exquisitely fun being a photographer. Like the moment when one of your friends says to you: Hey, I'm getting married in two weeks at a frozen waterfall with just the bride and I and two others...want to come be our photographer? We've been friends for a lot of years, so I was on board when as soon as he said "getting married." But frozen waterfall?!?! YES!!!!
It wasn't until a few hours after the discussion, when I got home and my brain fully engaged. March 12. Of this year? That was only ten days away. I had to call him back to confirm the date. Not only was this the smallest number of people I've photographed at a wedding, it was the shortest prep time I have ever witnessed.
Jordan and Natalie White were married on Sunday, 12 March, at the base of a frozen waterfall in the wilds of Northwest Montana. It was simply perfect.
And it taught me something important. Before this I was basically letting couples choose from three "packages" in terms of weddings. These ranged from 6-10 hours and gave couples various options. I thought this was making things easier. And maybe it does for some people. But after talking with Jordan I realized my packages are not built to serve the non-traditional weddings. Montana is a dream destination for a lot of people. That is especially true when it comes to destination weddings. I have only photographed a few of these destination weddings, mostly in Glacier National Park, but the smaller guests lists don't always lend themselves to the traditional packages.
So, while I haven't completely scrapped my pricing system based on this wedding, I have changed it. I will still offer so-called packages for those who want them. And I will always be upfront about what I charge. But I would rather work with a bride and groom individually to see what their specific vision is and what they need. It's not quite as clear cut as pre-made packages, but hopefully it will serve clients better. (On a personal note: when I am searching for information on a vendor I don't want to meet them for coffee or whatever until I know they are within my budget. It frustrates me when I have to jump through hoops to get basic costs - so, "do unto others...." I will always list my prices on my website).
Enjoy these photos from a day with Jordan and Natalie in the winter wonder of Northwest Montana. And if you are looking for a photographer in this area don't hesitate to get in touch. I would love to hear from you.


text:
What an exciting series it's been between the Toronto Maple Leafs and Washington Capitals. It could all come to an end if the Capitals turn in a win against the Leafs at the ACC on Sunday night.
It's been a back and forth affair, with the possibility of the Leafs up 3-2, instead of the Capitals, just as easily being true as well. As it is, though, the Caps outlasted the Maple Leafs in overtime in Game 5, setting up what could be a series clincher in Game 6 in Toronto.
If it feels like it's been nothing but overtimes in this series, you aren't imagining things. In four out of five games thus far, we've seen overtimes. And in the one that didn't go to extra time, it was a slim 5-4 win for the Maple Leafs.
All in all, this doesn't look like a series with the 8th seed taking on 1. The Capitals' struggles in the postseason are well documented, and the Leafs are giving them a workout in the first-round.
I don't think it's a matter of the Capitals overlooking the Leafs, they know that this is a good team are throwing everything they have at them. This is just the start for the Leafs, so no matter what happens tonight, there is nothing to feel bad about.
Yeah, it's going to sting, but when the dust settles it's going to be a year they can look back on and note the drastic improvements that were made. Mike Babcock and the Leafs aren't out yet this season, a win tonight would take this to a Game 7 where anything could happen. Let's get straight to our Capitals vs. Maple Leafs Game 6 pick.
Washington Capitals vs. Toronto Maple Leafs Game 6 Pick
Game 5 could have went either way, this game tonight could have easily been a close out scenario for the Leafs at the ACC. Not the case, as the best they can hope for is forcing a final and decisive Game 7. The last time the Capitals played in a Game 7, they were defeated by the Penguins who went on to win the Stanley Cup. The Capitals best avoid giving the Maple Leafs, a team with nothing to lose, a Game 7.
Like I've said, there hasn't been much separating the Leafs and Capitals, much to the surprise of some people. If there is a hockey god, he would give us a Game 7 between the Capitals and Maple Leafs. I can tell you one thing, considering how close this series has been, I don't see the Leafs as +125 underdogs in this game. Not with Mike Babcock behind the bench. I expect them to do what they've been doing all season long, playing with a lot of energy and effort. As much of a coinflip as this series has been, the idea of taking the underdog at home looks like a good pick to me.


text:
Search results for
Respiratory Physiology
Respiratory physiology is the branch of human physiology concerned with the study of respiration. The human respiratory system is a biological system consisting of a series of organs responsible for taking in oxygen and releasing carbon dioxide to the environment. The lungs are the primary organs of respiration, which takes in oxygen and helps breathe out carbon dioxide. The lungs are a part of the lower respiratory tract that begins at the trachea and branches into the bronchi and bronchioles. These divide until air reaches microscopic alveoli and the process of gas exchange takes place.
Related Journals of Respiratory Physiology
Biochemistry & Physiology: Open Access, Biology and Medicine, Respiratory Physiology & Neurobiology, Respiratory Physiology, Journal of Human Anatomy & Physiology.


text:
Product: JAN MARINI® Bioglycolic Bioclear lotion and cream
Benefits: Exfoliates and moisturizes
How to Get it: Available in our Office
Product Profile:
Jan Marini is an incredible line created by an incredible woman of the same name. It features potent formulations based on Jan Marini's belief that any skin type or condition can be measurably improved. Common conditions such as sun damage, fine lines, wrinkles, acne scarring and skin discoloration (just to name a few) can be greatly improved or eliminated through the use of these specialized formulations, which are ideal for all skin types. With this proven program, skin can be stimulated to appear clearer, younger, smoother and healthier. As featured in countless magazines and newspapers and lauded by many top celebrities, Jan Marini Skin Research provides unparalleled skin rejuvenation and restoration.
Apply: Daily
See Results: Within 1 month
Awesome for Hyperpigmentation! (Bioglycolic Bioclear Lotion)
Sierra Skin Institute
10479 Double R Blvd Reno, NV 89521
Monday through Friday
8:30am to 4:30pm
Closed for lunch
12 - 1 pm


text:
The Union of Comoros is an archipelago located in the Indian Ocean, north of the Mozambique Channel and northeast of Madagascar.
Political Context
After a decade of absence from the political scene, Azali Assoumani won the 2016 presidential elections. The Government introduced a series of fiscal and structural reforms amidst a stable political climate. The national congress convened in February 2018 to assess conditions after 42 years of independence recommended an overhaul of the system of a rotating presidency among the islands through potential constitutional reforms.
Economic Overview
There was an uptick in economic growth, from 2.2% in 2016 to 2.5% in 2017, caused primarily by improvement of the electricity supply and an increase in emigrant remittances. Private consumption remained the main engine of growth on the demand side. Public investments were geared toward the rehabilitation of priority roads (for example, the road linking the airport to the city center) and private investment exhibited momentum, particularly with the implementation of two hotel rehabilitation and expansion projects.
Real GDP growth is projected to increase slightly to 3% on average during the 2018-2020 period as a result of emigrant remittances and private consumption. Remittances from emigrants are expected to benefit from the economic recovery in France where the vast majority of the Comorian diaspora lives. Although the business climate is not expected to improve significantly, a number of positive developments are anticipated in the private sector, like the arrival of Turkish Airways and, in the telecommunications sector, liberalization of the internet service provider market and construction of a second undersea cable landing station.
The volatility of external grant aid, low domestic revenue collection, and existing expenditure pressures risk worsening public debt. This is particularly true against the backdrop of a weak budget framework. Moreover, maintaining a stable energy supply is proving to be a major challenge. Although the energy supply has improved, government subsidization of electricity production may not be sustainable. Lastly, the current process of overhauling the system of rotating the presidency among the islands is being met with resistance and poses a major political risk.
Social Context
With almost 400 inhabitants per square kilometer, the Comoros is densely populated, and over half of its population (53%) is under the age of 20.
According to the last household survey conducted in 2014, almost 18% of the population lives under the international poverty line set at $1.9 per capita per day. The incidence of poverty, which varies considerably from one island to another, seems highest in rural areas and on the island of Mohéli. There is considerable inequality, with a Gini index of 44.9.
Development Challenges
The Comoros, which was ranked 160 (out of 188) on the U.N.'s Human Development Index in 2016, must focus its efforts on combating hunger and malnutrition.
In 2012, almost 30% of children under 5 suffered from chronic malnutrition and stunted growth.
Furthermore, infant mortality remains high, with a rate of 36 per 1,000 births for children under the age of one and 15 per 1,000 births for children under the age of five, recorded in 2012.
The maternal mortality rate stands at 172 deaths per 100,000 live births.
Last Updated: May 17, 2018


text:
Accessories & Related Products
KEH Specifications
Canon Powershot A2500 Black Digital Camera {16 M/P} Description
The Canon PowerShot A2500 digital camera offers a 16.0 MP CCD image sensor paired with Canon's DIGIC 4 Image Processor to offer its users clear, vivid images with every click of the shutter. This compact camera is ideal for shooting in low-light situations by using the Digital Image Stabilization system to reduce blur and grain. With a 35mm-equivalent focal range of 28-104mm, this wide angle and telephoto range is perfect for any and every type of photography. The 5x optical zoom provides the user with the perfect range of functionality, and HD Video Recording tops off this ideal compact camera package.
KEH Specifications
- Megapixels: 16.6 MP
- Body Color: Black
- Sensor Size/Type: 1/2.3" / CCD
- Resolution: 4608 x 3456
- ISO: Auto, 100-1600
- White Balance: Auto, Cloudy, Custom, Daylight, Fluorescent, Fluorescent H, Tungsten
- Shooting Modes: Auto, Fireworks, Fish-eye Effect, Long Exposure, Low Light, Miniature Effect, Monochrome, P, Portrait, Poster Effect, Snow, Toy Camera Effect, Vivid Color
- Image Stabilization: Digital
- Optical Zoom: 5x
- Aperture Range: f/2.8 - 6.9
- LCD Size: 2.7"
- Shutter Speed: 15 - 1/2000 sec
- Built-in Flash: Yes
- Continuous Drive: 2.9 fps
- Video: Yes
- Memory Card Type(s): SD, SDHC, SDXC
- Battery: 1x NB-11L rechargeable lithium ion battery pack
- Weight: 4.4 oz / 125 g
- Dimensions: 3.8 x 2.2 x 0.8" / 97.7 x 56 x 20.9mm
- Manufacturer's Model #: 8253B001
General information
|Brand Name
|Product information


text:
Lycoming Mall's 2017 winter Home Party Expo!
The Lycoming Mall would like to invite you to participate in our Winter Wonderland Home Party Expo we will be hosting. If you are interested in participating in the show please complete the bottom of this form and return to mall Management Office ASAP. B12 ft. x 12 ft. - $100.00 - includes (1) one 8 ft. table 20 ft x 12 ft - Includes (2) two 8 ft. tables Additional 8 ft tables are available to rent at a cost of $5 each for the duration of the show. Burgundy skirting is also available by request. Both tables and skirts are limited and available while supplies last. Setup will be Friday, January 27th, 8-9:30 am and tear-down will January 29th 5-7pm. A $1,000,000 "each occurrence" general liability certificate of insurance is required during your tenancy ay Lycoming Mall.
ADDITIONAL INSURED LANGUAGE Named as additional insured: Lycoming Mal! Realty Holding. LLC Certificate Holder: Lycoming Mall, 300 Lycoming Mall Circle, Sulle 3021 , Pennsdale PA 17756 Return this completed reservation form with your check payable to "Lycomlng Mall" to the Lycoming Mall Office at 300 Lycoming Mall Circle Suite 3021 . Pennsdale PA 11756 by January 18th. A license agreement will be sent to you prior to the show ., " If you should hive any questions, please contact the mall office at 570.546.6681. DOWNLOAD form or fill out the form below.


text:
|Главная » Статьи » Мои статьи
5-HTP Utmost Study the Actual A single
5-HTP Utmost Study the Actual A singleWhen the body anatomy processes L-tryptophan, 5-HTP is definitely made. Our bodies consequently processes 5-HTP into serotonin, a significant neurotransmitter which will instantly influences brain as priligy as well as central nervous system. Given that 5-HTP allows the human body maximize its all-natural serotonin generation, it's actually a well-liked product for any suffering from various situations proportional to help serotonin insufficiency. Attainable uncomfortable side effects as a result of 5-HTP have to have deeper go through. Having said that, almost all of the best-known side-effects to this point occur on account of pairing 5-HTP with compounds, nutritional supplements, and also prescription drugs htp 5 5-HTP can lead to an excess of this, bringing about cardiovascular control device ailment or even acute court case with This Affliction. Eosinophilia-myalgia Malady, an illness associated with lean muscle tenderness and blood conditions, is considered to get related to 5-HTP; having said that, nobody kjnow for sure regardless of if the element themselves or maybe dirtied pockets connected with 5-HTP are accountable. Trivial unwanted effects like vomiting and nausea are already observed. For starters, apply on your own the bed meant for eventually engaged on ones own would like to shed pounds. This short article will look at a variety of benefits of keeping the appropriate body weight and even muscular mass within the body http://stillwater.patch.com/groups/fitness/p/phen375-reviews-does-it-work-and-where-to-buy-phen-375. Right now, ailments which can be frequently as a result of or even involving overweight tend to be improving inside wide variety. With the quite a few unintended side effects for fat, a lot of people are beginning to comprehend the necessity of fat burning, and consider them a mission don't just designed to strengthen visual appearance, but one's well being likewise. Naturally, the main benefit of using a additional slender, accommodate and muscular body likewise increases the willingness driving some sort of individual's aspire to shed extra pounds. There are many merchandise available in the market that advertise to help individuals reduce extra fatty acids which help using muscular. However, not every these surpass consumers' objectives. One complement that will shows off is certainly 5-Htp Max. Just what exactly units the application other than many other dietary supplements would it be targets the condition towards the core. What things can 5-Htp Maximum Conduct For you personally It is consisting of a drug free amino acid which are built and located in your system. Consequently, people that use the health supplement are just strengthening the creation in order to grow this amounts in your system instead of producing dangerous compounds for their process forever. Ever since the supplement is designed to control serotonin stages stated in mental performance, clients can anticipate that will: This kind of Exhilarating Unique state-of-the-art with natural weight deprivation is that this thing that allows you to shed the excess weight with out eating routine or perhaps work out. So when you're prepared to take which the second step to you as well as slim the fat completely compared to you should have this kind of supplement! For yrs pure garcinia cambogia reviews was implemented simply by clinical doctors together with hospitals to help individuals grow their ambiance. A Stunning consequence of 5HTP is the fact that many of us not alone explained they supposed pleased, fewer distressed and much more sentimentally steady . They also noted feeling considerably less keen significantly less likely to be exhausted plus result in overeating in which perhaps you may understand would be the #1 explanation why plenty of people gain pounds and also can't keep it off! So it's at this moment time for them to take which next thing plus shed extra pounds together with feel much better! Supplies are certainly small at this time through 5HTP. When you wish to make sure you are able to get ones container you'll want to sequence currently well before supplies are usually had sell outs! You don't have anything reduce except for the excess weight! A single substantial debate that all of the 5-HTP Max assessments that you may find out have been in have a preference for in this fat reduction sensational can it be is actually all-natural as well as will work in a natural way. The following means idea that no have any substances that may well cause harm to your body or even can have unwanted side effects as well as how it really works will be natural on top of that.
|Просмотров: 739 |
|Всего комментариев: 0
Добавлять комментарии могут только зарегистрированные пользователи.
[ Регистрация | Вход ]
[ Регистрация | Вход ]


text:
Release date:April 1, 2016
Studio:Pure Flix Entertainment
Director:Harold Cronk
MPAA Rating:PG (for some thematic elements)
Screenwriters:Chuck Konzelman, Cary Solomon
Starring:Melissa Joan Hart, Ernie Hudson, Jesse Metcalfe, David A.R. White
Official website:GodsNotDeadthemovie.com| Facebook| Twitter
Plot Summary:
"God's Not Dead 2" centers on Grace (Melissa Joan Hart), a Christian teacher, who is forced before a judge for honestly answering a question about Jesus in the classroom. With the principal and superintendent joining forces with a zealous civil liberties group, Grace faces an epic court case that could cost her a career she loves and expel God from the classroom.


text:
Behr Color Of The Year 2017. Here are a number of highest rated Behr Color Of The Year 2017 pictures on internet. We identified it from honorable source. Its submitted by organization in the best field. We believe this kind of Behr Color Of The Year 2017 graphic could possibly be the most trending topic taking into account we allocation it in google pro or facebook.
We try to introduced in this posting past this may be one of astonishing mention for any Behr Color Of The Year 2017 options. Dont you come here to know some further unique pot de fleurs pas cher idea? We essentially wish you can easily resign yourself to it as one of your mention and many thanks for your times for surfing our webpage. interest ration this image for your beloved friends, families, organization via your social media such as facebook, google plus, twitter, pinterest, or any extra bookmarking sites.


text:
This heartwarming video showcases a desperate man's campaign to get his cute granddaughter better treatment for her ultra-rare medical condition.
Will Newman, 66, created a YouTube video of sixteen month-old Ellie to highlight her rare 200,000/1 disease - cystinosis. The one-minute video shows tiny Ellie opening and closing a door with a number 10 painted on it with the text: 'I'm far too cute for my life to go down the chute.' Will made the video with the hope of bringing his family's plight of rigirous hospital visits to the attention of PM Teresa May - who spoke on Question Time about new medicines.


text:
Know thyself! How can we move forward if we don't know and understand ourselves? What do we believe? What do we stand for? How do we see ourselves?L
This culture of entitlement in sport
If Sport stakeholders in Trinidad and Tobago continue living in denial oblivious to the harsh fact of austerity. Sport will grind to a standstill as the consequence of the culture of entitlement and dependency .
TTOC steps it up for gender equality
Sport is a "Man's World". How then do we accelerate gender parity, unmask unconscious biases and cultural stereotypes?
Economic downturn hits sports hard
Sport is in for a tough ride as the country's economic horizon look very, very, challenging. Where do we go from here?
Tackling abuse in sport
THE CALL by president of the Trinidad and Tobago Olympic Committee Brian Lewis for greater attention to be paid protecting children from abuse during sporting activity is one which all must heed.


text:
LANSING, Mich. — Sen. John Proos is encouraging all Southwest Michigan residents to join him in recognizing the important contributions of career and technical education (CTE) to Michigan's economy and the lives of thousands of students.
"February is Career and Technical Education Month, and it is a time celebrate the efforts and accomplishments of the many students pursuing rewarding careers through CTE and thank the instructors who are helping these students reach their goals," said Proos, R-St. Joseph. "Michigan's economy is growing and creating jobs, yet thousands of positions remain unfilled because employers cannot find enough skilled workers. I have long supported applied learning education programs, because these rigorous areas of study can help us prepare all Michigan children for success and fill our current job skills gap."
Michigan is home to more than 330 companies engaging in automotive research and development, and these businesses spend $11 billion annually on research and development.
"The auto industry continues to play a driving role in our economy, and manufacturing — like much of the global economy — is relying more and more on advanced technologies and skilled workers who know how to use that technology and who can adapt to new innovations," Proos said. "CTE programs have become essential in ensuring that all Michigan students are given the opportunity to thrive, obtain a well-paying job and contribute to the economic success of our state and nation."
Proos has supported legislation to allow students to meet certain graduation requirements by completing CTE courses and programs and to make it easier for professionals with expertise in certain fields to become effective classroom teachers. Proos was also successful in enacting Public Act 288 of 2014, which encourages schools to establish applied learning programs that award credit toward a college degree or an industry-recognized professional certificate.
"During Career and Technical Education Month, I urge all area families to express their appreciation for everyone involved in our CTE programs," Proos said. "They are working hard to support our economy and ensure every student has the chance to achieve the American Dream."
Proos also serves on the MiSTEM Advisory Council, which is dedicated to improving science, technology, engineering and mathematics (STEM) education in Michigan and promoting innovation and collaboration in STEM to best prepare students for careers in critical fields.


text:
My Problem
I dropped my nexus bringing in groceries, which smashed the screen. I replaced the screen myself but broke a connector on the motherboard in the process! I bought a new motherboard from iFixit and now, at last, my Nexus lives again. It was a horrible two weeks without it.
My Fix
I broke a connector when I w . . .


text:
International Student Shares Peace Knowledge
Contrast in Culture Shared by Zambian Peace Advocate
While preparing to leave the Kootenays after four months of study at Selkirk College, Issa Sadi Ebombolo had a moment that helped illustrate the difference between Canada and the work he does as a peace advocate in Zambia. It happened while he was standing in a bank line in downtown Nelson.
"In the most conflicted countries in Africa, you cannot have a bank without a security guard standing up with a gun," Ebombolo says. "The gap is just too big, there is no second class. There is just the higher class and poor. The poor have no other option other than use violence in order to have access to the resources. Any business places in these most conflicted countries will need a gun for protection. When I didn't see a person standing with a gun at the bank in Nelson, this was an important determinant of peace."
It's one of many observations Ebombolo is packing home after four months enrolled in Peace Studies on the Castlegar Campus.
Issa Sadi Ebombolo spent four months in the West Kootenay studying at Selkirk College.
A Journey for Understanding
Ebombolo arrived to Canada in August after being selected to take part in the Selkirk's Mir Centre for Peace exchange program with the African Peacebuilding Institute. The institute offers an annual intense and experiential education opportunity to Africans who are working at the community level across the continent. The Mir Centre has built a relationship with the institute so that Selkirk's Peace Studies students can take part in this annual program.
Ebombolo works with an organization called Peace Club in Lusaka, Zambia where he is one of the directors. Trained as a mathematics/science high school teacher, Ebombolo switched gears in 2003 when he dedicated himself to peace building and conflict transformation on the African continent.
"I have learned a lot at Selkirk College," says the 44-year-old. "From the basic training in my peace education in Africa, it's all about peace at a community level. The four months I have spent at Selkirk, I have had an opportunity to learn peace at a global level and this is very important to me. The knowledge I have acquired at Selkirk College, I will use it in my organization and beyond Zambia."
Zambia is located in the southern half of the continent. It is a stable and powerful African nation, with the World Bank naming it one of the world's fastest economically reformed countries. Since independence in 1964, there has never been an armed conflict in Zambia.
This is not the case north west of Zambia where the Democratic Republic of Congo has been devastated by a lengthy and bitter civil war. Ebombolo grew up in Congo and the country remains one of the places he focusses peace efforts on.
While taking part in his studies at Selkirk College and during his discussion in the community, Ebombolo found those he interacted with were very interested in his work and the current situation in the most war-torn countries in Africa. He also discovered many times, those he spoke with had a clouded vision of the reality in Africa today.
"It's not about Congo alone, but all about the whole continent," Ebombolo says. "The media has painted the whole continent with a black picture and this black picture has remained in the brain of the people. You can see from the questions I received over the last few months that the picture people have about the whole continent is war, diseases, HIV and AIDS, corruption, the killings, forests, animals… this is what is in the mind of the people."
To read more about Ebombolo's experience at Selkirk College head to the full feature at selkirk.ca.


text: OK here is the dilemma-- my SO and I are going to the LV VIP/VIC party on Thursday. SO said he will buy me whatever I want, but I have been feeling reallllly guilty over ALL of the stuff he has been buying me lately.:shame: So I came to the conclusion that I am going to buy something from LV for MYSELF for once. LOL Since I am a 'starving college student' I am going to put it on my credit card (bad, I know!) However, during Xmas break, I am going to work more hours ( I work like 5 hours at Coach right now...will increase to apx. 20 hours/week while on break) so I will be able to pay it off...however, one of my potential purchases will take longer to pay off than the other one! Should I get the Poche Toilette 26 to use as an everyday cosmetics pouch and occasional clutch for $260, or splurge and get the Azur Speedy 30?? Keep in mind I already have 3 Speedys... what to do?!?!?!?:s TIA!!!


text:
My name is Meg Nalezny. I'm an occupational therapist (OT) and yoga instructor with a specialty in adapting yoga for all bodies, minds, and circumstances. I provide in-home and community-based yoga and occupational therapy consultations, workshops and speaking engagements in the beautiful Twin Cities area.
I'm delighted that you're here.
Read on for a bit of my story. It's a lovely one, and it starts on a small vegetable farm in western Minnesota.
After graduating college with a highly useful English and psychology degree and minimal life direction, my growing interest in all things agricultural and an ache for the outdoors led me to an internship at Earthrise Farm in Madison, Minnesota.
In mid May, fresh off the college campus, I rolled up the gravel driveway at Earthrise and was instantly, lovingly absorbed into the busy hum of farm life. As I weeded lettuce, picked tomatoes and made strawberry jam, it occurred to me that I loved all parts of the process – every step in the food and life cycle, down to the stinky broccoli stalks decomposing in the compost heap and the sticky jam cleanup. Because in each step – in the interplay of weather, human handiwork, and millions of micro-organisms – was real magic.
Each day, I sank gratefully into the mystery of our delicately balanced (yet incredibly robust) system of seasons and cycles. I felt awed, rooted, and strong in myself – body, mind and heart. I smelled the shift in the air as we transitioned from delicate June nights into thick August ones. I watched weather roll from one corner of the wide prairie sky to the other. I felt the sting of nettles in the potato patch and the impossibly soft skin of ripe Garden Peachtomatoes. My senses were full – in the most nourishing, stimulating, soul-sustaining way.
I loved the farm, and hated to leave after the last produce left the vines. But knew I wasn't a farmer – or, more precisely, I wasn't meant to nurture vegetables and marshal chickens exclusively. Even as future gardens simmered in my imagination, I ached to bear witness to the transformations that happen in each stage of human living, too – the planting, weeding, and composting cycles of our life stories.
I'd felt first-hand the glories of delicious exhaustion by sensory smorgasbord and physical toil – I believe we all know this experience as children, and sometimes we're lucky enough to re-learn as adults. Could it be that only those with a tract of land and the under-ten contingent have full access to the body-mind-balance club? Impossible!
I left the farm with a full heart and a full-grown determination to honor my inner rhythm and help others come home to theirs, regardless of circumstances. All I needed was an avenue – a means for making contact with those who need a hand in getting reacquainted with balance, and some tools to clear the way.
Enter: occupational therapy. A profession born when observant folks realized that sick people heal more quickly with purpose in their days and a rhythm to their routines. With its whole-person, whole-life philosophy, it was perfect.
I jumped into grad school and first jobs with abandon, all engines and energies full power, only to be knocked back on my caboose. Somewhere, perhaps in my four hundredth online posting to grad school web classes, or maybe as I dashed to my desk for a drink of water between back-to-back patients, I lost heart. I couldn't imagine feeling less rooted, less balanced, less connected to a rhythmic way of living. It felt ludicrous to spend ten hours a day enabling others' life balance, only to drag myself home, totally spent, and eat takeout while watching a gaggle of women fight over a live Ken doll on network t.v. This was my reality, and it stunk.
When I surfaced enough to take note of what had unfolded, I felt terribly lonesome for a sense of my inner body, for the rhythm of the seasons, and for a sense of enough. I couldn't fathom abandoning my beloved and hard-earned new career, but I felt equally averse to dragging myself through each day.
For years, I had nurtured an on-again, off-again relationship with an internet-yoga-in-the-basement practice. I'd dig out my mat, set up the computer on a folding chair, and have at it until (no more than fifteen minutes later) I found myself crouching in front of said computer checking emails. My focus was lacking, to put it mildly.
A new yoga studio opened in our neighborhood, and I gathered up the courage to invest in a class package. I successfully made it through entire classes now (in the company of other humans, my pride prevented me from running to the studio lobby to check my phone). Each asana (movement) practice became a breadcrumb in the trail back to my body and balance, ultimately leading me to a stellar yoga teacher training program. It was love at first pose.
In the company of my fellow yoga teacher trainees, my body relaxed, and my heart gratefully cracked open time and again, releasing stored sadnesses and making room for the start of a kinder, gentler internal dialogue. I felt fluid, joyful, and strong again – and yet, outside the sacred space of the studio, the nagging not enough clung like a squash bug to the vine. Particularly at work.
I started to blend yoga into my clients' occupational therapy sessions more regularly. Sometimes it was a movement sequence for strength, stamina or coordination: forward fold, plank, down dog, warrior. Other times, I'd find myself half-aware of my breath, or grounding my feet on the floor during a meeting. The blessedly tenacious tendrils of yoga worked their way into every available crevice in my OT and home life.
An oh-so-gradual seismic life shift was in process. I lived the same life externally, but the pixels in my lifework picture were slowly coming into focus and nudging me firmly to my next phase. I heeded the nudge and learned to adapt yoga for all bodies with Mind Body Solutions. My training course took place on sacred ground, in the presence of safe and loving teachers, and I found that in such a setting, I no longer cared to listen to the "not enough" voice; I knew, in my bones, that this lifelong journey was for me.
Soon, I made the transition from the clinic to more sustainable outside OT work. With room to breathe and a gentler life pace, I found the space in my heart, head and days to give flight to Gray Bird Yoga & OT.
I'm delighted to offer personalized individual and small group yoga sessions in your home or at a community location, in traditional style or adapted to your needs.
I'm also available for individual occupational therapy consults & I welcome opportunities to speak to groups of all shapes and sizes. I'm delighted to create customized workshops and series on yoga, OT, and the ways their wisdom can take us home to ourselves and help us inhabit our bodies with joy, grace and strength.
I believe each of us can dwell in a state of groundedness and hope in our bodies, regardless of circumstance – sometimes we just need a hand. I'm delighted to offer you mine.


text:
Enjoy the vibrant and sharp flavours of Chinese Sichuan cuisine in a stylish setting. Cream and golden hues complement cherry blossom patterned rugs. Cracked tinted mirror walls studded with bronze Chinese longevity symbol buttons add to the feel. Vignette effects set the mood to highlight the finest Chinese offering in the state. It's a restaurant experience that delights.Savour the fresh specialties that are made possible because of the natural herbs and vegetables sourced from the valley.Do try the delightful Jasmine tea sugar free mousse and the locally sourced lotus stem which is expertly sliced to soak in a divine honey and chilli sauce making it a house favourite. Very hip.
Diced chicken in Sichuan black bean sauce,Lotus stem honey chilly,Jasmine tea mousse


text:
Archive for September, 2017
Foundational Tools To Jumpstart Your Small Business!
Starting any business can seem daunting. There are many decisions to be made and sometimes it is difficult to prioritize where to start and what tools can be of most use to you as you are laying the foundation for your company. There is an overwhelming number of applications and tools to sift through in […]
Equifax Data Breach – The Need for Cyber Liability Protection
Equifax, one of the three major consumer credit reporting agencies announced this week that they were subject to a prolonged and sustained data breach from mid-May to July. The breach, discovered on July 29, put 143 million consumers personal information (names, birthdays, addresses, social security numbers) at risk. Initial indications are that more than […]
Introducing Paul Rosen as CoverWallet's COO
We are excited to introduce Paul Rosen, as our newest addition to the CoverWallet team! Paul joins CoverWallet as our new Chief Operating Officer, to help guide us as we strive to provide our customers best-in-class products and service. Paul is joining us from OnDeck, a small-business lender, where he served as the Chief Sales […]