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Christ is Risen! He is Risen Indeed!
April is the month that we walk with our Risen Savior for the 40 Days of Easter.
- A Church 'Father' once wrote that if every star in the sky were an act of Jesus in the world, the Resurrection from the Dead would be … THE SUN!
- The Victory of our Lord is just that BIG!
Our Triune God is personal.
- This means that we are baptized by name into Christ.
- This means that at Holy Communion the body and bread are for you … personally. In English, you can be plural like 'You-All' or singular like 'You' as a person. In Greek the endings of the words are different … plural has a different ending than the singular.
- At the Lord's Supper the singular you is used when Jesus said … "This is my body, this is my blood given and shed for YOU."
- Our Lord wants you to know this love personally.
- Our Triune God is personal that's why we are baptized by Name.
Enjoy this poem that does a great job of explaining the relationship between Jesus and YOU.
The U in JesUs
The U in JesUs
Before U were thought of or time had begun,
God stuck U in the name of His Son.
And each time U pray,U'll see it's true,
U can't spell out JesUs without including U.
U're a pretty big part of His Wonderful Name
For U, He was born; That's why He came!
And His great love for U is the reason He died.
It even takes U to spell crucified.
Isn't it thrilling and splendidly grand
He rose from the dead with U in his plan?
The stone was moved, the gold trUmpet blew
And this word ResUrection is spelled with a U!
When JesUs left earth at His Upward Ascension
He felt there was one thing He just had to mention.
"Go into the world and tell them it's true
That I love them all-just like I love U."
Christ is Risen…
Pastor Steve


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The best annual festivals and events in the Dordogne
- "Comic Strip Festival" a massive 4-day event (third largest in the world) held at the end of January in Angouleme.
- Truffle Festival Sarlat an event on the third weekend in January celebrating every aspect of the Perigord black truffle (Dordogne)
- "Fest de l'Oie" this annual goose fair is held over 2 days in early March in Sarlat-
le- Canedawith geese parading through the town, cookery demonstration much consuming of goose (Dordogne)
- "Fete de la Fraise" in Beaulieu Sur Dordogne, held on the second Sunday in May in celebration of strawberries including the making of an 8ft strawberry tart (Dordogne)
- "Fete des Fraises et des Fleur" in Vergt on 19th May 2019 with up to 15 000 visitors (Dordogne)
- "Fetes des Fromages Fermier" celebrating cheese in Rocamadour on Whit Sunday
- "Les Floralies" St Jean de Cole, a huge floral festival held the second weekend in May(Dordogne)
- World Music Festival 21st June 2019 celebrated across France
- Lamb festival in Bellac with the Grand Chapter of the Lamb Brotherhood and a procession (Limousin)
June and July:
- "Itinéraire Baroque" in the Green Périgord. A festival dedicated to Baroque music and Romanesque architecture (Dordogne)
- The good eating festival at Piages in the Périgord-Limousin Regional Nature Park (Dordogne)
- Chefs' roundtable at the Lanaud Centre in Boisseuil: demonstrations of recipes using limousin beef and catering (Limousin)
- Snail Festival in La Coquille (Dordogne)
Filibreeis a festival on July 5th-7th highlighting everything Occitan including the language and culture. Its location moves each year and for 2019 thousandswill flock to Perigueux for the event (Dordogne)
- Blues Passions Festival in Cognac from July 4th-8th in celebration of blues and featuring major Blues players
- French National Day 14th July celebrated across France, Mialet has a huge Vide Grenier and Fireworks
- "Festival des Jeux du Théâtre" in Sarlat, this theatre festival is one of the most famous in France (Dordogne)
- "L'été musical en Bergerac" an eclectic programme of events at some of the region's most famous historic sites (Dordogne)
- "Souillac en Jazz" International jazz festival from 13th-20th July in Souillac
- "Vezere Festival" 39th annual classic music festival played in venues across the area around Brive (Dordogne)
- "Bastille Day" 14th July celebrated national holiday across France. Large vide
grenier, food event and fireworks held in Miallet
- "Fete du Cognac" 25th-27th July a major event in the Charente region where you can try Cognac, Pineau and Charente wines alongside local produce (Charente)
- "Festival International des Arts du Mime et du Geste, Mimos" in Périgueux 23rd to 28th July. For one week, street theatre and mime take over the town (Dordogne)
- "Itinérance Médiévale en Vallée du Dropt", from 7th -31st August in the Bergerac region you can relive the Middle Ages in all its glory! (Dordogne)
- "Flamenco Festival" in Bergerac where the town adopts Spanish rhythms at this 3-day event attracting leading names from the flamenco world
- Limousin beef day at Saint-Léonard de Noblat (Limousin)
August and September:
- "Sinfonia en Périgord", near Périgueux. A festival showcasing Baroque music
August to October:
- "Festival de Musique du Périgord Noir" in Montignac. The Aquitaine's largest festival, featuring over 20 classical music concerts
- "Vintage Days" in Perigueux a three-day event on the first weekend in Sept. Celebrating everything vintage including over 100 old vehicles parked in the centre
- "Hot Air Balloon Festival" in Rocamadour at the end of September, is a massive festival dedicated to hot air balloons
- Snail festival at Boisseuil (Limousin)
- Toques and Porcelain at Limoges: tastings, exhibition to combine Limoges porcelain and Limousin gastronomy.
- Hemp festival at Cognac la Forêt (Limousin)
- Ovine Tech at Bellac which is a trade fair where sheep take pride of place (Limousin)
- French Cuisine Festival
- Fetes de la Chataigne (Chestnut Festival) Dornazac last weekend in the month
- Ancient apple varieties day at Magnac-Bourg
- Frairie des petits ventres gastronomy festival in Limoges every 3rd Friday in October in the Boucherie quarter.
- Sweet chestnut festival at Dournazac (Limousin)
- "Rue des métiers d'Art" in Nontron. This fair brings together the best artisans in a delightful setting and is THE show for rural arts and crafts! (Dordogne)
- "La Foire du Livre" Brive huge book event
- Annual Turkey festival in Varaignes on November 11th celebrating all things Turkey and including a Bourru and chestnut fest. 10,000-15 000 visitors each year (Dordogne)
- Apples and other local fruit at Mortemart by the West Limousin apple crunchers association (Limousin)
- Orchard apple festival at Saint-Just le Martel (Limousin)
- Gourmet book festival in Perigueux held every 2 years on the odds. Includes cookery demos, food pairing and other culinary delights (Dordogne)
- New Beaujolais third Thursday in Month
- Christmas markets in the centre of both Limoges and Perigueux
- Capon festival at Blond (Limousin) with a Brotherhoods' procession and capon racing
- Christmas markets in Limoges and the Haute-Vienne

subset: commoncrawl


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Offer your clients a full yoga class
This experience requires a clear space, or can be done in the office during lunchtime using chairs. This will require staff to change into gym wear, and will leave them with the full benefits of yoga practise.
Our team include accredited Ashtanga, Hatha, Kundalini and Vinyasa teachers to give your staff a truly invigorating experience.
Choose whether you would like your lunchtime yoga sessions to be held:
Twice a week
Once a week
Once a month


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Photo: Randy Mayor; Styling: Jan Gautro
Use the same spicy-sweet glaze for pork chops. Accompany with sautéed Broccolini and couscous.
How to Make It
Step 1
Combine first 9 ingredients in a small bowl; rub spice mixture evenly over both sides of lamb chops.
Step 2
Heat a grill pan over medium-high heat. Coat pan with cooking spray. Add lamb chops to pan, and cook for 3 1/2 minutes on each side. Brush each chop with about 1 teaspoon preserves. Turn chops over, and cook for 1 minute. Brush chops with remaining preserves. Remove from heat.


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I am backlogged on my 366 project.
Mainly because there are a handful of days (and growing) where one photo doesn't sum it up. A series of photos does… so that means I need to write some blog posts. Don't get me wrong, I love blogging. But I love the idea of it more than the reality. Blogging takes time… I can't just post a picture and run (that's what Flickr is for). I need (and want) to tell a story. It may be a primarily visual story but still, it should almost always have some words to go with it. Then there is the downsizing of photos… it's just hard to fit this stuff in. I'm not complaining… I'm sure many of you go through this same thing. I guess I just wanted to talk about the nitty-gritty of it all. And maybe offer up an excuse for my absence. I probably don't need one. I could probably just post and run, right?
I guess this is a snippet of my internal tug-a-war, really.
Anyway, let's get on to the pretty pictures, shall we?
These were my top two photo choices for April 4. I remember feeling a giddiness this afternoon leaving work… cause I took the following day off during the week just for myself. I had a bunch of errands to take care of but it still felt like a treat. The chance to sleep in on an odd thursday… total luxury.
I just started shooting Spectra this year and I have to say I really love it. I have been lucky to find a handful of old Polaroid softtone film and I am really having fun with it.
In the end, I chose the top photo because I feel like I take too many flower photos in my 366. It needs some more variety… I am sure it will evolve over the year but right now… my photos are very flower heavy. Understandably, I think since it IS spring right now.
More soon! Have a lovely day!


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A bright new look for this week's Leinster Leader
In shops now!
The front of this week's Leinster Leader - out now!
We're bringing a new look to the Leinster Leader newspaper this week. We have enjoyed working on it and we hope you like reading it too. While there is still the same great depth of coverage and reporting, and your favourite columnists, it has been revamped and revitalised with bigger and better community, lifestyle and business coverage. Do let us know what you think!
Along with the best Kildare news, sport and views, we've lots of interviews, including: Hazel Gaynor on her new book, Brian Dowling on his 'Kildare Life', PJ Gallagher on his visit to Clane with his new show 'Dickhead'. Plus, report and photos from the Adam Burke fun run, Newbridge College Debs, a new, expanded community news, lifestyle and business sections.
In news: Tributes paid to Naas resident who died in climbing accident, Kildare shopping centre on sale with €1.62m price tag, Sallins restaurant wins Michelin Bib Gourmand. In sport, Ardclough win against all the odds
Plus, we shine a light on the issue of homelessness in Kildare, and our legendary sports editor Tommy Callaghan looks back as he marks an amazing 50 years working with the Leinster Leader.
Tommy shares, in this week's paper, his memories of walking through the old green timber gates of the Leader office on the first Monday of September back in 1967, to begin his career in the printworks.
Tommy essentially created the job of sports reporter — and editor — at the Leinster Leader, and he has since become one of the country's best.
To all of us who work here, he is a friend, mentor and rock of sense. Don't miss his wonderful story – plus tributes from some of Kildare's sporting greats – in this week's Leinster Leader – out now!
Celebration: Leinster Leader sports editor Tommy Callaghan was yesterday presented with a cake to mark his 50 years at the Leader by managing editor Laura Coates and staff members Paula Campbell, Niamh O'Donoghue, Giselle Mentos, Fiachra Gregan, Conor McHugh, Colm Schwer, Henry Bauress, Sarah Peppard, and Iconic Newspapers group editorial director Alan English Picture: Tony Keane


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MOTORISTS sat at a standstill on the M4 after a multi-vehicle crash causes two lanes to be closed.
The crash happened during rush hour yesterday (Thursday), at around 5.15pm and emergency services were quickly on the scene.
Three cars were involved in the crash and fire crews rescued one woman from a car who was then looked after by paramedics from South Central Ambulance Service.
A RBFRS spokesman said: "At 5.10pm on Thursday, 8 August, we received reports of a road traffic collision involving three vehicles on the M4 westbound, between junctions 8 and 10.
"Royal Berkshire Fire and Rescue Service crews from Maidenhead and Slough were sent to the scene, alongside one officer.
"Upon arrival, crews released one woman from a vehicle, who was then transferred into the care of South Central Ambulance Service.
"Crews were on the scene for approximately an hour and twenty minutes."
#M4 Lane 1 blocked J8/9 to J10 Westbound due to multi vehicle traffic collision - Traffic officers are enroute #Holyport #Winnersh— Highways England (@HighwaysEAST) August 8, 2019
Police closed two lanes to carry out the recovery of the vehicles involved.
The crash happened westbound between Maidenhead junctions 8/9 and Bracknell/Wokingham, junction 10/11.
Queues backed up from Slough, westbound towards Reading and the delays were about two hours.
Royal Berkshire Fire and Rescue Service and an incident commander arrived on the scene for about one hour and 20 minutes.
South Central Ambulance Service and Thames Valley Police also attended.


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Valley Township, Pennsylvania Area Code
Valley Township, PA is officially utilizing an area code overlay in which area codes 484 and 610 serve the same geographic area. Ten digit dialing (area code + seven digit number) is necessary.
In addition to Valley Township, PA area code information read more about area codes 484 and 610 details and Pennsylvania area codes.
Valley Township, PA is located in Chester County and observes the Eastern Time Zone. View our Times by Area Code tool.
Select Any Pennsylvania City or Town Alphabetically
Area Codes Look Up By State and City
Area Codes Look Up in Surrounding Places


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Thrangrycat flaw allows crooks to inject backdoor via Cisco devices
Recently discovered Thrangrycat flaw makes millions of Cisco devices insecure
Recently, Red Ballon technology experts discovered a vulnerability named Thrangrycat[1] or CVE-2019-1649. This type of flaw is affecting numerous Cisco devices having the TAm (Trust Anchor module) activated.[2] The module has been included in a big variety of Cisco's products since 2013 to make sure that the produced hardware is unique and does not lack authenticity.
The vulnerability appears to be really dangerous as it can allow bad actors to inject malware-based components on some of Cisco's devices and products such as firewalls, switches, and routers. What is even more worrying is that these types of products are widely used in enterprises and government networks.
Unfortunately, experts have also discovered other flaws that allow making changes to the TAm via FPGA bitstream and inject malware:[3]
The vulnerability is due to an improper check on the area of code that manages on-premise updates to a Field Programmable Gate Array (FPGA) part of the Secure Boot hardware implementation. An attacker with elevated privileges and access to the underlying operating system that is running on the affected device could exploit this vulnerability by writing a modified firmware image to the FPGA.
Attack demonstration by using the CVE-2019-1862 flaw
Even though Cisco released a report saying that exploiting the flaw and connecting to the targeted system requires leveled privileges, Red Balloon specialists have revealed that cybercriminals have the possibility of abusing the Thrangrycat flaw remotely. This can be done by connecting it together with other vulnerabilities which altogether could launch specific commands or even gain access to the targeted computer system.
In order to show how this type of attack works, the researchers used an RCE flaw, also known as CVE-2019-1862[4] for the demonstration process. This vulnerability gives permission to a logged-in admin to execute specific commands through another machine on the Linux shell of the targeted device that includes root privileges. Once access is gained, the criminal can avoid the TAm module by using the Thrangrycat flaw and then inject the backdoor virus.
Cisco keeps updating all its products that are found to be vulnerable
Cisco revealed that no suspicious attacks were detected by using the two beforementioned flaws. However, once the flaws are being tested, numerous Cisco-based units that include an FPGA-related TAm all over the world are vulnerable and can easily be misused by bad actors to plant some malicious backdoor on the targeted system.
Talking about the affected products, Cisco claims to keep in touch with all users and perform regular updates if something new is discovered.[5] Some good news is that all vulnerable products are included in the list provided by the company while others remain untouched and safe to use. The problem was provided to Cisco in November 2018 when Red Ballon Security reported it and more details will be provided in a conference in August, known as "Black Hat USA security".
- ^ Thrangrycat. Thrangrycat. Official image.
- ^ Pierluigi Paganini. Thrangrycat flaw could allow compromising millions of Cisco devices. Security Affairs. Word Press.
- ^ Cisco Secure Boot Hardware Tampering Vulnerability. Cisco Tools. Security Center.
- ^ Cisco IOS XE Software CVE-2019-1862 Command Injection Vulnerability. Security Focus. Important details.
- ^ Catalin Cimpanu. Thrangrycat flaw lets attackers plant persistent backdoors on Cisco gear. ZDNet.com. News articles.


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College of Nursing, University of Bamenda, PMB 20, Bamenda, Cameroon
Received date: March 05, 2019; Accepted date: March 20, 2019; Published date: March 27, 2019
Citation:Bodzewan EF, Abimnui PW (2019) The Quality of Healthcare Rendered in the Regional Hospital Bamenda, North West Cameroon and Assessing the Patients Experiences. Ann Clin Res Vol 7 No.1:300.
The WHO Framework for Health Systems Performance Assessment recommends that decision makers at all levels need to quantify the variation in health system performance, identify factors that influence it and ultimately articulate policies that will archive better results in a variety of settings. The performance of subcomponents of systems such as regions within countries or public health services also needs to be assessed. Health outcomes are a reflection of clinical quality/ appropriateness of care and are co-produced by care providers and users. Their roles and responsibility differ but intertwine for the achievement of quality. While the provider is guided by professional and ethical policies, the user has needs and expectations to be met. Therefore, measuring users' experiences as recipients of health services plays a significant role in assessing the delivery of quality healthcare.
This study aimed at using patients' experiences as a measure in assessing the quality of care rendered in the Regional Hospital Bamenda. A cross-sectional survey will was employed where patients who received care in the RHB were sampled to give a snapshot of the general opinion of patients who frequent the hospital. The PAHC instrument for in and out patients was used to collect data for analysis in SPSS version 20. Regression analysis, a 0.05 significance level was used to calculate the correlation between the overall ratings of the hospital performance and the dimensions of care.
Majority of patients, 52% to 91.7%, had their various needs attained with the care they received though two of the expected care needs were unmet to a greater population. Most of patients revealed that they experienced a moderate (44%) and high (24%) global level of satisfaction with the quality of care rendered to them. The dimensions of care which had statistically significant associations with the overall hospital rating of quality of care received were identified as factors which positively influenced these patients' experiences of care in the hospital. There is need for improvement in quality care provision to achieve better health outcomes.
Health care delivery; Quality; Patients; Hospital days; Patient's experiences; Health care services; Doctors; Nurses; Bamenda Regional Hospital
Statement of research problem
Quality of healthcare is the extent to which health care services provided to individuals and patient populations improve desired health outcomes. In order to achieve this, health care must be safe, effective, timely, efficient, equitable, and people-centred. WHO highlights that getting the patients perspective on quality is among the six policy recommendations to improve quality of care and amplify policy impact [1,2].
Patient experience is the sum of all interactions shaped by an organization's culture that influences the patient's perception across the continuum of care. It encompasses the range of interactions that patients have with the health care system, including their care from health plans, and from doctors, nurses and staff in hospitals, physicians' practices and other health care facilities [3].
The Institute of Medicine, USA [4] reports that as medical science and technology has advanced at a rapid speed, the health care delivery system has floundered in its ability to provide consistently high quality care to all. In view of improving this quality, the WHO Framework for Health Systems Performance Assessment recommends that decision makers at all levels need to quantify the variation in health system performance, identify factors that influence it and ultimately articulate policies that will archive better results in a variety of settings. The performance of subcomponents of systems such as regions within countries or public health services also needs to be assessed. In every health system, organizations must perform four basic functions; financing, provision, stewardship and resource development. Stewardship consists in performance assessment and consumer satisfaction among others. The aspects of Health system performance involves; population health, health outcomes, clinical quality and appropriateness of care, responsiveness, equity and productivity [2,5].
Health outcomes are a reflection of clinical quality/ appropriateness of care and are co-produced by care providers and users. Their roles and responsibility differ but intertwine for the achievement of quality. While the provider is guided by professional and ethical policies, the user has needs and expectations to be met. Therefore, measuring users' experiences as recipients of health services plays a significant role in assessing the delivery of quality healthcare. Patients have important experiences with care provision, unknown to care providers and expressing these expectations can be very valuable and educational for care providers [6]. Patients also often have other expectations, wishes and priorities and it is - for effective care-crucial to know.
In some developed countries, assessment of healthcare quality using the patients' experience has been done, and found moderately high levels of satisfaction with care ranging from, 63.5% to 70.2% across different hospitals. In low income countries, existing literature on this is limited. There are no documented studies in Cameroon [7].
This study revealed the experiences of patients on the quality of health care received identify influential factors, promote decision making in care provision and increase retention in care. It also served as a ne for future evaluation of service performance and in monitoring effectiveness of interventions.
Study objectives
General objective: To assess patients' experiences as a measure in assessing the quality of care rendered in the Regional Hospital Bamenda.
Specific objectives:
• To assess the extent to which patients' needs are met with the care they receive.
• To assess the patients' satisfaction relative to the service delivery rendered them by care providers.
• To identify factors that influence delivery of quality care to meet patients' expectations and desired outcomes.
• To propose strategies aimed at quality improvement through customer satisfaction.
Research question
What is the quality of healthcare rendered to patients admitted in the RHB as per patients' judgments?
The patients' experiences with the quality of healthcare delivered in the RHB would be satisfactory.
Description of study setting
The study was carried out in the Regional Hospital Bamenda, located in the Azire Health Area, Bamenda Health District in the North West Region of Cameroon. It has had the status of a 3rd level Reference Health Institution for the region since 2009 to serve an estimated 2, 212, 631 inhabitants [8]. Following the Cameroon system health policy, about 20% of all the region's health problems are referred to the Regional Hospital resulting in a target population of 442, 526 inhabitants.
In 2017, 14,214 admissions were recorded out of 71,293 consultations. The hospital has 400 beds and staff strength of 457 workers offering both general and specialized care on outpatient and inpatient basis [9]. It had undergone quality assessment from a South to South project with a Tanzanian hospital from 2011 to 2015. This assessment was done using general indicators which focused on the global quality of care in the hospital. Although patient satisfaction was an aspect, the patients' experience was not the center of the assessment.
The study population comprised of in-and-out patients who received care within the recent past in the hospital.
Eligibility criteria
Inclusion criteria: Out-patients who received care within the recent past in the hospital, and patients who have just been discharged following at least 24 hours of hospitalization.
Exclusion criteria: Patients who had been hospitalized less than 24 hours and those who had gone home were excluded.
Study design
A cross-sectional design was employed where-in; patients who received care in the Regional Hospital Bamenda were randomly sampled to give a snapshot of the general experiences of the entire patient population who received care in the hospital; on the care rendered by care providers and their findings analyzed as per the study objectives.
Sample size determination
Using a 95% confidence level and p<0.05, the Yamane simplified formula was used to determine the sample size.
Where n=The sample size, N=population size which is 14,214 and e=The level of precision.
n=14214/1+14214 (0.05)2, giving a sample size of 389 participants.
Sampling technique
A simple random sampling technique was used to obtain a sample from the patients who seek health care at the Regional Hospital Bamenda. Every patient (from lying-in wards and outpatient departments) who have been consulted or discharged from the hospital during the data collection period and who gave consent was recruited in the study.
Data collection tool and data collection method
The PAHC instrument was implored. Its reliability and validity had been tested in Ethiopia, a low income country like Cameroon, and found to be appropriate and feasible to administer.
Separate questionnaires were used for outpatients care (O – PAHC, consisting in 24 questions) and inpatients care (I–PAHC, consisting in 22 questions) covering nurse communication, doctor communication, physical environment, pain management and medication and symptom communication. Items are scored using a 4-point Likert scale, ranging from 1 (Never) to 4 (Always) in the I-PAHC survey and 1 (Strongly disagree) to 4 (Strongly Agree) in the O-PAHC survey. Additionally, in both questionnaires, patients provided an overall evaluation of care (scored 0-10) and were asked if they would recommend the facility to friends and family (on a 4 point scale from Definitely NO to Definitely YES). Based on the global ratings grouped by the Centres for Medicare and Medicaid Services (CMS) into one of three categories, 0-6 (Minimum global satisfaction), 7-8 (moderate global satisfaction), 9-10 (high global satisfaction), the overall hospital rating of the hospital will be categorized as: 0-6 (Minimum global satisfaction), 7-8 (moderate global satisfaction) and 9-10 (High global satisfaction).
Trained assistants who do not work in the facility (to control bias) and who show mastery of the questionnaires and participants' confidentiality went round with the researcher and administered the questionnaire face-to-face on a daily basis to willing participants. This was preceded by pretesting to roll out flaws in questions and lapses in responses as well as the duration of time spent in completing the tool. Nevertheless participation in the study was of free will and when a participant wished to withdraw, they were not forced. In this case the incomplete questionnaire was discarded.
Data management
Responses from questionnaires were analyzed in Statistical Packaging for Social Sciences version 20 (Software SPSS INC, Chicago, IL, USA) and Microsoft Excel 2013. Regression analysis, a 0.05 significance level, was used to determine the correlation between the dimensions of care and the overall ratings of the hospital performance.
Strengths and Limitations
Though the study involves the patient in quality healthcare assessment, promotes patient centered care and recommends strategies for quality improvement, limitations include recall bias for patients who have stayed too long in the hospital and can't clearly remember their whole experience. In addition, since sickness is most often associated with pain some of the responses may be irrational. However, randomization minimized the effect of these limitations on the study outcome. Regarding the outcome, it is expected that patients will rate the quality of care they receive using their experiences in the hospital.
Socio-demographic data
A total of 382 out of 389 patients participated in the study resulting in a 98.2% response rate. They comprised in 175 (45.8%) outpatients and 207 (54.2%) inpatients.
Age distribution of respondents: The mean age of respondents was 35.75 (Figure 1) ranging across 7 to 84 years.
They consisted of 3% children (7 to 17 years) and adults 96.4% (18 years and above). Male respondents were mostly within the age group 31-45 years whereas females were mostly aged between 18-30 years. In total, majority (43%) of respondents were within the age group 18-30years and only a few (2%) of them were aged 76+ years (Figure 2).
Gender distribution of respondents: Both genders were represented with 58% females and 42% males as shown in Figure 3.
Marital status of respondents: A greater proportion of respondents (54%) were married, (30%) of who were females and 45% were singles relative to 1% divorcees and 4% widows/ widowers as illustrated in Figure 4.
Occupational distribution of respondents: Respondents' occupations were categorized under six groups as follows:
• Technician/Engineers comprised in technicians, engineers, environmentalists, welders, weatherperson, plumbers.
• Businessmen comprised of traders, butchers, hair dressers seamstresses, businessmen and business women.
• Salary earners comprised of bankers, accountants, secretaries, military and nurses.
• Students comprised of applicants, students, pupils and cleaners.
• Others were religious workers, retired and security officers.
• Housewives were housewives and farmers.
As displayed in Figure 5, 27.2% of respondents were businessmen, 26.7% were students while 3.4% of them were found in the occupation group 'others'.
Educational qualification of respondents: With regards to level of education, 41% respondents had completed secondary and 38% had had tertiary education. 16% of them had undergone primary education meanwhile very few (5%) had no educational experience (Figure 6).
Language distribution of respondents: As seen in Figure 7, an overwhelming 90% of respondents revealed that English was their first language unlike French which recorded 9%.
Univariate analysis of all dimensions of care to determine the extent to which patients need were met
Nurse's behavior: Respondents expressed that nurses (45%) usually treated them with respect and courtesy more than they always do (39%); nurses always listened to them carefully (45%) more than they usually do (42%), nurses usually explained things to them in a way they could understand (43%) more than they always do (39%). This is contrary to very low responses of nurses never treating them with courtesy and respect, listening to them carefully and explaining things to their understanding ranging from 3% to 13% as illustrated in Figure 8.
Doctor's behavior: Similarly 44% of respondents expressed that doctors always treated them with courtesy and respect while 42% said they usually do not (Figure 8). Forty eight percent of them expressed that doctors always listened carefully to them than usually (36%), doctors always explained things to them in a way that they could understand (46%) than usually (38%). Likewise, fewer respondents 3% to 15% revealed that doctors never or sometimes treated them with courtesy and respect, listened to them carefully and explained things to them in a way they could understand.
Remarkably, 8% of respondents never distinguished nurses from doctors while 15% sometimes did, 35% usually did and a greater 42% always knew the difference (Figure 9).
Physical environment/Time spent with doctor: Forty eight percent of respondents reported that their rooms were always kept clean and 44% replied it was usually clean unlike the 3% and 6% who were clear that their rooms were never or sometimes kept clean respectively (Figure 9). An average response of 56% was indicated that baths were usually kept clean and 4% who never met clean baths.
With respect to time spent with the doctor, exactly half (50%) of respondents expressed that they usually had enough time to discuss their medical problems with the doctor even though 8% of them never had such time (Figure 10).
As illustrated in Figure 11, about half (52%) of in-patients always experienced a quiet environment at night dissimilar to those who never had a quiet night (7%).
Similarly, 49% of these patients had their personal privacy respected whereas 14% reported theirs being respected sometimes. 12% of them suffered complete absence of personal privacy (Figure 12).
Pain management: Out of the percentage of patients who responded 'Yes' to have experienced pain, 52% of them reported that the staff always did everything they could to control it with a similar 52% who had their pain well controlled. Similarly, those who remarked that staff usually (21%), sometimes (14%) and never (13%) did everything to control pain have an almost equivalent outcome on pain control as shown in Figure 11.
Generally Pearson's correlation analysis on pain management revealed that there was no significant correlation between the patient's overall rating of their health and pain management [Pain was well controlled (r=0.118, p=0.091), Staff did everything to control pain (r=0.127, p=0.068)].
There was a strong negative significant correlation between experiencing pain and having the staff do everything they could to help with pain (r=-0.596, p<0.01).
A significant regression equation was found thus: (F (2,204)=17.096, p<0.001) with R2=0.114 for Staff communication of reason for prescribing new drugs to a patient and the Doctors showing courtesy/respect being significant predictors to better pain management as judged by the patients.
Medication communication/cost of care: Most patients (65%) unlike 35% had new medications prescribed to them during their hospital visit of which only 48% were told the reason for the new prescription and medication side effects only communicated to 34%. Although great proportions (69%) of these patients were educated on signs and symptoms to
look out for after leaving the hospital, 31% of them left uninformed. Seventy two percent patients responded that they paid their hospital bills and found it inexpensive (58%). A majority (74%) of patients reported being able to easily find their way around the hospital and it was the first time for 56% of respondents to visit the hospital (Figure 13).
Availability of drugs: Sixty nine percent of respondents had their drugs available in the hospital pharmacy whereas 31% of them could not find their drugs there (Figure 14).
Recommending hospital to others: As seen in Figure 15 respondents (59.2%) expressed that they will probably and definitely (30.4%) recommend the hospital to others meanwhile 6.5% of them might not and 3.9% were sure not too.
Rate overall health: A greater percentage of patients (66%) reported an overall good health, 14% reported excellent health, 17% and 3% rated their health fair and poor respectively (Figure 16).
Analysis of overall hospital rating to determine the patients' level of satisfaction with the care received
Generally, on a scale of 0–10, 32% respondents rated the hospital between 0–6 resulting in minimum global satisfaction, 44% rated it between 7–8 resulting in moderate global satisfaction and 24% rated it between 9–10 resulting in high global satisfaction (Figure 17).
Identification of factors influencing care
Persons' Chi square test was performed to determine the significance of association between each dimension of care and the overall hospital rating and using Cramer's V to determine the strength of the association between the two variables.
Respondent's age, gender, marital status, occupation, level of education and first language had no significant relationship with the overall hospital rating.
Nurses' courtesy
A significantly strong association was found, χ2 (3)=51.59, p<0.01. Satisfied respondents were mostly those who usually (37%) or always (36%) experienced nurses' courtesy and respect while others were dissatisfied despite haven usually (8%) and always (3%) had courtesy/respect from nurses as shown in Figure 18.
Patients listened to by nurses
A significantly moderate association was found, χ2 (3)=25.76, p<0.01. Respondents whom nurses usually listened to (32%) and always listened to (41%) carefully expressed satisfaction. Nevertheless 10% and 4% of them were dissatisfied respectively (Figure 19).
Doctor's courtesy
Significant strong association were found, χ2 (3)=46.77, p<0.01. The majority of satisfied respondents were those who usually (34%) and always (40%) experienced doctor's courtesy. Yet 8% of those who usually experienced this were dissatisfied (Figure 20).
Patients listened to by doctors
There was a significantly moderate association, χ2 (3)=16.32, p<0.01. A majority of satisfied patients were those whose doctors usually listened to (28%) or always listened to them carefully (42%). Minimal proportions of satisfaction were expressed by those whose doctors sometimes carefully listened to them (7%). Remarkably, 4% of those who never experienced this still reported satisfaction (Figure 21).
Satisfactory explanation by doctors
A significant moderate association was found, χ2 (3)=15.81, p<0.01. The most satisfied respondents (40%) were those whose doctors always explained things to them in a way they could understand (Figure 22).
Ability to distinguish doctors from nurses
A significant moderate association was found, χ2 (3)=16.54, p<0.01, 28% and 37% of patients who usually and always distinguished between nurses and doctors respectively. The most dissatisfied patients in relation to this were those who sometimes (10%) distinguish the two (Figure 23).
Room clean and satisfactory
A significant moderate association was found, χ2 (3)=20.39, p<0.01. Respondents expressed high levels of satisfaction when their rooms were usually kept clean (35%) or always kept clean (42%). However some were dissatisfied even when their rooms were usually kept clean (9%) or always kept clean (5%) (Figure 24).
Recommend hospital
A strong association was found χ2 (3)=55.49, p<0.01. Respondents who would probably (49%) or definitely (28%) recommend the hospital to friends and family were satisfied though 10% of those who would probably did so were dissatisfied (Figure 25).
Payment of hospital bills
There was a moderate association found, χ2 (3)=11.37, p<0.01. A huge proportion (66.5%) of respondents who paid their hospital bills expressed satisfaction though 11.8% of them were dissatisfied. Interestingly, 6.8% of those who did not pay hospital bills were dissatisfied (Figure 26).
Rating overall health
A strong association was found, χ2 (3)=42.12, p<0.01. Fifty seven percent of respondents who rated their health as good were satisfied while 9% of them were not. Out of the 14% who rated their health as excellent, 1% declared dissatisfaction (Figure 27).
Experienced a quiet night
A moderate association was found, χ2 (3)=13.59, p<0.05. Descending levels of satisfaction were registered by those who always had a quiet night (48%), usually (22%), sometimes (10%) and never (6%) found the hospital quiet at night. Meanwhile levels of dissatisfaction were generally minimal ranging from 1% to 5% (Figure 28).
Personal privacy
A moderate association was found, χ2 (3)=16.15, p<0.05. Great proportions of respondents whose personal privacy was usually (20%) and always (46%) expressed satisfaction. The highest level of dissatisfaction was from 5% of those whose personal privacy was not respected (Figure 29).
Pain control
A moderate association was found, χ2 (3)=10.32, p<0.05. Respondents who had their pain usually (18%) and always (49%) controlled were satisfied. Interestingly, while 3% of patients whose pain was always controlled expressed dissatisfaction, 9% of those who never experienced pain control expressed satisfaction (Figure 30).
Aspects to control pain
A moderate association was found, χ2 (3)=13.99, p<0.05. An exact 50% of satisfied respondents were those who indicated that the staff always did everything they could to control their pain. Lower levels of satisfaction were recorded by those who remarked that staff usually (16%), sometimes (10%) and never (11%) did everything to control their pain (Figure 31).
Table 1 illustrates a summary of the results of the Chi square test with the Cramer's value showing the strength of the association between each of the dimensions of care and the overall hospital rating. It was observed that recommending the hospital to family and friends, doctor's courtesy, nurse's courtesy and rating overall health were the strongest predicting factors to the overall hospital rating.
|Variable 1
|Variable 2
|Degrees of freedom (df)
|Chi Square (χ2) value
|Cramer's V
|Recommend hospital to family and friends
|Overall hospital rating
|Nurses courtesy/respect
|Doctors courtesy/respect
|Rate overall health
|Nurses explained
|Everything to control pain
|Personal privacy
|Nurses listened
|Quiet night
|Pain control
|Room cleaned
|Distinguish doctors and nurses
|Doctors listened
|Doctors explained
|Pay hospital bills
|**For p-values lower than 0.01
*For p-values lower than 0.05 but greater than 0.01
In this study the patients' status was found to have no significant influence with the overall hospital rating implying that the quality of healthcare delivered to both in and out patients was proportionate. Therefore where applicable, respondents' responses were merged into four categories: Never, Sometimes, Usually and Always to ease data interpretation. Meanwhile, respondents whose first language was not English exhibited enough knowledge to understanding and responding to the questions adequately.
A response rate of 98.2% signifies that the patients demonstrated willingness and interest to air their views with the appraisal of the quality of healthcare they received. It also means that a representative population participated in the study cutting across different gender, age groups, educational levels and occupations.
Extent to which patients' needs were met from care received
In relation with the above results, there is a general shift, far above average, in the expressions of patients pertaining to their experiences with the various dimensions of care received in the hospital and the extent to which the care met their needs. This is evidenced by the majority of responses being positively inclined to 'Usually' and 'Always'. For all aspects of nurses' behavior, 84% of patients felt nurses treated them with respect and courtesy, 87% of them were listened to carefully and 82% received explanations from nurses in a way they could understand. With regards to doctors' behavior, similar proportions were revealed for doctors who showed respect and courtesy (86%), doctors who listened carefully to patients registered 84% and 84% of patients also spelled out that they received explanations from doctors in a way they could understand. This means that these patients expected respect and courtesy during their visit and this need was met above for the greater population. These results are higher than those of who found that 68.9% of patients in Bangladesh experienced respect and politeness from care providers [10].
The physical environment of the hospital was generally reported to be clean especially rooms (88%) and baths (71%). A quiet night was also ensured to 78% with personal privacy maintained to 74% of patients. This findings contrast with [10], who found that personal privacy was maintained to less than half (45.1%) of patients and [7], who found average values of 54% for patients having a quiet night [11] remarks that perceptions of neatness of wards and buildings, the décor and the appearance of the nursing staff will influence whether a patient will return to a hospital or not.
Eighty two percent of patients spent enough time with the doctor unlike the 91.7% of patients who reported spending much time with their doctor [10]. It is possible that this had a lot to do with the doctors' behavior which engulfs respect/ courtesy, listening and explaining. It could also be that the patients low expectations that were easily met.
The 77% of patients who could distinguish between doctors and nurses signifies that they were aware of the various professional cadres so that their expectations were not misplaced or misread.
New medications were prescribed to 65% of patients. Prescribed drugs were available to 69% of patients in the hospital pharmacy. This is likely in line with the national list for essential drugs made available in public hospitals in Cameroon. Therefore where prescriptions require a drug that is out of this list, patients are expected to purchase them out of the hospital. Most patients (69%) had an explanation of symptoms to look out for after leaving the hospital. This shows that they were educated upon discharge from the hospital.
Out of 78% patients who experienced pain, it was reported that 52% of them had their pain controlled pointing out that the staff did everything they could to ensure so. This findings are lower than those of Gupta et al. [12], who found that on the average, approximately 71% of patients in critical access hospitals had their pain always well controlled compared to about 67% of patients in acute care hospitals. For those who reported not having their pain controlled, it could be attributed to the fact that they could have lacked the prescribed drugs for financial reasons or due to unavailability in the hospital pharmacy. Also they could have been suffering from chronic pain which might require longer periods to be abated. Inadequate pain management can also result in poor patient outcomes leading to increased healthcare costs.
Most patients (80%) rated their overall health within 'good' and 'excellent' implying that the care they received had a positive impact on their overall wellbeing. Accordingly Goldstein et al. [13] recorded lower proportions of 40% patients rating their overall health as 'good' and 'excellent'.
Most of the patients (56%) had visited the hospital at least once before which can explain the reason why a majority of them (74%) found it easy finding their way around the hospital. In addition, the presence of a hospital map, direction signs, and visible names of offices and units also eases movement around. Despite this, some patients (26%) could not find their way around probably due to inability to read signs or because they were visiting the hospital for the first time.
Remarkably, a greater proportion (58%) of those who reported paying their hospital bills pointed out that they were inexpensive. This could be because the study setting was a public health facility and users were aware that they have to pay bills for services rendered to them. Besides there are clear verbal explanations upon admission and written public notices in the hospital educating patients on the cost of various services. As such they are not taken by surprise during payments. On the other hand those who reported not paying bills could have been registered under an insurance scheme or are paupers registered under the social service.
On the other hand, some dimensions of care registered greater response values negatively inclined to 'Never' and 'Sometimes'. Though new medications were prescribed to a majority of patients, a greater proportion (52%) of them did not receive any explanations regarding the new prescriptions neither did they (66%) receive education on the side effects of the drugs they were placed on. These are aspects of care which patients expected to be exploited implying that a majority of patients registered these aspects of care lacking during their care process.
In summary, majority of patients had their various needs attained with the care they received though two of the expected care needs were unmet to a greater population.
Assessment of level of satisfaction of care received
Majority of patients (44%) rated the overall hospital within the range 7–8 representative of a moderate global satisfaction with the quality of healthcare received while 32% rated it between 0–6 being minimum global satisfaction and 24% rated it between 9–10; being high global satisfaction. This indicates that though a larger number of patients were moderately satisfied with the quality of care they had during their contact with the hospital, some experienced care of high quality while a few experienced a minimum. Therefore their experiences were more geared towards moderate and high satisfaction with quality of care.
This is probably because a majority of them showed that their needs were almost completely met. When patient's needs and expectations are more than averagely met, the resulting effect is greater satisfaction. Since families and friends are closer and believe in each other, a satisfied patient would be fast in encouraging other sick family members and friends to visit the same hospital and probably see the same doctor or nurse if possible [11]. Patients also prefer to stick to the same hospital and same doctor because they have an already established relationship and the level of trust is higher. The findings of this study contrast with [7], who found that in some states, 71.9% of patients gave their care a high global rating while in others 49.9% did so.
Factors influencing care delivery to meet patients' needs
The age, gender, marital status, occupation, level of education, first language of patient had no relationship with their overall rating of the quality of health care rendered them.
The results show that fifteen out of the twenty six dimensions of care were statistically proven to be significant predicting factors to the overall hospital rating of quality care. The strengths of this association varied with the strongest ranging from choosing to recommend the hospital to family and friends to nurse's courtesy/respect, doctor's courtesy/ respect and overall rating of their health. When patients experience staff as cheerful, kind, caring and courteous as well as highly skilled and prompt in service, then they are more likely to return to the same hospital should the need arise [11].
Moderate associations were recorded for nurses explained in a way that could be understood, pain controlled, staff doing everything to control pain, ensuring personal privacy, nurses listening carefully, having a quiet night, room kept clean, distinguishing doctors and nurses, doctors listened carefully, doctors explained in a way that could be understood and paying hospital bills.
The presence of this association implies that the overall rating of the hospital was reflective of the quality of health care receive by these patients. It also means the tool was suitable for measuring patients' experiences with the quality of care they received in this setting corresponding with [14]. These findings falls in line with [7], who realized highest hospital ratings strongly correlated with the willingness to recommend the hospital to others and with [10], who established that the most powerful predictive factors of overall rating of hospital care services was provider's behavior towards the patient (particularly politeness and respect), respect of privacy, quiet environment at night.
Even though there was absence of a correlation between Pain control and the Rating of the patients' health, Pain control significantly determined their Overall rating of the hospital probably due to the fact that those who experienced pain and had it well controlled expressed that staff did everything they could to control it. It could also be because those patients who have experienced chronic pain and have been accustomed to it did not reflect it on the overall rating of their health and the overall rating of the hospital quality of care.
This study agrees with [12], on better pain relief when patients had good communication with their doctors (r=0.84). This is shown in the aspects of 'Doctor's showing courtesy/ respect' and the 'Staff communicating the reasons for new medications' as significant predictors of pain control. It is therefore probable that patients who experienced pain but said that the staff did not do everything to control it reported a significant poor pain control related to the fact that overall inadequate pain control leads to poor patient outcomes and higher health care cost. On the other hand, a remarkable proportion of these patients who reported the staff not doing everything to control it expressed satisfaction with the care received possibly because they have had chronic pain and have been accustomed to their pain.
With regards to those who experienced pain and expressed that the staff did not do everything they could to help with it points out that when some patients are faced with pain, the staff do not ensure that they practice all they could to relief it. This could be linked to the absence of pain control protocols, possible lack of empathy or poor communication which are all aspects of pain management.
In summary the dimensions of care discussed above which had statistically significant associations with the overall hospital rating of quality of care received were identified as factors which positively influenced these patients' experiences of care in the hospital. On the other hand, the dimensions of care listed in Table 2 which did not have any significant relationship with the patients overall hospital rating of quality care could have been viewed as important but did not directly influence their judgment on the quality of care rendered to them.
|Variable 1
|Variable 2
|Degrees of freedom (df)
|Chi Square (χ2) value
|Cramer's V
|Experience pain
|Overall hospital rating
|Stay expensive
|First time
|Ease around
|Available drugs
|Side effects
|Reason for medication
|New medication
|Leave hospital symptom explained
|Time with doctor
Table 2 Summary of Chi square test results for dimensions of care with no association with overall hospital rating.
A majority of patients expressed their experiences with the quality of care rendered to them, met their needs and expectations to a greater positive extent. Nevertheless, the expectation of being informed on the reason for prescribing new drugs and the explanation of side effects of drugs were unmet for a majority of them. A majority of patients revealed that they derived moderate and high degree of satisfaction with the quality of care rendered to them.
The overall rating of the hospital's quality of care from these patients experience was strongly predicted by the their choice to recommend the hospital to family and friends, nurses' courtesy and respect, doctors' courtesy and respect, and the overall rating of their health. Moderate predicting factors were nurses' explaining things in a way that could be understood; staff doing everything to control pain, maintenance of personal privacy, nurses listening carefully; having a quiet night, having their pain controlled, rooms kept clean, distinguishing doctors and nurses, doctor listening carefully, doctors explained, and could pay their hospital bills. Therefore from the above results, the patients' experience of the quality of care rendered to them in the Regional Hospital Bamenda is satisfactory implying that there is need for maintenance and improvement in the provision of quality care to achieve better outcomes.
tempobet giriş


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While (couples facing IN) can have from 3 to 30 couples, 4-couple Rueda has an extensive vocabulary of calls.
3-couple circle with Rueda di•ná•mi•ca and TOCADOF calling paradigms:
5-couple circle with traditional Rueda de Casino:
Many calls are common to all groups but others are group-specific. A example from Havana, CUBA:
Mike Eskeldon's RUMBANANA Salsa Group has an on-line video collection of their 4c and 5c Rueda calls: A example:
To view their 29 videos, click: Rumbanana library.
common 3c and 4c Rueda calls: ruedastandard
Workshops on Social Rueda Structures and Casino = Rueda Festival Boston
SalsaNor Rueda Congress … ruedafestival Stockholm …. ruedafestival Stuttgart


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atm its gets extremely difficult to manage Large villages of to even set up a city area, here a few suggestions.
- More storage controls allow us to set which item and a limit on specific items going into warehouses/barns, For example you can set one barnto hold 300 firewood and 500 food and nothing else or you can set it to only hold 200 tools max and any amount of other items and so on when they fill up the villages will find the next available storage area that meets there requirments if they dont find one it just acts as the warehouse is full.
- Caravans there 2 problems 1st problem is thats there no way to make them leave any items behind the only option is take everything or nothing at all and pause trade routes every couple days to balance things manually which is just so bad when you have like 30-40 routes on a map....... Allow us to set if there more than X amount of an item he takes the extra or have trade route work 2 ways where he tries to balance the resources between the 2 storage area's, second problem is there not enough routes on a building when your building 6+ Caravan building to maintain resources its just gets ludicrous..... add more trade route for each donkey on that building i would do 4 per donkey so 20 per building total. I would change the whole building to the merchant tries to balance the resources between routes and 4 trade routes per donkey allocated to that building.
Baked goods - These take a wee bit on the long side to craft especially when your eggs keep getting taken the moment they end in a warehouse as food source instead of baking ingredients you need like 5-10 chickens farms just to get a bakery consistantly stocked with eggs which isnt good tbh not to mention one pie takes sooo long to cook i feel it should be halfed by its current amount especially bread since it has pretty much same value as potatoes. (pretty muuch impossible to stockpile any kinda of baked goods atm and then you get a ludicrious amounts of basic food filling 20+ barns only to have it all go in the winter :P )
Cosmetics terrain changes - Can we get some way to add different ground textures that can be placed below buildings kinda like how pavers work atm however you can place it after the building is built and wont interrupt the building at all. For example i use to use to make squares of dirt road under every farm plot i made so it didnt have grass and it looked better however it resets to default ground after loading the game being able to paint area under building would be nice for example dirt for farms/orchards and stone around the building for foundations/paths all the way to the doorways.
Pavers rails should be removable by building ontop of them its nice having paved area's but when you cant remove unwanted railing for building its just frustrating, for example i spent about an hours trying to add a fishing hut off paved area by transforming terrain up to remove the railing and then trying to remove as much of that dirt as i could to not get the railings back so i could place a fishing dock going off the edge of a paved pier its realy should be simplier, simply having building get priority over the railings (Removes them to make room for them) which make a huge difference
The first 3 things and major issues for me, im kinda getting sick of restarting worlds around the year 50 mark simply because by that time i wanna have a city major population hub which you just cant manage with the logistics required to maintain resource routes. I liked having a central hub with specialized villages branching off it but maintaining the resource flows gets unbearable and if you slip up for a second and not pause a trade route one side will starve of freeze to death -.-
Edit: yes im aware there probably mods to help with this but i rather not use mods since they disable achievements and tbh i shouldn't have to use them to make the game bearable they should be there to add to the game not make it playable.


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Mon, 27 February 2006
Chances are if you're using Adobe GoLive CS2, you're probably also using Photoshop and maybe Illustrator too. The great thing about GoLive is that it works hand in hand with .PSD and .AI files. In this episode I'll show you how to incorporate them into each other using Smart Objects.
Direct download: GLSmartObjects.m4v
Category:GoLive -- posted at: 12:00am EDT


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Hdud, IM, El-Shafei, AA, Loughna, P, Barrett-Jolley, R and Mobasheri, A (2012) Expression of Transient Receptor Potential Vanilloid (TRPV) channels in different passages of articular chondrocytes. INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 13 (4). pp. 4433-4445.
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We aim to continuously reduce the environmental impacts of our paper products throughout their whole lifecycle. Our papers are made of renewable material, recyclable and biodegradable and produced using bioenergy where possible.
Life-cycle sustainability is all about well-managed paper production. This is why we invest in maintenance and process improvements to continually optimise the environmental performance of our paper mills.


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BEST MARIJUANA DISPENSARY IN Princeton Junction 8544 Mercer County
h2>Looking for the Best Marijuana dispensary in Princeton Junction, then you've come to the right place.
CannabisSativaPhd.com aims to bring the ultimate local directory of cannabis dispensaries in the world. You have reached the local dispensary page for Princeton Junction 8544 New Jersey. Once NJ legalizes marijuana for recreational use, it will mean the options to get your cannabis will be greatly increased, and we want to make it easier for you to find and locate the best local dispensary.
Here are some of the factors to consider when picking a local cannabis dispensary in Princeton Junction.
- Quality of the Marijuana at the specific dispensary.
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If You are looking for Marijuana Dispensary in a city near Princeton Junction– See our city dispensary list below.
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Marijuana Dispensary Princeton Junction
Marijuana Dispensaries in Princeton Junction


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"Sanctification is the invariable result of that vital union with Christ which true faith gives to a Christian. 'He who abides in Me, and I in him, the same brings forth much fruit' (John 15:5). The branch which bears no fruit is no living branch of the vine. The union with Christ which produces no effect on heart and life is a mere formal union, which is worthless before God. The faith which has not a sanctifying influence on the character is no better than the faith of devils. It is a 'dead faith, because it is alone.' It is not the gift of God. It is not the faith of God's elect. In short, where there is no sanctification of life, there is no real faith in Christ. True faith works by love. It constrains a man to live unto the Lord from a deep sense of gratitude for redemption. It makes him feel that he can never do too much for Him that died for him. Being much forgiven, he loves much. He whom the blood cleanses walks in the light. He who has real lively hope in Christ purifies himself even as He is pure (James 2:17–20; Titus 1:1; Gal. 5:6; 1 John 1:7; 1 John 3:3)."
– J.C. Ryle, Holiness, p.21


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The following summary of planned new and ongoing road improvements over the coming week is correct as of Friday 27 February and could be subject to change due to weather conditions or unforeseen circumstances. All our improvement work is carried out with the aim of causing as little disruption as possible.
M6 Junction 16 Crewe and Junction 18 Holmes Chapel
Work is taking place to repair two bridges, which carry Congleton Road and Betchton Road over the M6. Lane closures and a 50mph limit will be in place along sections of the M6 while the work is taking place. The scheme is due to be completed by May..
M6 Junction 17 Sandbach
A major project is being carried out to reduce congestion and allow for faster journey times through junction 17 of the M6, including building a new roundabout and a new link road from the A534 to the M6. Work is taking place overnight between 8pm and 5am during the week, and until 7am at weekends. Some lane closures will also be in place, along with a 40mph speed limit on the A534. The project is due to be completed in .March.
M6 Junction 23 St Helens
A scheme is taking place to tackle congestion at the M6 junction with the A580 East Lancs Road near St Helens. Some overnight closures of the junction will be required while the work is carried out, and a temporary 50mph speed limit is currently in place on the slip roads. The closures will be publicised in advance on roadside signs, and will be in place between 9pm and 5am during weekdays, and until 7am at weekends. Some lane closures will also be needed at all times of day, and the project is due to be completed by April
M6 Junction 26 Orrell
A major project is taking place at Orrell Interchange, which will see extra lanes and traffic lights added to the junction with the M58 and the A577. The majority of the work is taking place overnight or at weekends. The scheme is due to be completed by the end of March.
M6 Junction 32 Broughton Interchange
A project is being carried out to reduce congestion around the motorway junction which connects the M6 to the Blackpool-bound M55. There will be narrow lanes, plus some overnight slip road and carriageway closures until the project is completed by March.
M6 Junction 35 Carnforth
A scheme is taking place to install four electronic message signs and CCTV cameras near junction 35 of the M6. Lane one of the motorway will be closed during the work, and lane two will also be closed overnight towards the end of the project. The new signs and cameras are due to be switched on by the end of March.
M53 Junction 2 Moreton
A project is taking place to upgrade the section of the M53 at junction 2, removing weight restrictions and reinstating lanes. The southbound exit and entry slip roads will close to all traffic during the scheme. The northbound slip roads will also need to be closed overnight at times and there will be at least two full weekend closures of the main motorway carriageway to allow the bridges to be removed and replaced safely. A 50mph speed limit and narrow lanes will be in place.
M56 Junction 6 Hale to Junction 5 Manchester Airport
A section of the M56 will be closed for an entire weekend from 10pm on Friday 27 February until 5am on Monday 2 March while work takes place to install a £5.5 million new bridge at Thorley Lane. The motorway will be closed between junction 6 at Hale and junction 5 at Manchester Airport. A diversion will be in place for people travelling to Manchester Airport, and other drivers are being advised to avoid the M56 and find alternative routes.
M56 Junction 7 Altrincham
A project is underway to add an extra lane to the eastbound side of the M56 at junction 7 to ease the flow of traffic onto the motorway. Narrow lanes and a 50mph speed limit are in place while the work is being carried out. Some overnight closures of lanes and the eastbound carriageway will also be required during the scheme. It is due to be completed in
M56 Junction 11 Daresbury
A major project is taking place to tackle congestion at junction 11 of the M56 near Daresbury. Clearly signed diversions will be in place when roads are closed. The project is due to be completed by the end of March.
M60 Junction 8 Sale to M62 Junction 20 Rochdale
A major scheme is taking place to cut congestion and improve journey times on parts of the M60 and the M62 in Greater Manchester. The scheme will require some overnight closures affecting the full carriageway and slip roads, with a 50mph limit in place for the safety of workers and drivers. The project is due to be completed in Autumn 2017.
M65 Junction 4 Blackburn to Junction 10 Burnley
A project is taking place to replace lane markings and reflective road studs along sections of the M65. The lighting at the junction 8 slip roads and roundabout is also being repaired, and the project is due to be completed by the end of March.
M65 Junction 5 Shadsworth
A project is taking place to tackle congestion at junction 5 of the M65 by installing of traffic lights at the roundabout and improving the layout of the junction. The majority of the work will take place between 9.30am and 3.30pm during weekdays, and between 10pm and 5am at weekends. Some lane closures and the eventual full closure of the roundabout, including the approach roads, will be required and publicised in advance. The project is due to be completed in March.
A55/A483 Roundabout, Chester
Drivers travelling between Chester and Wrexham are being urged to avoid the roundabout that links the A55 to the A483 while work takes place to upgrade the junction. There are currently lane closures on the roundabout, which are causing significant delays. Drivers travelling to and from the southern part of Chester are being encouraged to use the A534 and the A41 while the lane closures are in place. Drivers heading to and from the northern part of the city can use the A550, A55, A494 and M56 as an alternative route.
A66 near Center Parcs
Temporary traffic lights will be place on the A66 near Center Parcs while drainage work takes place.
A66 Stainburn bypass between Stainburn Roundabout and Chapel Brow Roundabout
The road will be closed overnight between 8pm and 6am for resurfacing work, with a diversion in place. Some lane closures will also be in place during the day.
A550 Ellesmere Port
The A550 will be closed overnight for survey work between Hooton and the junction with the A494 from Monday 2 March to Saturday 7 March. The route will be closed between 10pm and 5am, and a diversion will be in place.
A556 Bowdon to Knutsford
A £192 million project is being carried out to create a new dual carriageway linking the M56 to the M6 in Cheshire. A mile-long section of the existing A556 will be upgraded from junction 7 of the M56 near Bowdon before breaking away to the west, bypassing the village centres of Bucklow Hill, Mere and Over Tabley. It will then join up with junction 19 of the M6 near Knutsford. A temporary 40mph speed limit is currently in place between Bucklow Hill and Bowdon, and the new dual carriageway is expected to open in Winter 2016/17.
A585 Windy Harbour
A major scheme is taking place to improve the A585 crossroads at Garstang New Road, Fleetwood Road and Windy Harbour near Blackpool. The scheme will involve the realignment and widening of the existing crossroads to create extra lanes through the junction. There will be a compulsory 30mph speed limit along a mile of the A585 and a short section of the A586, with temporary traffic lights in place. Work is expected to be completed in March.
A590 between M6 Junction 36 South Lakes and Brettargh Holt roundabout
A 24-hour lane closure is in place on the westbound side of the A590 while work takes place to install a new electronic message sign. The road will also need to be closed on some nights, with a diversion in place. The scheme is due to be completed by the end of March.
A595 Whitehaven
Work is taking place to install traffic lights at the A595 junction with Mirehouse Road in Whitehaven. Temporary traffic lights will be in use between 9.30am and 3.30pm while the work is carried out, and the project is due to be completed by the end of March.
A5036 Seaforth
A new road is being built through the centre of a roundabout near Liverpool Docks to ease congestion in the area. The two lane westbound road will mean traffic heading towards the docks on the A5036 will no longer need to go around the Bridge Road roundabout. Traffic lights are also being installed, and the road is being resurfaced. Lane closures are currently in place leading up to and on the roundabout between 8am and 5pm. The project is due to be completed in March.
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m.cnn.com – (CNN)What happened to a contestant in a hot-pepper-eating contest may give spicy food aficionados one more reason to "fear the reaper," according to a recent case report.
The 34-year-old man, who was not identified, experienced a series of intense headaches and dry heaving after eating a Carolina Reaper, reportedly the hottest pepper in the world, during the contest in New York.
The man developed excruciating pain in his head and neck, prompting him to go to an emergency room, according to an article published Monday in the journal BMJ Case Reports. "The patient ate the pepper and immediately starting having a severe headache that started in the back of the head and spread all over within two seconds," said Dr. Kulothungan Gunasekaran, an internal medicine physician at Henry Ford Hospital in Detroit and a lead author of the report, who was not involved in the patient's care.
"Because he could not tolerate the headache, they sent him to the ER," he added.
When the patient arrived at the hospital, physicians were not positive what had caused his symptoms. The man did not have any neurological deficits such as slurred speech, muscle weakness or vision loss that would have indicated a stroke. CT imaging also ruled out a blood clot or bleeding in one of the large blood vessels supplying the brain.
But a CT angiogram of the brain's blood vessels did reveal something unusual: a substantial narrowing of the left internal carotid artery and four other blood vessels supplying the brain.
"Then CT angiography was done, which showed narrowing of the blood vessels in the brain," Gunasekaran said. "You could see the beaded appearance [of the arteries], and the yellow arrows point to the narrowing of the blood vessels."
Gunasekaran and Dr. Gregory Cummings, the neurologist on the case, eventually diagnosed the man with reversible cerebral vasoconstriction syndrome, or RCVS, probably caused by the hot peppers.
RCVS is typically characterized by an intense "thunderclap" headache due to constriction of blood vessels in the brain and usually resolves within a few days or weeks, according to Dr. Anne Ducros, professor of neurology and head of the migraine and headache unit at the University of Montpellier, who was not involved in the report.
It is normally associated with certain medications, such as ergotamine or triptans, and illicit drugs, such as cocaine and amphetamines — not peppers. Severe cases can even be life-threatening, according to Ducros.
"A proportion of patients will have a severe form with strokes, and they can get either an intracranial hemorrhage of an ischemic stroke," Ducros said. "But the mortality is low, around 2% … and most patients who die from RCVS are young women and often in the postpartum state.
"But most of them will do well with only recurrent headaches, and then they have a total recovery," she added.
Hot peppers have a high concentration of capsaicin, a chemical responsible for the spiciness of certain foods. The substance is known to cause constriction of blood vessels in some parts of the body and is even used at low concentrations in some topical medications.
An unnamed ghost pepper hit a Carolina gentleman with a super move. I think he hit down, half circle forward, square, circle. He definitely wouldn't have survived that Hellfire Challenge 😂. If something spicy ever sends me to the ER y'all can revoke my JG card.


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AniCura Joins the Mars Petcare Family
11 Jun, 2018, 09:21 BST
WASHINGTON, June 11, 2018 /PRNewswire/ -- AniCura, a leading European provider of high-quality veterinary care for companion animals, is pleased to welcome Mars Petcare as its new owner. As part of the Mars Petcare family, AniCura gains improved opportunities to continue developing advanced veterinary care and medical quality, whilst also benefiting from a long-term perspective, in-depth industrial knowledge and a global veterinary community.
AniCura was established in 2011 by Fidelio Capital and The Animal Hospital Foundation in Greater Stockholm as the first merger of companion animal hospitals in the Nordic region. Over the past seven years, the company has grown to employ more than 4 000 veterinary professionals at 200 animal hospitals and clinics across seven European countries. Today, AniCura is a role model and leading provider of advanced veterinary care, well-known for its investments in quality and people.
̶ We have been on an amazing journey for the past seven years with strong support from our owners to build a European quality leader. To strengthen our capabilities and continue our rapid development, we look forward to join a family-owned business with deep industrial knowledge and a long-term dedication for pet health. We couldn't be more excited about partnering with Mars to ensure we provide the best possible veterinary care now and in the future, says Peter Dahlberg, CEO AniCura.
Mars Petcare is a family-owned company with 75 000 employees in more than 50 countries. Pet care has been an important part of Mars for over 80 years and today Mars has a growing veterinary business with approximately 50 000 veterinary professionals globally. The acquisition of AniCura represents Mars Petcare's strategic entry into the European veterinary care sector. It brings together Mars Petcare's global veterinary expertise with AniCura's well-established European business.
̶ Mars Petcare has a long and global history of providing nutrition, veterinary care and science for pets across the globe. AniCura enjoys an exceptional reputation in the veterinary market with its quality programme, strong corporate culture and high share of referrals. Together with the team at AniCura, we look forward to benefitting from each other's best practices and competencies, improving clinical practice and continuing to advance the veterinary profession in both Europe and North America. This will support us in our purpose to create a better world for pets, says Poul Weihrauch, President, Mars Petcare.
AniCura's existing management team, led by CEO Peter Dahlberg, will continue to lead and develop the business with a maintained focus on quality, innovation and entrepreneurship, nurturing a strong, unique culture and taking clinical decisions close to the patient and customer.
Opportunities for knowledge and best practice sharing builds on the collective experiences of veterinary care companies such as BluePearl, VCA, Banfield and Pet Partners in North America and Linnaeus in the UK, all part of the Mars Petcare family.
AniCura will continue to operate as a stand-alone business and brand. The acquisition is subject to regulatory approvals.
For further information, please contact
Maria Tullberg
Group Communications Manager
This information was brought to you by Cision http://news.cision.com
The following files are available for download:
SOURCE AniCura


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The 10 Best Trading Computers and Laptops - stockstotrade.com
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dr. Igor MaljkovićPlastic surgery, Belgrade
More reviews
The first time I met with Dr. Igor Maljkovic I just knew he was going to be my doctor. He was really professional and friendly which made me feel quite relaxed about the whole procedure. He made me opt for bigger implants than I had intended to chose, and I will be greateful to him for the rest of my life for making me change my mind and make the right decision.
On the day of the operation I came to the hospital around the noon, doctors did all the necesery analysis and around 16h I was ready to get on the table. The whole operation lasted a bit more than an hour. The waking part and the next 5 days were the most dificult, but with the right dosis of medicines I had no bigger problems nor pain. On the 5th day I already managed to stand up from my bed all by myself. Its been two years since I did it and the scars are hardly noticing. I am more than satisfied with my new breasts as they look really natural, and they go perfectly with my body constitution.
I would recommend Dr. Maljkovic to everybody!
The first time I met with Dr. Igor Maljkovic I just knew he was going to be my doctor. He was really professional and friendly which made me feel quite relaxed about the whole procedure. He made me opt for bigger implant... More
First time with plastic surgery. Dr. Maljković accompanied me through the whole journey, from first consultation to recovery and follow-ups. He is always available to dispel any doubts and answer any questions at any tim... More
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Experienced Sales graduate required to work in a rapidly expanding e-commerce company. You will be involved in all aspects of sales within this busy consultancy firm and assist the Sales team and Directors in various aspects of promoting and selling the business. Fantastic opportunity to bring your outgoing personality to this dynamic role and grow as a true sales professional.
Tasks and Responsibilities:
· Supporting the software and services business
· Conducting strategic market research to identify sales opportunities
· Approaching new and existing client base utilising a variety of platforms
· Extensive telephone liaison
· Forward thinking with a "can-do" "achieve" attitude.
· Building lasting relationships with clients
Essential requirements:
· Excellent level of spoken and written English.
· Excellent communication skills both written and verbal
· Good listening and questioning techniques
· Good memory and task management skills
· Extremely self motivated and target driven
· Sales and marketing experience B2B and B2C
· Presentable and professional in both appearance and work ethics
· Attend trade shows and events and comfortable in networking
· Previous telephone sales experience within customer service or business environment
Desirable attributes:
· Clean driving licence and access to own transport
· Permanent Position
Company activity:
Our client is a highly respected and recognised consultancy firm offering effective collaboration and internal communication solutions.
· Surrey
Remuneration details:
· The salary range for this position is NMW - £20k dependent on experience. Bonus option also
If you are an undergraduate, check out our undergraduate opportunities here: http://bit.ly/PlacementUK-opportunities
NB: This remuneration package is not negotiable under ANY circumstances. Any attempt by the applicant to re-negotiate the remuneration will result in immediate and permanent withdrawal of our services.


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Melissa & Doug - Reusable Sticker Pad - Face It!
- Brand: Melissa & Doug
- Product Code: 9103
- Reviews:
In this lighthearted sticker activity pad, kids put the finishing touches on five crowds of characters. Each sticker features a different funny face, and every scene features lots of bodies to put them on. Use the stickers to fill a scene with unique characters - then change them around to mix up the crowd! The funny faces and busy scenes combine for countless possibilities and hilarious results. Contains 150 reusable stickers to fill five reusable play scenes.
Ages: 3+(MND9103)
Be The First To Review This Product!
Help other Ed Resources Pty Ltd users shop smarter by writing reviews for products you have purchased.


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Andres Hernandez | United States | Fiction | 2018 | 16 min
Monday from Andres Hernandez on Vimeo.
Diego takes off to the woods with Anna to escape the pressures of life. Raquel, his steady partner, feels she is doing all the work in their relationship and nags him to find work. Caught between the responsibilities of adulthood and the freedom of youth, Diego is not yet ready to give up on his dreams and take some mediocre job.Español
Huyendo de la desazón Diego escapa con Anna al bosque. Raquel su pareja estable siente que ella ésta cargando todo el peso de la relación y presiona a Diego a buscar trabajo. Pero Diego debatiéndose entre la adultez y la ligereza de la vida, no quiere renunciar a sus sueños y aceptar un empleo mediocre.
Andres Hernandez studied Filmmaking at the National University of Colombia, where he began working as Director always with a cinematic flavor. In Colombia his work was recognized in International Film Festivals like San Sebastian Film Festival in 2007, Clermont Ferrand International short film Festival 2011, and Short film Corner Cannes Film Festival 2011. After earning his degree, he worked as a Camera Assistant before moving to LA where he completed a MFA in Cinematography at NYFA.
Last year, he began his work in Colombia as a Cinematographer with the web series Natural Selection, which won awards at Roma Web Fest and Dublin Web Fest. He also worked as Cinematographer in a long Documentary Available on NETFLIX.


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Button Corner Paperwrap Book Keepsake Box with Drawers
Collectable keepsake box from the delightful Button Corner range.
An ideal gift for a newborn or Christening present.
Store and keep all things precious in this fine and cute keepsake box. Book design so can be displayed standing upright or flat.
Supplied in a decorative presentation box.
Overall size approx: 23cm (9") tall x 23cm (9") wide x 9cm (3½") deep.
Button Corner: "As cute as a button!" A superior baby gift range designed exclusively in the UK. A neutral colour scheme using gentle creams and oatmeal, has been chosen to reflect the current trend in nursery colours. The star of the range is the cutest teddy which appears on each product as well as the packaging. Each piece is packaged in a beautiful gift box together with a coordinating gift tag that provides a treasured and welcomed keepsake.
- Free standard delivery is 3-5 working days from despatch.
- Express delivery options available at checkout.
- Vast majority of items posted within 1 working day*.
- Professionally packaged for safe delivery.
- Delivery tracking numbers provided.
Once your order is despatched we will email you to confirm and the email will provide your delivery tracking details.
* working days are Monday to Friday.
Delivery Address:
We will post to whatever UK address you provide us with. You can choose your desired address either on the checkout/payment page or the paypal payment page.
Returns Information:
We have a 30 days no quibble returns policy. Please simply return your item(s) back to us within 30 days for a full refund or exchange. For instructions please see our returns policy or contact us.
- Long established retailer serving customers since 1974.
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Once your order is despatched we will email you to confirm and the email will provide your delivery tracking details.
* working days are Monday to Friday.