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Size at birth is influenced by environmental factors, like maternal nutrition and parity, and by genes. Birth weight is a composite measure, encompassing bone, fat and lean mass. These may have different determinants. The main purpose of this paper was to use anthropometry and principal components analysis (PCA) to describe maternal and newborn body composition, and associations between them, in an Indian population. We also compared maternal and paternal measurements (body mass index (BMI) and height) as predictors of newborn body composition.
Weight, height, head and mid-arm circumferences, skinfold thicknesses and external pelvic diameters were measured at 30 ± 2 weeks gestation in 571 pregnant women attending the antenatal clinic of the Holdsworth Memorial Hospital, Mysore, India. Paternal height and weight were also measured. At birth, detailed neonatal anthropometry was performed. Unrotated and varimax rotated PCA was applied to the maternal and neonatal measurements.
Rotated PCA reduced maternal measurements to 4 independent components (fat, pelvis, height and muscle) and neonatal measurements to 3 components (trunk+head, fat, and leg length). An SD increase in maternal fat was associated with a 0.16 SD increase (β) in neonatal fat (p < 0.001, adjusted for gestation, maternal parity, newborn sex and socio-economic status). Maternal pelvis, height and (for male babies) muscle predicted neonatal trunk+head (β = 0. 09 SD; p = 0.017, β = 0.12 SD; p = 0.006 and β = 0.27 SD; p < 0.001). In the mother-baby and father-baby comparison, maternal BMI predicted neonatal fat (β = 0.20 SD; p < 0.001) and neonatal trunk+head (β = 0.15 SD; p = 0.001). Both maternal (β = 0.12 SD; p = 0.002) and paternal height (β = 0.09 SD; p = 0.030) predicted neonatal trunk+head but the associations became weak and statistically non-significant in multivariate analysis. Only paternal height predicted neonatal leg length (β = 0.15 SD; p = 0.003).
Principal components analysis is a useful method to describe neonatal body composition and its determinants. Newborn adiposity is related to maternal nutritional status and parity, while newborn length is genetically determined. Further research is needed to understand mechanisms linking maternal pelvic size to fetal growth and the determinants and implications of the components (trunk v leg length) of fetal skeletal growth.
A large body of recent research has linked birth weight and simple body proportions at birth like ponderal index (weight/length3) to a range of diseases of adult life [1,2]. For example lower birthweight and ponderal index are associated with an increased risk of adult cardiovascular disease [3], and both low and high birthweight with an increased risk of type 2 diabetes mellitus and the metabolic syndrome [4-8]. These studies have led to intense interest in fetal growth and its determinants. Factors known to influence fetal growth include the 'maternal environment' (for example the mother's nutritional status and parity) and maternal and paternal genes [9,10].
Birthweight is a crude composite measure encompassing bone, fat, muscle and visceral mass. The proportions of these components may differ between populations [11], and have different determinants and associations with long-term outcomes. Relatively little is known in this area. Several studies have examined associations between the anthropometry of mothers (and sometimes fathers) and their babies [12-14], but such data can be difficult to interpret, due to strong correlations between the different indices of body composition. Others have overcome this by using principal components analysis [PCA], a statistical technique that transforms multiple observed variables into a smaller number of uncorrelated components that are interpretable [15-18]. In white Caucasian populations, PCA has fairly consistently identified fat (skinfold measurements) and skeletal size (length) as the main fetal components, with maternal body fat (skinfolds, BMI) and the skeletal size (height) of both parents respectively as their strongest predictors [15-17]. These findings have been corroborated by studies using more sophisticated measures of parental and newborn body composition, such as dual X-ray absorptiometry (DXA) [19-21].
An earlier study used PCA to describe neonatal anthropometry in relation to CVD risk factors in childhood an Indian population [18], but did not examine determinants of the neonatal components. Detailed anthropometry collected from mothers during pregnancy and their newborns in the Mysore Parthenon Study [22-24], enabled us to examine the body composition of mothers and babies in an Indian population. We included all body measurements recorded; for the mothers these included external pelvic diameters, which were of interest following an earlier Mysore study which showed that the risk of type 2 diabetes was increased in adult offspring of mothers with larger pelvic diameters [25], and for the babies the measurements included leg length in addition to crown-heel length, in view of recent interest in this measurement as a marker in adult life of poor growth in early development [26-29]. The main aim of this paper was to use anthropometry and principal components analysis (PCA) to describe maternal and newborn body composition, and associations between them. Our secondary aim was to compare associations of maternal and paternal height and BMI with neonatal body composition.
Study Sample
Between June 1997 and August 1998, 1539 women booking consecutively into the antenatal clinic at the Holdsworth Memorial Hospital (HMH), Mysore were screened [22]. They were eligible for the study if they were not known to be diabetic before pregnancy, planned to deliver at HMH, and had a singleton pregnancy of < 32 weeks gestation, determined by their last menstrual period (LMP) or a first trimester ultrasound scan. Of the women screened, 1233 women were eligible and 830 (67%) agreed to participate. The study was approved by the HMH research ethics committee and informed verbal consent was obtained from the women.
Maternal measurements during pregnancy
At 30 ± 2 weeks gestation, detailed maternal anthropometric measurements including height, weight, head and mid-upper arm circumference (MUAC), skin fold thicknesses (triceps, biceps, subscapular and suprailiac) and external pelvic diameters (interspinous, intercristal and external conjugate) were measured by one of two trained observers using standardised methods. A Harpenden anthropometer (CMS instruments, London, UK) was used to measure external pelvic diameters. Measurements were taken in triplicate to the nearest 0.1 cm and average was used. The subject was asked to stand up straight with feet slightly apart and with the lower abdomen completely exposed to identify and mark the bony landmarks. Intercristal diameter was measured taking the widest transverse measurement, with the subject standing face on, by placing the tips of the callipers on the outer margins of the iliac crests. Interspinous diameter was measured, with the subject standing face on, by placing the tips of the callipers on the outer edges of the anterior superior iliac spines. External conjugate diameter was measured, with the subject standing side on, by placing one calliper tip on the anterior, upper margin of the pubic symphysis and the other on the spine of the last lumbar vertebra. Inter observer variation studies done at the time of data collection showed the amount of variation attributable to observers was only 0.004%, 0.8% and 1.2% for interspinous, intercristal and external conjugate measurements respectively. Maternal arm muscle area (AMA (cm2)) was calculated using the formula [(MUAC-π*triceps skinfold)2/4 π] [30]. We measured their husband's height and weight on the same day, or at the time of delivery, or at home. Maternal fasting plasma glucose concentration was measured as described previously [22]. Socio-economic status (SES) was assessed using Kuppuswamy score, a standard questionnaire method based on education, occupation and income of the main breadwinner [31]. We asked mothers about tobacco smoking, but none of the women were smokers.
Deliveries and measurements of babies at birth
Six hundred and seventy four women went on to deliver their babies at HMH (81% of the participants), at a gestational age ranging from 29 to 44 weeks. Detailed newborn anthropometry was performed according to a standard protocol, within 72 hours of birth, by one of four trained observers. Weight was measured using a digital weighing scale (Seca, Germany) and crown-heel (CHL) and crown-rump (CRL) lengths using a Harpenden neonatal stadiometer (CMS instruments, London). Head, chest (xiphisternum), abdominal (umbilicus) and MUAC were measured with a blank tape, marked and measured against a fixed ruler. Skinfold thicknesses (triceps and sub-scapular) were measured using Harpenden skin-fold callipers (CMS instruments, London). Of 674 babies, 324 (48.1%) were male and 350 (51.9%) female. Seven still born babies, 4 with major congenital anomalies, 51 preterm babies (< 37 weeks gestation) and 41 babies born to mothers with gestational diabetes (GDM) were excluded from this analysis, leaving 571 mother-offspring pairs (Figure 1).
Figure 1. Flow diagram depicting the study participants included for analysis.
Statistical Methods
Variables not satisfying normality assumptions were either log transformed (maternal weight, body mass index (BMI), maternal and neonatal skin-fold thicknesses) or square root transformed (supra-iliac skin-fold). Birth measurements (unadjusted for gestation) were used in PCA to describe neonatal body composition. Two PCAs were performed to describe the relationships between the neonatal variables and between the maternal variables. PCA is a dimension-reduction technique [32]. The aim was to reduce the anthropometric variables into smaller sets of independent factors that retained the information that distinguished individual differences between babies or mothers. The extracted components are a weighted linear composite of the original variables. The first component explains the most variance and each subsequent component attempts to capture the maximum of the remaining variance. Each component is orthogonal or independent of earlier components. The factor loadings reflect the contribution and direction of correlation between each variable and component. These are used for interpretation, and as such the retained factors should be biologically meaningful. Similar to a previous study [17], we examined the use of a factor rotation (varimax) to more clearly distinguish those variables that correlate highly with each component and aid interpretation. Standardised factor scores with a mean of 0 and standard deviation of 1 were ultimately produced using the rotated PCA. The correlation matrix was used to perform the PCA. Since similar factors were identified in both boys and girls, the sexes were pooled.
Factors were retained based on the % of variation explained (we investigated the plausibility of factors explaining < 10%), an inspection of the scree plots and also whether they were physiologically interpretable. The standardised neonatal and maternal factor scores were then used as variables to assess the mother-baby relationships. Associations between maternal components and each neonatal component were estimated using simple regression. The first set of models contained all maternal components together (they are independent so there is no confounding) and were also adjusted for gender. Effects in boys and girls were stratified where there was a statistically significant interaction (p < 0.05). Additional models were then produced with further adjustment for parity, SES and gestational age. In the regression analysis we have examined the associations between maternal components and neonatal leg length (standardised) instead of leg component as the correlation between neonatal leg factor and leg length and crown to heel is so strong that there ceases to be any extra additional information from using this factor as opposed to just leg alone, regardless of the correlation with crown to heel. And actual leg length is remarkably uncorrelated with factors 1 and 2 either.
Since we had limited anthropometric data on the father, comparisons between father-baby and mother-baby associations were restricted to parental height and BMI. Similar to the above, 2 sets of models were produced, the first adjusted only for gender (interactions were also tested), and in the second maternal and paternal variables included together in the model and further adjusted for parity, SES and gestational age. Stata v10 was used for all analyses.
Excluding preterm births from the analysis, anthropometric characteristics of the babies and mothers are summarised in Table 1. Mothers had a mean age of 24 years with a mean height of 154.7 cm and a median BMI of 23 kg/m2, and 51% were primiparous. Fathers had a mean age of 31 years with a mean height of 167.2 cm and a median BMI of 23 kg/m2.
Table 1. Characteristics of the study cohort
Principal components analysis
PCA reduced the 10 birth measurements to three components (Table 2). The varimax rotation more clearly distinguished the newborn components. The first component (explaining 35% of variance) showed high correlations with birthweight, crown-heel and crown-rump length and head circumference, the second (33% of variance) showed high correlations with MUAC, triceps and subscapular skin folds and the third (15% of variance) showed a high correlation with leg length. We interpreted them as 'truncal skeleton+head', 'fat' and 'leg length' components respectively. Since actual leg length was so strongly correlated with neonatal factor 3 (r = 0.99), and also showed very little correlation with factors 1 (r = 0.01) and 2 (r = -0.00), we substituted it for the principal component in the regression analysis, to increase clinical relevance. Whether we used factor 3 or actual leg length made no difference to the overall interpretation.
Table 2. Principal components analysis: Unrotated and Varimax rotated components matrix of neonatal anthropometry.
PCA reduced the 12 maternal anthropometric measurements to four components (Table 3), and again the rotated analysis produced clearer differentiation between measurements. The first component (explaining 39% of variance) was correlated with weight, BMI, and all four skin folds. The second (23% of variance) was correlated with all three pelvic measurements. The third and fourth components (12% and 11% of variance) were correlated with height and AMA respectively. We interpreted these components as maternal 'fat', 'pelvis', 'height' and 'muscle'.
Table 3. Principal component analysis: Unrotated and Varimax rotated components matrix of maternal anthropometry.
Relationships of maternal components to neonatal components
Of the four maternal components, fat was the strongest and only significant predictor of neonatal fat (Table 4). An SD increase in maternal fat was associated with a 0.16 SD increase in neonatal fat. Maternal pelvis and height, and for boys only, maternal muscle (p for sex interaction = 0.007), positively predicted neonatal truncal skeleton+head. None of the maternal components was related to neonatal leg length.
Table 4. Regression analysis of maternal components, fasting glucose, parity, socio-economic status and gestation as predictors of neonatal components
Relationships of maternal parity, gestation, SES and glucose to neonatal components
Higher maternal parity was associated with increased neonatal fat (Table 4). Higher socio-economic status was associated with increased neonatal fat and truncal skeleton+head. Longer gestation was associated with larger neonatal truncal skeleton+head and longer leg length, but no increase in fat. There were no significant associations between maternal fasting glucose and neonatal components.
Comparison of maternal and paternal associations with neonatal components
Maternal BMI predicted neonatal fat and truncal skeleton+head, more strongly than paternal BMI, and in the multivariable analysis, only maternal BMI remained a significant independent predictor of these neonatal components (Table 5). Paternal height predicted neonatal leg length more strongly than maternal height, and in the multivariable analysis remained the only significant predictor of neonatal leg length. Both maternal and paternal height predicted neonatal truncal skeleton+head, although both associations were of borderline statistical significance in the multivariate analysis.
Table 5. Regression analysis of maternal and paternal height and BMI as predictors of neonatal components
Summary of main findings
We used principal components analysis to study body composition in a large sample of healthy urban South Indian pregnant mothers and their full term newborn babies. Rotated PCA extracted four maternal components, which we interpreted as fat, pelvic size, height and muscle, and three neonatal (baby) components, interpreted as truncal skeleton+head, fat and leg length. We found that maternal fat predicted neonatal fat. The mother's pelvic size and height, and for boys maternal muscle, predicted neonatal truncal skeleton+head. In a comparison between maternal and paternal associations with newborn size, maternal (but not paternal) BMI predicted neonatal fat and neonatal truncal skeleton+head, while paternal (but not maternal) height predicted neonatal leg length. These findings are summarised in Figure 2.
Figure 2. Relationships between parental and newborn size.
Strengths and weaknesses of the study
Strengths of the study were the detailed standardised anthropometric measurements for mothers and babies, including measurements not available in other studies (pelvic size for mothers and leg length for babies). Weaknesses were that there was no information on maternal weight gain during pregnancy, that the maternal measurements were collected during the third trimester of pregnancy (which means that maternal weight included fetal weight and that skinfolds could reflect fluid retention as well as adiposity), and that paternal measurements were limited to weight and height.
Principal components analysis (newborns)
Several other studies have used PCA to examine newborn body composition in different populations [15-18]. Each used slightly different newborn measurements, although there was considerable overlap, and all had birth weight, crown-heel length, head circumference, mid-arm circumference and triceps and subscapular skinfolds. One of these was from another Indian population [18]. They all used a similar analysis to ours, putting all newborn measurements into the analysis together, and one study used the varimax rotation [17]. The studies using unrotated analyses [15,16,18] produced similar results, identifying two main components: firstly, overall size (with high loadings on all measurements) and secondly, a contrast between skeleton and fat (strong loadings in opposite directions for length and/or head versus skinfolds). The study that used varimax rotation, of white Caucasian babies from Exeter, UK [17] showed, as in our study, that this technique produced clearer differentiation between components. It too identified fat and skeleton (length+head), as the two main components. Our study differed from the Exeter study in differentiating leg length from crown-rump (trunk) length. Unlike knee-heel length in Exeter (the nearest equivalent in the Exeter study to leg length in our study) leg length did not have a strong factor loading in our neonatal R1 and was the only measurement with a strong factor loading in our neonatal R3 (Table 2). None of the other neonatal PCA studies had a separate measure of leg length.
Principal components analysis (mothers)
The Exeter study also performed PCA on maternal measurements [17]. As in Mysore, the first two principal components loaded strongly on skeletal measurements (height and head circumference) and fat (skinfolds). In the Mysore data, we identified maternal pelvic size (all three pelvic measurements) and maternal muscle (arm muscle area) as two additional components. These data were not available in the Exeter study.
Relationships between maternal and newborn body composition
We found that the maternal fat component was a strong, and the only, predictor of neonatal fat. This is consistent with other studies, that have used skinfolds, or other specific measurements of neonatal adiposity (including TOBEC and DXA) [19,20]. Along with our finding that maternal BMI, and not paternal BMI, predicted neonatal fat, this adds to other evidence that newborn adiposity is determined principally by factors operating through the mother [9,17]. These are likely to include the availability of nutrients, and their transfer to the fetus. As shown in other studies [9,17,33,34], neonatal fat was also increased in mothers of higher parity, which may reflect more efficient materno-fetal nutrient transfer in 'experienced' mothers. Women of higher parity tend to be heavier and fatter, which could explain some of this effect, but the association between parity and newborn fat remained statistically significant even in the multivariate analysis, which included all maternal body composition components, suggesting that parity has an independent effect on newborn adiposity. It is well known that babies born to diabetic mothers have increased body fat at birth [9] due to transfer of glucose across the placenta. The Exeter study, and the large, recently published multi-centre HAPO study, showed that even in non-diabetic pregnancies, neonatal adiposity is positively related to maternal fasting glucose concentrations [17,35]. We did not find this association in our data; although we have shown previously in this cohort that fasting glucose concentrations in non-diabetic mothers predicted newborn ponderal index [22]. The association between maternal fasting glucose, and the newborn fat component, was positive in our study but non-significant. This may be because the sample size was too small; we calculate that our study had only 50% power to detect an effect of the magnitude shown in the HAPO study.
The strongest maternal predictor of the neonatal truncal skeleton+head component was maternal height. Other maternal predictors, independent of this association, were pelvic size and (in male babies) muscle. The babies' truncal skeleton+head component was also positively related to paternal height and to gestation. The correlation with both maternal and paternal height supports other evidence that genetic factors make an important contribution to fetal skeletal growth [10,21,36,37].
The association of neonatal trunk length with maternal pelvic size, independent of other maternal measurements, is a new finding. External pelvic diameters are thought to be chiefly measurements of the bony skeleton, although they also incorporate subcutaneous fat. Our data suggest that pelvic size varies independently of maternal height, and of our index of maternal fat. Several studies have shown associations between maternal pelvic measurements and adult disease in the offspring, including stroke, hypertension, diabetes and cancer [25,38-41]. A recent study showed that the mother's intercristal diameter, but not height, predicted breast cancer in the adult female offspring [40]. The authors suggested that the growth of pelvic width is influenced by circulating oestrogen concentrations during puberty, whereas overall height is more strongly influenced by growth hormone. We are not able to comment on the implications of this for fetal development other than to say that the mother's pelvic size appears to reflect something more than her overall skeletal size and adiposity. More research into female pelvic development, and its relationship to fetal growth, is needed.
Relationships of maternal muscle to neonatal size have not been widely studied. Similar to our findings, maternal arm muscle area predicted neonatal length and not neonatal fat in a Peruvian population [42]. A recent study examining geographical variation in relationships between maternal body size and neonatal phenotype reported a significant association between maternal muscle and neonatal length in an African (DR Congo) population but not in other populations (including one other Indian population) [13]. Arm muscle area is an unsatisfactory measurement of maternal muscle mass, however, and more research is required to address associations between maternal muscle and fetal growth.
The third neonatal component, leg length, was predicted by paternal height. While the determinants of leg length at birth have been little studied, short leg length in childhood has been associated with maternal smoking and with poor childhood SES [43,44]. It has been described as a more sensitive indicator of the childhood environment than overall height [43,44]. Studies have also reported stronger associations of short leg length than of short overall height with elevated adult insulin resistance and cortisol concentrations and with an increased risk of diabetes and cardiovascular disease, suggesting important biological differences between these two length measurements [26-29]. The association between leg length and paternal height suggests that newborn leg length is at least partly genetically determined.
An exact equivalent of leg length was not available in the Exeter study, but leg length was measured using the same technique as ours in the Southampton Women's Survey [45]. Leg length in Southampton babies (mean = 16.5 cm) was almost identical to Mysore babies (16.7 cm) whereas crown-rump length was longer (mean = 33.6 cm in Southampton and 32.0 cm in Mysore), (Sarah Crozier, personal communication). One possible explanation for our findings is that the greater muscularity of UK babies (including larger buttock muscularity) makes leg length (as measured by crown-heel length minus crown-rump length) appear falsely short in the UK babies. However, a fetal ultrasound study in India showed comparable femur length measurements to western studies, even though birthweight was lower [46]. In another Indian study, crown-heel length was relatively preserved (-1.01 SD compared with UK babies), even though birthweight was considerably lighter (-1.74 SD) [11]. Another interpretation of our data is therefore that leg growth is preserved in Indian babies, even in the presence of marked growth restriction. The issue of whether the small Indian baby is growth-restricted or appropriate for maternal size is a much-debated question. Birth weight has risen in the upper socio-economic strata of the Indian population, as maternal heights have increased, suggesting that the small babies of small mothers have not realised their 'potential'. Lower birth weight is associated with higher infant mortality in India, and with higher cardiovascular disease risk factors in Indian children [47]. There are also strong associations between low birthweight and childhood stunting, lower educational achievement, and lower birthweight in the next generation, independent of early-life socio-economic status [48]. Hence, we think that growth restriction is an appropriate description.
In conclusion, the neonatal anthropometric variables in Mysore showed a broadly similar underlying variance structure to that shown in other studies. Neonatal leg length was an important independent component in the babies, and pelvic diameters formed an independent component in the mothers; neither of these measurements were included in earlier PCA studies. Our findings are in keeping with previous research suggesting that newborn adiposity is influenced by the mother's nutritional status and parity, while neonatal length is genetically influenced. Our study has indicated areas for future research, including pelvic growth and the mechanisms by which maternal pelvic size are related to fetal growth, and the implications of truncal skeletal growth versus leg growth in the fetus. The neonatal components we identified will be useful in studying associations between other maternal exposures (such as micronutrient status) and fetal development, and between newborn size and later outcomes such as cognitive function and risk markers for adult disease.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
SRV conceived the idea of performing a principal components analysis, contributed to the analysis and interpretation of the data and drafted the manuscript. GVK recruited the mothers, carried out maternal and newborn measurements and assisted in writing the manuscript. AKW carried out the statistical analysis, and assisted in data interpretation and drafting of the manuscript. JCH recruited the mothers, carried out maternal and newborn measurements, coordinated the pregnancy phase of the study and also assisted in the writing of the manuscript. CHDF designed the cohort study, contributed to the data interpretation and assisted in drafting the manuscript. All authors have read and approved the final manuscript.
We are grateful to all the women who participated in the study, to Dr BDR Paul and Dr Prasad Karat (former and current Medical Director) and staff of the Department of Obstetrics, HMH. We acknowledge the contribution made to the study by Ms Annamma, Mrs Baby, Late Mrs Devaki, Mrs Lalitha, Mrs Lalithakala, Mrs Savitha, Mrs Swarnagowri and Mrs Surekha. We acknowledge the support by SNEHA-India. The study was supported by the Parthenon Trust, Wellcome Trust and Medical Research Council, UK.
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Fall CHD, Stein CE, Kumaran K, et al.: Size at birth, maternal weight, and type2 diabetes in South India.
Diabet Med 1998, 15:220-227. PubMed Abstract | Publisher Full Text
Lawlor DA, Davey Smith G, Ebrahim S: Life course influences on insulin resistance: findings from the British Women's Heart and Health Study.
Diabetes Care 2003, 26:97-103. PubMed Abstract | Publisher Full Text
Lawlor DA, Davey Smith G, Ebrahim S: Association between leg length and offspring birthweight: partial explanation for the trans-generational association between birthweight and cardiovascular disease: findings from the British Women's Heart and Health Study.
Paediatr Perinat Epidemiol 2003, 17:148-55. PubMed Abstract | Publisher Full Text
Kulkarni SR, Fall CH, Joshi NV, Lubree HG, Deshpande VU, Pasarkar RV, Bhat DS, Naik SS, Yajnik CS: Determinants of incident hyperglycemia 6 years after delivery in young rural Indian mothers: the Pune Maternal Nutrition Study (PMNS).
Diabetes care 2007, 30:2542-2547. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Phillips DI, Syddall HE, Cooper C, Hanson MA: Association of adult height and leg length with fasting plasma cortisol concentrations: Evidence for an effect of normal variation in adrenocortical activity on growth.
Am J Hum Biol 2008, 20:712-715. PubMed Abstract | Publisher Full Text
Jelliffe DB, Jelliffe EFP: Prevalence of protein-calorie malnutrition in Haitian preschool children.
Am J Public Health 1960, 50:1355-1366. Publisher Full Text
Kuppuswamy B: Manual of socio-economic status scale. Manasayan Publication, Delhi; 1962.
Joliffe IT, Morgan BJ: Principal components analysis and exploratory factor analysis: Review.
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Joshi NP, Kulkarni SR, Yajnik CS, Joglekar CV, Rao S, Coyaji KJ, Lubree HG, Rege SS, Fall CH: Increasing maternal parity predicts neonatal adiposity: Pune Maternal Nutrition Study.
Am J Obstet Gynecol 2005, 193:783-789. PubMed Abstract | Publisher Full Text
Guihard-Costa AM, Papiernik E, Kolb S: Maternal predictors of subcutaneous fat in the term newborn.
Acta Paediatr 2004, 93:346-349. PubMed Abstract | Publisher Full Text
Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, Hadden DR, McCance DR, Hod M, McIntyre HD, Oats JJ, Persson B, Rogers MS, Sacks DA, HAPO Study Cooperative Research Group: Hyperglycemia and adverse pregnancy outcomes.
N Engl J Med 2008, 358:1991-2002. PubMed Abstract | Publisher Full Text
Veena SR, Kumaran K, Swarnagowri MN, Jayakumar MN, Leary SD, Stein CE, Cox VA, Fall CHD: Intergenerational effects on size at birth in South India.
Paediatric and Perinatal Epidemiology 2004, 18:361-370. Publisher Full Text
Lunde A, Melve KK, Gjessing HK, Skjorven R, Irgens LM: Genetic and environmental influences on birthweight, birth length, head circumference, and gestational age by use of population-based parent-offspring data.
Am J Epidemiol 2007, 165:734-741. PubMed Abstract | Publisher Full Text
Barker DJP, Godfrey KM, Osmond C, Bull A: The relation of fetal length, ponderal index and head circumference to blood pressure and the risk of hypertension in adult life.
Paediatric and Perinatal Epidemiology 1992, 6:35-44. Publisher Full Text
Kumaran K, Fall CHD, Martyn CN, Vijayakumar M, Stein CE, Shier R: Blood pressure, arterial compliance and left ventricular mass; no relation to small size at birth in South Indian adults.
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Barker DJ, Osmond C, Thornburg KL, Kajantie E, Forsen TJ, Erikkson JG: A possible link between the pubertal growth of girls and breast cancer in their daughters.
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Barker DJ, Osmond C, Forsen TJ, Kajantie E, Erikkson JG: Maternal and Social Origins of Hypertension.
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Frisancho AR, Klayman JE, Maros J: Influence of maternal nutritional status on prenatal growth in a Peruvian urban population.
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Gunnell DJ, Davey Smith G, Frankel S, Nanchahal K, Braddon FE, Pemberton J, Peters TJ: Childhood leg length and adult mortality: follow up of the Carnegie (Boyd Orr) Survey of Diet and Health in Pre-war Britain.
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Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, Sachdev HS, Maternal and Child Undernutrition Study Group: Maternal and child undernutrition: consequences for adult health and human capital.
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Pre-publication history
The pre-publication history for this paper can be accessed here:


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Download our iPhone app here http://www.mmafighting.com/iphone-download For more check out http://www.mmafighting.com watch video >>
MMANEWSLEAK EXCLUSIVE: Welcome back to another installment of the health and wellness with The Baked Chef™. Since it is the holiday season and some of us are watching our weight, I decided that I wou watch video >>
Welcome back to another installment of the health and wellness with The Baked Chef™. New Years Eve is here once again and most likely you're training for an up coming fight. You don't want to ruin a watch video >>
MMANEWSLEAK Exclusive: In this installment of health and wellness we are going to take a look back at the worst injuries of 2010. Fighting is a combat sport that leads to a host of injuries. The to watch video >>
Chad Mendes spoke with the media after his WEC 52 win over Javier Vasquez, talking about the build-up leading to it, the bad blood and broke down the in-ring action. watch video >>
WEC featherweight contender Chad Mendes comments on his WEC 52 co-main event win over Javier Vasquez as well as hanging out with Tim Sylvia. Interview by Danny Acosta. Video by Rick Lee. watch video >>
Megan Olivi talks to Chad Mendes about his awesome front flip and his thoughts on beating a tough opponent in Javier Vazquez. watch video >>
Quick highlights from the WEC 52 weigh-ins, featuring Urijah Faber, Joseph Benavidez, Takeya Mizugaki, Chad Mendes and the rest of the fighters on the card. watch video >>
I share my opinion about Thai Burgers as I eat lunch with fellow MMA fighter Roger Huerta. watch video >>
The WEC's Joseph Benavidez, Chad Mendes, and WEC President Reed Harris sit down to discuss the upcoming WEC 50 card, as well as Urijah Faber. watch video >>


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Secure IP ChatBuild 64
editor's review
Secure IP Chat is a simple and efficient application that can play both the roles of a client and server for a chat service. With it you are able to connect to one or more computers over the Internet to exchange thoughts through text messages or voice, transfer files, as well as to share your computer screen or webcam.
A straightforward interface which makes it all that more practical
Secure IP Chat's GUI can be described in a word as being 'basic'. Depending on personal taste, this can be either an advantage or a disadvantage. It's up to you to decide whether you like the flat design or not but if your main concern is to have a reliable chat solution, then Secure IP Chat will suite you just fine.
The basic design not only means that it will consume very little of your system resources, but it also makes it very simple to configure and run both the server and client. Since there are no complicated menus to go through and everything is pretty much explanatory, almost anyone can use Secure IP Chat.
All popular communication methods available in a light package
With Secure IP Chat you can take advantage of all the commonly know communication types. You are able to use standard text chat and if you have a microphone, then voice chat is also possible.
The application works well on local networks as well as over the Internet, which makes it a viable solution for sending work related files between employees that are present at different locations.
If you're the network admin or simply the one everybody calls up for assistance, the you'll surely appreciate the fact that Secure IP Chat also provides screen sharing capabilities. It's a feature that makes it very easy to guide that person through all the necessary steps needed to resolve an issue.
A handy chat client that doesn't leave you with a headache
With the above to consider along with the fact that it offers RSA and Rijndael 256bit encryption, it's safe to say that Secure IP Chat is an application worth having.
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Craig Florian has resigned from his Ward I seat on the Glenwood City Council, but hopes to be elected back to the council in the Nov. 8 city election as the representative for Ward II.
Mills County is now taking applications for Iowa Disaster Assistance from individuals affected by the hail storms on Aug. 18 and Aug. 22 as well as from those individuals and families who have had flood-related expenses.
Applicants must meet the income requirements and present receipts for expenditures related to either event listed above. Expenses must fit into the application guidelines with a maximum reimbursement amount of $5,000 per household.
The levees near the banks of the Missouri River in Mills County are no longer in the hands of the Iowa National Guard.
Floodwaters may be receding in areas of Mills County but dangers remain for motorists on the county's many closed roads, said Mills County Engineer Kevin Mayberry.
Mayberry, speaking at a Flood Policy Group meeting at Glenwood Community High School earlier this month, said many of the county's roads closed entirely or partially by floodwaters in evacuated portions of western Mills County could be months away from being passable due to damage caused by the water.
Iowa was notified late last week by Federal Emergency Management Agency Director Craig Fugate that the state's request for activation of the Federal Individual Assistance Program for Fremont, Harrison, Monona, Pottawattamie and Woodbury counties has been denied.
Mills County was not included in the original request due to a low number of significantly affected homes in our area during the original assessment process.
The mayors of Hastings and Silver City said they were surprised to learn last week the post offices in their respective communities are among the more than 3,700 nationwide being considered for permanent closure by the U.S. Postal Service.
"Actually, we are kind of surprised because in the past, we've been told because of the number of rural customers we have, the fact that we have a postmaster and the fact that the school (Nishna Valley) is considered to be in Hastings, we'd be OK," Hastings Mayor Troy Hatcher said.
The Iowa Department of Transportation is counting on a "crossover" on Interstate 29 south of Exit 32 in western Mills County to provide relief to flood-detoured motorists utilizing the Plattsmouth Bridge to travel between Iowa and Nebraska. The IDOT implemented the temporary crossover last Wednesday.
EDITOR'S NOTE - Mills County released the following announcement Wednesday: A Mandatory Evacuation Order was issued Wednesday by the Mills County Board of Supervisors and Mills County Emergency Management, affecting four residences in northwest Mills County.
Their mission is to identify potential problems and trouble spots that could compromise the structural integrity of the Missouri River levee system in western Mills County.
Working in teams of two, soldiers from the Iowa Army National Guard have been patrolling Mills County's 26 miles of levee since mid-June. Most of the soldiers assigned to Mills County are members of the 1168th Transportation Co., based out of Audubon, Perry and Marshalltown.
PACIFIC JUNCTION – Gov. Terry Branstad visited Mills County Wednesday afternoon to assess Missouri River flood damage and get a personal look at the flood prevention efforts being carried out by local governmental agencies, homeowners and private businesses.
Copyright © 2015
The Opinion Tribune is your source for local news, sports, events and information in the city of Glenwood and Mills County, Iowa.


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Edward Snowden, who fled the United States on the heels of releasing sensitive information about National Security Agency surveillance, may now try to present himself as a serious protector of American rights.
But go back a few years, and he was — as he touted in a 2002 biographical profile at the now-defunct site Ryuhana Press — a Tekken video-game-playing high-school dropout. And he liked his "girlish figure," he wrote. The site was aimed at selling Japanese anime, the Daily Mail reported.
Using his nicknames, "The True HOOHA" and "Phish," Mr. Snowden, 18 years old at the time, posted about attending a convention for anime enthusiasts in Maryland, the Daily Mail reported.
SEE ALSO: China fears: U.S. officials worry Edward Snowden will pass NSA secrets to Chinese
"I like my girlish figure that attracts girls," he wrote in one posting, the Daily Mail reported. "And I like my lamer friends. That's the best biography you'll get out of me coppers."
He also joked on the site that he "got bullied" to be one of the website's editors by a group of artists and "beautiful nubile young girls," the Daily Mail reported.
Mr. Snowden, who turns 30 this month, has gone dark in Hong Kong. Some theorize he may be planning to seek asylum there; others say he might be considering an offer to live in Russia, made by President Vladimir Putin.


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Today DeadSpin came out with an interesting article regarding New England Patriot's tight end Rob Gronkowski.
Gronkowski has been known to party with women, but this time the guy will be partying with smart girls.
The course is 99 dollars and takes place on November 11th. You have to be over the age 21 because there will be liquor.
I don't know about you, but this sounds like trouble.Do you follow the NFL Draft? If so follow NFL Draft Diamonds on Twitter and Facebook for up to date NFL Draft News, NFL Draft Projections, and NFL Draft Rankings. Jesus is the only way to Salvation


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It Takes More Than a Tool
July 31, 2015
Tools alone don't get a job done. If that were true, a simple trip to the local hardware store would mean countless DIY projects could be considered complete. No, even the best tool in the world is only part of the equation. So what else is needed to go from supplies to success? Consider adding […]Read more


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Protests in Sao Paulo Turn Violent During World Cup Match
by Delisa Morris
Impunity Watch Reporter, South America
BRASILIA, Brazil – While the England and Uruguay World Cup match was coming to an end, protests in São Paulo on the other side of town turned violent. This demonstration turned into antigovernment riots, ostensibly calling for free public transit in Brazil. The riot was one of the largest demonstrations over the course of the World Cup so far.
A protester jumps over a fire barricade during a violent protest in Sao Paulo. Image courtesy of Time.com
Initially more than a thousand people had gathered to commemorate the one-year anniversary of a successful protest against a transit fare hike. However, like other transit protests, this one was a flash point to release deep-seated frustrations over poverty and government spending.
At first things were peaceful, like most of the recent demonstrations across Brazil over the course of the World Cup have been, the protest quickly escalated when groups of masked men began to set fires in the street and shatter bank windows.
Tensions were high in the city after a group of men dressed in black threw explosives – possibly fireworks – into a bar crowded with England supporters viewing their country's match. The men fled to a bus and were arrested harboring knives, more fireworks and brass knuckles.
A few hours later, around 2,000 Brazilian protesters took to the streets to mark the anniversary of last year's public transportation protests. The demonstration was organized by Free Fare, the same group that started last year's massive protests. Thursday's protest began peacefully, but some marches later turned to violence and vandalism as the England-Uruguay game started on the opposite side of the city. As they did last year, the demonstrators set up burning barricades. Police responded with tear gas and finally quelled the unrest after five hours or so. Eyewitnesses claim the anarchist group "Black Block" was behind much of the violence and destruction of property.
The protesters broke the windows of banks and broke into a car dealership to smash the cars there. Television images showed groups of masked men spray painting graffiti on cars, firing off rockets and smashing public property as police responded with tear gas
One of the largest Brazilian protests during the World Cup soccer tournament thus far, and it was the first to become overtly violent. A police spokesperson reported no injuries to either protesters or foreign soccer fans.
While a number of anti-government protests have broken out in Brazil since the World Cup began, most have been on a much smaller scale. Most of the demonstrations in the past few weeks have sought to confront a government that protesters say pays insufficient attention to both public resources and its employees.
The protest shut down one of the city's main thoroughfares, though the impact of traffic was limited due to a national holiday on Thursday.
For more information, please see:
Reuters – Sao Paulo protest turns violent as World Cup game ends – 19 June 2014
The Wall Street Journal – Protests in Sao Paulo Turn Violent – 19 June 2014
International Business Times – Sao Paulo Protests Devolve Into Violent Riot After England-Uruguay World Cup Match – 19 June 2014
Time – Amid the World Cup, a Violent Reminder of Brazil's Discontent – 20 June 2014
About the Author
Delisa Morris Delisa Morris is a Law Student and Master of Science Candidate in Public Relations at Syracuse University in Syracuse, New York. She is originally from Chicago, Illinois and completed her Bachelor's degree at the University of Illinois at Urbana-Champaign.
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CBS comes to terms with TIme Warner Cable after 3 weeks on hold with customer service
NEW YORK, NY - The protracted negotiations between CBS Corp. and Time Warner Cable over broadcasting rights finally came to a conclusion, with both sides agreeing on a new broadcasting contract. The conclusion was finally able to be reached after CBS Corp. spent over three weeks on hold with Time Warner Customer service.
"We thought we were making headway a few weeks back," said chief CBS contract negotiator William Reynolds. "The automated voice that came on over the on-hold music said that our wait time was down to just three days. A few minutes later, the line went dead, so we had to call back and were moved to the back of the line."
The negotiations first became intense several months ago, when the customer service line operator offered to transfer the CBS legal team to a supervisor. "I could tell that whoever we were talking to was playing Candy Crush saga the entire time," explained Reynolds. "I could clearly hear the music in the background. I knew it was a gamble when we asked to speak to a supervisor. I knew that we lost the gamble when the transfer actually went to the janitor's office."
Cable customers now, however, can rest assured that the many CBS Corp owned channels missing from their service will now be restored. "I'm glad we found common ground and got this resolved," said Reynolds. "Though I think I personally got screwed on the deal. During one of the incorrect transfers, I ended up letting a guy talk me into upping my internet bandwidth and adding whole home DVR."
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DoDEA's Weekly Highlights for September 25-October 1, 2015. DoDEA Highlights is weekly recap of the news and events happening in DoDEA Schools around the world. - Read More...
DoDEA's College and Career Readiness Priority is focused on providing a world-class education for military-connected students. - Read More...
DoDEA will pursue our commitment to become a more effective and efficient school system by redistributing human and capital resources and clarifying organizational roles, responsibilities, and expectations. - Read More...
The Department of Defense, in collaboration with the Department of Veterans Affairs, is promoting the "Power of 1" campaign. - Read More...
The Department of Defense (DoD) joins the Nation in celebrating National Hispanic Heritage Month from September 15 - October 15,2015. - Read More...
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Amphetameanies at Festivals
The Amphetameanies are a nine-piece ska band from Glasgow, Scotland. Meanies' members are: Jane (vocals), Stan (vocals), Joel (drums), John Disco (guitar), Gordy (bass), Helen (keys), Mick (trumpet), James (sax) and Lindsey (trombone). They have released two albums so far, Right Line In Nylons and Now! That's What I Call... The Amphetameanies., and numerous singles and EPs. Their latest single release (December 2009) is a double-A side of 'Good One Go' and 'Nothing's OK' Read more on Last.fm.
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The late Howard Zinn: "The idea that the US was an empire did not occur to me until after I finished my work as a bombardier with the Eighth Air Force in World War II."
A September 17 Supreme Court ruling declared unconstitutional articles of the elections act that allow corporate donations to election campaigns.
William John Cox is a retired prosecutor and public interest lawyer, author and political activist. His efforts to promote a peaceful political evolution can be found at VotersEvolt.com, his writings are collected atWilliamJohnCox.com and he can be contacted at email@example.com.


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Comic Book: The Nail
For want of a nail the shoe was lostThe Nail (or JLA: The Nail) is a three-issue comic book mini-series published by DC Comics. It is a self-contained story by Alan Davis which stands outside of the mainstream continuity of The DCU.In this universe, Martha and Jonathan Kent's truck has a tire puncture caused by a nail. This prevents them from discovering the spaceship containing the baby Kal-El, and so, there's no Superman. There is, however, still a Justice League of America, consisting of Batman, Wonder Woman, Aquaman, The Flash (Barry Allen), Hawkwoman, the Atom (Ray Palmer), Martian Manhunter and Green Lantern (Hal Jordan). There's also a great degree of xenophobia for the "metahumans," fueled by anti-metahuman propaganda from Perry White and backed by Metropolis mayor Lex Luthor; slowly metahumans begin to disappear as other issues arise requiring the attention of the publicly disliked JLA.The story was later followed up by a sequel in JLA: Another Nail which ties into the original story and wrapped up several loose ends.The same general plotline was used for Flashpoint as well. See also Bullet Points for this series' Marvel Universe counterpart.Dark Horse Comics also has an unrelated short series called The Nail, about a wrestler nicknamed The Nail protecting his family from demons.
For want of a shoe the horse was lost
For want of a horse the knight was lost
For want of a knight the battle was lost
So it was a kingdom was lost
All for want of a nail
For want of a shoe the horse was lost
For want of a horse the knight was lost
For want of a knight the battle was lost
So it was a kingdom was lost
All for want of a nail
This works contains examples of the following tropes:
- A God Am I: Jimmy Olsen when beating the crap out of Batman specifically calls himself one and demands that Batman do the same. He tells him to go to hell instead.
- A House Divided: The Justice League suffers from this a little bit since Superman was never there to be the even head that guided them.
- Alternate Universe
- Anyone Can Die: It's an Elseworld, so there's no harm done to the Post-Crisis continuity.
- Badass Pacifist: The Kents, in this universe. They become the Team Parents for the metahumans, with the help of Dr. Lana Lang.
- Badass Normal: Batman and Catwoman. The latter is especially noteworthy as she manages to take down a bunch of other Batman villains single-handed when the Joker pits them all against each-other.
- Battle Couple: Batman and Catwoman again.
- And in Another Nail, Big Barda and Mr. Miracle.
- Bittersweet Ending: Kal becomes Superman and manages to turn the world's view of metahumans around. But not without losing the parents who raised him and having to renounce his peaceful life afterwards.
- Batman actually retiring from the JLA, despite being acquitted from having killed the Joker.
- For worse/better/whatever, it's not over: see Another Nail.
- Beware the Superman: Ironically, it's a result of there being no "Superman".
- Body Horror: Happens when Jimmy Olsen's body starts to reject its new Kryptonian DNA during his climactic fight with Superman.
- Broken Pedestal: Jimmy Olsen has this in spades concerning super-heroes. Come The Reveal, we see just how bad it really is
- The Commissioner Gordon: Harvey Bullock is the new commissioner of the Gotham City Police Department.
- Conspiracy Theorist: This world's version of Green Arrow, on top of him being crippled and ultra bitter after the incident that left him like that and killed Hawkman.
- Dating Catwoman: Aside from the Trope Namer, Green Lantern and Star Sapphire's relationship has shades of this.
- Does This Remind You of Anything?: The whole metahuman witch hunt thing.
- Driven to Madness: Jimmy Olsen, courtesy of being exposed to Kryptonian DNA.
- Elseworld
- Elite Mooks: Played straight with the Liberators initially, but ultimately subverted when they're revealed to be Glass Cannons.
- Evil All Along: Jimmy Olsen
- Faceless Goons: The Liberators, save one moment where Hal unmasks one and exposes them as Bizarro-type clones of Kal-El
- Famous Last Words: A gut-punching last sentence from the Big Bad: "We should have been friends."
- Fat Bastard: This version of Lex Luthor seems to have put on a few pounds.
- Forced to Watch: The Joker uses his newly bestowed energy powers to capture Robin and Batgirl, and then make Batman watch while he rips them apart.
- For Want of a Nail: Inspired by the Trope Namer.
- Get A Hold Of Yourself Man: Alfred and Selina have to team-up to give an effective one to Batman.
- Gory Discretion Shot: Poor, poor Robin and Batgirl.
- Heroic BSOD: Batman has truly massive one after the Joker kills Batgirl and Robin and even worse when he utterly snaps and kills the Joker right then and there.
- Amish!Kal-El has another when his parents are brutally murdered by Jimmy.
- Intrepid Reporter: Lois Lane as always
- Joker Immunity: Averted, as the Joker ends up having his neck snapped by Batman going into full Papa Wolf mode. On live television.
- Leeroy Jenkins: Robin and Batgirl. It gets them killed.
- Love Redeems: Selina goes straight specifically to be with Bruce.
- The Man Behind the Man: Lex Luthor (believed by the Justice League to be the Big Bad) is implied to be manipulated by Starro until it's revealed that "Starro" is actually a mutated Krypto. The real Big Bad is none other than... Jimmy Olsen.
- Monster Clown: The Joker, natch
- Not Helping Your Case: Batman seen killing the Joker on live television only added further xenophobia and mistrust towards the metahumans and vigilantes.
- Papa Wolf: Batman. This is one of the few universes in which he breaks his Thou Shall Not Kill oath, and he does so after The Joker brutally murders Batgirl and Robin.
- Person of Mass Destruction: Jimmy Olsen and Kal-El. Their fight is even described as apocalyptic by other characters.
- The Reveal: Jimmy Olsen is the Big Bad and has Kryptonian powers.
- Sanity Slippage: Up to Eleven with this version of Oliver Queen, who had previously lost an arm, an eye, and the use of his legs to AMAZO.
- Jimmy Olsen is also revealed to have suffered from this a great deal.
- Silver Age: Set in a pre-Crisis on Infinite Earths style universe, the story also features Silver Age features such as big splash pages featuring individual characters doing something impressive.
- Sliding Scale of Idealism Versus Cynicism: Likely as a means of showing how integral Superman is to the DCU, this world (and story) lean just a bit more towards the cynical side of the spectrum than the usual portrayal of the DCU. That said, the ending is a (mostly) happy one.
- Technical Pacifist: Kal-El, having been raised by an Amish couple, is opposed to violence. This does not stop him from going to town on a Kryptonian Jimmy Olsen.
- Unstoppable Rage: Batman turns utterly murderous after Joker kills his sidekicks, which concludes with him breaking his Thou Shalt Not Kill rule and snapping the Joker's neck.
- With Great Power Comes Great Insanity: What happens to Jimmy Olsen as a result of his exposure to Kryptonian DNA.
- Would Hurt a Child: The Joker shows this to horrific extremes when he murders Robin and Batgirl.
Tropes associating with Another Nail
- Badass Normal: Lois can handle Eclipso no problem. Jonathan Kent even gives him a good whack on the head with a shovel.
- Big "NO!": Batman, after waking up from a nightmare where the Joker kills Robin and Batgirl. He wakes up the moment the Joker forced his eyes open.
- Eldritch Abomination: The Limbo Cell.
- Empathic Weapon: Somewhat with a particular Green Lantern ring. Its wielder was killed while trying to save some of the slaves on Apokolips. The ring fled before the killer could take it. It chose Big Barda as the new wielder since she's the only native on Apokolips worthy of such a weapon. It let the Guardians know about this "in a tone and authority that surprised" them. It also merged with a Mother Box and bonded with Mister Miracle, with Highfather's approval.
- Heroic Sacrifice
- Mythology Gag: Superman was seen saving a plane when one of its engines was blown, like in Superman: The Movie.
- Sexy Shirt Switch: Lois is seen wearing a large shirt and walking barefoot while staying with Kal at the Kent Farm.


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I am realtor in Miami and put up for sale 4-5 luxury homes each month and need someone to look at the video, the professional photos, and create copy to make the property sound fantastic. The writing should be focused on the lifestyle and benefits that the buyer will enjoy from living there. I dont want just a list of features. You should write something about the area, the community (if condo or gated community), and the main 1 or 2 rooms in the house that will appeal the most to the buyer. IF condo, then you should talk about amenities also. IF waterfront/ boater/ ocean, then discuss the view and the lifestyle etc. It will be needed on 2-3 day turnaround so that we can make the brochures, and post the description on the internet.
I prefer someone who knows the Miami and Fort Lauderdale area, or Florida, but it is not necessary. I also prefer someone who has done this for other luxury agents in the USA, but it is not a deal breaker.
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Family saves elderly man from SC flood waters
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text:
A career in corporate America has also honed his diplomatic skills. "I have an appreciation of the implications of trying to make change in a large and complex environment," he says. "That is difficult. It has to be approached with humility. I have learned through first-hand experience that when you are changing anything having to do with someone's job you have to be very aware of the fact that for most of us there is probably nothing more important than what we do. So when you are making these changes you have to engage these people and bring them along."
Arnold turned to The Encore Fellowship Network, a program that originated in 2009 to tap into the expertise of Silicon Valley executives. The program has expanded across California, with similar programs now in Arizona and New York, all of which share the mission of identifying executives and other innovators who are willing to share their expertise to tackle stubborn social issues.
In The Encore Fellows program, participants work anywhere from six months to a year with stipends generally ranging between $20,000 and $35,000. Half of the stipend is paid by the California HealthCare Foundation and the remainder paid by the organizations that receive the expert help.
After an interview and screening process, Arnold was taken on as an operational analyst and consultant in July 2011 for La Clinica Del Raza, an Oakland, CA-base community health system with 29 clinics in three counties.
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text:
Right...and?<quoted text>
You need to get your facts straight before using examples.
(((According to a sworn deposition taken in November 2010, Marissa Alexander's husband, Rico Gray, 36, said that on August 1, 2010, he and Alexander began fighting after he found text messages to Alexander's first husband on her phone. The two were already estranged - according to her father, Alexander had been living at her mother's since the birth of the couple's daughter nine days earlier, and Gray, a long-haul trucker, said he spent the night before in his tractor-trailer. Gray began calling her names, saying "If I can't have you, nobody going to have you," and blocking her from exiting the bathroom.
Alexander pushed past Gray and went into the garage where she got her gun from her car's glove compartment.
Gray told prosecutors in the deposition that Alexander came back into the house holding the weapon and told him to leave. He refused, and what happened next is somewhat unclear. In his deposition, Gray said "she shot in the air one time," prompting him and the children to run out the front door. But when Gray called 911 the day of the incident, he said "she aimed the gun at us and she shot."
In August 2011, a judge rejected a motion by Alexander's attorney to grant her immunity under the "Stand your Ground" law. According to the judge's order, "there is insufficient evidence that the Defendant reasonably believed deadly force was needed to prevent death or great bodily harm to herself," and that the fact that she came back into the home, instead of leaving out the front or back door "is inconsistent with a person who is in genuine fear for her life.")))
He said - she said v He said - He's dead.
She went to the Garage to get the gun(wrong), Zimmerman continued to follow against the wishes of the police when he was not in harms way(wrong).
She was black(harmed no one) and gets 20 years, Martin was black, was not trespassing, comitted no crime other than asserting his personal rights not to be harassed by Judge Dredd Zimmerman and his killer is acquitted.
Thanks for helping me with my argument.


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Come and explore the stunning Cape Town scenery from the back of a fully imported trike...the only one of its kind in South Africa. An experience you will never forget!!!
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Fantastic Holiday House sleeps 6 people , only 500 meters from the beach Comfortable bedrooms Safe parking in double garage & on street parking for 2 vehicles. 5 km from shops and wine routes
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