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Results include: Mud Baths, Mud Masks
Spa Experience at Ironmonger Row Baths
Old Street, London 2 mi from Mayfair
Inside the restored Ironmonger Row Baths, Old Street, Spa Experience is an affordable luxury day spa that offers a diverse range of treatments from traditional thermal therapies to the latest beauty innovations. You'll find yourself wrapped up in an experience devoted to melting away your stress and tensions and come away looking and feeling your best. Re-opened in 2012, the building retains many lovingly restored historical features to provide the perfect environment in which to rejuvenate your mind and body. If you want to lift your spirits and pamper yourself or a friend, you will be sure of a warm welcome. Bring a little bit of indulgence into your life and expect value for money.
La Sultane de Saba Deep Cleanse Rassoul
50 mins
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Ananta Skin & Body
Holborn, London 1 mi from Mayfair
Nestled between Holborn and Chancery Lane stations, Ananta Skin & Body is a tranquil day spa delivering a unique blend of innovative treatments and traditional beauty services. Using trusted brands and time honoured techniques, they offer an enriching experience to improve your health and wellbeing. Their interior is expertly designed to maximise your comfort. With Lavender, Jasmine and Geranium floors, you are treated to a luxurious session on a floor to suit your preference. They fuse Eastern and Western approaches to create an internationally inspired menu, providing an all-encompassing experience that caters to your needs. Looked after by a team committed to delivering exceptional service, Ananta Skin & Body is the ideal escape for an afternoon of rejuvenation and rediscovery.
Dermalogica Nourishing Sea Mud Therapy
1 hr
Dermalogica Mud Massage Therapy
1 hr
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Beauty Fusion at Grays Inn Barbers
Holborn, London 1 mi from Mayfair
Six minutes from Chancery Lane Station, Holborn, Beauty Fusion is a haven of relaxation and beauty under Grays Inn Barbers. They offer waxing, nail treatments and massages for men and women. An extensive menu is provided in a tranquil, contemporary space away from the busy London streets. Polite and friendly staff put you at ease throughout professional and well thought out services that make use of a good selection of products. They bring experience and knowledge to providing an effective and stress free experience at a convenient location.
Deep Cleansing Back Treatment
1 hr
Save up to 25% from £41.25
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Spa Experience at Swiss Cottage Leisure Centre
Swiss Cottage, London 2 mi from Mayfair
Within the Swiss Cottage Leisure Centre, Spa Experience is an affordable luxury day spa that offers a diverse range of treatments from traditional thermal therapies to the latest beauty innovations. You'll find yourself wrapped up in an experience devoted to melting away your stress and tensions and come away looking and feeling your best. If you want to lift your spirits and pamper yourself or a friend, you will be sure of a warm welcome. Bring a little bit of indulgence into your life and expect value for money.
La Sultane de Saba Deep Cleanse Rassoul
50 mins
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Le Beautique Spa
Marylebone High Street, London 0.5 mi from Mayfair
Located in Marylebone, just minutes away from Regent's Park, Le Beautique Spa is a cutting-edge salon providing a range of luxurious and revitalising treatments. An inviting and relaxing atmosphere - complete with a selection of authentic Russian cocktails - creates the perfect escape from life's stresses. Whether you're looking for some last minute maintenance or want to indulge in a little self-care, you can look forward to a unique and satisfying experience. Le Beautique Spa's professional and highly skilled team are dedicated to providing a service tailored to your individual needs. With everything from hair styling to manicures on offer, you are guaranteed to find your ideal treatment.
Full Body Wrap with Moroccan Rhassoul Clay
1 hr 20 mins
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Beauty at The Circle Gym & Spa
London Bridge, London 3 mi from Mayfair
Beauty at The Circle Gym & Spa offers a luxurious and tranquil environment that is sure to leave you feeling relaxed, revitalised and invigorated. Our therapists are all fully qualified, have a wealth of experience, and offer a personal and professional approach to beauty therapy. The Circle is a family-owned, boutique Gym & Spa nestled near the iconic Tower Bridge. With a fully kitted Gym spread over three rooms, class studio, a luxurious swimming pool, jacuzzi, sauna, and a Spa that boasts an extensive range of treatments; The Circle Gym & Spa offers you the complete health club experience. Individual, Couples and Corporate Memberships are available on a no monthly contract basis. With Tower Bridge and Bermondsey Tube Stations only a short walk away, and free parking to all members; we are easily accessible. The Circle Gym & Spa Team look forward to welcoming you soon.
Dermalogica Enzymatic Sea Mud Pack
1 hr
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The Spa in Dolphin Square
Pimlico, London 1 mi from Mayfair
The Award-Winning Spa in Dolphin Square, a luxurious retreat close to the west end, set within 3.5 acres of private gardens next to the Thames in Westminster. A quiet haven where you can escape the noise of the city, the ideal setting for you to recharge your senses. Spa Facilities An exotic hideaway fusing age-old traditions with contemporary spa philosophies. Featuring an authentic Moroccan Hammam, Rhassoul chamber and salt infused steam room, you are immersed in luxury from the moment you step inside. Their spa mentors are on hand to guide you through your journey, combining their expert care with a bespoke range of treatments, rituals and signature experiences. Accommodation Dolphin Square offers a range of serviced apartments equipped with contemporary furnishings and wide range of facilities and amenities. Most apartments feature super kings sized beds, Hypnos pocket-sprung mattresses with alpaca duvets. Other Amenities Dolphin Square's Sports & Fitness centre facilities incl. 17ft heated swimming pool, sauna and steam room. For a relaxed dining setting, the Dolphin Bar & Grill caters for breakfast, lunch and dinner for you to enjoy. Nearby Attractions Perfectly placed by the river, you have the whole of London at your doorstep. Take in a show in the city's glamorous Theatreland or indulge in some retail therapy with a visit to Oxford Street. You'll find some of the capital's most recognisable landmarks just a short walk away, including Buckingham Palace, Big Ben and The London Eye. Directions Mere moments from Pimlico tube station, the hotel is also easily accessible by rail from both Victoria and Vauxhall stations, with fantastic links to Heathrow, Gatwick and Stansted airports.
The Luxury Rhassoul Ritual, a purifying experience for Two Incl. Moroccan Mint Tea
55 mins
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Arabian Hammam
Maida Vale, London 1 mi from Mayfair
Easy to find in Maida Vale, Arabian Hammam is a specialist day spa. Offering both standard beauty services - including facials and massages - as well as Turkish Hammam experiences, their treatment menu has been designed for both women and men. Highly trained, friendly and professional therapists aim to leave you feeling relaxed and revitalised and will carefully prepare each package to meet your individual needs. You'll discover a pleasant, serene and relaxing ambiance and will not feel at all rushed. The hammam itself is of a middle eastern tradition said to reduce muscle tension, improve sleep and nourish skin. You'll leave this family-run spa feeling rested, calm and cleansed.
Hammam Experience
1 hr 30 mins
Save 42% £49
Authentic Arabian Hammam
1 hr 45 mins
Save up to 25% from £63.75
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Casa Spa
Paddington, London 1 mi from Mayfair
Established for over 11 years, Casa Spa is a family run business that has specialised in the Authentic Hammam, Massages, and Facial treatments. Founded by Tunisian born Halima Hermi, Casa Spa was one of the first ever Hammam establishments in London that was not owned by the state or a corporate company. This is what has given Casa Spa that personal touch to its service. Each customer to us is an individual and never a number. The business was created out of the passion of making people feel great and relaxed in themselves. That is what the Hammam is about, it is a cleansing ritual that was created to detox and calm the body. We offer a great range of packages that would suit all people whether it is a group, a couple or an individual.
Mother and Daughter Package for Two
1 hr 40 mins
Save 25% £120
Rural Moroccan Retreat Inc. Three Treatments
1 hr 30 mins
from £59
Traditional Arabian Hammam
1 hr 30 mins
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Massage Today Mobile
West London, London 0.4 mi from Mayfair
Mobile therapist
Massage Today Mobile is a mobile massage and therapy service based servicing West London. Zsolt is an experienced male massage therapist with over 12 years in service, offering a wide range of massage therapies. Let beauty and relaxation come to you in the comfort of your own home. Massage Today is sure to fulfill all your needs.
Therapeutic Moor Mud Experience
1 hr - 1 hr 30 mins
Save up to 20% from £70
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Massage Today Covent Garden
Covent Garden, London 0.6 mi from Mayfair
Found a short walk from Covent Garden station, Massage Today is a massage and therapy centre which offers a number of different services. The venue's masseuse, Zsolt, is a highly trained massage therapist who boasts over 12 years experience, meaning he will be able to provide a bespoke massage which is tailored completely towards you and your needs. Visit today and you will be sure to enjoy a professional, attentive service and leave feeling relaxed and rejuvenated.
Therapeutic Moor Mud Experience
1 hr - 1 hr 30 mins
Save up to 20% from £70
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Massage Today Bayswater
Bayswater, London 1 mi from Mayfair
Found a short walk from Royal Oak station, Massage Today is a massage and therapy centre which offers a number of different services. The venue's masseuse, Zsolt, is a highly trained massage therapist who boasts over 12 years experience, meaning he will be able to provide a bespoke massage which is tailored completely towards you and your needs. Visit today and you will be sure to enjoy a professional, attentive service and leave feeling relaxed and rejuvenated.
Therapeutic Moor Mud Experience
1 hr - 1 hr 30 mins
Save up to 20% from £65
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Camberwell, London 3 mi from Mayfair
Callabash Beauty is a mobile beauty therapist covering the Camberwell and wider South East London area. It is run by Florence Ross who provides a wide range of professional beauty and holistic treatments including hair removal, facials, tinting, massage, manicures and pedicures. All of which are provided from the comfort, convenience and privacy of your own home.
Rasul & Mud Treatment
1 hr
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Agua Bathhouse & Spa at The Mondrian
Southwark, London 1 mi from Mayfair
Morgans Hotel Group will reveal agua Bathhouse & Spa on 30th September, set in Mondrian London at Sea Containers. Embracing the Hollywood glamour, renegade origins and bold nature of the hotel group and its aspirational Mondrian brand, this boutique bathhouse will create a distinct social hub for guests. Filled with authentic spa experiences, personalised treatments and an original selection of skincare, some of which agua is introducing to the global spa arena, guests are encouraged to explore a diverse range of therapies in an eclectic and comforting setting.
Agua Signature Mud Cure
30 mins - 1 hr
from £75
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Writing a paper on the values of leaders and followers
Write a 2 page paper on the following what are values, instrumental values, and terminal values. What is Zemk's approach, include the veterans,the baby boomers,the gen xers, and the millennials. Also where do leaders and followers get their values from and how do they differ from one other, what specific value traits will a leader have and a follower have.
Write a 3 page paper on an actual real life leadership case topic should be values related to your personal experiences. This should be made up not taken from the internet that demonstrates values of a leader and followers how were they misuses or used correctly where did they obtain those values. Where on Zemke's approach do these values fit. What did the leader and follower do wrong what did they do right?
Write 3-5 pages of teaching notes about the case you just made up, include 3 questions that you would ask if you had to teach this case to the class also answer those three question.
All this should be in APA format.
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Create an Account - Increase your productivity, customize your experience, and engage in information you care about.
October 20, 2017
Main Street
October 21, 2017
1200 Railroad Ave.
October 21, 2017
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110 Veterans Memorial Lane
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October 21, 2017, 8:30 AM - 11:00 AM @ Public Works
Trees will be mostly flowering trees to add color to the city with some shade trees that grow well in our city. Trees are 3-5' in height and in a 3 gallon container. Residents will be able to select two trees per residence with proof of ownership, water bill, license etc. The trees can be picked up at Public Works. For more information, contact City Arborist Art Finn at 727-724-1555 x1303.


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At Wayne Wright, we want our clients to remain part of our client family long after we resolve your case. We keep in touch by inviting you to the various functions and events to show our appreciation for you. Our Wayne Wright Client Appreciation Picnic is an absolutely free event enjoyed by thousands of clients and their families, who gather for fun entertainment, free prizes, free food, free refreshments, free games and attractions and much more. Join the Wayne Wright Client Family and keep us updated with any changes in your address or phone number or email address.


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Why a Sprung Hub Disk is Not the Best for Racing
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Expert Reviewed
wikiHow to Choose a Dog Fence for Your Yard
Three Methods:Considering a Traditional FenceUsing a Hidden Fencing SystemPreventing Jumping and DiggingCommunity Q&A
If you have a dog, it's important that you also have a fence around your yard. Most importantly, a fence can help keep your dog safely within your yard, while allowing them to run around without being tied up. There are many different types of fences to choose from. For a traditional fence, you have to consider material and size. Hidden electric fences are also an option, of which there are also multiple types. [1]
Considering a Traditional Fence
1Check local fencing regulations. Your community may have laws about the materials and sizes allowed for residential fences. Don't rely on a fencing company to know the regulations. Contact your town hall for specific by-laws and regulations for your area. Breaking them may result in fines and the requirement to remove your fence.[2]
2Weigh the benefits of a tangible fence. A tangible fence is generally more protective of your dog, if it is installed and maintained properly. It is also far less likely to cause your dog anxiety, as there is no physical discipline associated with it. Likewise, it can help block visual stimuli such as people and other dogs walking by that may excite your dog and cause them to bark or bite. However, these fences are also generally more expensive, and need to be maintained with repairs over time.
- If you're hoping to fence around ½ an acre, you will spend anywhere from a few hundred dollars to a few thousand, depending on materials. [3]
- Account for the full-grown size of your dog. Your fence may need to be higher than you expect. If you have a breed of dog that will stay small, four or five feet will likely be enough. This is often not the case for larger dogs, especially agile breeds.
- If you have a husky, golden retriever, or another large breed of dog, go with a fence that's about six feet tall.[4]
3Save money with a chain-link fence. Chain link fences are especially common for good reason. They are cheap, and extremely durable. However, they allow your dog to see out (and other dogs to see in), which can contribute to the occasional bark-off. Chain link fences are also relatively each to jump, if your dog is a bit acrobatic.[5]
4Opt for a wooden privacy fence with a mild-mannered dog. Wood fencing is reasonably priced, lasts for over a dozen years, and can provide visual privacy for you and your dog. However, many dogs are able to push wood pickets out of wood fences, and wood fences tend to be the easiest to dig under.[6]
- If you do go with wood, see to it that any horizontal beams are not able to be used as launch pads from which your dog could jump the fence.
- Vinyl fences can offer similar advantages, but tend to cost more than wooden fences.
5Build a solid, permanent fence. Concrete, brick, or other solid, permanent walls are especially effective in protecting your dog and keeping them contained. However, these are also the most expensive to install and maintain. While concrete blocks are relatively cheap, they are also relatively unsightly, and may be banned in your area.[7]
Using a Hidden Fencing System
1Evaluate the risks associated with a hidden fence. A well-trained dog is unlikely to break the perimeter set by an electric fence. However, an electric fence does not physically prevent a dog from leaving your yard. Moreover, electric fences are not appropriate for all dogs, as they may cause anxiety for some.[8]
- For instance, if your dog is angered by another dog walking by and decides to pursue them, they may ignore the brief jolt their collar gives them when they cross the electric fence.
- If a fence is improperly set up or used on an animal with a low pain tolerance or one that is prone to anxiety, the shock experienced when crossing the fence boundary may foster an overall fear of the fence in the dog.
- Further, electric fences do not prevent anything from entering into your yard. This could leave your dog vulnerable to attack from another animal, and may create liability if someone enters your property and is bitten by your dog.
2Choose a hidden electric fence. Use an invisible electric fence to create a zone in which your dog is free to move with neither the expense nor the visual consequence of a traditional fence. Your dog will also need to wear an electronic collar that serves two purposes. First, the collar plays an warning tone that your dog will hear whenever they near the perimeter. Second, the collar will shock them with a harmless but bothersome electric current if they attempt to cross the invisible fence. There are many benefits to such a system.
- They are quite affordable, and will almost always cost less than a traditional, tangible fence.
- They are quickly and easily installed in a few hours.
- Training for your dog will likely be quick and effective as well.
- You have several different types to chose from, with the main difference being the use of a buried wire or a wireless system.
3Go with a buried wire fence system. An electric fence that relies on a buried wire to establish the boundaries of your dog's safe zone is especially easy to customize. For instance, you can establish exact, specific areas within your yard that are off limits, such as a pool or flower beds.[9]
- These systems also have greater range, and can be used to establish a safe zone up to 100 acres in size.
- Costs range from $165 to $320.[10]
- Setup is quite simple. It involves burying a continuous circuit of wire around the perimeter of your yard. To do so, use a flat spade to dig a 3in (8cm) trench wherever you want to lay the wire. This can usually be completed in one or two days.
- Your transmitter (which keeps track of where your dog is relative to the fence) will usually be stored inside, near a power source.
4Opt for a wireless electric fence. Another type of electric fence does not require you to bury a wire around the safe zone you wish to create for your dog. However, the range of these systems is more limited, and is based on a radio signal that reaches a certain distance from a centrally located transmitter to determine the perimeter.[11]
- Advantages associated with this type of electric fence include an extremely easy installation, and the ability to move the system with ease - even for a vacation.
- However, this type of system is limited to a circular safe zone, usually extending about 90 ft from the transmitter in all directions. As such, these systems are most appropriate for smaller yards.
- Costs range from $220 to $350.[12]
5Train your dog carefully. Electric fences do work for a lot of people's dogs. However, training is vitally important for your fence to work. To help during training, use yard flags or another clear indicator to provide a visual information to your dog about the fence's location. The specific system you purchase will include specific information on setup, as well as training.[13]
- Further, recognize that your dog ultimately learns to stay within the perimeter via negative reinforcement, even if you train them with positive reinforcement to respect the perimeter during training. As such, using an electric fence does mean that your dog will wind up being shocked at one point or another, likely during training.
Preventing Jumping and Digging
1Identify where your dog is getting out. The two main ways dogs can escape from a traditional fence are digging and jumping. To check for evidence of digging, walk the interior and exterior perimeter of your fence. Keep in mind that the hole they're squeezing through may be smaller than expected.[14]
- Any sign of digging indicates you may have found an escape hatch. If you're certain they aren't digging and they keep getting out, they've likely found a way to vault the fence.
2Do a bit of digging yourself. One way to deter a digger is by digging beneath your fence all the way around and adding a foot or so of chicken wire going straight down, then burying this added part of the fence. Your dog will likely try again, but may give up when they encounter this new barrier.[15]
- For especially serious diggers, you can add an L-footer to the bottom of your fence. This extends down off of your fence, turns 90 degrees at ground level, and extends inward into your yard for about a foot. This will greatly diminish a dog's ability to choose.[16]
3Contain leapers with a chicken wire lean-in. If you think your dog is getting over your fence, one option is add something to the top of your fence to prevent them from doing so. Chicken wire can likely do the trick. It's cheap and easy, if a bit unsightly. Simply staple, nail, or tie chicken wire to the top of your current fence, and bend it inwards to form a ¼ circle or so.[17]
- Make sure there are no sharp spires of chicken wire that your dog could jump into and scratch themselves on.
4Use coyote rollers for persistent jumpers. Coyote rollers are designed to keep wild coyotes out of fenced-in areas, but they can also help keep your dog within your fence. Most commonly, coyote rollers are long metal tubes affixed to a frame on top of the fence that allow the tube to spin.[18]
- Coyote rollers can be purchased from several different online companies, but they are not cheap. You can make a more affordable version yourself using PVC piping and other hardware from your local home improvement store.
5Plant vegetation along the inside of the fence. Persistent fence-jumpers, or dogs that have worn a path patrolling the inside of your fence-line may be dissuaded from doing so by landscaping. Dense shrubs are especially effective in keeping dogs back from the fence. In fact, the deterrence offered by landscaping within your fence can prevent escape attempts generally.[19]
6Add to a chain link fence. If you go the chain-link fence route but find that you and the other neighborhood dogs are prone to singing to one another, you may want to add something to keep them from seeing one another. There are plenty of options. One easy, good-looking option is zip-tying some reed fencing to the inside of your chain link fence. You can also tie on bamboo poles or wind plastic slats through the fence itself. While none of these are perfect, they will diminish the chorus of canine greetings.[20]
7Provide a backyard activity. Many dogs who are trying to escape simply need more stimulation to be happy in your yard. If they like to dig, consider adding a sandbox where they are allowed to do so. Further, play with your dog a while each time you go into your yard together. Play fetch or simply run around together.[21]
8Don't leave your dog outside. Though it can be tempting to let your dog out on their own to take care of business or catch some rays, it's not recommended. Even with the safety of a fence, your dog can wind up getting themselves in trouble by eating something it shouldn't or getting wound up in something you forgot to put away.[22]
- Do not rely on running loose in the yard as your dog's only form of exercise and mental stimulation. Taking your dog for regular walks or runs, engaging in play in the home, and providing appropriate physical exercise and mental stimulation for their breed, size, and age will help curb attempts to escape the yard and other mischievous behaviors.
Community Q&A
Sources and Citations
- ↑ http://www.drsfostersmith.com/pic/article.cfm?aid=217
- ↑ http://www.petful.com/pet-products/what-size-fence-should-you-get-for-your-pet/
- ↑ http://www.petsafe.net/fencing
- ↑ http://blog.fenceauthority.com/posts/fences/fantastic-fences-for-big-dogs
- ↑ http://www.petful.com/pet-products/what-size-fence-should-you-get-for-your-pet/
- ↑ http://www.petful.com/pet-products/what-size-fence-should-you-get-for-your-pet/
- ↑ http://www.petful.com/pet-products/what-size-fence-should-you-get-for-your-pet/
- ↑ http://www.petful.com/pet-products/what-size-fence-should-you-get-for-your-pet/
- ↑ http://www.drsfostersmith.com/pic/article.cfm?aid=217
- ↑ http://www.petsafe.net/fencing
- ↑ http://www.drsfostersmith.com/pic/article.cfm?aid=217
- ↑ http://www.petsafe.net/fencing
- ↑ http://www.drsfostersmith.com/pic/article.cfm?aid=217
- ↑ http://www.petful.com/pet-products/what-size-fence-should-you-get-for-your-pet/
- ↑ http://www.petful.com/pet-products/what-size-fence-should-you-get-for-your-pet/
- ↑ https://notesfromadogwalker.com/2013/08/08/dog-fence-fixes/
- ↑ http://www.petful.com/pet-products/what-size-fence-should-you-get-for-your-pet/
- ↑ https://notesfromadogwalker.com/2013/08/08/dog-fence-fixes/
- ↑ https://notesfromadogwalker.com/2013/08/08/dog-fence-fixes/
- ↑ https://notesfromadogwalker.com/2013/08/08/dog-fence-fixes/
- ↑ http://www.petful.com/pet-products/what-size-fence-should-you-get-for-your-pet/
- ↑ http://www.petful.com/pet-products/what-size-fence-should-you-get-for-your-pet/
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Would you like to get your GED® certificate in Burnham ME? The GED® exam is for adults who have not received their high school diploma. The certification that you receive upon passing the Maine GED® examination is accepted as an equivalent credential to a high school diploma by employers and colleges throughout the United States.
The GED® examination covers basic skills that students learn about in high school. Lessons taught in GED® classes include math, science, writing, reading, and social studies. These are the subject areas that make up the GED® exam in Maine.
Typically GED® programs in Burnham ME are offered at:
- Burnham Adult Education Centers
- Burnham Public Library
- Burnham Literacy Centers
- Burnham Community Colleges


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By P. Schiano, A. Ecer, J. Periaux and N. Satofuka (Eds.)
Read Online or Download [(Parallel Computational Fluid Dynamics 1996: Algorithms and Results Using Advanced Computers )] [Author: P. Schiano] [Dec-1997] PDF
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Detonation, because the authors indicate, differs from other kinds of combustion "in that each one the real strength move is by way of mass circulate in robust compression waves, with negligible contributions from different tactics like warmth conduction. " Experiments have proven that those waves have a fancy transverse constitution, and feature wondered scientists via yielding a few effects which are at odds with the theoretical predictions.
Applied Optimization: Formulation and Algorithms for Engineering Systems
The place to begin within the formula of any numerical challenge is to take an intuitive proposal in regards to the challenge in query and to translate it into special mathematical language. This publication offers step by step descriptions of ways to formulate numerical difficulties so that it will be solved by means of current software program.
Extra resources for [(Parallel Computational Fluid Dynamics 1996: Algorithms and Results Using Advanced Computers )] [Author: P. Schiano] [Dec-1997]


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A regular meeting of the Jackson County Commissioners was held yesterday, July 20. Consideration and action was taken to approve the Detention Services Agreement by and between CommunityWorks LLC, and the County of Jackson for detention services and use of the detention facilities of the Cleveland County Regional Juvenile Detention Center at a rate of $24.34 per child, per day, effective July 1, 2015 through June 30, 2016. In addition, Detention Services Agreement by and between CommunityWorks, LLC, and the County of Jackson for detention services and use of facilities of the Pottawatomie County Juvenile Detention Center (Carter Hall) at the of $24.34 per child. per day, effective July 1, 2015 through June 30, 2016, was also approved.
Jackson County Treasurer, Renee Howard, presented an officer's report of the tobacco tax collected. For May 2015, $1,389.70 in tobacco tax has been collected from the State of Oklahoma, a total of $142.30 more than the previous month.
Blanket purchase orders and supplemental appropriations for the months of September 2015, May 2015, and June 2015 were approved.
The bridge inspection invoice, consultant invoice amounts and approvals, and report of conference between Bridge Owner and Bridge Inspection Consultant prepared by Circuit Engineering District (CED) #7 and the execution of any documents pertaining to such gained approval from the County Commissioners.
Resolution No. 2015-43, for Turkey Creek Bridge replacement located 1.3 miles West and 0.7 miles South of Duke, Project No. J3-0058(04)RB, State Job No. 30058(04) District #3 was also approved.
Matters concerning the Treasure's office were the declaration of surplus items; four printers, printer/fax/copier combo and marrow carriage printer, along with the sale of property acquired at resale; ID# 0735-00-007-011-0-000-00, lots 11 and 12, block 7, Austin and Peden Addition to the town of Eldorado, was all approved.
Agreement and Resolution No. 2015-44, authorizing participation in the National Purchasing Cooperative between the National Purchasing Cooperative and Jackson County Board of County Commissioners was granted approval. The agreement included a list of vendors.
There was no new business, claims were approved and the meeting was adjourned.
Reach Tinita Tennant at firstname.lastname@example.com


text: Here are Ray's links of the day: #1: http://www.checksum.org/download/netsend/ This command line utility allows you to net send people and control the "from" name in the messenger service message. So, you can mess with people and do things like: netsend LUCIFER computerA "KILL FOR ME NOW." Rumor has it can only net send by computer name and is unaware of any messenger service registered names in the target machine's netbios table. I tried net sending by username that does have a <03> registration, and the person did NOT receive the message. #2: http://news.cis.dfn.de/ This is a free nntp server that performs well. It is not open to the public, and it does require that you e-mail them requesting access. A simple e-mail like this: Name: Ray Costanzo E-mail: ray@xxxxxxxxxxxx is ample. One drawback is that their terms of use mandate that you use a valid e-mail address when you post. This will generate spam, but what I do, as I'm sure many people do, is setup an e-mail address in my domain for it and just delete all messages from that account. They are pretty quick to reply with your authentication information for their nntp server, and they have a decent list of groups. Sorry, I don't think they have any of those "binaries" groups. ;] ----------- Ray at work ********************************************************************************************************** The information contained in this e-mail message is intended only for the personal and confidential use of the recipient(s) named above. Distribution, publication, or retransmission of this message is strictly prohibited. This message may be a bank to client communication and as such is priviliged and confidential. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, and delete the original message. The sender of this e-mail specifically "opts-out" of the Electronic Signatures and Global and National Commerce Act (E-Sign) and any and all similar state and federal acts. Accordingly, but without limitation, any and all documents, contracts, and ageements must contain a handwritten signature of the sender to be legal, valid, and enforceable. ********************************************************************************************************** ******************************************************** This Week's Sponsor - RTO Software / TScale What's keeping you from getting more from your terminal servers? Did you know, in most cases, CPU Utilization IS NOT the single biggest constraint to scaling up?! Get this free white paper to understand the real constraints & how to overcome them. SAVE MONEY by scaling-up rather than buying more servers. http://www.rtosoft.com/Enter.asp?ID=147 ********************************************************** To Unsubscribe, set digest or vacation mode or view archives use the below link. http://thethin.net/win2000list.cfm


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This was a nice motel / hotel and we will stay here again. They had an elevator, which I needed as our room was on the 3rd floor. Very nice, helpful staff.
- Official Description (provided by the hotel):
- Hotel is conveniently located 11 mile north of Denver Downtown (Pepsi center, Coors Field, Mile High Stadium, Elitches). The RTD park-n-ride across from Hotel for Express bus service to DIA, Denver DTN, Boulder or just local transportation. Stay here, then Hub & Spoke to Estes Park, Ft. Collins, Greeley, Golden, Central City/Black Hawk. We're only 90 miles from Pikes Peak, Air Force Academy in Colorado Springs Area. Going to Water World, Boondocks, Jump Street ? Ride RTD to Rockies, Bronco, Nugget, AV's or CU-Buff games. ... more less
- Reservation Options:
- TripAdvisor is proud to partner with Booking.com, Expedia, Hotels.com, Ebookers, HotelsClick, Evoline ltd, Cancelon, getaroom.com and 5viajes2012 S.L. so you can book your Super 8 Westminster Denver North reservations with confidence. We help millions of travellers each month to find the perfect hotel for both holiday and business trips, always with the best discounts and special offers.
- Also Known As:
- Super 8 Westminister Denver North Hotel Westminster


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Hey so you made it to my contact page, go crazy and actually contact me. Don't be shy send over an email, but keep the spam and long paragraphs to a minimum.
I'm a freelance illustrator / webdesigner with experience in designing new sites /logos/ branding for businesses. I am proficient in dreamweaver/ photoshop but I still love the old fashioned pen to paper style of art.
I believe in the d.i.y ethos in art. Building my own 4 colour screen printer to make merch for myself and independent shops in the southwest. I have a vast experience in producing graphics for print and working colaboratively on projects.
Online marketing strategist, SEO, website content management. Creative thinker coming up with new ideas and seeing them though to marketable templates/ graphics in order to drive businesses forward.
If you are interested in working with me you might like to check out my online cv, I have joined businesses that have made record breaking profits and i'm pretty good at drawing too.


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We welcomed a delegation from Botswana at Land Registry Head Office last week, for a 2 1/2 day programme. Visits from groups originating from all over the world are a regular occurrence for us in the International Unit, but how do the groups contact us, what does it involve to organise a study visit and what do the visits mean for Land Registry?
Most of our enquiries come through known contacts, from returning organisations who deliver programmes for overseas delegations and through the International Unit mailbox and telephone number found via the website. Recent visits have included delegates from Botswana, China, Saudi Arabia, Nigeria, South Korea, Cyprus, Russia and Malaysia.
We have to ascertain exactly what the visitors would like to hear about when they're here, which is not always an easy task. Often we end up amending the programme to include last minute requests when the group arrive! As well as arranging a suitable and informative programme there are many practical requests we take care of including assisting with visa applications, arranging facilities for prayer, organising refreshments (including adhering to any particular dietary requirements), arranging an interpreter if required and putting together packs for the group to take away.
The International Unit team has lots of experience collectively from across the organisation but we are not experts in every topic and so the involvement of our colleagues from relevant areas of the organisation is vital. Not only is the quality of the visit improved, but this work also provides opportunities for different people to get involved, some of whom have already expressed an interest in international work. The visiting delegations don't just stay at Head Office either; it really depends on what the visitors are interested in and where they are located. For example Information Systems in Plymouth is great if visitors are particularly interested in IT, Nottingham Office for visitors brought from Nottingham University, Telford Office for visitors brought to us by the University of Wolverhampton and Weymouth Office is ideal when combining with a visit to Ordnance Survey. Through these visits, our staff are given an opportunity to get involved in something a bit different and it's a chance for them to practice their presentation skills. They also have the opportunity to engage with visitors from other countries and learn how things are done overseas.
Our visitors are from diverse countries and cultures, which enables us to learn from others and bring this knowledge back into the organisation. It also allows us to stay open to the worldwide environment and make sure that we uphold our vision to be recognised as a world leader in digital delivery of land registration services. We welcome Ministers, Permanent Secretaries, Deputy Permanent Secretaries, academics, and our counterparts from registration authorities overseas to Land Registry and we have received very positive feedback from visiting delegations. We also receive income from the majority of our visits which contributes to the cost of hosting these events. There have also been occasions when the visits have resulted in follow-up consultancy work in country, for example a training design and evaluation project in Uganda.


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Gluten Free Almond Fruit Loaf.
click on image to enlarge [+]
250g Dates, chopped
1 Cup Ground Almonds
1 Cup Red and Green Cherries
1/2 tsp Gluten Free Baking Powder
1/2 Cup Raisins
3 Eggs
1/2 Cup Mixed Peel
2 Tbsps Honey
1 1/2 Cups Brazil Nuts, chopped
1 tsp Vanilla Essence
1 Cup Walnuts
2 Tbsps Rum
Preheat oven to 150°C. Place chopped dates, cherries, raisins, mixed peel, Brazil nuts and walnuts into a bowl. Stir in the ground almonds and baking powder. In another bowl, beat the eggs until thick and then mix in honey and vanilla essence. Add the egg mixture to the dried fruits. Spoon into two loaf tins lined with baking paper or use a lined ring cake tin. Bake for 1 1/2 to 2 hours. Once cooked, brush rum over the loaf whilst it is still hot. Leave to cool in the loaf tins.


text: Davis Community Church believes in a bottom-up approach to ministry together. The various ministries of DCC are open to everyone and are a great first step toward creating meaningful relationships with others. If you are looking for a way to find community in Davis, there's no better way to do that than by joining an intentionally loving, open and accepting group. Read about DCC's ministries below, and click on "contact a ministry" to learn more and connect.


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C. 1990 Vintage .50 ct. t.w. Diamond Ring in 14kt Yellow Gold. Size 7
Item#: 883124
C. 1990. From our Estate collection, .50 ct. t.w. marquise and baguette diamonds alternate in this visually-interesting ring set in polished 14kt yellow gold. Diamond ring. Exclusive, one-of-a-kind Estate Jewelry.
Product Details (for C. 1990 Vintage .50 ct. t.w. Diamond Ring in 14kt Yellow Gold. Size 7)
3/16 inch
14kt close 14KT: Karat (abbreviated kt or K) is a unit that indicates the purity of gold in the metal. 14kt is 58.33% gold. In the United States, 14K yellow gold is most favored and used in jewelry. Yellow Gold close YELLOW GOLD: Gold is a precious metal with a natural yellow color. It is quite soft and often alloyed with other metals to increase its strength. The purity of the metal is indicated by a unit called a "karat," with 24kt having the highest percentage of natural gold.
Polished close POLISHED: A buffed-out finish used to produce a mirror-like shine.
Gemstone 1:
Diamond close Diamond: The hardest and most brilliant of all gemstones, a diamond can make the heart race with its pure and fiery spark. An ancient symbol of love, a diamond is the preferred gemstone for tokens of affection, such as rings, earrings, necklaces and bracelets. Diamond is the birthstone for April. (Quantity: 5, Shape & Cutting Style: Marquise close MARQUISE: An elliptical shape that comes to a point at the top and bottom. Sometimes referred to as a "navette." , Color Grade: H-I close Color Grade H-I: Near-colorless , Clarity: SI2-I1, Weight: 0.35 ct. t.w.)
Gemstone 2:
Diamond (Quantity: 16, Shape & Cutting Style: Baguette close BAGUETTE: An elongated rectangle step-cut. Typically used for smaller diamonds, but can be found in other gemstone as well. , Color Grade: H-I, Clarity: SI2-I1, Weight: 0.15 ct. t.w.)
All weights and measures are approximate.
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text:
New Space and Orbit GamesFree
Never played Space and orbit games If you love to combat with aliens and conquer over the outer space, then you will be amazed by a large collection of space and orbit games in this App Destroy the alien enemies and save the earth from the strongest forces Win over the strange creatures and flying objects Show your gaming skills and protect the blue planet from extra terrestrial attacks
Downloads: 72+ (for Android)Report app for spam or abuse!
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Download GTA 5 apk file by clicking the download button given below If you are downloading the file


text:
"Only Our Service Exceeds Our Quality!"
Infinity Cutting Tools is a worldwide distributor of high quality woodworking tools with headquarters in Tampa, Florida. We specialize in premium quality router bits, router bit sets, shaper cutters, carbide sawblades, stacked dado blades, planer & jointer knives, insert tooling, and many more woodworking accessories.


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Scrabble?! LEVITATIONS
Is LEVITATIONS valid for Scrabble? Words With Friends? Other games?!
Definitions of LEVITATIONS in various dictionaries:
- noun - the phenomenon of a person or thing rising into the air by apparently supernatural means
- noun - movement upward in virtue of lightness
- noun - the act of raising (a body) from the ground by presumably spiritualistic means
There are 11 letters in LEVITATIONS: A E I I L N O S T T V
Scrabble results that can be created with an extra letter added to LEVITATIONS
To search all scrabble anagrams of LEVITATIONS, to go: LEVITATIONS?
Rearrange the letters in LEVITATIONS and see some winning combinations
11 letters out of LEVITATIONS
10 letters out of LEVITATIONS
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8 letters out of LEVITATIONS
7 letters out of LEVITATIONS
6 letters out of LEVITATIONS
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Contextual use of LEVITATIONS
About LEVITATIONS
What's nearby LEVITATIONS
Lookup in Wiki for LEVITATIONS
Anagrammer is a game resource site that has been extremely popular with players of popular games like Scrabble, Lexulous, WordFeud, Letterpress, Ruzzle, Hangman and so forth. We maintain regularly updated dictionaries of almost every game out there. To be successful in these board games you must learn as many valid words as possible, but in order to take your game to the next level you also need to improve your anagramming skills, spelling, counting and probability analysis. Make sure to bookmark every unscrambler we provide on this site. Explore deeper into our site and you will find many educational tools, flash cards and so much more that will make you a much better player. This page covers all aspects of LEVITATIONS, do not miss the additional links under "More about: LEVITATIONS"


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How to for photography in severe storms.
Here be Dragons… and Other Things I Like
How to for photography in severe storms.
|Which famous photographer are you?Henri Cartier-Bresson: Known for street photography and photojournalism"We are passive onlookers in a world that moves perpetually. Our only moment of creation is that 1/125th of a second when the shutter clicks, the signal is given, and motion is stopped…"
|Click Here to Take This Quiz
Brought to you by YouThink.com quizzes and personality tests.
|Which time and place do you belong in?
Paleolithic Ages
You belong at the dawn of man, you are strong and innovative, and love the outdoors (Possibly enjoy spelunking as well)
|Click Here to Take This Quiz
Brought to you by YouThink.com quizzes and personality tests.
I created a new Flickr group, Living Dolls.
About Living Dolls
Little dolls (or Barbie doll sized) bought at thrift stores or other second hand places. There are an endless supply of unwanted dollies, cheap. Buy those which appeal to you and seem fixable. Clean them up, make them new clothes if you can and when you have photographed them all you wish to find them a new home. I suggest taking them to your local women's shelter or hospital.
The dolls are put into situations where they are in peril or just struggling to live as a little doll in the great, big world. Think of unique and creative ways a small doll (just a couple of inches tall) would make a life for herself. How would she (he) live, where would she live and how would she keep her existence a secret?
There are other groups for adult stuff with dolls. This should just be fun.


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1966 Wantagh Ave Wantagh, NY 11793 (800) 649-3739
Can't find the item you are looking for using the search and browse tools above? Click Here to view a wider selection that includes items we can special-order for you.
Be safe out there with Serfas' TL-STN Seat Stay Taillight. This water-resistant safety beacon will get you noticed out on the road with a large, super-bright 1/2-watt red LED flanked by 6 brilliant smaller LEDs. Plus, the weatherproof silicone body stretches to easily mount to any tube on your bike. Use a few Seat Stay Taillights for 360-degrees of visibility! This great light has steady, strobe and flash modes.
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Brands Cycle and Fitness :: 1966 Wantagh Ave, Wantagh, NY 11793 (Map) :: (800) 649-3739
Home | Cart | My Account | Contact Us | Policies and Shipping | Your Privacy
*Free shipping on parts, accessories, bicycles and most exercise equipment to the 48 contiguous states.
Some restrictions apply on some oversized items.


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Skinny Water Comes to All 520 Stop & Shop and Giant Supermarkets
BALA CYNWYD, Pa.–(BUSINESS WIRE)–SKINNY NUTRITIONAL CORP. (OTCBB: SKNY), the makers of Skinny Water® and leader in the zero calorie enhanced water category, today announced the company has been authorized for sale in both Stop & Shop® and Giant® supermarkets. Skinny Water will be available in all Stop & Shop and Giant's 520 locations. Skinny Water also has regional authorizations with Acme Markets®, Giant Food Supermarkets®, Shaw's® and others. The total number of chain-authorized stores now is over 3,000.
"Being on the shelves of Stop and Shop and Giant supermarkets is an important step for Skinny Water," says Ron Wilson, CEO of Skinny Nutritional Corp. ® "Consumers everywhere are looking for a great tasting drink that doesn't have all the sugar and calories that many of the other beverages on the market have. Between Stop and Shop and Giant®, their 520 stores in 7 states will provide a great number of those people with exactly what they are looking for."
The Skinny Water lineup features six great tasting flavors, including Acai Grape Blueberry (Hi-Energy), Raspberry Pomegranate (Crave Control), Orange Cranberry Tangerine (Wake Up) Goji Fruit Punch (Shape), Lemonade Passionfruit (Total-V), and Peach Mango Mandarin (XXX-Detox). Every bottle of Skinny Water has calcium, potassium, and EGCG and has zero calories, sugar, sodium, no preservatives, and all natural colors and flavors.
About Skinny Nutritional Corp.
Headquartered in Bala Cynwyd, Pa., Skinny Nutritional Corp., the creators of Skinny Water®, a zero-calorie, zero-sugar, zero-sodium and zero-preservative enhanced water. Skinny Water comes in six great tasting flavors that include Acai Grape Blueberry, Goji Fruit Punch, Peach Mango Mandarin, Raspberry Pomegranate, Orange Cranberry Tangerine and Lemonade Passionfruit. Skinny Nutritional Corp. also expects to launch additional branded products, including Skinny Tea®, and other Skinny branded beverages. For more information, visit www.SkinnyWater.com.
About Stop & Shop
The Stop and Shop Supermarket Company, based in Quincy, Mass., employs more than 59,000 associates and operates stores throughout Massachusetts, Connecticut, Rhode Island, Maine, New Hampshire, New York and New Jersey. For more on Stop & Shop, visit www.stopandshop.com.
About Giant Food
Giant Food LLC, headquartered in Landover, MD, Operates 182 supermarkets in Virginia, Maryland, Delaware and the District of Columbia, and employs approximately 21,000 associates. Included within the 182 stores are 163 full-service pharmacies. For more on Giant, visit www.giantfood.com.


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For the Cat in the Hat skewers, they are sliced strawberries and cubed pound cake. You can go the easy route and buy the already made frozen pound cake but I could only find sliced ones at the store (I couldn't find the loaf). I couldn't justify paying $4 for six slices so I baked some last night. You can also make these really fancy and more appropriate for dessert/adults by drizzling them with melted chocolate. Yum! And please note that I used Popsicle sticks instead of the sharp wooden skewers since my little toddler will be eating these. This is very important if you have little ones in the house! Safety first.
Nathaniel thought the green scrambled eggs were cake :) He eventually figured out they were eggs once he touched them and he did not have any issue eating them at all.
Oh, and we are going to watch Lorax tomorrow. Happy birthday, Dr. Seuss!
Linking up to:


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Apartment Smaragdinus A24
Smaragdinus A24 Dubrovnik apartment is located in old Dubrovnik, minutes away from Dubrovnik old town - Ploce Gate, Dubrovnik old town - Pile Gate and Onofrio's Fountain.
Just 2 km from the center of Dubrovnik known for Dubrovnik Bridge, Lapad Beach and Lapad Bay. Offering croatian meals, Restaurant Mimoza is around 250 meters away.
The apartment offers rooms with free Wi-Fi, a dining area and a sofa for a comfortable stay in Dubrovnik. There is a private bathroom.
Guests can benefit from a kitchen fitted with a microwave and a dishwasher.
Fast access to Dubrovnik airport within 5 km is provided.


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It has been reported that Nigeria President, Muhammadu Buhari, has issued an order for the Special Investigation Panel of the Nigerian police to investigate his chief of staff, Alhaji Abba Kyari, over allegations of bribery.
According to Vanguard, the investigation is tied to an alleged N500 million bribery. The money was said to have been paid to the Chief of staff by officials of South African owned Tele Comms Company, MTN, in order for him to influence government to have a change of mind on its position over the $5 billion fine imposed on the company.
Recall that the Nigerian Communications Commission, NCC, gave a $5 billion fine on MTN for failing to disconnect subscribers with unregistered phone lines bought before January 2012; a disobedience believed to have expedited activities of terrorists and kidnapping kingpins who perpetrated several of their homicidal and wicked acts that proved costly to the nation.
However, after several failed attempts by MTN to fight the huge fine imposition, firstly through the courts and after through diplomatic means, an online media (Sahara Reporters) published a report on 20th September 2016, adding that MTN officials gave a bribe of N500 million to Alhaji Abba Kyari, in order that he might use his closeness to President Buhari to influence the federal government decision in their favour.
The Presidency, worried by the claim, is said to have directed the inspector general of Police, Ibrahim Idris to open an investigation into the matter and come out with findings regarding the accusation.
Unfortunately but, a source close to the investigation panel who spoke under anonymity as he was not authorised to speak on the matter, disclosed that days after the investigation began, efforts to get Sahara reporters to present evidence of the N500 million bribe; when it was given, where and how the money was collected have all failed and the fact that the online medium is based in the U.S makes it more frustrating.
The source said:
"Officials of MTN, who were invited and interviewed over the allegation, have vehemently denied that any such money emanated from the telecommunication company and that since the beginning of the $5 billion fine saga, no one had been approached for a bribe.
"Another thing is that if such volume of money was paid through the banks, discreet investigation of financial dealings on the part of MTN and on the part of the COS has to this point not disclosed any transactions of such."
There are indications that the team of Police Investigators handling the case may conclude the report of the allegation soon if the grace period it has given the online media organisation ends and they still do not give evidence to support the allegation


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|Home | About | Journals | Submit | Contact Us | Français
Natural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention.
To examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1) epidemiology of injury and disability, (2) impact on health and rehabilitation systems, and (3) the assessment and measurement of disability.
Qualitative literature review and secondary data analysis.
Absolute numbers of injuries as well as injury to death ratios in natural disasters have increased significantly over the last 40 years. Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI), and long bone fractures. Studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. Lack of health-related rehabilitation in natural disaster relief may result in additional burdening of the health system capacity, exacerbating baseline weak rehabilitation and health system infrastructure. Little scientific evidence on the effectiveness of health-related rehabilitation interventions following natural disaster exists, however. Although systematic assessment and measurement of disability after a natural disaster is currently lacking, new approaches have been suggested.
Health-related rehabilitation potentially results in decreased morbidity due to disabling injuries sustained during a natural disaster and is, therefore, an essential component of the medical response by the host and international communities. Significant systematic challenges to effective delivery of rehabilitation interventions during disaster include a lack of trained responders as well as a lack of medical recordkeeping, data collection, and established outcome measures. Additional development of health-related rehabilitation following natural disaster is urgently required.
Natural disasters result in significant mortality, morbidity, and disability due to high numbers of traumatic injuries that severely impact the health of the injured population and the overall health system of the affected country. Emergency response and recovery efforts to mitigate disaster-related disability by both host national and international responders are significantly challenged by the relative absence of health-related rehabilitation perspective. The primary objective of this paper is to examine the role of health-related rehabilitation in natural disaster relief in terms of three lines of inquiry: first, the epidemiology of injury and disability in natural disasters; second, the impact of natural disasters on health and rehabilitation systems; and lastly, the assessment and measurement of disability due to natural disasters. Selected challenges to and strategies for providing effective health-related rehabilitation following a natural disaster are also addressed.
A natural disaster may be defined as 'sudden ecological disruption or threat that exceeds the adjustment capacity of the affected community and requires external assistance' (1, 2). Natural disasters include earthquakes, floods, tidal waves (tsunamis), landslides, hurricanes, volcanic eruptions, as well as droughts (2).
Natural disasters result in immediate, significant loss of life and long-term physical impairments such as spinal cord injuries (SCI), traumatic brain injuries (TBI), amputations, fractures, and peripheral nerve injuries (3); related mental health conditions including situational anxiety and post-traumatic stress disorder occur concomitantly (4–7). In addition to acute injuries, persons also suffer exacerbations of pre-existing chronic health problems and disabilities (8–11).
Though saving lives immediately after a natural disaster is the highest initial priority, the focus of the local and international medical response effort quickly shifts to the treatment of severe, traumatic injuries and related health problems (12). From the perspective of health-related rehabilitation, the primary focus is the 'functioning' of the surviving population. As defined by the World Health Organization's (WHO) International Classification of Functioning, Disability, and Health (ICF), 'functioning' is a dynamic interaction of the health and health-related domains of 'body functions and structures' as well as 'activity and participation.' 'Disability' is an umbrella term for impairment in body functions or structures and limitation in activity and/or restriction in participation. Since an individual's functioning and disability occurs within a larger social and individual context, the ICF also includes environmental and personal factors (13) (see Fig. 1). Accordingly, health-related rehabilitation is a major health strategy that focuses on the functioning (i.e. functional status) of persons with physical or mental disability and considers their resources and environment (14, 15).
Health-related rehabilitation begins with the onset of injury or disease and can extend over a lifetime, often involving treatment in the hospital, community, and home settings. Since a person's functional needs require attention in the immediate living environment as well as in the greater community (15), a range of activities including provision of accessible and appropriate home care; housing; transportation; and educational, vocational, and social opportunities is necessary. Based on the person's unique medical needs, health-related rehabilitation is best delivered by a multi-disciplinary team including, at a minimum, a specialist in Physical and Rehabilitation Medicine (PRM), a physical therapist, an occupational therapist, and a rehabilitation nurse (16).
As an expert in disability and functioning who is also trained in the diagnosis and treatment of general health problems, the PRM physician performs a critical role in integrating rehabilitation efforts with other health strategies and providers. Physical and occupational therapists trained in neurological and orthopedic rehabilitation perform indicated interventions; a rehabilitation nurse provides overall medical case management; the rehabilitation psychologist provides impairment and bereavement counseling and also connects the patient to psychosocial supports in the community – especially critical when family members, relatives, and homes are lost (17). Non-medical caregivers ideally become increasingly involved in the rehabilitation process as the person's medical status and needs change. Their committed participation is essential for optimal outcomes and even survival, especially for the low functioning, highly dependent patient in the home setting.
This paper is based on a scientific literature review supplemented by secondary analysis of injury data as well as reports from the gray literature.
A qualitative literature review was conducted including searches of the internet-based, open access databases PubMed and Google Scholar. Due to high relevance to the role of health-related rehabilitation in disaster relief, searches were performed on the epidemiology of injury and disability in natural disaster, the impact of natural disasters on health and rehabilitation systems, and the assessment and measurement of disability due to natural disasters. These lines of inquiry were chosen according to the key aspects of the MICRODIS research program on health impacts of natural disaster (18).
The WHO-sponsored Emergency Events Database EM-DAT ( www.emdat.be) served as the data source for numbers of injuries and deaths in natural disasters by year of event (1970–2010), region, and country. Absolute numbers of injuries and deaths due to natural disasters of all kinds were extracted by year and region (N=246). As regards earthquakes, we also calculated ratios of injuries to deaths for each year and country (N=568); cases in which no deaths were reported were excluded. We compared these data along 10-year periods by analyses of variance. To test for statistical significance of differences in numbers of injuries, numbers of deaths, and injuries to death ratios between time periods, we performed post hoc tests with Dunnett's T3 correction for multiple testing in the case of inhomogeneous variances between groups (19). Level of significance was alpha error probability (p)=.05. The Dunnett T3 correction is conservative in that the family wise error rate (i.e. the error rate for the whole set of comparisons between groups) will never exceed alpha. In the case of injuries and deaths due to all natural disasters, we performed a separate analysis for the Asian region (N=41). We supplemented the post hoc comparison of time periods with two negative binomial regressions of the number of injuries and deaths, respectively, on the year of the event. In the case of injuries to deaths ratios in earthquakes, we calculated a Generalized Estimated Equation (GEE) model, fitted to a negative binomial distribution, and using country as panel and year as time variable. All calculations were made either with Stata 11 or with SPSS 14.
The incidence of morbidity and mortality caused by natural disasters is highly variable and depends upon many environmental and human factors (20–22). Earthquakes in the People's Republic of China from 2000 to 2009, for instance, injured 387,829 persons (0.7% of all affected persons) and killed 87,947 people (0.17%) (22). A higher percentage of the affected population was injured (4.4%) or killed (2.5%) in the Armenian earthquake of 1988. Adolescents and persons aged 40 and older were disproportionately injured; also, persons residing in taller buildings and higher within the buildings suffered higher incidences of injury (20). The 2010 earthquake in Haiti injured about 300,000 (8.8%) and killed 222,570 people (6.5%) with 3,400,000 being affected (22). Significant causes of this devastating effect include the proximity of the epicenter to the densely populated center of Port-au-Prince on a busy weekday afternoon and the low-quality concrete building construction. Conversely, in the United States earthquakes affected 30,619 persons from 2000 to 2009; 523 injuries (1.7%) and only 3 deaths are reported (22). Floods, by comparison, cause fewer injuries than earthquakes; the recent flood in Pakistan, for example, resulted in 2,327 injuries (0.00011%) and 2,021 deaths (0.00010%) reported (22).
Fig. 2 shows the absolute number of primary injuries reported globally across all natural disasters from 1970 to 2010. The Asian continent is significant for an increase in the absolute number of reported injuries despite the fact that the population of the Asia-Pacific region has been growing more slowly than that of the rest of the world since 1990, dropping from 1.5% in the early 1990s to 1.0% in 2008 (23).
Fig. 3 displays mean numbers of reported injuries and deaths due to all natural disasters in Asia in 10-year periods since 1970; injuries are more prominent than deaths dating from 1980 to 1989. The following differences in mean numbers of injuries were statistically significant according to Dunnett T3 post hoc tests: 1970–1979 versus 1990–1999 and 1980–1989 versus 1990–1999. The difference of the periods 1980–1989 and 2000–2010 was almost significant (p=.054). No differences in mean numbers of death reached the level of significance (see Figs. 2 and and3).3). This result was confirmed by the two negative binomial regressions of the numbers of injuries and deaths, respectively, on year of event (injuries: b Year=0.064; p<0.001; deaths: b Year=0–.003; not significant).
Fig. 4 indicates the odds ratio of sustaining injury compared to death in earthquakes globally since 1970; the increasing odds of injury over time may be due to both, advances in natural disaster response and changes in definitions of injury, measurement, or reporting of data. The following differences were statistically significant according to Dunnett T3 post hoc tests: 1970–1979 versus all other periods; 1980–1989 versus 2000–2011. It is important to note that results may be different if other time periods were chosen. However, a significant trend regarding an increase in the (odds) ratio of injuries to deaths over time was also confirmed by the GEE model (b Year=0.049, p<0.001) (see Fig. 4).
Data on types of disaster-induced injury and potentially disabling conditions are less available and mostly derived from chart reviews of individual hospitals as opposed to multi-center or population-based studies (24). Consequently, disability in the community in developing regions is relatively unstudied. Major and potentially disabling injuries after natural disasters that have been documented include SCI, TBI, limb amputation, long bone fractures, crush injuries, and peripheral nerve injuries (25–30). Minor injuries include conditions such as swollen feet and legs, leg pain and cramps, tendonitis/fasciitis, wound infections, and musculoskeletal strain and pain (31–34).
Reliable data on the distribution of these injury types in disaster-affected populations are widely unavailable.
Key concepts such as definitions, even conventional, that describe the population exposed to death and injury from earthquakes have yet to be established. As a result, not only are results from different studies not comparable, denominators are inadequate even within a study, making rates and ratios suspect. (35)
Various sources of bias in recording of injury data exist as well. Studies reflect findings in individuals who present for care at medical facilities, largely excluding those who do not, for example; even more significantly, functional health outcomes and long-term disability measures are seldom collated for analysis even if performed. Finally, aggregate population injury is rarely systematically assessed at the time of disaster when its knowledge could potentially have the most impact.
Persons with pre-existing physical disabilities and those with chronic physical and mental health conditions as well as very young and old people are at increased risk for suffering additional co-morbidities as a result of a natural disaster. Even when evacuated safely, the loss of medications, assistive devices, and support personnel can worsen the condition of these vulnerable persons and further impair their overall functioning and quality of life (10, 36, 37). Moreover, these persons often have greater difficulty meeting basic needs following a natural disaster since adequate transportation and sheltering are often not included in local disaster response plans (9, 11). Compromised basic and specialty medical care following a natural disaster also increases risk of medical complications including infection, organ failure, and even death (38–40). According to a study after the great Hanshin-Awaji earthquake in 1995, it was found that the odds ratio (OR) of death for persons with pre-existing physical disabilities nearly doubled (41); a similar study after the Taiwanese earthquake in 1999 (40) found that the OR was 1.7 for deaths of persons with pre-existing moderate physical disability and doubled for persons with pre-existing mental conditions.
There are few studies that evaluate the effectiveness of rehabilitation interventions following a natural disaster. Since prospective, randomized controlled trials of specific interventions following disaster are not feasible, retrospective analyses of hospital cohorts, observational studies, and surveys are performed to measure the clinical impact of physical rehabilitation on disaster-induced disability. For example, it was demonstrated following the 2005 earthquake in Pakistan that patients under the care of PRM physicians had reduced lengths of hospital stay, fewer complications, and better clinical outcomes than patients in centers with no physiatrist supervision (42, 43). Conversely, it was noted that although early rehabilitation of SCI survivors in major provincial hospitals following the 2008 Sichuan Earthquake showed generally positive results, post-discharge follow-up resulted in a reverse of functional gains as well as secondary complications in some patients due primarily to insufficient long-term, community-based rehabilitation (CBR) resources (44).
The significant negative health consequences of natural disasters usually overwhelm the affected society including the health system (45), especially in low-resourced regions of the world where most natural disasters occur (46). Moreover, health professionals and their families may be affected themselves, thereby limiting medical facility and professional organization response as well as disrupting overall societal function (47). Destruction or weakening of pre-existing rehabilitation services translates into minimal rehabilitative strategy being practiced during the immediate emergency response, further burdening an already challenged post-disaster health system. Poor functional outcomes and long-term negative consequences for the individual, community, and society result. The unexpected death or disability of an earning family member, for instance, can impoverish the family (36). Efficient use of rehabilitative strategies will not only help unburden the challenged health system by mobilizing patients, but will also facilitate recovery of the post-disaster society by facilitating victims' access to education and employment opportunities.
Regrettably, the provision of rehabilitative services is extremely limited during the immediate emergency response due to surgical bias of responding teams and the general lack of rehabilitation knowledge of team members. The lack of host rehabilitation and health services infrastructure compounds the lack of rehabilitation perspective; often few or no rehabilitation services or professional providers, especially PRM physicians, exist in areas affected by natural disasters (10, 48–50). To compensate for this lack of expertise, rehabilitation training strategies are required (50, 51). Foreign rehabilitation responders can provide focused training to fellow team members as well as to local rehabilitation and non-rehabilitation providers in the field, hospital, and community settings throughout the disaster response. This expertise results in improved patient outcomes and also builds local rehabilitation infrastructure capacity.
Ideally, rehabilitation providers participate in victim triage, consult peri-operatively, and assist with post-operative care. Lack of rehabilitation expertise post-operatively, for example, can result in pressure sores and wound infections in mobility-limited persons (10). In an extreme case, SCI patients were found to be waiting for a cure and had not begun rehabilitative measures 8 months after the 2003 earthquake in Bam, Iran (52). Missed critical, injury-specific therapeutic windows result in longer hospital lengths of stay and translate to suboptimal functional outcomes with long-term negative consequences for the individual and the society (36). Besides making critically needed hospital beds available, effective rehabilitative strategies also help return family members to work producing income to sustain the family and reconstruct the post-disaster society.
Foreign responding organizations with rehabilitation personnel face significant challenges to effective deployment within the disaster zone. Individual rehabilitation providers must be properly qualified, the team deployment-ready, travel arranged, and on-scene assignment confirmed with the host country responsible organization(s). On arrival in the host country, travel to the deployment areas can be complicated by vehicle terrain and uncertainty.
Even if effectively deployed, however, international service providers must be aware that rehabilitation service coordination between the host organization, local Disabled persons organizations (DPOs), the central disaster rehabilitation response authority, and collaborating rehabilitation non-governmental organizations (NGOs) may be limited (3, 48, 53). Unfortunately, since 'disability' is considered a 'cross-cutting issue' (54) within the humanitarian response framework (i.e. as opposed to specifically identified areas of coordination including 'food,' 'education,' and 'health'), disability issues appear at risk for more inefficient communication, coordination, and resource allocation (55). Consequently, responding foreign teams must assume responsibility for coordinating directly with other rehabilitation providers to ensure that appropriate interventions are performed in the acute care setting initially and subsequently in community follow-up.
Also, closely held cultural beliefs about health-related rehabilitation and disability (36, 52) sometimes limit the potential impact of rehabilitative services. Often, disability is viewed as a static rather than as a dynamic condition (56). For example, in many low-resourced countries it is believed that persons with permanent impairments such as SCI will depend on their families and be an object of charity their entire life. Disability is alsocommonly believed to be contagious and therefore to affect the entire family (54, 57).
Severe traumatic injuries sustained in a natural disaster require specialized management from the onset to reduce mortality and morbidity and to optimize individual functioning including social participation. Delay in treatment reduces effectiveness of rehabilitative therapies, resulting in poorer outcomes. Both TBI and SCI victims require immediate evacuation from the disaster zone to tertiary care facilities as opposed to nearby temporary shelters, field hospitals, or community hospitals. Spinal cord patients require specialized transport/transfer protocols and expert consultation for decision-making on definitive management (conservative vs. surgical) (48, 49).
Once stabilized and managed in the appropriate inpatient setting, these patients can be transferred to either a less acute care setting or to their home where they will benefit from treatment provided by their caregiver, a community-based facility, or a mobile rehabilitation service depending on specific needs. These services would also identify and treat disaster victims who may not have received care as well as those with pre-existing disability who could benefit from rehabilitative therapies. Optimal rehabilitative and medical care initiated following a natural disaster, however, results in a higher incidence of survivors with a significant physical disability (i.e. SCI) that can require significant long-term rehabilitative care. Lesser impaired individuals will also require necessary rehabilitation.
Patients can be trained in the use adaptive technologies, assistive devices, and mobility aids depending on their level of functional need. Medical equipment, however, must be compatible with the technological standards and physical environment of the affected community (58); powered wheelchairs are difficult to operate and maintain in developing countries, for example (59).
Significant injuries and associated surgical and rehabilitative care are often poorly documented during the immediate response to a natural disaster due to the emergent focus on saving and salvaging lives amidst chaotic, austere conditions. The loss of host facilities and personnel combined with the influx of international teams with varying recordkeeping practices can compromise recordkeeping further. Even well-established teams, however, may maintain substandard records and not provide them to receiving facilities on transfer or to patients upon discharge unless directly instructed by the host institution or government. Independently functioning international teams that do keep adequate records may not provide them to the national hosts on departure. This fragmentation and inconsistency of medical recordkeeping compromises surgical-rehabilitation continuity of care, especially as patients are transferred to the community, resulting in poorer patient outcomes.
Incomplete medical recordkeeping also limits further analysis since epidemiological data of post-disaster injury is usually extracted from individual hospital chart reviews and therefore may not accurately represent the affected population. (Also, facility records only reflect injured persons who present for care, as indicated earlier.) Consequently, comprehensive data following a natural disaster from which long-term delivery of rehabilitative services can be planned is not generally available.
Compounding incomplete disaster baseline and vital statistics, measurement of the impact of disaster-induced disability is further challenged by the lack of availability of appropriate standard indicators. The Disability Adjusted Life Year (DALY) is the main indicator of cost-effectiveness of risk control measures and widely used by WHO and the World Bank (60); however, its use is limited in national health services. The DALYs are based on an individual's underlying medical diagnosis and therefore they do not reflect the change in functional status or well-being due to rehabilitation services. Moreover, DALYs may be unreliable since they do not adjust for personal or environmental factors (61, 62). Other functional status measures (63) such as the Functional Independence Measure (FIM) (64, 65) are employed in research and clinical settings. Unfortunately, their use is generally restricted to the inpatient setting in developed countries and field use is impractical as these instruments require trained administration and are time-consuming to administer. Moreover, their inter-cultural validity as well as suitability for largely illiterate populations is questionable, indicating use of language independent assessment tools (66).
To answer the call for more effective assessment of the impact of rehabilitative interventions on the lives of persons with disabilities, several measures have been proposed based on the WHO's International Classification of Functioning, Disability, and Health (ICF). The WHO Disability Assessment Schedule (WHODAS 2.0) is an example of open resource instrument that can be used in population surveys (67). Regardless of what measure and indicators are developed, however, the humanitarian health community must readily adopt these evidence-based approaches in order to better measure the impact of its rehabilitation programming and to reduce the delayed health impact on the affected population (68).
System impacts of disability and rehabilitation after a natural disaster can foreseeably be modeled with cost-effectiveness analyses (CEA). These CEAs are economic evaluations widely used in developed countries to assess the relative value of one intervention over another for a given problem or condition. Their use in developing countries is relatively uncommon, although WHO has published standard guidelines for CEAs. One present rehabilitation-related use in the post-trauma setting is that of physiotherapy associated with evaluation of an orthopedic procedure (69). Rehabilitation procedures are more amenable to CEAs than therapeutic treatments. A wider use of existing measurement and assessment measures in addition to the development of new ones is required to more effectively measure the impact of physical rehabilitation strategies on disaster-induced disability in individuals and populations following a natural disaster.
This focused review has examined the role of health-related rehabilitation in disaster relief in terms of the epidemiology of injury and disability in natural disasters, the impact of natural disasters on health and rehabilitation systems, and the assessment of disability due to natural disasters. Selected challenges to and strategies for providing health-related rehabilitation following a natural disaster were addressed.
Although significant mortality, severe disabling injuries, and long-term disability have been demonstrated in natural disasters, health-related rehabilitation is only marginally employed as a disaster planning and response strategy. The necessity of more comprehensive baseline disaster disability statistics and more effective measurement of rehabilitation outcomes in disaster is emphasized. This focused review is intended to guide further inquiry into the role of health-related rehabilitation in disaster relief with the aim of strengthening the rehabilitation perspective in the response to natural disaster.
We gratefully acknowledge the members of the Rehabilitation Disaster Relief Committee of the ISPRM and other members of the international rehabilitation community for their advocacy of the role of health-related rehabilitation in disaster relief.
The authors have not received any funding or benefits from industry or elsewhere to conduct this study.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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Education: Start adding slots
Published 10:00 pm, Tuesday, October 30, 2007
When the state began offering high school juniors and seniors a chance to take some of their classes at community colleges, it was an experiment with a lot of potential benefits. Giving capable students a greater challenge. Offering alternatives to students who found the structure or social milieu of high school stifling. Saving money long term by letting students finish higher education sooner.
Nearly two decades after its 1990 inception, Running Start is an accepted and still-growing part of students' and families' planning for higher education. About 17,000 students enroll in at least some community college classes, earning credit for high school graduation and earning higher credits.
That's an educational and societal success that the Legislature ought to recognize financially. As a Seattle P-I story reported, the State Board of Community and Technical Colleges says state funding comes up short of the actual costs of instruction. The board is making a very reasonable request for an additional $35 million over five years.
That extra money would bring tangible returns. The state board figures Running Start may save taxpayers close to $50 million per year by shortening the time students spend in public education. Young people likely enter the work force sooner, too.
We have a long way to go before public education frees itself from some unnecessary structures. Running Start has broken the mold in ways that should be encouraged.


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The Hitman's Bodyguard Sorry (2017) R | 118 min | Action, Comedy
The world's top bodyguard gets a new client, a hit man who must testify at the International Court of Justice. They must put their differences aside and work together to make it to the trial on time. The Hitman's Bodyguard 2017 Action Comedy MovieRipe
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Release Date 18 August 2017
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For those of you who haven't checked it out yet, I would advise checking out Raising Hope. The show premiered in late 2011, and was one of the new shows that pleasantly suprised me.
The premise of the show is that a slacker in his mid 20's accidentally gets a woman pregnant, and then inherits the baby girl after she is executed for being a serial killer. It is up to him and his family to raise the baby, even though they are far from the tradtional family. In fact, at times they are selfish, paranoid, and wildly inappropriate. Yet they are still warm and caring, despite their eccentricities.
The show mixes clever visual humor and wonderful dry wit to create an experience that suspends your disbelief about the situation and allows you to enjoy the character development. The dynamics between characters is always amusing, and the situations are always delightfully ludacris. This is definitely a show for people who enjoy slightly surreal comedy.
The show is kind of a mix between Arrested Development and Full House. Yeah, I just made that comparison. Basically, it's about a family of nearly crazy people having to raise a baby girl as best they can. The show is funny, it's quirky, and there's lots of love and life lessons learned in a spectacularly unusual fashion every week. I gave it a shot, and ended up loving it.