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These companies have business interest in bus and rail and inspection and testing services respectively. Previously sanitation had been under the direct responsibility of the Ministry of Environment. Saidi Yakubu Othman has outstanding regulatory credentials, having lengthy experience in dealing with government entities and regulators.
In corporate, the firm has an especially strong standing in compliance and regulatory disciplines. This was done carefully, after a monitoring period of two years to ensure safe water quality.
After six years of difficult negotiations, the Prime Ministers of Singapore and Malaysia signed a Memorandum of Understanding in paving the way for an agreement in with Johor that allowed the construction of the dam. As part of the Western Catchment Scheme, completed inanother four rivers were dammed.
The Lower Peirce Reservoir and the Upper Seletar Reservoir were completed in and respectively, in order to supply the rapidly modernising colonial city with sufficient water. Sembcorp Marine is our top pick as we expect order wins to double for Singapore yards by Efforts focus in many areas, but especially in team-based learning, student-centred learning, grading and assessment, effective classroom discussion, impactful feedback, and intercultural engagement for all the divisions - Sciences, Social Sciences, and Humanities.
One was signed in and another one in An improvement in day rates for jackup market should also help sales of existing unsold rigs. RC4 believes in catalysing a generation of systems citizens in Singapore by employing systems thinking and systems dynamic modelling to elicit mental models to emulate the complexity of the problems around us — such as population dynamics, diseases and healthcare.
Mr Wong has been practising law with Ramdas and Wong since June Water from catchment areas[ edit ] See also: Given that most Chinese oil companies are still conservatively budgeting capex inwe believe capex will continue to increase inwhich should support a fundamental recovery in OFS names in NEWater is the brand name given to ultra-pure water that is produced from reclaimed water.
Inthe government initiated a study, the Singapore Water Reclamation Study NEWater Studyto determine if reclaimed water treated to potable standards was a viable source of water.
The low-rise interconnected buildings are nestled against the backdrop of the Kent Ridge Forest, visually distinct with their brick-clad exteriors, open courtyards and heritage trees. The Dar es Salaam office of IMMMA Advocatesa member of the DLA Piper Africa group, suffered a severe explosion in Augustwith reports indicating that several armed men had specifically targeted the building; the motive for the attack has not been identified at the time of writing.
He is a member of the Investment Committee. Located across the NUS Kent Ridge campus, this is where some 2, undergraduate students, 1, graduate students and 1, researchers work, live, and learn in close proximity.
Additionally, the firm has illustrated its market presence in private equity transactions for sizeable private equity houses and development finance institutions DFIs and continues to be a leader in capital markets issuances and banking and finance transactions.
The firm is noted for both Tanzania and East Africa matters. Alongside a vibrant student life, the residential college is a space for discussions on diverse issues, allowing students to develop meaningful engagement with real-world matters. Wastewaterwhich is called used water in Singapore, is treated in conventional advanced wastewater treatment plants that are called reclamation plants in Singapore.
They foresaw the payment of a water rate in addition to the rent for the land.
Both will expire in Mr Wong holds a LL. Dispute resolution, including high-stakes litigation in the telecoms and oil and gas sectors, is another key feature of the practice. The team is also active in telecoms sector IPOs and regulatory work in the industry.
Singapore was thus interested in building a dam on the Johor River in Malaysia and an associated new water treatment plant.
Sadock Magai has a formidable record in mining, oil and gas, and telecoms transactions.MARKET OVERVIEW - The market may struggle as China's intent to bolster economic growth through a looser fiscal policy failed to lift sentiment amid the rumbling trade row, with recent corporate earnings showing little surprises thus far.
A platform to share Singapore Stock Market and Regional News, Technical Analysis of Markets and Analysts Research Reports.
Get detailed information on Keppel Corp (ultimedescente.com) including stock quotes, financial news, historical charts, company background, company fundamentals, company financials, insider trades, annual reports and historical prices in the Company Factsheet. Legal market overview. Tanzania's economic, political and social environment has suffered over the last year and beyond, which has led to considerable challenges for the legal community, not just in responding to a difficult economic climate.
Hyflux, which is developing Singapore's second and largest desalination plant, 'is now in advanced discussions with reputable contractors' to develop the core. Registration to SRI-CONNECT is limited to people with a direct, active and professional interest in Sustainable & Responsible Investment.
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How To Find The Best Group Health Plan For Your Business
The Group Health Insurance industry continues to change with premiums continuing to rise. You have probably changed insurance carrier's multiple times hoping to secure for the deal of the year.
So, the question is: Is that all there is? Change carriers and tweak my benefits?
What To Consider In Your Group Health Plan Decision
Not all Group Health Insurance plans are the same and one of the largest problems we come across in the industry is that so few companies are aware of all of their options. Most of the time, the reason behind this is because businesses are often dependent upon their insurance agent to present them with their group health options. In doing so, it is important for businesses to note and understand that like the differing group health plans on the market, not all agents are alike. Agents often differ greatly in regard to their level of experience and general knowledge pertaining to new and emerging trends in the industry.
Final Market Stabilization Rule
Change in Household Size
Special Enrollment Period
Loss of Coverage
Special Enrollment Period
– Termination of group coverage
– Reduction of hours to part-time status
– Loss of employer contribution
– Cobra ending
5 Tips for Fighting the Flu in the Workplace
Fighting the Flu can be a big disruption for business. Employees who are sick may need to take time off to recover and may not be as productive when it comes to getting work done. In addition, symptoms such as coughing, sneezing, and fever can spread germs to healthy employees.
Don't Wait Until the Health Insurance Deadline to Apply
Health Insurance Terms
Understanding Health Insurance Terms
Coinsurance is your share of the costs of a covered healthcare service calculated as a percent (for example, 20 percent) of the allowed amount for the service. You pay coinsurance plus any deductibles you still owe for a covered health service.
A premium is the amount of money charged by an insurance company for coverage. The cost of premiums may be determined by several factors, including age, geographic area, tobacco use, and number of dependents.

subset: commoncrawl


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It must be my day for problems.
When trying to slide the Bendix assembly onto the starter shaft, it will go as far as covering the key slot about 3/4's then stops.
Anyone have a trick to getting it to continue? I put gear oil in the assembly shaft and on the starter shaft, didn't help.
I've never had that problem, but perhaps there is a burr on the shaft near the key slot, or perhaps the key is not staying fully seated in its slot as you try to slide the Bendix assembly into place.
Take the assembly back off, check for burrs, smooth any off, then take a break and come back to it again with a fresh start.
Again, be careful not to let the key pop out and jump into the starter hole!
Yes, There is a chance that your starter shaft is bent slightly or has a burr on it. Mine would not go on so I got my half inch reamer out of the tool box and held it with vice grips. I put the Bendix assembly in a vice and proceeded to ream out the hole. The assembly slipped right on the shaft as it should.
You might make the hole a little bit too large but the locking cap screws and little Woodruff key will hold it together.
Good Luck !
I got it on by lightly tapping on the end with a socket protecting the fitting. However now when I put key in the slot, and slide on the head and then rotate it so the holes in the head and the shaft line up, they don't line up with the Bendix spring angle thingie. Do you have to forcibly rotate the spring to get it to line up with the other two holes?
I did mention that this is my day for problems, didn't I.
again many thanks
Sounds like your spring may have twisted and taken a set due to abuse in the past (like trying to start with the spark advanced). The holes in the spring ends should line up, like in this picture of a new spring:
It is a new spring, in fact it is the complete set.
Hmmm, I'm at a loss then. I don't suppose it would hurt to twist the spring a bit to get things to line up.
Can anyone else comment on whether they have had this problem?
yes you may have to wind up the spring a little. It should be very close to fitting when you assemble it. I first put the front cap screw through the spring hole and fastened it to the starter shaft. I had to use a taper punch and insert it through the mounting hole in the spring and stick the end of the punch into the threaded mounting hole at the end of the Bendix and pull it around with that tapered punch. Then I held the spring there and inserted the cap screw with the tang in the rear of the Bendix.
Here's where its at, about 3/8" from matching up.
Frank, Ill try to "spring" stretch it into position.
Thanks Guys.
good luck with strong fingers
After 7 hours
multiple missteps
lots of help from MTFCA
a bunch of scrapped knuckles
some finger exersizezing
And clouds and more clouds of blue smoke (no children allowed)
I have the whole thing installed!!!!
Tomorrow I'll close it up and with much prayer see if it works.
For now it's time to lower the blood pressure.
Congratulations and good luck!
Sorry but I am going to say this; there a rotating sleeve on the end of the bendex, inside the spring. When you install the end piece it fit's into a slot in that piece. You should not have to wind the spring up unless the sleeve is jammed. With the end piece installed with out the bolt you should be able to rotate the whole spring/bendix assembly around.
Yes what you say is true, I was able to do what you say with the old starter drive assembly. However this new assembly had very tight tolerances and nothing moved easily or even at all without exerting some force.
Hopefully everything will function as intended and I will find that out in the morning.
also, removing the original assembly wasn't as easy as just slipping it off, it also required exerting some force, so as Frank mentioned above, I suspect the starter shaft may have some issues.
I'll update in the morning. Hopefully it will start with the starter and there will be no unforeseen extra noises etc.
My fingers are crossed!
Thanks to all the finger crossing provided by you guys, she now starts with the push of a switch, no unusual noises and it engages and disengages as intended. If someone comes across similar difficulties, I think its safe to say that a tight fit is not necessarily a bad thing.
think of it this way, the back screw is the only thing preventing the whole mechanism from spinning on the starter shaft. a tight fit would in my opinion lessen the chance of that screw loosening up (less wobble).
Anyway thanks for all the help and digit crossing.


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NFL: Fined Vikings WR Randy Moss $5,000 for wearing cap on sideline that was not approved by league.
Bears: Released WR Bobby Engram, CB Thomas Smith and DE Clyde Simmons. Placed DE Al Wallace and CB David Mitchell on waived-injured list.
Bills: Released QB Jack Hawley, FB Josh Roth, WR Rocky Henry, G Josh Lind and DE Kendrick Office.
Broncos: Placed RB Howard Griffith on IR. Released P Nick Harris, OL Ethan Brooks, OL Phil Ostrowski, former Ravens OL Quentin Neujahr, S Greg Brown, WR Chris Doering, CB Darryl Pounds, PK Steve Lindsey, LB Antonio London, RB Basil Mitchell, FB Mike Stack and QB Mike Van Raaphorst.


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Meghalaya enhances assistance under NSAP
Staff Reporter
SHILLONG, Jan 10: In order to bring parity between CM's Social Assistance Scheme implemented by Social Welfare Department and National Social Assistance Programme (NSAP), a centrally sponsored scheme implemented by Community and Rural Development Department, Meghalaya government has decided to enhance the assistance under NSAP.
The amount assisted under CM's Social Assistance Scheme is Rs. 500 per month per beneficiary for the infirms, widows and disabled pensioner. Whereas, under NSAP, assistance per beneficiary to the Old Age pensioner is Rs. 250 per month including an amount of Rs. 50 only topped up by the State Government. The assistance for Widow and Disabled pensioner is Rs. 300 per month per beneficiary.
A press statement from the state government issued here on Wednesday informed that the Chief Minister has announced in the National Convention that this disparity is to be immediately addressed, towards which, Rs. 431.27 lakhs have been sanctioned as State Assistance for old age pensioner, Rs. 58.82 lakhs for Widows and Rs. 11.62 lakhs for disabled pensioner for bringing at par the quantum of assistance between the two schemes.
Henceforth, the pensioners/beneficiaries under NSAP will get Rs. 500.00 per month. This will be effective from December 2017. The Deputy Commissioners and BDOs have been requested to create awareness about the new scale of assistance being provided by the State Government. This initiative will benefit over 52000 beneficiaries across the state.


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Worldliness had entered the church, and therefore, people were seeking power and position to lord over people. Yes, Paul clearly makes that argument in 1 Timothy 5: They grow from the inside of their faithful journey before it is exercised outward.
Verse 14 could even be a four-part guideline for pastoral ministry: What does it mean that God gives grace to the humble? Respect Your Leaders 5: Theology in the context of world Christianity: Look at what he says to the disciples in Matthew 6.
Why is a plurality of leadership in the church important? He says in Proverbs 6: All of these must be done for the strengthening of the church. Their growing faith and their joyful attitude in life evidences this. Healthy churches follow the biblical model of a plurality of eldership.
These healthy churches also have percent of their church members in a Bible study or in small groups. That the only proper Biblical way to describe the human being as spiritual, mental, and physical. Obey your leaders and submit to their authority.
The primary skill set they must have is teaching 1 Tim 3: Many churches are going through discord and problems because of pride that makes them independent.
What way is God calling you to put the garment of humility on and serve his people? A key to happy marriage: Prophecy, when it comes from the Holy Spirit, edifies or builds up the church. Though this is promised only to elders, it is certainly true of all the redeemed. Christ is the Chief Shepherd.
This can often be very difficult. Is it not the one who is at the table? I would like every one of you to speak in tongues, but I would rather have you prophesy.
Also a dispute arose among them as to which of them was considered to be greatest. We see this in 2 Corinthians No single pastor has all the spiritual gifts needed to lead the church.
Help [] the weak. One thing that sticks out in my mind is a knife I had attached to my side. Leadership is not a "zero sum game.
Churches that have this servant mind-set have to turn people away from ministries. Real giving is always out of a grateful and generous heart-not out of obligation or manipulation. Listen to what Paul says to the elders of the Ephesian church in Acts Remember therefore from where you have fallen; sorrow, and do the works you did at first.
Gossip is absent and conflict is dealt with; spiritual growth is glorifying our Lord, and the Fruit of the Spirit is at hand. Ultimately, you should be able to ask questions regarding where your church is headed without feeling fearful of church leadership.
Taking a look at the accounts contained in Revelation the church was quite busy performing great functions.Though there is no perfect church, there are healthy and unhealthy churches.
I have been in church literally my entire life, so I have seen the great, the good, the bad and the downright ugly. After witnessing and having endless discussions about the church culture, I have compiled a list of five signs that signal you are a part of an unhealthy church.
A key to happy marriage: Keeping separate lives While too much independence ― the kind that leads to infidelity or workaholism ― is a marriage breaker, too much dependence isn't the answer either. Keys to a Healthy Christian Community (1 Thessalonians ) by Dr.
Ralph F. Wilson Audio and power plays of various kinds. We've got to get our church communities healthy if we expect to attract people to Christ and create an environment in which they can be discipled effectively. Respect Your The next key to a healthy congregation. Big Question: What are characteristics of healthy churches or church members in 1 Peter –7?
Healthy Churches Have a Plurality of Elders To the elders among you, I appeal as a fellow elder, a witness of Christ's sufferings and one who also will share in the glory to be revealed (emphasis mine).
Keys to a Healthy Church Jesus First Around 2, years ago Jesus Christ of Nazareth came to this earth and dwelt among man.
His life, death and teachings leave the ideal model in attaining a healthy prayer life, first class leadership, inseparable community and worldwide missions. What Does a Healthy Church Look Like?
(Part 1) Finally, a complete guide to the vibrant, dynamic, empowered, totally awesome, and really, robust church.Download


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Attempt These Ideas To Constantly Look Your FinestUnderstanding fashion can help you to look and feel your best. If you have a bad fashion sense and are unhappy with your look, this article will be of great benefit to you. Read on to learn a number of fashion tips that will help you to improve your style and look.
If you are overweight, you have to be very careful about wearing clothes that have stripes. Make sure you wear vertical stripes if you are going to wear any at all. Wearing stripes that run horizontally will only do the trick of making you look larger than you really are.
Do not buy clothing just because it is on sale. If the item does not fit with your overall style or does not look good on you, it is not really a bargain. You'll end up donating it and that's just flushing cash down the toilet.
Lip gloss is a girl's best friend! There is nothing worse than dry, chapped, uncomfortable-feeling lips. That's where a pretty gloss comes in! Whether you like the super-glossy look or something a little more subdued, lip gloss is a great way to keep your lips looking and feeling their best throughout the day.
How to apply your makeup depends on where you are going. For example, if you are going for an interview, keep your makeup looking natural and highlight your best feature. For instance, if you have beautiful eyes, wear a soft color that enhances the color of your eyes. If your best feature is your cheekbones, add a little color to the apple of your cheeks.
Don't carry a ton of makeup inside your makeup bag. Pick products in some seasonally appropriate colors that you like. Think about what you need for day versus night. Once you open up makeup, it may ruin. Bacteria can build on it, too.
The basic black dress is essential for any woman's wardrobe. You can wear this dress for casual occasions by accessorizing it with a pair of comfortable pumps. You can wear the same dress for a more formal occasion if you put up your hair and accessorize with a pearl necklace and earrings.
If you are going to a formal event and aren't quite sure what to wear, you can't fail with a simple black dress. No matter what the decade, a simple, little black dress has always been in style and will never go out. Consider this next time you aren't sure what to wear.
Always keep a little (or not that little) black dress in your closet. A classic black dress is always in season and looks great at formal occasions. There are brand name styles as well inexpensive but elegant varieties. There is no reason to skip buying a black dress to add to your wardrobe.
A good tip if you're trying to improve your fashion sense is to take it easy on the logo designs if you're keen on certain brands. visit this weblink looks silly when you're always wearing a shirt with a big fat logo on the front. Subtlety is the key here so you might want to tone it down sometimes.
When you purchase a new coat or jacket, check the vent and arm areas to ensure that they aren't tacked with loose stitches. These threads do not look good and should be removed. Simply cut them with scissors. This is a simple step you might wanna take to bring up your style.
One way to make sure that you look great is to find a specific cut or brand that fits you well and buy multiples of it. This is important because you will not always find that perfect outfit, especially if you are shopping at the last minute. Buy more than one of the same color even, just in case it gets damaged somehow.
One great fashion tip is to check not only the outside but the inside of a garment for how well it is put together. Quality stitching and materials that are used on the inside of a garment is probably a good sign that it was put together with care and that the designer knew what they were doing.
If you are overweight, never wear clothes that have a horizontal stripe pattern. These stripes will give the illusion of widening and this is not the look you want to achieve. Patterns must run from head to toe to make you look taller and more slender.
Many people are under the impression that bright colors should only be worn in the spring and summer; this is not true. http://unitheaven81joe.blogdon.net/ways-to-take-advantage-of-your-the-clothes-in-your-closet-4795245 is perfectly fine to wear brighter colors in the winter; it is just a matter of how you wear them. While bright sweaters are fine, bright pants are not!
Now, you probably have a better idea of how to change your image forever. Use these fashion tips to create a better image and make a good first impression on people. Choose outfits that reflect your personality and people will start noticing you.


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Detailed Notes on how do you make money
I think The main element here is traffic. What at any time sort of Web site you've you may earn very good money For those who have targeted visitors. That's what attrack advertisers PERIOD.
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Our spacious apartment homes include top quality amenities bringing you all the comforts of home in a relaxing and luxurious atmosphere. We will pamper you with the best community amenities apartment living has to offer. Our new community amid wide open spaces will make you eager to call The Azure your home. Contact us today to find out more about our new community, and let us show you why The Azure is one of the best places to live in Midland
From family friendly trips with kid friendly activities to local plumbers lawyers, spas, and contractors. Judy's Book has millions of listings and reviews for the best and not so great. Whether you're looking for a specific business or just trying to discover great places we make it easy. We're a family oriented site focusing on bringing trusted reviews and recommendations to moms and others. Green and Sustainable places are becoming more relevant to Judy's Book users, have a favorite place? Write a review and tell users why it's Green!


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Color(s): Pale Gold
Polished logo lettering accents the front of this saffiano leather MICHAEL Michael Kors cross-body bag. The top zip opens to a logo-lined 2-pocket interior. Adjustable shoulder strap. Leather: Cowhide. Weight: 15oz / 0.43kg. Imported, Vietnam. Measurements Height: 5in / 12.5cm Length: 8.75in / 22cm Depth: 2in / 5cm Strap drop: 23.5in / 60cm


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Tuesday: Fed Chairman Ben Bernanke warned the "severe" U.S. recession may drag into 2010 unless the government succeeds in stabilizing the banking system and financial markets. Debate continues on bank "nationalization," with Bank of America insisting it won't need a bigger U.S. stake; and analysts wondering if Citigroup actually needs the government to pick up more than 40 percent. Experts told CNBC that fears of nationalization are overdone — and we're now entering the epicenter of the recession.
Fed & FDIC: The People Who Can Really Solve the Problem
Dial down your focus on the Treasury, said Kevin Ferry of Cronus Futures Management. Give it a chance to straighten out an exceedingly complex problem, administration-wise. Dial up your focus on the Federal Reserve and the FDIC, the two institutions that are going to be the "real guide out of this problem."
Dread of nationalization is not wholly realistic, because the deposit base has actually been nationalized already, says Ferry. He differs from his Chicago colleague Rick Santelli in that Ferry feels toxic assets should be compartmentalized, not politicized.
(See Bernanke's Response to 'Santelli's Tea Party')
Eye of the Storm; Hold Out for H2 '09
We're reaching the epicenter of the recession, according to Chris Varvares of Macroeconomic Advisers, and we should see growth resuming in the second half of the year. Q4 looks even worse with each revision, and now appears the numbers will show GDP growth at negative six percent. Q1 is likely to come in at negative five percent, with more retreat in the second quarter. H2 growth now looks like 2 percent, maybe a little more.
No More Soothsayers — We Need Cheerleaders Now
Performance Trust Capital's Brian Battle accused the Obama administration of being like Spiro Agnew's nattering nabobs of negativism: "Pass this package or else." Absent any positive reinforcement from the administration, the financial community looked for for it in Ben Bernanke's remarks today. Battle said Sen. Christopher Dodd's phrase, "temporary nationalization," is an oxymoron. The market demands a more systematic response.
CNBC Investment Tools:
CNBC's Companies in the News:
Bank of America
JPMorgan Chase


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Reuters reveals how watchdogs failed to spot $2 billion Indian bank fraud
In an in-depth report, Reuters uncovered new evidence showing how the Reserve Bank of India failed for years to detect a $2 billion fraud at Punjab National Bank. Reuters also detailed how the RBI failed to respond adequately to red flags in the banking system, or correct a breakdown of normal practices at the nation's second-largest state-run bank. The failings heighten worries about what other problems might lurk within India's state-run lenders, which hold some 70 percent of the sector's assets in the world's fastest-growing major economy.


text: img_002104 SeMeN SPeRmS SuPeR SiTe BLArRrG !!! Squirts from the Underground The Internets Mind Pollution Ghetto \/\/\//\\((8)(8)) ~☠ GRAFFITI BLArRrG! PHOTOS WORK PRESS MUSIC DONATE IRAK! 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Theresa Newell 2015 DMP PPN's True Health and Liberty
I promise
I have an income source that brings in $5000+ monthly above my pension by May 1, 2016. I spend a maximum of 30 hours weekly on these work activities and 30 minutes daily in the search for this position Monday through Friday. I exchange my leisure reading/game time to complete this research and subsequently engage in the work activities.
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I always keep my promises Theresa Newell


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Diabetes, a disease marked by high blood glucose levels, can give rise to complications in various parts of the body. THIS Quarterly looks at the various conditions associated with this illness.
Did you know that World Diabetes Day falls on 14 November?
The day was created in 1991 by the International Diabetes Federation and the World Health Organization to create awareness about the disease and the increasing health concerns it poses to health authorities. With an estimated 425 million people living with the disease all around the world, diabetes appears to be one of the biggest epidemics of this century.
Diabetes is a chronic condition, and there is no cure for it. There are three major types of diabetes: type 1, type 2, and gestational. All three affect the body's ability to use the energy found in food.
When sugar or carbohydrates are consumed, the body breaks them down into glucose, which fuels all cells in the body. The cells need insulin to take in the glucose and convert it into energy. With diabetes, the body does not make enough insulin, or cannot use the insulin it produces, or a combination of both.
Since the cells cannot take in the glucose, it builds up in the blood. High levels of blood glucose can damage the tiny blood vessels in the kidneys, heart, eyes, or nervous system. Over time, and especially if left unmanaged, it can give rise to heart disease, blindness, and arthritic problems, to name a few. Besides suffering from disabilities, many diabetics also die from complications due to the disease.
This insidious and 'invisible' illness has far-reaching consequences for the patient. So serious and pervasive (one in nine Singaporeans suffer from it) is diabetes that Prime Minister Lee Hsien Loong spoke at length on it at the National Day Rally in 2017. As he pointed out then, in the early stages, there are few warning signs; by the time it has wreaked havoc on other parts of the body, it may already be too late.
That's why it is important to learn about the complications caused by diabetes.
Few people associate arthritis with diabetes, but the two diseases are closely connected. Research shows that diabetes increases your risk of rheumatoid arthritis (RA) and arthritis-related issues by around 20%. By the same token, having RA increases your risk of developing diabetes by 50%. There are various explanations for this.
Chronic inflammation due to diabetes may result in RA. Both RA and type 1 diabetes are autoimmune diseases, and research suggests that some people tend to have more than one type of autoimmune disease. This is partly due to genetics. Scientists have found a common gene in both individuals with type 1 diabetes and a specific subset of individuals with RA, which may contribute to the development of both conditions.
Just as the body attacks its own cells within the joints in RA, the body can also attack its own pancreatic cells that make insulin, resulting in diabetes.
RA is a disorder where your body's immune system is unable to distinguish healthy cells from harmful ones such as bacteria and viruses. This confusion results in your immune system releasing antibodies that mistakenly attack healthy and functional cells and tissues. The disease is characterised by chronic inflammation and loss of function in the joints. Unlike osteoarthritis, which causes wear and tear to occur, RA can attack joints in various parts of the body at the same time, causing inflammation. Left untreated, RA can damage the organs and other tissues that surround the affected joints.
Risk factors for RA are:
While there is no known prevention or cure for RA, lifestyle modifications such as not smoking as well as losing excess weight may help prevent diabetes. This in turn reduces the risk of RA.
If you have RA, there are ways to help control the pain, prevent disease progression and further complications. For most cases, your rheumatologist will prescribe medications based on the severity of the condition. Common ones include non-steroidal anti-inflammatory drugs, steroids, diseasemodifying anti-rheumatic drugs, and biologic agents.
Aside from medications, therapy also enables you to manage your pain better and improve the quality of your life. If medications and therapy do not help, and there is severe damage of the joints, surgery is recommended.
Leong Keng Hong Arthritis and Medical Clinic
6 Napier Road
#04-18 Gleneagles Medical Centre
Singapore 258499
Tel: 6472 4337
In Singapore, one in five pregnancies — that is more than 6,000 women each year — is affected by gestational diabetes. This figure is high by international standards — according to the International Diabetes Federation, only one in seven births is affected by gestational diabetes globally.
In Singapore, it has also been found that two out of three mothers with gestational diabetes will develop diabetes later in life.
Gestational diabetes is a condition that happens during pregnancy, usually in the second half. Hormonal changes predispose the mother to build up glucose in her blood. If her pancreas cannot produce enough insulin to manage this, her blood sugar levels will rise and cause gestational diabetes.
One of the complications of gestational diabetes is an increased risk of having a baby who is larger than normal, leading to possible birth injuries to the baby, or the mother faces a higher chance of requiring a C-section to deliver the baby.
Other problems include fetal abnormalities if she is an undiagnosed diabetic, perinatal death, pre-term birth, an increased likelihood of developing high blood pressure or preeclampsia. Conversely, at delivery, there could be issues of low blood sugar and delayed lung maturity in the baby, which can result in temporary breathing problems. The child is also more likely to develop type 2 diabetes as an adult.
Your chances of getting gestational diabetes are higher if you were over 35 years of age, overweight before pregnancy, or have a family history of diabetes. Other risk factors include having given birth to a large baby in an earlier pregnancy or a baby who was stillborn or had certain birth defects.
Screening tests for gestational diabetes are recommended between Week 24 and 28 of the pregnancy. If you have had gestational diabetes before, or if your doctor is concerned about your risk of developing the condition, the test may be performed before the 13th week of pregnancy.
If you are diagnosed with the condition, your doctor will want you to monitor your blood sugar levels to ensure good control to minimise complications. You may need to take insulin or other medications to assist in optimal control.
Faithfully following the treatment regimen will help you experience a healthy pregnancy as you would without gestational diabetes and deliver a healthy baby.
If you are planning to conceive, lower your risk of acquiring the disease by:
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Adults with diabetes are two to four times more likely to die from heart disease than those without. While diabetics are more likely to develop heart disease, those with type 2 diabetes are particularly at risk.
Coronary artery disease (CAD) is the cause of death in more than half the patients with diabetes. In one study, at least 68% of people aged 65 and older with diabetes die from some sort of heart disease. Other studies show that the risk of heart attack in diabetics is equivalent to that of non-diabetics with a prior history of heart attack. Women with diabetes are also more likely to die of heart disease than those without. One study showed that women with diabetes have a risk of cardiovascular death up to 7.5 times higher than women without diabetes.
Even with glucose levels under control, the risk of heart disease is present. This is because diabetes causes wear and tear of blood vessels, making the heart work harder. In Asia, type 2 diabetes usually occurs in the setting of metabolic syndrome, a cluster of conditions — hypertension, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels — that occur together, raising one's risk of developing diabetes. This is also known as insulin resistance syndrome, or Syndrome X.
The most common cause of heart disease in a diabetic is hardening of the coronary arteries, or atherosclerosis. This is caused by a buildup of plaque in the blood vessels. When the plaque breaks up, the body sends platelets to seal it. As the artery is small, more so in diabetic patients, these platelets could block blood flow and trigger a heart attack.
Heart attack symptoms include shortness of breath, feeling faint, nausea, excessive and unexplained sweating, and pain in the chest, shoulders, jaw and left arm. But diabetics may not get chest pain — it is believed that diabetes-related nerve damage blunts such feelings.
Diabetics who present with heart attacks are at an increased risk of dying from their cardiac event or developing heart failure. Heart failure is a serious condition where the heart cannot pump blood adequately, which can lead to fluid buildup in the lungs, causing breathing difficulty, fluid retention, and swelling in other parts of the body. Diabetic patients also have a higher incidence of multi-vessel disease and greater number of diseased vessels. Early screening of CAD in diabetics is important to ensure that appropriate medical treatments and interventions are carried out, particularly for diabetics participating in high-intensity sports.
To avoid diabetes-led heart disease, diabetics should:
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Did you know that diabetes is one of the leading causes of blindness in adults? One major eye problem in people with diabetes is diabetic retinopathy. It occurs when diabetes weakens or damages blood vessels in the eye. Particularly susceptible are those who have had diabetes for many years, have poor diabetes control and high blood pressure, or have had previous stroke and heart disease incidence.
If your blood glucose level has stayed too high for too long, it blocks off the small blood vessels that keep the retina healthy. Your eye will try to grow new blood vessels, but they will not develop well. They start to weaken, then blood and fluid leak into your retina. Nerve fibers in the retina may begin to swell. Sometimes the central part of the retina (macula) begins to swell (macular edema), causing blurring of vision. As your condition worsens, more blood vessels become blocked and closed off, causing the growth of new, abnormal blood vessels in the retina (proliferative diabetic retinopathy). Scar tissue builds up as new blood vessels grow in your eye. This extra pressure can cause your retina to detach. It also leads to glaucoma and other problems that may result in blindness.
Macula edema, or proliferative diabetic retinopathy, can be treated using anti-VEGF injection or retinal laser treatment. The injection or laser stops new vessels from leaking and growing. Although the treatment procedures cannot restore lost vision in some cases, it can — combined with follow-up care — reduce your chance of blindness by as much as 90%.
In the late stages of the disease, if the retina has become detached or a lot of blood has leaked into your eye, your doctor may suggest vitrectomy. This is a surgery to remove scar tissue, blood, and cloudy fluid from inside the eye. Keeping your blood sugar and blood pressure under control will help to slow down diabetic retinopathy, and may even prevent it. It also helps if you quit smoking.
It's important to get an annual dilated eye examination to spot early signs of the disease. Women with diabetes who become pregnant require a comprehensive eye examination during the first trimester and a close follow-up with an ophthalmologist throughout the pregnancy.
Diabetics also have a higher risk of developing open-angle glaucoma, where the increased pressure in the eye can damage its nerves and blood vessels, causing changes in vision. There may be no symptoms until the disease is far in advance, with significant vision loss. Symptoms can include headaches, eye aches or pain, blurred vision, watering eyes, halos around lights, and loss of vision.
3 Mount Elizabeth
#10-04 Mount Elizabeth Medical Centre
Singapore 228510
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The most common hand conditions associated with diabetics are carpal tunnel syndrome, trigger finger, limited joint mobility, and Dupuytren's contracture. Diabetics also tend to be more susceptible to hand infections compared to non-diabetics.
Carpal tunnel syndrome (CTS)
The incidence of CTS in the diabetic population is between 11% and 21%. The mechanism is due to glycosylation of soft tissue, causing collagen cross-linking, and leading to thickening and stiffening of the transverse carpal ligament and peritendinous tissue. Furthermore, diabetic microvascular angiopathy of the nerve leads to polyneuropathy and increases the susceptibility of the median nerve to compression in the carpal tunnel. CTS presents with similar symptoms in diabetic and non-diabetic patients.
These include tingling in the hand, which affects the thumb, and index, middle and ring fingers. Tingling is often worse at night or in the early morning. It may be triggered by activities that involve strenuous or repetitive gripping.
When the condition worsens, tingling and numbness become continuous, with weakness and wasting of muscles at the base of the thumb. Patients may drop objects unknowingly and experience pain. If the condition is detected early, medications, avoiding aggravating activities, and a wrist splint can relieve symptoms. Surgery is recommended if the symptoms are severe or do not respond to other treatments. Symptoms are expected to alleviate after surgery but the improvement may not be as great in diabetics due to poorer nerve regeneration. Diabetic patients undergo carpal tunnel release surgery four to 14 times more than the general population.
Trigger finger
The prevalence of trigger finger in the diabetic population is 20%. Trigger finger in diabetic patients is more often bilateral and affects multiple digits, responds less well to corticosteroid injections, and more commonly requires surgery. Symptoms include painful swelling, stiffness, and triggering or locking of the affected finger.
While trigger finger can be treated with medication, rest, finger splint or steroid injections, those with diabetes are more likely to require surgery.
Limited joint mobility (LJM)
The prevalence of LJM in the diabetic population is 30%. Patients with LJM are unable to fully straighten the finger joints. It usually starts in the little finger and extends to the other digits. Patients are unable to place their palms flat — e.g. on the table (table top test) or together (preacher's sign). LJM is related to the patient's age as well as the duration of diabetes. Some studies show that LJM is associated with microvascular complications such as diabetic retinopathy.
Diabetic patients have an increased risk of infection because hyperglycaemia depresses cell-mediated immunity and white blood cell function. Peripheral neuropathy numbs the extremity to pain and sores, and injuries may be left untreated, leading to infection and complications. Furthermore, poor blood flow in diabetics impedes healing and may result in amputation or even death. In one study, diabetic hand infection was caused by several bacteria (polymicrobial), Gram-negative bacteria, and the usually common Staphylococcus aureus bacteria in 55%, 73% and 36% of the specimen respectively.
Keeping your blood glucose levels as close to normal as possible will help keep your hands healthy and free from the above conditions.
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#09-07 Mount Elizabeth Medical Centre
Singapore 228510
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Research methodology methods
Research Methods and Research Methodology are often confused to be the same thing but there lies a basic difference between them.
Textbooks on Qualitative Research and Method/Methodology
Methodology | Hogrefe eContent
Research method versus research methodology - SlideShareWhile there is a broad range of research methods used by action researchers, not all are suitable for classroom-based research with all student groups.What is the basic methodology for a quantitative research design.You may also use the earlier material about research methodology. methodology.A suitable method can be replicated or repeated in a similar way.
BMC Medical Research Methodology | Home pageThe three-volume APA Handbook of Research Methods in Psychology features descriptions of many techniques that psychologists and others have developed to help them.
How to write the methods section of a research paper.Doing this shifts it away from its true epistemological meaning and reduces it to being the procedure itself, or the set of tools, or the instruments that should have been its outcome.European Journal of Research Methods for the Behavioral and Social Sciences.
Historical research:-it allows one to discuss past and present events in the context of the present condition, and allows one to reflect and provide possible answers to current issues and problems.Why Most Published Research Findings Are False by John P. A. Ioannidis.A virtual resource center for applied social research and evaluation by Bill Trochim of Cornell.Alana, Slater, T. and Bucknam, A. (2011). Action Research for Business, Nonprofit, and Public Administration - A Tool for Complex Times.You will learn how to conduct research and what methods to use.RESEARCH DESIGN Qualitative, Quantitative. and Mixed Methods Approaches SECOND EDITION John W.
Research methods - definition of Research methods by TheIn general, I would say these are not really things we should worry about.The rest of the paper should reflect the application of the research methodology.
The goal of applied research is to improve the human condition.The purpose of this guide is to provide advice on how to develop and organize a research paper in the social sciences.
Measurement, Evaluation, and Research MethodologyResearch Methods KINE 5300 Definitions of Research The main goal of research is the gathering and interpreting of information to answer questions (Hyllegard, Mood.Dear Dora, the contents of Chapter 3 varies across universities, but usually, it describes the methods or methodology section.Introduction Case study research excels at bringing us to an.
Psychological Research - Crash Course Psychology #2Blood pressure readings using a sphygmomanometer Having listed the methods in the above table, you should justify why you used such methods and the guiding principles for using those methods.The research design is the methodology and procedure a researcher follows to answer their sociological question.
Proper Research Practices 8:40--.Any description of a means of calculation of a specific result is always a description of a method and never a description of a methodology.
The Research Methodology Program prepares professional practitioners in psychometrics and test development, and prepares scholars who make contributions to the study.What links here Related changes Upload file Special pages Permanent link Page information Wikidata item Cite this page.Prerequisites: IS 2000, a statistics course, and either IS 3500 or IS.
The research which is done for human welfare, animal welfare and plant kingdom welfare.Main page Contents Featured content Current events Random article Donate to Wikipedia Wikipedia store.


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Iron is a girl's best friend
by Emma Brace
My penis size is 5 inches. Will it satisfy my wife? (Sex query of the ...20 Sep 2013
They say that diamonds are a girl's best friend – I'm going to dispute that! Yes diamonds are pretty and sparkly and cost a fortune but seriously what else do they do for you? Now Iron, iron is a whole different ball game. Getting acquainted with the iron will reward a girl in so many ways, it will torch body fat, make you stronger, both physically and mentally, make you fitter, healthier and shape the body you want (possibly aiding in the quest for very large diamonds…), so I say iron is a girl's best friend!
The simple fact is, resistance (strength) training is essential for losing body fat and, more importantly, keeping it off. And before you think if you look at a dumbbell you're going to turn into Lou Ferrigno ready to do battle with Mr Schwarzenegger on the Olympia stage trust me when I say that will not happen. Women simply do not have the genetic make-up. And, if the truth be known, most men fail to make lean muscle gains of gargantuan proportions so you're quite safe!
What strength training will do for you is shape a body to die for; taught tushys, shapely legs, shoulders and arms (no bingo wings around here!), a strong back and flat tum to name but a few.
How does it do this? Well ladies, here comes the science bit
Lean muscle is what we call 'metabolically active', it burns calories 24/7, around the clock, even when we sleep, so the more lean muscle we can create, the higher our metabolic rate, the more calories we burn at rest. When we talk about strength training we're talking about weight bearing exercise and that doesn't mean you have to lift the equivalent of a small house; just some basic moves with weights that challenge you but don't crush you.
I've lost count of the number of girls I see day in day out smashing away at the cardio, never changing shape and perpetually on a starvation diet. Why is this? Killing yourself with hours of cardio will merely make you a smaller version of what you already were because the muscles you already have are capable of carrying your bodyweight, it follows that lose enough 'weight' (and note that amazing 5lbs you lost in the first week is water not fat) the less those muscles have to carry around; if they are not needed the body will lose them, it's called catabolism. With this catabolism comes a lowered metabolic rate, so we burn less calories throughout the day. Yes, do enough cardio and restrict your diet enough and you will drop body fat but you will also lose lean mass, so the second you even slightly over-eat the weight will go back on because you have less metabolically active mass. You won't create a toned shapely body, you will merely change the number on the scales, and that means nothing because dropping 'weight' does not mean dropping 'fat'. Introduce strength training in addition to a sensible amount of cardio and you will be able to maintain, and increase, the lean muscle you have at the same time as dropping body fat which will leave you with a greater proportion of lean body mass to body fat and you will not have to continually starve yourself for the rest of your life!
Now one thing is absolutely certain, it is much easier to lose muscle through catabolism than it is to build it. So, when you're busy dieting and 'cardio-ing' and losing lean muscle and then decide to hit the weights, it will take you far longer to regain your precious lost lean mass than it would have to maintain it in the first place. So hit the iron from the word go! Don't make your quest for a happy healthy body a painful one, work with your body and it will work with you. Strive not only to maintain your current level of lean mass but to increase it, and when you've stripped away that fat you will be left with tone, shape, strength and great skin tension. (Read: Firm 'em up: Expert tips to get the breasts you want without surgery!)
How else does the iron help?
We've all heard the adage 'fat is not burned in the gym but in the hours outside it'. Well, let's explain why this is the case and to do so we need to delve into the world of EPOC, and no I'm not talking about a small hairy alien from Star Wars, I'm talking about Excess Post-Workout Oxygen Consumption. Most people are far too concerned with the calories they burn whilst doing exercise when what they really should be concentrating on is the calories burned after exercise when the body restores itself to the rested state it was in prior to your workout. To do this the body must replenish muscle glycogen used in your workout, restore blood lactate levels, return the heart rate and body temperature to normal, all of which expends calories. So the level of EPOC is directly related to the intensity of your workout; the higher the intensity (increased load, shortened rest periods) the greater the 'after burn'. So the greater the weight you lift the greater the EPOC and we like EPOC, how fab to know that whilst resting post workout your body is furiously burning calories whilst you sit down! (Read: Top 5 fitness tips for women)
How do we increase EPOC? There are a number of ways in which we can benefit from the after burn to a greater extent. Shorten your rest periods, this will force your body to work harder and require far greater recovery post workout. Lift heavier, this will raise your heart rate (especially with lower body exercises). This increased heart rate is what helps generate EPOC, so the longer you can raise your heart rate the greater the number of calories that will be burned so girls get squatting, get lunging, use those legs! There is a reason the squat is the king of exercises! Don't fear lifting heavier, do so and you will increase the rate your body burns fat. Scientific fact!
A great body doesn't come from cardio or wishing, a great body comes from lifting, from hitting the gym and reminding the iron who you are, from a healthy diet and a will to succeed. Challenge yourself, challenge your body, it is adaptive, it will change.
So I choose iron over diamonds any day. What do you choose?
Happy training girls! (Read: Developing Self-Motivation through others)
Content Source: PhysiqueElite
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