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text:
Girls Health Day is a one-day series of workshops to educate girls aged 8-14 about various issues including drug and alcohol abuse prevention, female health issues, self-esteem building techniques, healthy social media behavior and cyber bullying. Girls Health Day is usually held on the last Saturday in January and there is no charge to attend. This event is held at Lakeview Regional Hospital.
Project Prom/Project Homecoming helps junior and senior high school girls enjoy an evening at their prom or homecoming. Local high school counselors identify candidates as having special economic needs. Dresses, shoes and accessories are donated by members or local businesses. The girls are then invited to Dogwood Cottage "boutique for a shopping day" where they are free to choose an entire wardrobe at no charge. Due to the enthusiastic response to Project Prom, we launched a fall project, Project Homecoming, in 2015.
In partnership with St. Tammany parish government, JLGC continues its steadfast work on the Children's Museum of St. Tammany. The vision of the CMST is a community where play is encouraged, creativity is nurtured and learning is enjoyed. Exhibits and educational programs are being designed to encourage children to make new and surprising discoveries, explore the wonders of the local environment and planet, stimulate creativity and expression, and nurture the desire for life-long learning. We anticipate the opening of CMST in approximately three to five years. This is a project of enormous magnitude and one that will bring equal value of imagination, discovery, exploration, creativity and a love of learning to our children in St. Tammany. CMST's first stop is Kid's Town, located at the Mandeville Trail Head at Koop Drive, scheduled to open in Fall 2017! To get more detailed information about the Children's Museum of St. Tammany and Kid's Town, please visit their website at www.CMSTkids.org
Museum Without Walls is a traveling educational program, developed and implemented by Junior League volunteers. It brings creative learning to the preschoolers of St. Tammany Parish Schools. JLGC volunteers have visited area schools to spread the word about the future Children's Museum of St. Tammany Parish. Museum Without Walls brings the vision of the museum to the students with activities and arts and crafts projects that focus on Louisiana's nature, culture, flora and fauna. Funding by the JLGC is used for supplies, training and informational seminars.
JLGC is excited to announce a new project for the Fall 2017 year: we will be hosting a children's craft area at the Covington Three Rivers Art Festival! This program was initially started by TRAF and the Junior League is excited for this opportunity to grow and expand on the existing activities. The JLGC Children's Area at the Three Rivers Art Festival is free for all festival attendees. This project is scheduled to run through Fall 2020.
The Kids in the Kitchen program is an AJLI-initiative that was implemented in 2006. The program is designed to help communities address the growing issues surrounding childhood obesity and nutrition. JLGC implemented the project in 2006 as a one day event but more recently has hosted several events throughout the year focusing on nutrition and healthy eating.

subset: commoncrawl


text:
Fathom the bowl
Traditional drinking song
Come all ye bold heros, give an ear to my song
And I'll sing you the praises of brandy and rum.
From the clear crystal fountain near Ireland shall roll.
Give me the punch ladle I'll fathom the bowl.
I'll fathom the bowl, I'll fathom the bowl.
Give me the punch ladel I'll fathom the bowl.
From France we do get brandy, from Jamaica comes rum
But sweet oranges and apples from Portugal come.
Now stout and strong cider are Ireland' s control
Give me the punch ladel, I'll fathom the bowl
My wife she do annoy me when she's laid at her ease
For she does wht she likes and she says what she please.
My wife she's the devil, she's black as the coal.
Give me the punch ladel I'll fathom the bowl.
My father he do lie in the depths of the sea
With no stone at his foot but what matters to he
Is the clear crystal fountain near Ireland shall roll
Give me the punch ladel, I'll fathom the bowl.
Atelier Voix : 06 73 91 43 76
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text:
Paris Fashion Week Front Row Report: Kate Moss Causes Chaos at Saint Laurent
Meanwhile, while others drank, DJ Leigh Lezark said skipping the bubbly is her way of making early morning shows.
PARIS – Following a triumphant Oscar evening suiting up Jared Leto, Ellen DeGeneres, Brooklyn Decker and several party-bound celebrities in his signature skinny tuxedos, Los Angeles-based Saint Laurent designer Hedi Slimane showed a women's collection that was more rock 'n' roll than red carpet.
With a '60s silhouette, the sparkly shifts and go-go boots will find fans in young Hollywood, but it was models and musicians in the front row.
PHOTOS: Oscars 2014: The Red-Carpet Arrivals
Alex Turner and Miles Kane of Brit band The Last Shadow Puppets, sporting the slicked-back Saint Laurent hair of last season, brought their own bottle of Ruinart champagne to the front row, where they were seated with The Strokes' Fabrizio Morretti and model-musician Karen Elson.
Elson compared the vibe to the excitement of seeing a favorite band. "I always get the same feeling when a show's about to start," she said, though she admitted that when she's onstage the jitters are different. "Walking out on the runway I'm nervous, but it's exhilarating more than nerve-racking. Music is a lot more involved."
STORY: Jennifer Lawrence Glows in Third Dior Campaign
Kate Moss caused a bit of mayhem when she arrived. Photographers and guests alike angled for a photo as she posed with Jade Jagger. After the chaos died down, she sat with both husband Jamie Hince and ex Jefferson Hack. Valerie Trierweiler, who recently split from French president Francois Hollande after affair allegations, and the first lady of French film Catherine Deneuve, were seated across from them, next to late designer Yves Saint Laurent's longtime partner, Pierre Berge.
PHOTOS: Oscars: The Top 10 Best-Dressed
Much of the music crowd was decamping for club Regine, despite the next day's early Chanel show.
DJ Leigh Lezark shared her secret for having both late nights and early mornings after four weeks of following the fashion calendar around the globe. "I've gotten used to not drinking. It's not the easiest plan, but it's the best," she said, after confirming plans with Elson.
Turner and Kane were ushered backstage with glasses in hand but left their open bottle on the bench, only to have it swept up quickly by security.


text: Péter Járosi obtained a degree in Economics at the Faculty of Business and Economics of Janus Pannonius University, Pécs, in 1991, and qualified as a Programmer Mathematician at the Faculty of Science, József Attila University of Szeged. He holds a PhD in Economics from the University of Pécs (2011). Previously he served as Associate Professor at the Budapest Business College and Managing Director of the National Exchequer Resources Directorate in Budapest. His research focuses on regional economic development policy modeling. Dr. Járosi teaches Mathematics, Computer Programming and Modeling of Regional Economics. In the MTA-PTE (Hungarian Academy of Sciences – University of Pécs) Innovation and Economic Growth Research Group he works as a research fellow together with Attila Varga, who was presented the RRI Outstanding Alumni Scholar award in 2011. The main purpose of Péter's visit is to expand the research connections between the Regional Research Institute and the University of Pécs, especially in the topics of spatial econometrics and input-output modeling.


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Domestic Violence
Domestic violence cases are treated very seriously in Georgia and in some divorce cases we find it necessary to ask the court to issue a Family Law Protective Order. The danger of serious violence is at its highest point when a person acts on a decision to leave an abusive relationship.
This order prohibits the offender from having contact with the victim for a specified period of time. If a person is found to violate a restraining or protective order, he or she could be jailed and charged with a separate crime, including aggravated stalking.
Domestic violence in the simplest terms is abuse by one partner against he other in a marriage or other intimate relationship. All types of physical attack including pushing, shoving, hitting, sexual assault, and other physical violence are all forms of domestic abuse. The law also covers stalking, intimidation, isolating a partner from others, withholding money and all types of emotional abuse as domestic violence.
There are two types of family violence protective orders in Georgia. Temporary ex parte orders are intended to protect you from the abuser until the court schedules and conducts a hearing and family violence protective orders are issued after a court hearing in which you and the abuser both have a chance to tell your sides of the story and present evidence to the judge.
You can receive a temporary ex parte order without a court hearing and without the abuser's prior knowledge. A hearing is mandatory before you can receive a long-term family violence protective order.
Warner Robins divorce attorney Lynn Hamilton Johnson can help you understand the Georgia domestic violence laws and take steps to get protection orders in place when necessary.
An ex parte family violence protective order can:
- Order that the abuser not do or attempt to do any of the following: injure, mistreat, bother, follow, harass, harm, or abuse you or your family or household members;
- Order the abuser not to interfere with your travel, transportation, or communication;
- Order the abuser not to follow, place under surveillance, or contact you for the purpose of harassing and intimidating you;
- Give you possession of the house and force the abuser to leave (you can ask the court to have the sheriff send someone home with you to enforce this part of the order);
- Make the abuser provide decent alternate housing for a spouse, former spouse, parent, or child of the parties;
- Order the abuser to stay a certain number of yards away from you and/or your children, your residence, workplace, children's school, etc. and to have no contact with you, directly or indirectly;
- Award you (or the other party) temporary child support and/or spousal support;
- Give you temporary custody of your children and set temporary visitation rights;
- Order the abuser not to get rid of and pets or property of yours or that you share with the respondent and provide for possession of the personal property of the parties;
- Order the abuser not to disconnect or have disconnected home utilities, change or have changed and/or cancel or have canceled auto, health or life insurance for you, your children or for the respondent and not interfere with your mail or your children's mail;
- Order law enforcement to help you get your personal property if you are not given possession of the home and order the abuser to return certain specified property to you; and/or
- Give you possession of a car.
A final family violence protective order can:
- Order all of the protections listed above;
- Order the abuser to go to counseling to try to prevent future family violence and/or drug or alcohol counseling; and
- Award costs and attorney's fees to either party.
Temporary Protective Orders carry serious consequences. Violating a Protective Order could result in arrest and incarceration. If a Protective Order is granted following a hearing, the Respondent's name becomes public record in Georgia's Protective Order Registry and is available for viewing by prospective employers and the community at large.
Whether a judge orders any or all of the above depends on your need for protection and the facts of your case. If you live in fear because of family violence, contact Lynn Hamilton Johnson at 478-922-3889 immediately.


text:
The Lucky Coin is an accessory that has a 20% chance of dropping 1-10 Copper Coins, 2% chance of dropping 1-10 Silver Coins, and a 0.2% chance of dropping 1-10 Gold Coins when you attack a monster or one of your traps attacks a monster. The Lucky Coin is a very rare drop from all pirate themed enemies in a Pirate Invasion. It is useful if you are collecting money for buying an expensive item, or lots of items.
- The Lucky Coin is comparable to the Golden Bullets and Flask of Gold, as they also produce bonus money from enemies.
- This accessory is useful against Bosses, as every time you hit them you have a chance to earn a reasonable sum of money. However, its lack of defensive bonuses could hamper your performance, so only use this if you are confident you can kill the boss you choose.
- The average amount of coins earned per hit is 1.221 silver. (0.2*.055 + 0.02*5.5 + 0.002*550)
- There's an oversight in multiplayer that allows the Lucky Coin to work on statue-spawned-mobs. This is an efficient way of AFK coin farming.
Update Info
- No longer drops coins from statue spawned monsters.
- Added to the game.


text:
Preparing for a last-minute showing4/24/2010
Step 2: Critical Eye Test
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- Mow and water the lawn.
- Store any toys or garden equipment.
- Clean up pet droppings.
- Clean gutters and downspouts.
- Add potted plants to the porch or deck.
Step 4: Closing Touches
- Turn on all lights.
- Open drapes and blinds.
- Open windows to let in fresh air.
- Burn scented candles or open jars of lightly scented potpourri. If you dont have either on hand, you can always bake cookies (the oldest trick in the book) or simmer a few drops of vanilla extract on the stove.
- Turn off all TVs, stereos and computers.
- If possible, relocate pets to a friend or neighbors home during the showing.
- Clean the litter box thoroughly to rid your home of smells. If pets can be temporarily relocated, remove the litter box entirely.
- Hang fresh towels in every bathroom.
- Put fresh liquid soap or bar soap in each bathroom.
- Remove rugs to showcase hardwood floors.
- Put out fresh flowers and fill candy dishes.


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Over recent years, I've come to notice that my vegetarian lifestyle is often accompanied with a heightened sense of consciousness in relation to environmental and health issues. I am more aware of what I put into my body, and I am more aware about the amount of waste that I produce. Suffice to say, this doesn't mean that I don't enjoy the occasional processed food item. I do. I am just aware now that these are not the healthiest of options, so I opt for moderation over deprivation. It also doesn't mean that I won't buy anything in a package - I will. I just try to re-use as much as possible. notice how I didn't say "Recycle"... because I've also learned that tossing paper and plastic into blue bins doesn't do much to save the planet.
So, what do I re-use? First off, I opt for glass jars over plastic whenever possible - because once the food inside them is done, they're washable and re-usable, even heatable... a chemical-free alternative to leeching plastic lunch containers. As for the things that come in plastic that I can't live without - yogourt containers, for example - I bring the empties to the art teacher at my school so that she can use them for projects in class, as well as holders for art supplies.
And then, there's my food. I like to throw away as little food waste as possible. Unfortunately, my area doesn't have a composting program, and living in a small top floor apartment, it's just not an option for me to be doing on my own. So, I reduce the amount of waste that I produce in the first place. I do this by buying less groceries, more often. I've been told that it's the "European" way of shopping, and whether it is or not, I've come to find that it's the best way to eat. The benefits of buying a little at a time (instead of one big grocery order): Foods are fresher, I get more exercise with bi-weekly walks to the market, I save money, and I waste less. Tips for anyone who'd like to try this - keep essentials on hand such as oils, vinegar, seasonings and grains. Buy one or two vegetable items at a time, and use it all up for a meal or two. To save even more money: buy what's on sale each week - this will also encourage you to eat a bigger variety of veggies and fruits.
Ok, so what does this all have to do with the mouth watering picture above, you ask? My waste-not methods encouraged me to use up every inch of my winter squash after I made this (or this, or this...). I couldn't bear to throw out all the lovely little seeds! Inspired by watching my mother roast pumpkin seeds every halloween, I decided to roast these baby versions of them and see what came out. Oh. My. Goodness. Heaven in a handful. The best part - you can eat the shell. Warning - these are very addictive.
Roasted Spicy Squash Seeds
an original recipe by allison sklar
what you'll need
seeds from a fresh winter squash (butternut or acorn squash seeds work best)
1 tbsp grapeseed or light olive oil
1 tbsp Montreal Steak Spice*
* if you can't find this in your area, you can order some on Amazon, or make your own with a recipe here.
If you've never had this spice mix before, get ready to be introduced to your favorite seasoning mix ever. I put this on everything from sweet potato fries to avocado salads to tuna sandwiches!
how to do it
Preheat oven to 300F. (I do this in a convection/toaster oven for faster results.)
Rinse the seeds, removing any squash goop, and pat dry with paper towel. In a small bowl, mix seeds with oil and spice, coating evenly. Spread on a parchment-lined baking sheet and bake for about 8 to 12 minutes (if in toaster oven, 4 to 8 minutes), or until golden. I highly recommend to turn your oven light on and check on these often. Every oven is different and it is possible to burn these very quickly. When the seeds change colour (brownish gold), they're ready.


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Colourful prints used to only be worn during the summer months but, increasingly, more and more of us, designers included, have started incorporating prints into our autumn / winter wardrobes. And we shan't complain – anything that brightens the mood of a dull and gloomy is likely to get our vote.
Traditionally the domain of sea side resorts, a maxi dress in the right weight can be perfect for autumn days. And the subtle colours and luxe styling of this look from Paris fashion week do much to prove it.
It's street style blogger Peony Lim wearing a cashew fruit print maxi dress (thank you to commenter Michelle for the correction) in this look. And she rounds out the maxi with a white jacket, nude pointed pumps and an Hermès Birkin bag. Here the accessories are so simple and are in muted colours as to not steal spotlight from the maxi dress.
Vegetable prints were brought to the fore by Dolce & Gabbana's spring 2012 collection and it's nice to see them continuing to make an appearance on the street.
Photo: Imaxtree


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"Hello my name is Lisa, I qualified in permanent make up in 2001, in Harley Street London with Dawn Craigg. Who was the top trainer technician at the time in the industry. I trained to rigorously high standards which allows me to give you results which can be as subtle or dramatic as ...read more
What sort of people have it done? How would I know which colour to choose? What if styles change? Is it expensive? Does it look natural? How long will it last? Does it hurt? Is there a chance of infection? How long does it take to heal? What is the healing period like? What sort […]read more
Permanent cosmetic eye enhancement can create a natural looking effect that achieves the appearance of thicker looking lashes or a perfectly shaped liner that never smudges or wipes away. Perfect for those who are allergic to conventional eye make-up. Before & After: Brows Pictures wer ...read more
Lisa's techniques are the ideal way to create perfectly shaped eyebrows in a soft mist of colour or simulated hair strokes. If you have little or no eyebrow hair or would like to perfect the shape of your eyebrows, creating a youthful lift to the area that emphasizes the eyes, this t ...read more
Client had hardly any hair as such a stroke by stroke look was created.
Over 10 years Experience SemiPermanent Makeup Technican


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"OOHHH YEAHH! Booyah! Bing bing bing!" might be our favorite answer ever to the question, "Are you ready to try yoga?" These kids trying yoga for the first time is probably a lot like your first time trying yoga: hilarious, awkward, and at times downright outrageous. You want me to put what where? AND breathe? Except with kids it's even better because they don't have a filter and will say pretty much anything they're thinking. And for this we are grateful, because not only do kids sometimes speak our minds, they are highly entertaining while doing it.
The video is part of a Buzzfeed series, like a "Kids Say The Darndest Things" for the digital age. And boy do they. The kid in the jeans, who's only done "Mom Yoga" before, is our honorary spirit animal.
"Every second is like Mayhem!"
Never give up, buddy.
- Keeping the Peace in Kids' Yoga Class (Hint: It Isn't Easy)
- Avoid Morning Drama With 5 Kid-Friendly Yoga Poses
- Bringing Best Practices To Yoga In Schools — An Interview With Jennifer Cohen Harper and Traci Childress (Part 1)
- Kindergarteners Teach Us A Thing Or Two About Mindfulness In 'Just Breathe' Short Film


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- Research article
- Open Access
- Open Peer Review
Can colorectal cancer mass-screening organization be evidence-based? Lessons from failures: The experimental and pilot phases of the Lazio program
© Federici et al; licensee BioMed Central Ltd. 2008
- Received: 18 March 2008
- Accepted: 19 September 2008
- Published: 19 September 2008
Screening programmes should be organized to translate theoretical efficacy into effectiveness. An evidence-based organizational model of colorectal cancer screening (CRCS) should assure feasibility and high compliance.
A multidisciplinary Working Group (WG), reviewed literature and guidelines to define evidence-based recommendations. The WG identified the need for further local studies: physicians' CRCS attitudes, the effect of test type and provider on compliance, and individual reasons for non-compliance. A survey of digestive endoscopy services was conducted. A feasibility study on a target population of 300.000 has begun.
Based on the results of population trials and on literature review the screening strategy adopted was Faecal Occult Blood Test (FOBT) every two years for 50–74 year olds and, for positives, colonoscopy. The immunochemical test was chosen because it has 20% higher compliance than the Guaiac. GPs were chosen as the preferred provider also for higher compliance. Since we observed that distance is the major determinant of non-compliance, we choose GPs because they are the closest providers, both geographically and emotionally, to the public.
The feasibility study showed several barriers: GP participation was low, there were administrative problems to involve GPs; opportunistic testing by the GPs; difficulties in access to Gastroenterology centres; difficulties in gathering colonoscopy results; little time given to screening activity by the gastroenterology centre.
The feasibility study highlighted several limits of the model. Most of the barriers that emerged were consequences of organisational choices not supported by evidence. The principal limit was a lack of accountability by the participating centres.
- Faecal Occult Blood Test
- Cervical Cancer Screening
- Colorectal Cancer Screening
- Local Health Unit
- Faecal Occult Blood Test Positivity
Colorectal cancer screening (CRCS) for average-risk individuals using the faecal occult blood test (FOBT) is effective in reducing mortality from CRC and its use is generally recommended [1–4].
The challenges of disseminating evidence-based interventions are shared by stakeholders, researchers, the intended providers, the intended consumers [5] and, of course, governmental health agencies.
While quality-assurance monitoring is carried out to ensure safe procedures and practice in every clinical aspect of a screening-programme [6], planning and organisation are the only aspects not routinely monitored, yet are the strongest tools to assure the effectiveness of screening [7].
Well-planned interventions have been associated with statistically greater results, particularly for CRCS [8]. Unfortunately, the organizational aspects of an intervention are not usually subject to the same evidence-oriented criteria we apply to medical technologies or clinical procedures.
Which Type of screening test among those available (colonoscopy, flexosygmoidoscopy, FOBT Guaiac and the Immunochemical) [10–12].
Screening knowledge and attitudes of the involved Physicians (GPs and gastroenterologists). [13, 14].
The available Endoscopy resources and the additional workload in case of screening. [3, 4].
This paper describes the research involved in planning a colorectal cancer screening program in the Lazio region, Italy, and reports the results of the feasibility study conducted to test the organisational model.
The Lazio region has 5.3 million inhabitants and includes the city of Rome; the CRCS target population (i.e. people aged 50–74) is 1.5 million.
The Regional Public Health Agency (RPHA) is a technical branch of the regional government of Lazio: it coordinates, monitors and evaluates breast and cervical cancer screening in the 12 Local Health Units. The local government gave a mandate to the RPHA to organize CRCS, with an experimental phase, and a feasibility study [17–22].
The Colorectal Cancer Working Group (CRCWG)
The method adopted was based on organizing a Colorectal Cancer Working Group (CRCWG) made up of the principle professional figures involved: experts in gastroenterology, epidemiology, screening program organizers, general practitioners; representatives of the physicians' unions and of the regional scientific societies of endoscopists and gastroenterologists. The CRCWG reviewed the guidelines available, giving greater weight to those from governmental bodies; it also reviewed the literature regarding the characteristics of FOBT. They made operational recommendations based on those found in the literature; identified additional cognitive needs in cases where the evidence in the literature was insufficient or inapplicable; for these they identified general and specific objectives.
The experimental phase
Main studies/interventions conducted and main results achieved during the experimental phase conducted by the Lazio Regional Public Health Authority.
Main results
To describe GPs' the knowledge, attitudes and recommendations about colorectal cancer screening.
Survey of the GPs [18]
24% of the GPs correctly recommended screening for CRC; 22% did not recommend any; 6% under-recommended and 47% over-recommended. 22% of GPs recommended inappropriate follow up tests for patients with positive FOBT.
To describe attitudes and recommendations about colorectal cancer screening of the endoscopy centre physicians.
Survey of the endoscopy center's physicians [19]
Colonoscopy was perceived as the most effective screening test and was the most recommended (80%). FOBT was recommended by 61% of physicians and flexosigmoidoscopy by 11%. 50% over-recommended screening.
To evaluate the effect of the provider (GPs versus hospital) on compliance FOBT screening.
Randomised controlled trial [20]
24.5% of 1192 GPs agreed to participate in the trial. The compliance with the GP was 54% vs 17% with the hospital (RR 3.4; 95%IC 3.1–3.7). There was a high variability in the compliance obtained by the GPs. GPs with more than 25 patient visits per day and those who incorrectly recommended screening had lower compliance (OR 0.74, IC95% 0.57–0.95 and OR 0.76, IC95% 0.59–0.97, respectively).
To assess the effect of the type of FOBT, Guaiac or immunochemical, on compliance.
Cluster-randomised trial [21].
The immunochemical test (OC-Hemodia, Eiken) had a compliance of 35.8% and the Guaiac of 30.4% (RR 1.20; CI95% 1.02–1.44). The Guaiac test had a higher prevalence of positives (10.3% vs 6.3%); and had higher variability in the results.
To identify determinants of non-compliance to FOBT screening.
Case-control study nested in the trial [22].
About 31% of non-compliant people reported never receiving the letter offering free screening; 17% of the sampled population had already been screened. The major reason for non-compliance was "lack of time" (30%), the major determinant of compliance was the distance from the test provider: OR > 30 minutes vs < 15 minutes 0.3 (95%CI = 0.2–0.7).
To define criteria for a quality assurance program for CRC screening endoscopy.
A multidisciplinary panel consensus
A system of quality indicators was created: protection of "users" rights; location in which endoscopy is performed; medical and non-medical staff skills and training in colonoscopy and screening procedures; availability of CRCS-specific management protocols; technical and professional processes; early outcomes evaluation; adverse effects and follow-up management.
To estimate increase in colonoscopies resulting from screening.
Analysis of administrative databases.
Assuming a FOBT positivity rate of 3.5%, a 50% compliance rate, we estimated that nearly 50% more colonoscopies would be required.
The study was submitted and approved by the Committee for Ethics in Screening of the Regional Agency for Public Health, 16th June 2002, approval n°1.
The endoscopy resources
We analysed the administrative database of hospital records and the distribution of CCR admissions in the previous three years. According to the results of the analysis we selected the endoscopy centres with the highest volume (more than 500 hospitalizations for CRC or adenomas) and at least one centre in each province, to make second level testing feasible in rural areas.
The CRCWG reviewed the literature regarding quality of endoscopic services and defined quality indicators from a disease management perspective, and addressed particular aspects of the relationship between health professionals and patient safety. The endoscopic centres selected were evaluated based on these criteria.
To estimate the number of colonoscopies that would result from extending CRCS to the whole region we conducted a survey of the yearly census of the digestive endoscopy centres by the Regina Elena Institute of Rome and the Italian Society of Digestive Endoscopy (SIED) [19]. We estimated the amount of additional work that would result from screening, according to the following assumptions: a) the demand for colonoscopies produced by the screening program to be entirely independent of current demand for endoscopic exams, as they involve asymptomatic subjects; b) the screening exams were to be performed by facilities located in the subject's area of residence; c) a participation rate of 50% to the hypothetical campaign, and 3,5% of FOBT positivity.
The information system
To develop the organizational model we referred to RPHA strategic choices (disease management approach, according to a clinical governance framework [16, 23]) and to our original data.
According to the clinical governance framework, to assure citizens/patients safety we also planned a clinical risk management programme, using a systemic preventive approach and applying the HFMEA protocol [24]. The results have been incorporated into the organisational model and the management software.
The feasibility study
A feasibility study on a target population of 300,000 has been started according to the results of the decision-making process. Here we present the results of the first two years of activity, i.e. the first round. The following process indicators are reported to summarise the results of the feasibility study: the number of centres that started the program; the proportion of GPs that agreed to participate in the program; the proportion of the target population that have been contacted (invited); the proportion of people returning the test among the invited population; the positivity rate; the compliance to colonoscopy; the waiting time for colonoscopy.
All 20 gastroenterology centres included in the programme were visited by the RPHA before the program began. The centres that actually started to screen were visited a second time to assess and evaluate the program's progress and to identify critical points.
The screening strategies adopted were consistent with the Ministry of Health guidelines on CRCS, consequently the feasibility study did not need to be submitted to the Committee for Ethics.
The evidence collection and production
According to the main evidence, the CRCWG adopted as the screening strategy: FOB testing every two years for 50–74 year olds and, for positives, colonoscopy. We chose FOBT (OC-Hemodia, Eiken) based on the results of population trials [2], and the better compliance to FOBT than flexible sigmoidoscopy in Lazio [25]. All the high-volume endoscopy centres (more than 500 colonoscopies per year), and at least one in each province, were involved to face the predicted 50% increase in the colonoscopy burden induced by screening.
The critical needs identified are listed in table 1; objectives and study or intervention design are also shown. In order to obtain the necessary information to organize the most effective model of mass screening, according to CCRWG indications, we studied the following topics: physicians' attitudes and practices, type of FOBT, test provider, and individual reasons for non-compliance [17].
The main results of the studies/interventions carried out by the RPHA during the experimental phase are shown in table 1; most have already been published [17–22].
Use of data gathered to define the organizational model.
Experimental evidence/elements from
Organizational choices
Which Organizational framework?
▪ Literature on organisation topics
▪ RPHA Mission
Disease management as a factor to achieve effectiveness
Which Screening test?
▪ Literature evidence
▪ European Commission Recommendation [4]
▪ FOBT has a compliance of 3.1 compared to FS [25]
FOBT as screening test
Which FOBT type?
▪ Literature evidence
▪ The immunochemical test had a 20% higher compliance than Guaiac.
▪ Higher variability in the results obtained with the Guaiac test than the immunochemical [21].
Immunochemical test as FOBT test
Which FOBT provider?
▪ The compliance to the FOBT with GPs was 3.4 times higher than compliance with the hospital, independent of the type of test and geographical area [20]
General Practitioners as main provider
What the GPs think about screening? What they can do?
▪ GPs currently do not correctly follow up a positive FOBT [18].
▪ There was high variability among GPs: GPs with a heavy work load and those who incorrectly recommended FOBT for CRCS obtained lower compliance [20]
the GPs are not required to participate in the program, but they receive an economic incentive if they do.
Reference diagnostic Centre
▪ Number of CRC cases treated by hospital in the previous 3 yrs plus a guarantee of accessibility in rural areas
▪ A shared system of quality indicators and standards
▪ Attending a re-training course
▪ Centres belonging to Hospitals that have > 500 patients
▪ Centres complying with quality indicators
Why people do not respond to screening invitation?
▪ The first reported reason for non-compliance was "lack of time" (30%).
▪ The major determinant of compliance was the distance from the test provider. [22]
Territorial zoning regardless of administrative borders
Who manage the follow up of positives?
▪ GPs undependable for correct follow-up [18]
▪ Gastroenterologists not skilled in managing mass screening criteria [19]
▪ Neither physicians at endoscopy centers nor GPs tend to follow screening guidelines.
▪ Centralized management
▪ Guidelines-based software
Which software for screening management?
▪ Previous breast cancer screening experience about non-efficiency of in-house softwares, different for each Local Health Unit
▪ Mission: disease-management oriented
▪ Web based software
The organisational model (figure 1)
From the evidence found, we defined an organizational model, an information system, and software.
- 1.
to use a disease management approach, including patient treatment and follow-up, and managed according to the principles of clinical governance.
- 2.
the GP is the preferred provider because of its proximity to the healthy population.
- 3.
the GPs are not required to participate in the program, but they receive an economic incentive if they participate: about 10 € per person screened, based on an agreement between the Regional Health Authority and the GPs' trade unions.
- 4.
to offer FOBT as the first-level test (immunochemical method based on latex agglutination with automated analytical procedure). The patients of participating physicians are invited to pick up the test at the GP's office; all patients of non-participating doctors are directed by the local health unit to pick up the test at the local gastroenterology/endoscopy center; the letters were mailed by the Regional Agency for Public Health using centre-specific templates (timetable, addresses and letterhead), but the timing was determined by the gastroenterology centre according to their availability for providing tests and colonoscopies; A reminder was sent to non-responders after three months. The GPs decided when and how (phone, letter or other) to contact their target populations.
- 5.
the result of the test was automatically sent by mail if negative; if positive, the result should have been communicated by phone and letter, in the same phone contact a date for colonoscopy should have been fixed.
- 6.
the gastroenterology centres (20 in the region) collect all the faecal samples and perform the immunochemical analysis and plan the colonoscopy for all the positive samples (and possibly immediate polipectomy).
- 7.
the target population refers to the closest gastroenterology centre, independent of administrative borders
- 8.
the Local Health Unit must establish the administrative framework, and serve as the program's liaison with the GPs and the gastroenterology centres.
The Information System
A fundamental part of the organisational model is the information system. It is directly managed by the RPHA. The IS is structured in three sections: because there is no cancer registry in our region, the information about incidence and mortality is taken from the integration of the mortality database, the hospital discharge registry; the information about the screening process and outcomes is reported by the on-line record of each screening episode; an adverse events and near-misses information system has been planned.
A fundamental part of the information system as a tool in disease management is the software. We developed a web-based application with the following characteristics: instant access to information by any user, no need for system updates, few hardware needs by the user, information centralized in a single database, possibility of external housing for the server platform, integration with other technological tools (i.e. immuno-test analysers) and with databases (hospital discharge records, out-patient records, mortality database); automatic quality controls to assure that the health professionals involved comply with protocols.
Results of the feasibility study
Results of the feasibility study: process indicators and critical points
range among
critical points
Program activation
target population
N of centres started
50% (10/20)
See discussion
population of active centres
65922 (22,0%)
the following data refer only to the active centres
GPs participation
% of GP that agreed to participate
10,8% (57/526) 60,0% (57/95)$
(0,0 – 90,0)
GPs were actually involved in only 6 centres: in some LHUs,
administrative barriers prevented the participation; no interest by the GPs;
some GPs initially agreed but never send the list of target population.
Program extension (invited population/target)
41,1% (65922)
Most of the GPs do not actively invite, but only distribute the tests
opportunistically: difficult to exactly determine the contacted
21,0% (20315)
50,1% (45607)
Too slow invitation rhythm: the program did not cover the
whole target population within the two-year period.
Compliance to FOBT (proportion of returned test/invited population)
26,5% (27124)
79,9% (4258)
(73,1 – 91,8)
Impossible to monitor what the GP does. The compliance is biased
because of opportunistic strategies, without active invitation
by the GP.
16,6% (22866)
(4,7 – 34,1)
Low compliance: no accessibility
Positivity rate
7,1% (6908)
(3,2 – 9,2)
For 288 (%) tests the results were not available: high level of
lost samples and lost responses.
Compliance to colonoscopy°
49,1% (288)
(0,0 – 76,7)
Impossible to determine if missing data or low compliance.
Detection rate*
Very few centres input data correctly and timely.
high grade adenomas
Low grade adenomas
Waiting time for colonoscopy§
within 30 days from FOBT
Few colonoscopies due, but centres too busy. Very few centres input data correctly and timely.
31 and 60 days from FOBT
after 60 days from FOBT
Out of the 7196 samples returned, 288 could not be interpreted because the personal data or the sample itself was lost. Compliance to colonoscopy was very low, but during the site visits we observed that some colonoscopies had been performed without being registered; unfortunately it was impossible to quantify the phenomenon. Generally analyses of second level testing was limited due to the amount of missing information.
Carcinoma detection rates were 2.2/1000 and 2.4/1000 respectively for women and men, while the detection rates for high-grade adenomas were 11/1000 and 7.5/1000. Waiting times for colonoscopy varied greatly but tended to be long, with more than 22% waiting more than 2 months for colonoscopy.
The principal critical points noted during the site visits were: gastroenterology centre administrative staff related poorly to the healthy population, they had little experience managing the high number of patients and tests. Some of the centres were not easily accessible, i.e. hard to find, and required very short time for test pick up and return. There was such little time set aside for screening colonoscopies that the second diagnostic level was a bottleneck for the screening program, slowing down the rhythm of the entire screening process. Internet access at some of the centres was inadequate and unreliable, which prevented using the software.
Choosing an organisational model: the grey areas
We thoroughly planned all stages of the screening process, taking into account its various aspects in the effort to establish the best baseline conditions for CRCS for our target population. To identify the best options we adopted the principles of evidence-based medicine, applying strategies that had preferably been tested in trials or, if trials were not available or not feasible, had solutions recommended by sound observational studies. We decided also to produce our own evidence if we noted contextual differences that hampered the generalizability of other studies' results (GP's effect on compliance and GPs' attitudes) [20] or if there was not enough literature on the topic (effect of the type of test on compliance, gastroenterologists' attitudes) [21]. Nevertheless, grey areas remain and some of the solutions were adopted arbitrarily.
The colonoscopy workload was identified as a critical point, consequently we needed almost all gastroenterology centres with medium-high volume of activity in our region to participate in the program independently of their administrative condition, in particular we were interested in involving university hospitals and clinical research hospitals, institutions usually not involved in breast or cervical cancer screening. With this aim we made three decisions: 1) we decided to put the FOBT reading machine (OC sensor) in the gastroenterology centre; consequently the system used 20 machines to interpret the test, an inefficient solution that increased the cost per test; furthermore gastroenterology centres do not have experience managing routine diagnostic tests and or handling a very high number of negative responses. 2) We decided to use the nearest gastroenterology centre as the test provider for the target population from non-participating GPs; other public clinics could be used to bring the test provider closer to the healthy target population. 3) As a consequence of the central roles played by the GP and the gastroenterology centres, the Local Health Unit had a marginal role in the screening program management.
Finally the economic incentive offered to the GPs was established with an agreement between the Regional Health Authority ant the GPs' trade unions, but we do not know if other forms of voluntary participation would be less effective.
What did not work
First problem: only half of the centres chose to participate. One of the possible barriers that we identified is that the responsibility associated with prevention is unclear: in our health system the Local Health Unit is accountable for the health of the resident population within its borders, but most of the gastroenterology centres depends on the administrations of independent hospitals. In our model we tried to make the gastroenterology centre accountable for a preventive intervention and the LHU a sort of third player. This often resulted in a sort shifting of blame between the gastroenterology centres and the LHU.
Second problem: very few GPs agreed to participate, but wide variability was observed. It was clear that some LHUs did not have the administrative skills to enrol the GPs in the project, but all the coordinators working in the LHU screening programs (usually involved also in the organisation of breast and cervical cancer screening) reported that this task was difficult and time consuming.
We had great difficulty in determining how many people in the target population had been invited by the GP. This was the consequence of the freedoms obtained by the GPs' trade unions in the agreement: in fact, during the trial the target population that had their GP as test provider received a letter with a time schedule to pick up and return the FOBT; in the feasibility study we could not send mail to patients of the participating GPs because of union opposition. At the end of the round we were not sure if the GP's entire target population had had equal opportunity to be tested, generating an equality issue. The role of GPs in increasing screening attendance has been observed in several studies [26–30], but we faced so many difficulties that the advantages were largely outweighed by the problems; this is probably why other authors suggested the GPs' role be kept at signing the invitation letter [29, 30].
Some LHUs had problems in respecting the 7 day time period to transport the faecal samples from the GPs' clinics to the gastroenterology centre.
The compliance in some gastroenterology centres was unacceptably low, confirming the results of the experimental phase [20, 21]. Even though it was confirmed in the two settings of the experimental and pilot phases, the compliance rate obtained in our region by the gastroenterology centres is much lower than the Italian average (46%) [31]. These centres are used to treating a small number of ill patients and giving them a lot of attention, but they are not used to managing hundreds of people. Consequently they substantially reduced their availability to patients returning the FOBT.
The rhythm of mailing invitations to the target population had to be slowed in almost all centres because the colonoscopy workload was too high. This problem also occurred at centres that performed very few colonoscopies, revealing that they were not at all committed to screening and reserved very little time for this task. As a result, only one of the 20 centres invited the entire target population in the two year period.
Finally, there were also some problems with the management software. Some GPs did not enter all the required information, leading to the very confusing and unacceptable situation of sample results not being ascribed to a patient. Some gastroenterology centres had significant problems in entering colonoscopy results, mostly due to poor web connections, consequently the detection rates and colonoscopy compliance figures are not reliable. Nevertheless, the detection rate is in line with results of other Italian screening programs, while the compliance to colonoscopy is lower (41% vs 82%) [31].
Conclusion (Lessons from failures)
By analysing all the problems we encountered, a single underlying cause is apparent: a lack of accountability. In our opinion, the program will work when responsibilities are clearly re-established, the most important and difficult being the institution's and staff's level of commitment to and involvement with the program. This is not the first experiment that has failed because of the difficulty in accountability of health services and their employees. The problem is more evident in the implementation of preventive interventions: in a CRCS program physicians do not have to face a health problem posed by the patient, but must themselves motivate prevention in the healthy.
We took a disease management approach [5] to ensure effectiveness, taking into account the role that the organisation of the health care system plays in determining quality and effectiveness [32, 33]. Although the literature supports a disease-management approach, it does have some limitations. More general research is needed to assess effectiveness and the relative cost-effectiveness of different implementation strategies [34, 35]; more agreement is also necessary on definitions and methodology [36].
Conflict of interests
The authors declare that they have no competing interests, other than having contributed to the construction of the organisational model here analysed.
The following are members of the Colorectal Cancer Working Group: Anti M, Casale V, Di Cicco M, Stigliano V, Tammaro L, Chiriatti A, Barberani F, Di Giulio E, Gabbrielli A, Stroppa I, Morini, Scozzarro A, Pietropaolo V, Grassi A, Bazuro G, Del Manso F, Mancini U, Crespi M, Amodeo P, Assorgi G, Bagarani M, Schiffino L, Fracasso P, Mangia ML, Ferrara M, Pippa G, Vella A, Vernia P, Costamagna G, Petruzzielllo L, Delle Fave G, Pallone F, Capurso L.
We want to thank all the staff from the Screening Unit of the Agency for Public Health and all the professionals who are implementing the colorectal screening programs in local health units of Lazio region. We thank Margaret Becker for the English editing. The study presented in this paper have been funded by the Lazio Region and the Agency for Public Health of the Lazio region.
Authors' Affiliations
- Winawer S, Fletcher R, Rex D, Bond J, Burt R, Ferrucci J, Ganiats T, Levin T, Woolf S, Johnson D, Kirk L, Litin S, Simmang C, Gastrointestinal Consortium Panel: Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence. Gastroenterology. 2003, 124: 544-60. 10.1053/gast.2003.50044.View ArticlePubMedGoogle Scholar
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Pre-publication history
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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Read Colossians 1:24-28
When we really stop to consider what we mean by "God," our words fall short, our imaginations stumble, our concepts fail. We are like an old pocket calculator which, when faced with a calculation that exceeds its capabilities, flashes "Does not compute." And so we say that God is a "mystery." Yet, a mystery is not a problem to be solved, however complex – as if the concept of God was just a more complicated version of the general theory of relativity. Rather, a mystery is a reality so all-encompassing that we never stop discovering its depth or its meaning. We are both fascinated and overwhelmed by the mystery of God. This mystery beckons, it calls us to enter into the darkness in order to discover its light and glory.
This was
experience. Before his encounter with the risen Christ, his knowledge of God
was partial and obscured. In accepting Christ's suffering for him, in accepting
the darkness of the Cross, Paul came to discover the brightness of God's love
not only for him, but for the whole world. This is why the struggles of his
ministry are an occasion for him to rejoice: for as he enters more deeply into
identification with the suffering Jesus, he discovers more fully the
life-giving love of God. This is why he can write these strange but wonderful
words: "I am now rejoicing in my sufferings for your sake as I complete in my
flesh what is lacking in Christ's own suffering for the sake of his body, the
Church." Saint Paul
Through the struggles of his ministry, the rejection and suffering he experiences because of his faith, Paul comes to a greater understanding and experience of the depth of God's own love for all people. This is the "mystery" into which we can all enter, "Christ among us, the hope of glory." And Paul can only invite us to enter into this mystery ourselves, so that we will all grow into the fullness of this glory. For Paul, this is the great mission in his life, the great task he has accepted and for which he is willing to suffer and die.
People who truly know what it means to love also know that love is often costly and painful. It requires us to die to ourselves in order that others might come to greater life. A parent who suffers for his or her child's sake; a spouse who gives all in caring for a wife or husband; a social worker who cries over the pains of a broken family; a nurse or doctor who is torn by the ravages of a patient's disease: all these enter into the dark mystery which, when lived in love, somehow opens up into light. The "mystery" which has been hidden from all times then becomes our meaning and our hope.
Outside of love, the pains and struggles of this life can only drain and empty us. Encompassed by love, they become a way of knowing the mystery of God, of entering that mystery, of being upheld and embraced by that mystery. This was Paul's experience of Christ. May it also be ours.


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Rewards Programs
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Please note that we are unable to credit your account for purchases made in our office until you have registered for the program online. Therefore, we encourage you to sign up in our office or, within a few days of your visit. You must let us know when you do, so that we can credit your account. You can just drop us a note using the contact form to the left on this page. Points cannot be awarded beyond a few days of your visit. So, don't delay. Until you take care of that on your end, we are unable to do what needs to be done on ours.
Also, remember that Brilliant Distinctions Rewards points must be used within nine months.
Galderma is the owner of Dysport®, and the Restylane® family of products which, now includes Restylane® Lyft (formerly, Perlane®). The Galderma loyalty program is called Aspire. Learn more about Aspire Galderm Rewards at https://www.aspirerewards.com/app/home.do
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Download the FREE NEOCUTIS Swiss Rewards APP for your iPhone, Android, or other available devices. Visit the APP Store to download.
Purchase qualifying NEOCUTIS products from an authorized, participating skincare provider. (That would be us in this case..)
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Here's an older story – but still a good one. Another great example of a successful lottery pool! Reported by the LA Times.
Valley Lottery Pool Winners Soak Up Big Change Jackpot:
Seventeen workers shared in purchase of one of two lucky tickets for the $61-million prize.
It's not every day you show up at work and find out you won the lottery. But that's what happened to Henry Ramirez on Thursday morning.
"Walking into the office, people were screaming, 'You won, you won,' " said Ramirez, 29, a customer representative at the Valley One-Stop at Van Nuys, an employment training agency.
"I didn't even know what was going on. I didn't believe them until I checked the numbers myself."
But seeing the numbers–14, 21, 30, 35, 39 and 46– Ramirez realized he was one of the winners of a $61-million jackpot.
There were two winning jackpot tickets Wednesday night–one purchased in Commerce at 7 Day Liquor on 2482 S. Atlantic Blvd. and another bought in Van Nuys at the Jons Market at 6655 Van Nuys Blvd.
Ramirez was one of 17 people who pooled money to buy lottery tickets–including the lucky one from Jons Market.
Each of the winners in Ramirez's pool will get about $609,000 after taxes.
As of Thursday afternoon, the holder of the second lucky ticket had not yet stepped forward.
But Chi To, 24, who helps run 7 Day Liquor in Commerce, said his family will probably use the estimated $155,000 they receive as the retailer who sold a winning ticket to "pay the bills."
Jons Market will also receive $155,000.
In the Valley, the pool of 17 who held the ticket work for at least three companies–the Valley One-Stop, Noble Community Medical Associates in Van Nuys and Jons Market, where the ticket was purchased.
Eleven of the 17 went to claim their winnings at the state lottery office in Van Nuys on Thursday. Each participant had bought $5 in tickets, although two women split the cost of five tickets.
Maria Valencia and Martha Gonzalez, who both work at Noble Community Medical Associates, will split a share.
Valencia, 29, said she was in bed ready to go to sleep Wednesday night when her boss called with the news.
"No, you're playing with me. You're too calm," Valencia, of Granada Hills, recalled saying.
Valencia, a receptionist at the medical office, wasn't the only one who couldn't believe she had won.
Olinda Estrada, 28, said she called two 7-Elevens for the winning numbers. "I had a funny feeling in my stomach," she said.
Estrada, a medical assistant, said she wasn't convinced until she went to a third store and saw the numbers for herself. "I was stunned–my boyfriend was the one yelling and screaming," said Estrada, of Van Nuys.
"We have a lot of bills to pay," she added. "This will help a lot."
Comments are closed.


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Day 173: Swimming in Antiviral Waste
I worry about reports that Britain's rivers and lakes are full of Tamiflu and Relenza, which means ours are, too. Heck, I contributed my share—when I could stand up.
A flood of medicine that collects in urine has flushed into sewers since the pandemic struck. Human pee accounts for 1% of wastewater, but contributes more than half of all waste nutrients via stuff like vitamins, pharmaceuticals, and contraceptive hormones (as opposed to New York's famous Coney Island Whitefish, the plastic kind).
No one knows how the antiviral surge will affect wildlife or essential waterborne microbes. The question has never been researched. Vincent Racaniello long ago suggested that sewage from extensive use of Tamiflu might cause recombinant resistance to the antiviral. A tide of antidepressants unquestionably messes up fish and frogs. (Federal regulations force medical institutions to flush narcotics, stimulants, steroids, and depressants—any controlled drugs—down drains, rather than bury them in landfills.)
For the sake of those still uninfected, I'm now hoping the pharmaceutical-industrial complex gets vaccine out soon. I see reports that the first batch of bioactive chicken eggs is rolling off the line after many delays. There won't be that many and they won't go to regular folks. DHS and DOD will grab the lion's share. If there are black or gray markets, a lot of corporations will pay any premium to stave off a complete collapse in operations. (Have you tried telephoning any companies lately?)
In case any of you snag some vaccine, you should avoid popular pain relievers known as NSAIDS (non-steroidal anti-inflammatory drugs such as Aspirin, Tylenol, Aleve, and Ibuprofen) before getting any shots. A University of Rochester study says they may inhibit your ability to produce the antibodies you want; for an excellent translation, read the explanation at Effect Measure.
It stands to reason that quelling inflammation reduces our immune response; inflammation is an immune response. Taking a pill any time you feel lousy essentially stops your body from fighting what ails you.
Fever We Can Believe In
This is one of those medical "surprises" that keep cropping up because people don't want to believe it. Years after that Rochester study, the CDC urged parents not to give children Tylenol before their swine flu shots, citing what AP called a "surprising study" in Europe that found it useful to let children suffer a little fever after a vaccination. Duh. It meant they were building up antibodies to the virus. NSAIDS aren't so hot anyway: A Norwegian Institute of Public Health report says they seem to diminish driving skills.
When an H5N1 vaccine proves out, how will they inject the chosen few? Telekinesis? There's talk of sending EMS workers with shots, but it's tough enough for them to tend the sick, let alone deliver meds to those who remain well. I probably won't need a vaccine unless the flu keeps mutating, in which case it wouldn't work.
On the plus side, I feel as if one fever has replaced another. I'd like to see Anna soon, thank her with conviction. She'd make a great doctor, but she prefers to study psychology at what she calls "The Endorphin School of Mental Health" because she believes that stimulation through what wiki calls "excitement, pain, consumption of spicy food, love, and orgasm" is an effective way of putting people who are breaking down back into motion.
Having stimulated my natural opioid peptides, Anna has left me to recover while she lines up an alternative eatery in case Ric's landlord succeeds in evicting them. I picture her smiling innocently under wide, slashing brows, daring anyone to try to stop the LES DIY.


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Here are a some pictures from my spots at the WAC.
Plus here are some pictures from the Garden Centre
Hi Katherine, so many lovelies. Is the Milkshake sign original, is is tin, how much are you selling it for? Carl collects pennants, do you have any NSW/ACT ones?
Have a lovely weekend. I forgot to mention in the earlier comments that I hope that Lotte is feeling better. Tam x
There is an electric jug in one of the photos that looks like it's shaped like a frog? Or do I need to put my glasses on?
To "A Treasured Past" ... I'll have to see if I have any NSW/ACT pennants. We have a few stashed away marked for Ebay.
Hi Katherine - I was at the WAC on Thursday and didn't see these goodies - I love those wooden rolling pins. Will drop in next week. Hope all still good with Lotte. Take care F xxReplyDelete
What fantastic treasures! I must getup for a visit!!! I have my eye on that mannequin.... I have been looking for one... Hope to catch you very soon! XReplyDelete
Thanks for the virtual shopping experience, lots of lovely finds!ReplyDelete
Why American men should boycott American women
I am an American man, and I have decided to boycott American women. In a nutshell, American women are the most likely to cheat on you, to divorce you, to get fat, to steal half of your money in the divorce courts, don't know how to cook or clean, don't want to have children, etc. Therefore, what intelligent man would want to get involved with American women?
American women are generally immature, selfish, extremely arrogant and self-centered, mentally unstable, irresponsible, and highly unchaste. The behavior of most American women is utterly disgusting, to say the least.
This blog is my attempt to explain why I feel American women are inferior to foreign women (non-American women), and why American men should boycott American women, and date/marry only foreign (non-American) women.
Tens of millions of American men have had their lives completely destroyed by American women through the following crimes:
1. False rape accusations (it has been proven that up to 80 percent of rape accusations are FALSE)
2. False domestic violence (DV) charges (same as above)
3. Financial destruction of men in divorce courts through alimony and support payments (women get up to 95 percent of their ex-husband's income and savings, as well as the house, car, etc)
4. Emotional destruction of men by ex-wives who have stolen their children from them and forbidden contact
5. Divorced dads who commit suicide as a result
Not one single American woman has EVER condemned their fellow American women for committing these crimes against men. Silence means consent. Therefore, American women support and enjoy destroying men's lives and causing men to commit suicide. Apparently, American women think it is okay to be a criminal, just as long as you are a woman. Therefore, is it any surprise that a huge percent of American men no longer want anything to do with American women, other than using them for easy sex and then throwing them away?
Over 50 percent of American women are single, without a boyfriend or husband; so the fact is most American men no longer want to marry American women. Let these worthless American women grow old living alone with their 10 cats.
A national morning radio show talked about the Boycott American Women blog and was heard by millions of people.
Part 1: http://youtu.be/AMjqQmCiMOw
Part 2: http://youtu.be/iGfhbjw19pQ


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Cambridge, United Kingdom/2010
From Geo Hashing
In 2010, there were 27 expeditions undertaken by Benjw, MagicIan and Sourcerer. In the previous year there were only 19 so it's pleasing to see an increase in activity.
- 26 December 2010 (Sun): Sourcerer visited a deeply frozen field between Castle Acre and Lexham, north of Swaffham, Norfolk UK arriving at about 7.30 pm.
- 25 December 2010 (Sat): Sourcerer failed to reach a wetland with mature trees standing in pools of water covered with ice. West of Great Hockham, Norfolk, UK. It was the first hour of Christmas day.
- 28 November 2010 (Sun): Sourcerer visited a snowy wood of beech and oak, west of Snettisham, Norfolk UK, logged on Wikiloc
- 2 November 2010 (Tue): In a field north of Stansfield, Suffolk. Benjw was there at about 3:30pm.
| The Cambridge, United Kingdom graticule (52 0) earned the Mostly Active Graticule achievement
- 28 October 2010 (Thu): In Thetford Forest. Benjw was there just after 4 pm, and enjoyed both the tranquility of the pine woodland, and a rendition of the Star-Spangled Banner from the nearby RAF base.
- 20 October 2010 (Wed): Between woodland and a field, north of Bury St Edmunds. Benjw went, but couldn't get permission to access the point, despite local tenants egging him on.
- 12 October 2010 (Tue): In a field west of Soham. Benjw cycled a 27-mile round trip, along nearly every type of road and path known to man.
- 11 October 2010 (Mon): On the A14 just north of Newmarket. Benjw drove through the hashpoint at 8:39 pm.
- 2 October 2010 (Sat): On a public footpath outside Stretham, near Ely. Benjw arrived at about 6:30 pm and found a geocache a mere ten metres away.
- 1 October 2010 (Fri): Under a hedge in a field near Harston, south of Cambridge. Benjw visited, although it took two attempts to get the right spot.
- 24 September 2010 (Fri): A grassy area between two houses east of Boston, Lincolnshire. Sourcerer arrived 90 seconds before midnight and waited for the hashpoint to vanish. This was hash 5 of a pentahash taking in Canterbury, London East, London West, Northampton and the Cambridge graticules.
- 19 September 2010 (Sun): A conifer plantation between the Peddar's Way long distance footpath and Great Hockham, Norfolk. Sourcerer visited this spot. The GPS path is available at Wikiloc.
- 4 September 2010 (Sat): A sugar beet field east of Royston. Sourcerer visited this spot. It was the fourth point of a quad-hash covering Hull, Skegness, Northampton and Cambridge.
| The Cambridge, United Kingdom graticule (52 0) earned the Mostly Active Graticule achievement
| The Cambridge, United Kingdom graticule (52 0) earned the Mostly Active Graticule achievement
- 16 August 2010 (Mon): Off a footpath in a cornfield somewhere in the Fens. Benjw visited at 1:41 am as part of an over-midnight triple-hash expedition.
- 15 August 2010 (Sun): In a cornfield off the A1101 northwest of Littleport. Benjw made it a midnight geohash as part of a triple expedition.
- 14 August 2010 (Sat): Off a footpath through Easty Wood, near Cavendish, Suffolk. Benjw wasn't able to make a 4pm meetup, but went later in the evening.
- 13 August 2010 (Fri): A field, this time still full of corn, on the edge of Littleport. Benjw visited in the pouring rain at 4:30pm.
- 11 August 2010 (Wed): In a harvested cornfield at the south end of Soham. Benjw visited in the dark, at about 10:30pm.
- 10 August 2010 (Tue): At the edge of a field near North Pickenham, Norfolk. Benjw eventually found the village, but was halted by a "keep out" sign on the farm track.
- 7 August 2010 (Sat): In an elderberry tree near Syderstone. Sourcerer visited as part of a day trip to the north Norfolk coast.
- 2 August 2010 (Mon): On conservation land in Lakenheath Warren. Benjw discovered that it is inaccessible during the summer months.
- 30 July 2010 (Fri): By the side of a road west of Saffron Walden. Benjw visited in his lunch break.
- 27 July 2010 (Tue): On a public footpath through the golf course in Longstanton. Benjw cycled, and then on to the Northampton grat expedition.
- 22 July 2010 (Thu): Benjw drove through the hashpoint at nearly 70mph, on the A11 sliproad at Six Mile Bottom.
- 19 July 2010 (Mon): Benjw strolled up a hill and around a field near Little Shelford on the way home from work.
- 20 June 2010 (Sun): MagicIan completed this hash - his third of 4-in-a-row on this day - in an orchard near Wisbech.
- 7 January 2010 (Thu): Benjw attempted to get to a field in Hauxton, but was refused permission to enter private property.
Active geohashers[edit]
Graticule talk page[edit]
Nothing was added to the graticule talk page during 2010.


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Plan a Mountain Vacation in North Carolina
Whether you're planning a getaway or an event, be sure to enjoy all of the activities available during your stay at the Buck House Inn on Bald Mountain Creek.
Enjoy a hearty breakfast, and then explore the surrounding area with activities offering something for everyone.
Activities "On the Mountain"
- Golf at Wolf Laurel Country Club (guests receive 50% off one round for two)
- Horseback trail rides at the Bucktown Stables adjacent to the Inn
- Hiking on miles of nature trails (maps available)
- Guided off-road UTV trail ride
- Appalachian Trail access on Big Bald Mountain, only 10 minutes away
- Catch & release trout fishing in our stocked pond or in nearby streams
- Picnic lunch at the Pavilion with a gorgeous long-range view or backpack to Bald Mountain
- Casual or fine dining at Wolf Laurel Country Club
- Relax in one of the creek side swings along Bald Mountain Creek
- Play yard games on the front lawn: croquet, bocce ball, Frisbee, horseshoes
- Stroll and explore historic outbuildings on the Inn's eight acres: the spring house, old general store, the apple barn, and family cemetery
- Enjoy an evening around our cozy creek side fire pit with a glass of wine, hot chocolate, or s'mores
- Sit back and enjoy the scenic gap view from the veranda
Other Activities Nearby
- Golf at Mountain Air Country Club in Burnsville (special rate for Buck House guests)
- Antiquing and shopping in nearby Burnsville, Weaverville, Mars Hill, or Asheville
- Biltmore Estates and Winery in Asheville (1 hour)
- Numerous mountain festivals in the area, such as the Mt. Mitchell Crafts Fair in Burnsville every August (20 minutes)
- Variety of dining in Asheville (40 minutes)
- Cafes and delis for lunch in Burnsville (20 minutes) and Weaverville (30 minutes)
- Ziplining with incredible speeds and mountain views at Navitat
- White water rafting (class I-IV) on the Nolichucky River
- Whitewater rafting on the French Broad River (45 minutes)
- Mt Mitchell State Park near Burnsville, the highest point east of the Mississippi (30 minutes)
- Trout fishing on the Toe River or nearby creeks
- Roan Mountain State Park near Erwin, TN. (1 hour)
- Historic Jonesborough, TN, Storytelling Capital of the World (1 hour)
- Destination hikes in the vicinity (maps and directions available)