text:
- Research
- Open Access
Negative impact of chronic obstructive pulmonary disease on the health-related quality of life of patients. Results of the EPIDEPOC study
© Garrido et al; licensee BioMed Central Ltd. 2006
- Received: 09 March 2006
- Accepted: 23 May 2006
- Published: 23 May 2006
COPD is currently the fourth cause of morbidity and mortality in the developed world. Patients with COPD experience a progressive deterioration and disability, which lead to a worsening in their health-related quality of life (HRQoL). The aim of this work is to assess the Health-Related Quality of Life (HRQoL) of patients with stable COPD followed in primary care and to identify possible predictors of disease.
It is a multicenter, epidemiological, observational, descriptive study. Subjects of both sexes, older than 40 years and diagnosed of COPD at least 12 months before starting the study were included. Sociodemographic data, severity of disease, comorbidity, and use of health resources in the previous 12 months were collected. All patients were administered a generic quality-of-life questionnaire, the SF-12, that enables to calculate two scores, the physical (PCS-12) and the mental (MCS-12) component summary scores.
10,711 patients were evaluated (75.6% men, 24.4% women), with a mean age of 67.1 years (SD 9.66). The mean value of FEV1 was 35.9 ± 10.0%. Mean PCS-12 and MCS-12 scores were 36.0 ± 9.9 and 48.3 ± 10.9, respectively. Compared to the reference population, patients with COPD had a reduction of PCS-12, even in mild stages of the disease. The correlation with FEV1 was higher for PCS-12 (r = 0.38) than for MCS-12 (r = 0.12). Predictors for both HRQoL components were sex, FEV1, use of oxygen therapy, and number of visits to emergency rooms and hospital admissions. Other independent predictors of PCS-12 were age, body mass index and educational level.
Patients with stable COPD show a reduction of their HRQoL, even in mild stages of the disease. The factors determining the HRQoL include sex, FEV1, use of oxygen therapy, and number of visits to emergency rooms and hospital admissions.
- Chronic Obstructive Pulmonary Disease
- Oxygen Therapy
- Airflow Obstruction
- Autonomous Community
- Stable Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease (COPD) is characterized by the presence of a limitation to airflow that is not completely reversible and is associated with an abnormal inflammatory response to gases or inhaled toxic particles, mainly tobacco [1, 2]. COPD is currently the fourth cause of morbidity and mortality in the developed world [1]. The IBERPOC study, carried out in 7 different geographical areas with nearly 5000 patients, has shown that in Spain the prevalence of COPD in the general population aged between 40 and 69 years is 9.1%, and is a first-order public health problem [3]. This condition originates approximately 10–12% of primary care consultations and 35–40% of those of pneumology, and causes 35% of definitive occupational disabilities and 7% of hospital admissions [4].
As the condition progresses, patients with COPD experience a progressive deterioration and disability, which lead to a worsening in their health-related quality of life (HRQoL). However, it has been confirmed that the evaluation alone of the severity of COPD, measured by the degree of reduction of the forced expiratory volume in one second (FEV1), does not provide sufficient information to establish the health condition perceived by the patients. The interest for HRQoL measurement in patients with COPD has grown in recent years. The fact that HRQoL is the result of the interaction of multiple physical, psychological and social factors, unique for each individual, can justify this interest from the scientific community [5]. Each of these domains can be measured with the objective of establishing the performance or health condition and the subjective perception of health. The HRQoL can be quantified through various health evaluation questionnaires, both general and specific, widely validated [6]. The former covers a broad range of dimensions, enable the comparison between groups of patients with different diseases, and facilitate the detection of problems or unexpected effects [7]. One of them is the Short Form 36 (SF-36) questionnaire [8], that has an abbreviated version (SF-12) [9, 10]. Since one of the main objectives of the treatment of COPD is to improve the general health condition [1], it is important to identify possible factors determining the HRQoL of these patients. Some of these have been identified previously [11]. Relationships have been shown between HRQoL during acute exacerbation of chronic bronchitis with post-exacerbation functional status, hospital readmission for acute exacerbation or COPD and mortality [12–16].
The objective of this study was to assess the HRQoL of a group of patients with stable COPD followed in primary care and to identify the associated determinant factors.
Design and population of the study
This study is part of the EPIDEPOC study, a multicenter, epidemiological, observational, descriptive project, carried out in the primary care setting, with the aim of estimating the use of health resources and assessing the HRQoL of patients with stable COPD.
The recruitment of patients and the calculation of sample size correspond to that performed in the EPIDEPOC study. For the calculation of sample size, a cluster design was used, considering 3 types of variables: health centers, physicians, and medical records. Finally, it was estimated that it was necessary to include 2422 physicians, each of whom should recruit 5 patients. The screening of patients was performed at random by primary care physicians from all Spanish Autonomous Communities, whose distribution was weighed based on the population distribution of the different Autonomous Communities over the total national. The patients were recruited during a period of three months (from 1st January to 31st March 2003).
Subjects of both sexes, aged 40 years or older and diagnosed of COPD at least 12 months before the start of the study, were included. The diagnosis of the disease was performed according to the criteria of the Spanish Society of Pneumology and Chest Surgery (SEPAR) based on the demonstration, through a forced spirometry, of a forced expiratory volume in 1 second (FEV1) below 80% of the reference value and a FEV1/forced vital capacity (FVC) ratio below 0.7 after the bronchodilation test. The severity of the disease was rated at three levels according to the FEV1 value: mild (FEV1 60–80% of the reference value), moderate (FEV1 40–59% of the reference value) and severe (FEV1 below 40% of the reference value), in accordance with the SEPAR criteria [17].
Individuals suffering at the time of the study a neurological or psychiatric disease precluding measurement were excluded. Patients with an acute worsening of their COPD in the previous month were also excluded. An acute worsening was considered to be the occurrence of an impairment of the clinical condition of the patient characterized by an increased baseline dyspnea, purulent sputum, increased volume of sputum or any combination of these symptoms, of acute onset, and requiring a change in the regular medication of the patient [18].
The study was approved by the Ethics Committee of the Foundation Hospital Alcorcón, and all patients gave their oral consent to participate in it. All the information obtained will be considered as confidential and disclosed and kept following the regular safety standards (Organic Act 15/1999, of 13 December on the Protection of personal data).
Assessment of the patients
A single visit was completed, collecting in all cases the sociodemographic data, severity of the disease, comorbidity, and utilization of health resources in the previous 12 months. All patients were administered the SF-12 quality of life questionnaire, an abbreviated version of the SF-36 health questionnaire that contains 12 items [9]. These 12 items explain more than 90% of the variance of the physical and mental component scores of the SF-36. From them two scores can be calculated, the physical (PCS-12) and the mental (PCS-12) component summary, using a value of 50 with a standard deviation of 10 as reference population. In this study, the general Spanish adult population has been used as reference [19]. The SF-12 is scored from 0 to 100 so that, the higher the score, the better the health condition.
Statistical analysis
The analysis of the data was carried out through the statistical package SPSS 11.0 for Windows. The qualitative variables were described as frequency and percentage and the quantitative variables as mean, standard deviation, minimum and maximum. To analyze the relationship between the qualitative variables the χ2 Pearson test was used. ANCOVA and ANOVA models with sex, age and disease severity as covariates were applied for between group comparisons. Bonferroni adjustment was applied for multiple comparisons. To evaluate the correlation among the values of the quantitative data, the Pearson's correlation coefficient was used. Finally, a multiple regression analysis was performed using as dependent variable the physical or mental component of the HRQoL and as independent variables: age, sex, smoking, size of the habitat, educational level, body mass index, FEV1, treatment with oxygen therapy, visits to emergency rooms and hospital admissions. Independent variables included in the model were chosen from those showing significance differences in the bivariate analysis or deemed to be potential confounders. A value of p < 0.05 was considered to be significant.
Sociodemographic and clinical characteristics of patients
Characteristic (no. of patients)
Total no. of patients
Age (years) * (8665)
64.1 ± 9.7 (40; 98)
Age groups (8862)
40–54 years
963 (10.9)
55–64 years
2,249 (25.4)
65–74 years
3,669 (41.4)
>75 years
1,981 (22.4)
Sex (man) (10620)
8,030 (75.6)
Residence population (10341)
<10,000 inhabitants
3,022 (29.2)
3,449 (33.4)
3,870 (37.4)
Educational level (9018)
No studies
1,852 (20.5)
5,111 (56.7)
1,582 (17.5)
473 (5.2)
Smoking (10649)
2,468 (23.2)
6,153 (57.8)
Active smoker
2,028 (19.0)
35.9 ± 10.0 (4;80)
COPD Severity (9963)
3,634 (35.5)
5,471 (53,4)
1,146 (11.2)
Visits to E.R. * (9505)
1.4 ± 1.9 (0; 12)
No. of hospital admissions * (8670)
0.5 ± 0.9 (0; 11)
Oxygen therapy (10007)
1351 (13.5)
Associated comorbidity
Hypertension (9876)
4,706 (47.7)
3,995 (41.3)
Diabetes (9453)
1,598 (16.9)
Heart disease (9390)
1,770 (18,8)
Ulcer (9425)
1,637 (17.4)
Depression (9333)
1,196 (12,8)
Anxiety (9397)
2,084 (19.5)
Physical (PCS-12) and mental (MCS-12) component summaries related to the use of oxygen therapy and the utilization of health resources in the past year
No. of cases
Oxygen therapy:
3,131 (84.8%)
32.4 (31.3; 33.5)
45.8 (44.4; 47.2)
562 (15.2%)
30.3 (29.1; 31.6)
43.7 (42.1; 45.3)
No of visits to primary care:
1 to 5
1,941 (52.3%)
32.9 (31.3; 34.5)
46.4 (44.3; 48.4)
5 to 10
1,140 (30.9%)
31.0 (29.5; 32.4)
44.2 (42.3;46.0)
Over 10
612 (16.6%)
31.0 (29.7; 32.3)
44.6 (42.9; 46.2)
No. of visits to pneumology:
883 (23.9%)
32.8 (30.9; 34.8)
48.7 (46.2; 51.1)
1 to 4
2,711 (73.4%)
31.1 (30.3; 32.0)
44.7 (43.6; 45.8)
Over 4
99 (2.7%)
31.0 (28.9; 33.1)
41.6 (38.9; 44.2)
No. of visits to E.R.:
1,481 (40.1%)
34.8 (32.7; 36.9)
48.2 (45.5; 50.8)
1 to 2
1,508 (40.8%)
31.5 (30.0; 33.1)
45.6 (43.6; 47.6)
3 to 4
466 (12.6%)
30.2 (28.8; 31.7)
45.0 (43.2; 46.8)
Over 4
238 (6.4%)
30.9 (29.2; 32.7)
41.8 (39.6; 44.0)
No. of hospital admissions:
2,544 (68.9%)
33.7 (32.5;35.0)
47.4 (45.8; 49.0)
755 (20.4%)
32.1 (30.5; 33.7)
43.1 (41.1; 45.1)
257 (7.0%)
29.2 (27.4; 31.1)
44.3 (42.1; 46.6)
Over 2
137 (3.7%)
29.5 (27.2; 31.7)
43.8 (41.0; 46.6)
Coefficients of the multiple linear regression equation for the final physical component of quality of life
Independent variables
Coefficients (95% CI)
Standard coefficients
(44,8; 52,3)
(-0.28; -0.27)
(-1.91; -0.51)
Educational level
(0,82; 1,62)
(0,16; 0,26)
Oxygen therapy
(-3.75; -1.93)
Body Mass Index
(-0.24; -0.10)
≤ 2 visits to E.R.
(-1.02; -0.66)
≤ 2 hospital admissions
(-1.31; -0.54)
Coefficients of the multiple linear regression equation for the final mental component of quality of life
Independent variables
Coefficients (95% CI)
Standard coefficients
(50.5; 54.8)
(-6.57; -4.84)
(0.04; 0.11)
Oxygen therapy
(-3.38; -1.13)
≤ 2 visits to E.R.
(-0.86; -0.40)
≤ 2 hospital admissions
(-1.49; -0.53)
This study shows that patients with stable COPD have, as compared to the reference population, a reduction of PCS-12, even in the initial stages, though they only show a reduction in MCS-12 in the most advanced phases of the disease. The determinant factors of both components of HRQoL include sex, FEV1, use of oxygen therapy and number of visits to emergency rooms and hospital admissions. In addition, the age, educational level and body mass index are also variables that influence the PCS-12.
The women in our study had lower HRQoL levels than men, both in the physical and mental component of quality of life. Several authors have reported that women usually suffer more respiratory symptoms than men [20], which could partly justify this finding. Furthermore, it has been demonstrated that, after adjusting for smoking, women show a higher risk of hospital admission for COPD than men [21].
Most previous studies have detected a mild to moderate association between the different areas of HRQoL and the degree of airflow obstruction [22–28]. In our study, a higher correlation has been found with the physical vs the mental component of HRQoL. Thus, it seems that the effects of COPD on health are not only mediated by the severity of the airflow limitation. For instance, it has been shown that the health condition perceived by the patients correlates better with the degree of dyspnea [29, 30] or with the distance walked in the walking test [31] than with FEV1. The patients who obtain better results in these parameters report a limitation to fulfill their activities and the disease has less impact in their daily life.
The influence of hypoxemia and oxygen therapy on the HRQoL of patients with COPD has been assessed in previous studies. Some of them have found no relationship between HRQoL and the presence of respiratory failure [32, 33]. On the contrary, we have observed that the use of oxygen therapy is a predictive factor independent from the health condition perceived by the patients. Similar results have been obtained in other studies. Thus, Okubadejo et al. [34] demonstrated, through a multivariate model, the existence of a relationship between HRQoL and the severity of hypoxemia. More recently, Ferreira et al. [35] have also demonstrated a marked worsening of HRQoL in patients with COPD receiving long-term oxygen therapy, with greater influence on physical and social function dimensions. Several reasons have been proposed to justify the trend of the patients to reject the treatment with oxygen therapy. These include the negative expectation linked to the use of an apparatus for long time periods to maintain health, the noise caused by the device, the mobility restriction resulting of its use, and the limitation involved by the fact that the patient must be confined at home most of the time [33, 36, 37].
Acute worsening is a common adverse event in the natural history of patients with COPD. It is the most common reason for medical visits, hospital admissions, and death in these patients [38]. Furthermore, there is an increasing evidence of the impact of these events on the health condition of patients with COPD. Thus, it has shown that patients suffering more than three annual acute worsening of COPD had a significantly greater impairment in their quality of life than those with a lower number of acute worsening [39, 40]. Furthermore, Fan et al. [41] have shown that HRQoL is a predictive factor independent from hospitalization and mortality in these patients. In our study it has been also detected that the visits to emergency rooms and hospital admissions for acute worsening of the disease in the last year influence significantly the quality of life of patients with COPD, affecting both the physical and mental component.
The influence of age on HRQoL in patients with COPD is controversial. Some studies have detected no association between the two parameters [42] and others have demonstrated it through a logistic regression analysis that is an independent factor [23, 43]. In our study we have only found a relationship with the physical component of quality of life, but not with the mental. The same has happened with other parameters such as the educational level of the patients evaluated. It is possible that subjects with a higher educational level have a greater purchasing power and have more material resources and, on the contrary, those with a lower level belong to the most disadvantaged classes, complaining later of health problems, have a higher environmental exposure, and the percentage of smokers among them is higher [43].
There is no agreement on the relationship between BMI and HRQoL. There seems to be an association between a poor nutritional status and quality of life worsening in patients with COPD, particularly those with emphysema [44]. Our results confirm that there is an association, though it is only demonstrated with the mental component of quality of life. The same has happened in another recent study, which only found a relationship with emotional function, though it was weak [43]. On the contrary, other authors have not evidenced any influence of bodyweight on the HRQoL of the patients with COPD [29, 45].
Some limitations may have influenced the results of this study. First, we have used a generic questionnaire to measure HRQoL, less sensitive than the specific tools. However, the large sample size of our study enables to compensate this effect and give validity to our model. Second, all the patients were from primary care, so the results may not be extrapolable to all patients with COPD. However, a recent study evaluating this has found no relationship between HRQoL and the healthcare level [29].
In conclusion, the HRQoL of the patients with COPD is in part related to some parameters, including sex, airflow limitation, use of oxygen therapy and number of acute worsening and hospital admissions. However, these factors do not predict overall the high variability of HRQoL. Despite this, their measurement enables to identify the patients with a greater disability and enhances the assessment of the effects of various interventions on a standard basis.
To all patients and primary care physicians who have voluntarily collaborated in the EPIDEPOC study. This study has been financed by Pfizer S.A. and Boehringer Ingelheim SA through contract No. A040 signed with the University Rey Juan Carlos of Madrid.
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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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Commercial Tables T64 Ashwood Carbonize
- Antique wood grain veneer on MDF
- Standard Size only
- Quick Ship pre made, Mahogany Espresso only
Minimum order of 10 is required.
Shipping is calculated and charged separately for commercial grade orders.
If you make your order online, we'll contact you to confirm the wood finish and vinyl color and grade.
Call us for shipping cost, special bulk pricing and order details. 888-998-0552

subset: commoncrawl


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Short's Superfluid (6-pack bottles)
Superfluid is an American Double IPA with a large, but basic malt bill that explodes with resiny hop aromas! The hop flavors are the focus of this beer due to the lack of sweet specialty grains. Tasty qualities of citrus fruit and berries explode on the palate. Superfluid's perfect bitterness resonates across the palate, complementing the awesome hop intensity.
Beer Advocate score 90 points!
Short's Uncle Steve's Irish Stout (6-pack bottles)
Uncle Steve's Irish Stout is Short's version of the classic Irish Stout, complete with a dark color, soft head, and smooth full flavor typical of this lighter bodied beer. A simple grist formula provides a base of roasted malt flavors and a creamy drinkability everyone loves.
Beer Advocate score 84 points.
Desthil Wild Sour Here Gose Nothin (6-pack cans)
"Our Leipzig-Style Gose undergoes a spontaneous fermentation, similar to Belgian-style Gueuze/Lambic beers, and exhibits a complexity of acidic flavor and aroma contributed by wild yeast lactic fermentation. Lemon, lime and other citrus-like qualities are present in aroma and on the palate, which is balanced by the spicy character of added coriander and a mineral-mouthfeel from added sea salt."
Beer Advocate score 87 points.
Great Lakes Conway's Irish Ale (6-pack bottles)
A pint for Pa Conway! Our co-owners' grandfather and policeman who'd likely uphold that an Irish Ale with full-bodied caramel malt flavors is just the ticket.
Arrestingly smooth with a rap sheet of toasty biscuit and caramel malt flavors. Conway's Irish Ale pairs well with corned beef, stews, and a hard day's work.
Beer Advocate score 86 points.
Flying Dog Bloodline Blood Orange Ale (6-pack bottles)
Originally a small-batch release in the spring of 2013. Bloodline is brewed with blood orange peel and blood orange juice and hits the perfect balance between citrus sweetness and bitterness. Bloodline begins with huge grapefruit on the nose. Then, a delicate balance of citrus sweetness and bitterness. Try it with grilled light proteins, salads with fruity vinaigrettes, and fresh salsa.
Beer Advocate score 87 points.
Founder's Porter (6-pack bottles)
Pours silky black with a creamy tan head. The nose is sweet with strong chocolate and caramel malt presence. No absence of hops gives Founders' robust porter the full flavor you deserve and expect. Cozy like velvet. It's a lover, not a fighter.
Beer Advocate score 94 points.
Uncle John's Apple Blueberry Hard Cider (4-pack cans)
The base starts as our Uncle John's fresh apple cider which we ferment and blend with rich Michigan Blueberry Juice. This carbonated blush showcases the elegant flavors of ripe blueberries and finishes soft on your palate.
Speak up now by sending us an email, and we'll hold any of these brews for you! We'll email you when they arrive, so you know when to come grab them. Please note that we will hold beers for one week after the date that you reserve them.
Speak up now by sending us an email, and we'll hold any of these brews for you! We'll email you when they arrive, so you know when to come grab them. Please note that we will hold beers for one week after the date that you reserve them.
Sierra Nevada Otra Vez (6-pack bottles)
On our search for the perfect warm weather beer, we wanted something light bodied and thirst quenching, yet filled with complex and interesting flavors. We stumbled across the fruit of the prickly pear cactus, native to California. This tangy fruit is a great complement to the tart and refreshing traditional gose style beer. Otra Vez combines prickly pear cactus with a hint of grapefruit for a refreshing beer that will have you calling for round after round. Otra Vez!
Beer Advocate score 86 points.
Crankers Aphrodisiac (22 oz. bottles)
Chocolate Pomegranate Imperial Stout called Aphrodisiac (8.4%). This beer features rich chocolate notes with pomegranate backing it up. It is brewed with lactose to create a full rich body.
Beer Advocate score not available.
Odd Side Fight Milk (6-pack bottles)
8% alcohol. Imperial milk stout. That's all we know.
Beer Advocate score not available.
Atwater Cash for Gold (6-pack bottles)
This Dortmunder is as good as gold, maybe better. Pawn shops are a dime a dozen in the city of Detroit, but this lager sets its self apart from the craft masses.
Beer Advocate score not available.
Bell's Smitten Golden Rye Ale (6-pack bottles)
Drawn from one of our oldest recipes, Smitten Ale began as part of a series of rye beers at our Eccentric Café. The combination of sharp citrus & resinous flavors from the hops with the earthy, rustic overtones of the rye malt contribution yield an interesting take on the American Pale Ale.
Beer Advocate score 85 points.
Petoskey Brewing Horney Monk (4-pack cans)
A deep reddish, malty, and complex Belgian style ale. Six different types of malted barley, Belgian candied syrup and Belgian yeast are combined to produce a very smooth, complex and slightly sweet ale.
Beer Advocate score not available.
Right Brain Fire Starter (22 oz. bottles)
A deep bodied and roasty porter with strong smoky notes and a mild spicy finish. Flavor profile very similar to that of traditional Mexican Mole' sauces.
Beer Advocate score 86 points.
Stone Delicious IPA (6-pack bottles)
While our beers are many and diverse, yet unified by overarching boldness, India pale ales are our undeniable bread and butter. The result is an intensely citrusy, beautifully bitter beer is worthy of the simple-yet-lordly title of Stone Delicious IPA. Lemondrop and El Dorado hops combine to bring on a magnificent lemon candy-like flavor that's balanced by hop spice. It's unlike anything we've tasted in nearly two decades of IPA experimentation, and another lupulin-laced creation we're excited to present to hopheads everywhere.
Beer Advocate score 88 points.
Dark Horse Rain in Blood (6-pack bottles)
Our tribute to the late Jeff Hanneman and the greatest band of all time, Slayer. This pale ale is brewed with fresh blood oranges and blood orange juice that is hand squeezed at the brewery. It should be enjoyed fresh and paired with delicious heavy metal. SLAYER!
Beer Advocate score 81 points.
Schmohz Kiss My Scottish Arse (6-pack bottles)
In the spirit of Chas' Great Uncle McGlean, this Great Ale will not only lift your kilt, but raise ye spirit to an attitude of mighty altitude. Presented with the best of malts, grains and the select hops, it will not be for the faint of pint raisers.
Bring your bonnie lass and hold on!
Beer Advocate score not available.
Schmohz John T. Pilsner (6-pack bottles)
Fermented cold and slow for over four months to provide the old world taste of a set in its way beer. Very refreshing and definitely different.
Beer Advocate score not available.
Speak up now by sending us an email, and we'll hold any of these brews for you! We'll email you when they arrive, so you know when to come grab them. Please note that we will hold beers for one week after the date that you reserve them.
Short's Love Knife (6-pack bottles)
Love Knife is a brownish red Belgian Amber Ale that explodes with aromas of strawberry, banana, and nectarine. Malt sweetness is quite low, allowing for the fruit flavors to be apparent throughout the beer. One day while looking over popular Belgian beer styles, Tony noted that there were not a lot of Belgian Amber Ales. Therefore, he decided to create a recipe with a malt bill that loosely resembled a typical Amber Ale found in the states. By adding Belgian yeast and American hop varieties, Tony created a uniquely new and different hybridized style.
Beer Advocate score not available.
Rogue Double Chocolate Stout (750 ml bottles)
Double Chocolate Stout is an evolution of Rogue Chocolate Stout, which is flavored with imported Dutch bittersweet chocolate. The winner of three World Beer Championships Gold Medals. Pair with beef... and dessert.
Perfect for your craft beer loving Valentine!
Beer Advocate score 93 points.
Lagunitas Undercover Investigation Shutdown
(6-pack bottles)
Our malty and rich beer with a snappy hop finish truly defies style…Imperial Mild?...Uber ESB?... We do know for sure that it is Unforgiven and Unrepentant.
Beer Advocate score 90 points.
Arbor Brewing Company Espresso Love (6-pack bottles)
Oatmeal and 20 pounds of fresh roasted coffee from the Ugly Mug Café contribute to a mildly chalky espresso character balanced by a rich, sweet creamy maltiness. Coffee finish dissolves into chocolate with a slight roasty bitterness.Brewed with 100% fair-trade coffee from the Ugly Mug Café and Roastery in Ypsilanti, MI. Pairs well with desserts, especially dark chocolate, raspberries, and cheesecake.
Beer Advocate score 74 points.
Old Nation Sanders Chocolate Stout
(6-pack bottles)
A smooth cream stout with a chocolate finish.
Beer Advocate score 80 points.
Bell's Hopslam (6-pack cans)
Starting with six different hop varietals added to the brew kettle & culminating with a massive dry-hop addition of Simcoe hops, Bell's Hopslam Ale possesses the most complex hopping schedule in the Bell's repertoire. Selected specifically because of their aromatic qualities, these Pacific Northwest varieties contribute a pungent blend of grapefruit, stone fruit, and floral notes. A generous malt bill and a solid dollop of honey provide just enough body to keep the balance in check, resulting in a remarkably drinkable rendition of the Double India Pale Ale style.
Beer Advocate score 99 points!
Speak up now by sending us an email, and we'll hold any of these brews for you! We'll email you when they arrive, so you know when to come grab them. Please note that we will hold beers for one week after the date that you reserve them.
Beer Arrival List for Friday 01/08/16
Speak up now by sending us an email, and we'll hold any of these brews for you! We'll email you when they arrive, so you know when to come grab them.
Ballast Point Sculpin (6-pack bottles)
A trophy beer that's a testament to our homebrew roots. Our Sculpin IPA is a great example of what got us into brewing in the first place. After years of experimenting, we knew hopping an ale at five separate stages would produce something special. The result ended up being this gold-medal winning IPA, whose inspired use of hops creates hints of apricot, peach, mango and lemon flavors, but still packs a bit of a sting, just like a Sculpin fish.
Beer Advocate 97 points.
Old Nation Two Crow Stout (6-pack bottles)
I passed two crows on a branch in a field, still and calm. They seemed natural and out of place, all at once. Two Crow Black Sugar Stout is like that; black as night with something hard to define in its' nature. Dark Malts, noble hops and two kinds of house caramelized MI beet sugars combine to create a beautifully balanced high gravity stout. Strong stout with caramelized Michigan sugar. Not overly sweet or heavy for the ABV.
Beer Advocate score not available.
Old Nation Detroit Dwarf (6-pack bottles)
Inspired by the legendary "Nain Rouge"(French for Red Dwarf), our signature beer is full in flavor while remaining very balanced and crisp. It is our pride and pleasure to provide you with one of the finest Alt beers brewed in the United States. Alt beer (N. German ale: Dusseldorf). Amber ale fermented at lager temp. 4 time GABF Medal winner. World Beer Cup Silver Medal.
Beer Advocate score not available.
Stochasticity Project Grainiac (22 oz. bottles)
This hoppy, deep amber-hued beer was created to shine a light on rare, unexplored grains seldom used in the brewing world. In addition to barley, wheat, rye and triticale, we added malted millet and malted buckwheat to bring the total unique grain count to nine. The earthy, nutty notes of granola found in this experimental multigrain malt bomb are complemented by the citrusy, piney flavors of four classic American hops. We dry-hopped the beer with Cascade and Centennial hops at the end, adding more citrus notes and rounding out the grain bill's rich, bready character. This beer had its share of controversy inside Stone.
Beer Advocate score 87 points.
Short's Brewing The Liberator (6-pack bottles)
The Liberator was made as a 30th birthday gift to Joe Short. As a double IPA, this beast employs a sizable malt bill, but it is the crazy amount of hops added to the boil every 4 minutes, for 120 minutes, that really make this beer special. Fruity, floral, and piney hop flavors penetrate throughout the caramelized malt profile. The Liberator is a well-balanced, full bodied brew that has a bitter finish due to the post fermentation addition of lemon and orange zest. The original batch brewed on the Bellaire system had 42lbs of hops in it, compared to Huma, which has around 20lbs of hops per batch. Today's Elk Rapids batches have up to 138lbs of hops. The name, The Liberator, came from Joe's name for the Short's employees who carry out our company's mission statement as "Beer Libera
1629 S. State St., Ann Arbor MI 48104 - Market Phone 734.663.7848 - Event Catering 734.663.7010 - Fax 734.663.1553
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Updated: May 26, 2019


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Wednesday, May 13, 2015
Hair I Go Again...
Incidentally, if you have not yet seen or read The Boy In The Striped Pajamas, I urge you to do so immediately. Excellent book/movie. Not so good look for une femme d'un certain âge.
Not to mention un certain coif. I have found that many of my go-to looks don't "go" with my new 'do. For instance, my once-beloved skinny camo pants take on a decidedly aggressive air with very short hair. Then there's my sweater with the motorcycle on the front, my Rolling Stones tee, the raglan shirts that I bought in the boys' department. I used to wear these with all the confidence of long hair covering my neck. Don't even get me started on my favorite rainbow striped bikini. Wearing it now I feel as if I am making a statement that I don't intend to make. I mean, I'm cool with that statement. I support and respect that statement. But it's not my statement.
I made a Pinterest board for pixie cuts. Looking at it makes me excited for what is to come in an inch or so until I realize that all my pins are 100lb 25 year olds who probably wouldn't know a nasolabial fold if it smacked them in their angular faces. #Filters4Lyfe
I've decided that my style muse is Jean Seberg sans whatever led to her mysteriously od'ing on barbiturates in Paris. I know she was American, but she's got the insouciant french thing down pat.
I am pretty sure that the pesky space-time continuum does not allow me to be an ingenue anymore, but I strive for what comes next. The wide-eyed pixie after the elasticity around her eyes has gone slack. Hey, it happens.
But seriously. It's not too late. I can still return it. Does that shirt make me look like The Boy In The Striped Pajamas?
13 comments:
- Carol-Anne said...
I hope this isn't inappropriate to say....but if I were you, I'd never grow my hair long again! You look AMAZING in short hair & it's gotta be less work than the longer version!
- May 13, 2015 at 11:49 AM
- Petunia Face said...
Carol-Anne, thank you! I wish I had the guts to keep it short, because yes, so low maintenance! But I so miss hiding behind my hair. :)
In the meantime, I plan on having fun going through all the stages...
- May 13, 2015 at 11:57 AM
I'm probably not qualified to give fashion advice, since I wear a Snuggie Tuxedo to formal dinners:
However, I do feel comfortable commenting that your hair looks fantastic! I'm also amazed at how fast it's growing.
- May 13, 2015 at 12:11 PM
- Petunia Face said...
Well maybe I shouldn't grow it longer then and I can just hide behind a Snuggie Tuxedo rather than my hair!
- May 13, 2015 at 12:15 PM
Pardon my teenage-girliness, but ya look gorge, guurl. My hair would never look so good no matter how long/short it was. ( beauty queen emotiji)
- May 13, 2015 at 12:29 PM
From whom/what would a pretty lady like you want to hide?
Or, is that a question that would require you to lie on a couch and me to have a Steno pad?
"I see. And, how did that make you feel?"
- May 13, 2015 at 1:16 PM
Love your hair ... not crazy about the shirt. :-)
- May 13, 2015 at 2:33 PM
- A Perfect Gray said...
brow game strong.
sorry. i've been reading my sophomore- in-college son's comments on his instagram, and that's how they all talk.
i think its code for 'awesome brows'
hair not so bad, either.
- May 13, 2015 at 3:42 PM
- Petunia Face said...
Strike one for the shirt.
Brow game courtesy of Latisse and Kevin Aucoin Precision Brow Pencil.
Love you all!
- May 13, 2015 at 7:12 PM
I can't believe how thick your hair is and I think you look more striking with short hair. Just about every woman in the U.S. has long hair, seeing something different is so refreshing and in your case, you can carry short hair - you have the perfect symmetrical face for it. What's Brian saying and the kids? Do they like your do?
As for the shirt, I've read the book, seen the movie - no comparison with your shirt, however, I'd trade it in for a typical French Breton blue/white striped shirt. Have a croissant with it :-))
- May 14, 2015 at 8:51 AM
- Alex Blair said...
Super cute shirt! Comfy & stylish :-)
❤ Rocky Mountain Decals – Baby, Kids & Home Wall Decals ❤
- May 14, 2015 at 1:19 PM
- Cathi said...
I think the shirt and your hair are just fabulous! You have the perfect face for short hair but I totally understand the long hair thing as I've always kept my hair long too. Either way you look beautiful!
- May 15, 2015 at 8:11 AM
You look gorgeous with short hair. Those eyes!! I understand the long hair thing, though. You'll get there soon enough - embrace your pixie on the way because you've definitely got the face for it! xo
- Susan C.
- May 18, 2015 at 5:27 PM


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After conducting a national search which brought candidates from several states in the nation, the Governing Board of the Santee School District has selected Kristin Baranski as superintendent.
Mrs. Baranski currently serves as the director of Curriculum and Assessment in the school district. She began her career teaching Language Arts to 7th-grade students in Schaumburg, Illinois, then came to Santee as vice principal of Chet F. Harritt, Rio Seco and Hill Creek schools. She served as principal of Chet F. Harritt School from 2000 to 2003.
Mrs. Baranski is completing her doctoral studies in Organizational Leadership at Brandman University, Irvine. She earned her Master's Degree in Educational Administration at National-Louis University and her Bachelor's Degree in Elementary Education at Southern Illinois University. In addition, Mrs. Baranski served in the Educational Leadership Development Program at the University of San Diego as a supervisor of administrative credential candidates.
"Kristin was selected as our finalist from an outstanding field of candidates, including sitting superintendents and assistant superintendents from across the nation. Her credentials and 18 years of administrative experience in the District will be a tremendous asset in providing leadership as the District continues to grow and focus on supporting students and staff," said Board President Barbara Ryan.
The Board will address contract approval and appointment of the new superintendent at its Dec. 20 regular meeting. Mrs. Baranski will begin her duties as superintendent on Feb. 1, 2017.


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Yesoption Review
YesOption was founded in 2012, and it was the first company that offered Binary Options together with Forex to be used from one platform. This broker offers solid returns for trading Binary Options and there are attractive spreads for trading Forex.
Setting up an account with YesOption is simple, not different than setting up any account anywhere.
Their main page for trading is simple and you won't need experience to know how to navigate around. It is easy to see what currency pairs are possible to trade, where to click to set the amount of investing and what do you want to invest in. There is also a nicely displayed graph which tells about how currencies perform per day.
You can choose from three possible accounts to use at YesOption, which are not distributed according to the level of deposit and unlocked features, but according to the level of return. Those three are Standard account, Gold and the Platinum account. As by the time of writing this review, there was no mention of demo account. The holders of the standard account have all access to every trading facility, including assets, trading tools, instruments, and free access to customer support service. Also, there is a free course with a personal analyst. Something strange is offered here, and that is (only) one withdrawal for free. It's not clear whether other withdrawals would be charged.
Gold account holders have unlimited access to everything the standard account holders can have, however, they get an additional two percent return for every winning trade. They have a free withdrawal each month and two personal sessions each month with an analyst from YesOption.
As for the platinum users, they have unlimited access to everything the lower two account holders have, but with an additional four percent return for each winning trade. However, they have unlimited number of free withdrawals as well as sessions with personal coach every month.
All of the accounts at YesOption are not charged any commission, and all get free signals from top providers for the first two weeks. I am not sure what additional fees are charged for the continuance of receiving the signals.
The minimum investment is $25 for an option while the maximum is$2500. The maximum single short-term option is $1000, and those are 1 minute, 2, and five minutes.
Educational material
On the YesOption's landing page is a mute video showing the process of trading. The process shown is quite clear, even though it might seem confusing at first as there is no sound. But if you repeat the video knowing that there is no sound, you'll see that it can be understood.
YesOption's educational section is rich with videos that can help beginners, but can also be useful to advanced users too.
Traders can get to use Fibonacci calculator, a calculator for Forex and Binary options, as well as a calculator for Deal Size for Forex. Users are given daily financial news and analysis, and there is an economic calendar through which users can get reports and economical data.
Traders have a Heat Map for which helps them see the strength of a currency pair's or an assets trend. The Heat map at YesOption is simple to use as it basically lists currency pairs that are being traded the most. Without clicking anything, traders get to see the most traded currency pairs.
The lack of a demo account is to some extent caught up with a part of educational section also offers an interactive training eBook where a trader can get to execute binary options deals, as well at the Forex, and using the YesPlatform.
Withdrawing funds is possible with credit cards, debit cards, Skrill, CashU, Neteller or wire transfer. Depositing money has limits, as there is $8500 per day, $59000 per week and $255000 per month.
Before withdrawing there is a form online that needs to be filled out. As YesOption figured out, the safest way is to get the money towards the source of depositing.
For getting bonuses at YesOption users need to first contact their manager. There are no details given about what the bonus is and how is it obtainable. There were some mentions of winning awards such are cool gadgets. Registration will open more details.
As for free signals for every account user for the first two weeks, those can be obtained via SMS or email, besides being viewable from the homepage after logging in. there are 6 signals sent each day. Usually those are for 1 hour and half an hour of options for high/low for the most liquid assets.
Customer Support
Traders can contact a YesOption representative at any time via live chat, email or telephone to the UK. They have provided a number of local telephone numbers from around the world to ensure that all questions are dealt with in a language that is understandable and in a time zone that is relevant to the caller.
The website is only available in English, Russian, German and Arabic.
Overall, the lack of a demo account is hardly replaced by an educational interactive eBook, and that's a major flaw. Also the lack of clearer insight into what bonuses are might be a decider. However, referral program without limits to the number of friends and a clear and easy to navigate page is a thumbs up.
Reference: http://www.forex.in.rs/yesoption-binary-option-broker


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" (p. 155):
Another area in which the Gaon excelled was in his knowledge of anatomy. He once asked an eye doctor if he knew how many blood vessels and nerves go to the eye. The Gaon told him that one who does not konw the anatomy of the eye is unqualified to treat eye disease. Later the Gaon revealed tha thte eye has seventy blood vessles, equal to the numerical value fo the letter ayin, which means eye. [Rabbi Yechezkel Sarna, the late Rosh Yeshiva of Chevron Yeshiva, told this story to a famous professor of ophthalmology, adn the man expressed amazemnet that the Gaon could have known teh number of blood vesslels since it was only confirmed by doctors more than a century later].
This story has always bothered me, because it seems to support the myth that Rabbis know medicine better than doctors. Furthermore, I am not a doctor, but I am highly sceptical that this is even correct medically (why mention an un-named professor - simply quote the page reference in Grey's Anatomy if it is actually true). A quick search on google tells me that "Each eye has a different ammount of vessels, even to iddentical twins."
This website explains that depending on how you count there are two main sources of blood, four main blood vessels, and hundreds of capillaries in the human eye.
So it is not medically correct (nor is it particularly medically relevant). Yet this story is used to show that the Torah and Rabbis know more than science.
Yesterday, however, I found something even more interesting. I was looking at one of Rambam's letters, (p. 8 in this pdf - paragraph beginning with the words 've-hizaher she-lo te'ayen...') where he mentions al-Razi. I checked on wikipedia to find out more about him, and found this story:
During that time he was approached by a physician offering an ointment to cure his blindness. Al-Razi then asked him how many layers does the eye contain and when he was unable to answer he refused his services and the ointment stating "my eyes will not be treated by one who does not know the basics of its anatomy"
The reference here links to a book in Arabic which I cannot read. I am not convinced that it is necessarily a true story, but it makes much more sense when it is told about the foremost doctor of his age who ultimately died of eye disease!
Al-Razi really was a doctor - his books were translated into Latin and became the standard textbooks on medicine.
Al-Razi was "the first of the (physicians of medieval Islam) to treat medicine in a comprehensive and encyclopedic manner, surpassing probably in voluminousness Galen himself
This story seems to me to be too similar to the story of the Gra to be coincidental. Bear in mind that Muhammad ibn Zakariya al-Razi lived from 865 – 925. That is almost 1000 years before the Gra. And his works were known to Rambam, as well as the rest of the medieval world. So whoever first attributed the story to the Vilna Gaon most likely knew of the story from earlier sources.
So the message of the real story of the Gain and the eye doctor is not that all medicine is contained in Torah, or that through Torah a Rabbi can know more than a doctor. Rather it is a story about al-Razi's studies and documentation of medicinal knowledge to try to further scientific understanding.
I wonder why the professor of ophthalmology didn't simply mention al-Razi to Rav Sarna!


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President Obama will travel to South Africa to attend memorial services for Nelson Mandela, the White House announced Friday.
The South African government is organizing a series of events to mark the passing of Mandela, who continued to draw an outpouring of praise Friday for his role bringing an end to White minority rule in South Africa and as a champion or liberation and tolerance.
"President Obama and the First Lady will go to South Africa next week to pay their respects to the memory of Nelson Mandela and to participate in memorial events. We'll have further updates on timing and logistics as they become available," said White House press secretary Jay Carney.
Obama spoke in emotional terms at the White House Thursday as he described Mandela's impact on his own life. But he met with family members, rather than Mandela himself, when Mandela was hospitalized during Obama's trip to South Africa this summer.
According to the South African government, Mandela will be laid to rest at an official state funeral – which is expected to draw to dignitaries from around the globe.
Mandela will be buried in Qunu in the Eastern Cape on Dec. 15, after an official memorial service on the 10th at a stadium in Johannesburg.
His body will lie in state in Pretoria between Dec. 11 and 13.


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|I loved how the packaging was black this month! Too cute
|Love the Empire State image!
|New York, New York!
|The breakdown of the goodies inside
|What's inside?!
|First up, Caudalie Hand and Nail Cream. Super moisturizing and smells fruity and yummy!
|Next up, LipFusion lip balm by FusionBeauty. It's very moisturizing and it's meant to make your lips appears fuller! It smells minty fresh! I've been using it everyday and I'm enjoying it so far.
|This perfume is by Arquiste and it's called Flor Y Canto. It has a fresh floral scent, perfect for Spring time!
|This is the damage reverse Restorative Conditioner by Ojon. It's a hair treatment that is thick and creamy. Can't wait to try this!


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Bananas contain a good amount of fiber, which makes them a great energy booster. It contains potassium, iron, B Vitamins including B6 and B12 and it is good for a whole host of issues, including anemia, constipation and diarrhea, maintaining healthy bones and teeth, regulating blood pressure, kidney health and improved nerve function, and stress relief.
Even the peel of the banana is worthy of mentioning because it contains a number of antioxidants and can be used as home remedy to cure allergies, bruises, mosquito bites, skin irritation, warts, treating acne, and wrinkles. To use the peel in these situations, just apply a section of the banana peel to the affected areas and leave it on for half an hour every day until there is noticeable change.
If your skin is dry, here is an easy way to moisturize with only using banana peels! Instead of having to pay a few hundred dollars on facials or any kind of skin moisturizing, you can do this at home.
Benefits of Banana for Skin Care
Mashed Banana for Face
Mash a ripe banana and apply on your face and skin. Let it sit on your face for 15 minutes and then rinse it off with cold water. If you have time, massage your skin with ice cubes after this. The application of banana will make your face glow and even out the rough skin.
Banana Yogurt Face Mask
Blend Banana, vitamin E oil and Yogurt together. Apply generously to damp face and relax for half an hour. Rinse off thoroughly with lukewarm water and do your final rinse with cold water. To kick up the facial a notch, place the banana peel over the eye area (like you would a cucumber) or place it over areas where you have wrinkles or frown lines. Do this every other day and see the difference.
Banana & Coconut oil Mask
Mash a ripe banana and add some coconut oil. Mix it up and apply it on your face. It will give you fairer skin. You can also apply this mask on your hair for shiny soft hair.
Banana with orange Juice Face Mask
Take a ripe banana and mash it with a spoon or a fork in a bowl till it forms a smooth lump free pulp. Add 1 tsp. of thick yogurt and 1 tsp. of orange juice and mix the ingredients thoroughly. If you feel the mixture is too thick to apply, add a few drops of orange juice. Wash your face with a mild soap and use a soft towel to pat it dry. Apply the mask onto your face, using your clean fingers and massage it thoroughly onto your face for a minute. Apply a second thick coat onto your face and let it sit on your face for 15 minutes to allow the mask to work its magic!
Rinse your face with cold water to wash away mask's ingredients and to tighten your skin pores. Apply a good moisturizer of your choice to hydrate your skin.
Good Luck!


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We're women. We do things."
Genre: Adult Historical Fiction & Contemporary
Publisher: Penguin Books
Pages: 464
Publication Date: August 27th, 2013
Source: e-galley provided by publisher via NetGalley in exchange for an honest review
Find on Goodreads
A bestselling Australian writer's American debut and a heart-wrenching novel of World War I.
Iris Crane's tranquil life is shattered when a letter summons memories from her bittersweet past: her first love, her best friend, and the tragedy that changed everything. Iris, a young Australian nurse, travels to France during World War I to bring home her fifteen-year-old brother, who ran away to enlist. But in Paris she meets the charismatic Dr. Frances Ivens, who convinces Iris to help establish a field hospital in the old abbey at Royaumont, staffed entirely by women—a decision that will change her life. Seamlessly interwoven is the story of Grace, Iris's granddaughter in 1970s Australia. Together their narratives paint a portrait of the changing role of women in medicine and the powerful legacy of love.
The Medicine This is both a Belle and a Beast to me depending on which storyline we are discussing. The 1970s medicine was extremely interesting to me. They discussed patients and diagnoses, tests and possible outcomes. I loved seeing the OB-GYN world of the 1970s and how women were treated as doctors. I think the details were fantastic and I always looked forward to these chapters.
Grace I think Grace was the most well-developed character in the book. Whether you liked her or hated her, she had a voice and a direction in her story. She knew who she was and did her best to be the best doctor she could be. She is not a girly-girl by any means and resists those who are there to comfort her. She is not perfect but she is who she is. Her strength in the face of difficult situations is commendable and I found myself really drawn to her character and her point of view. She was the best part about this book for me.
Iris Along with my WWI POV, I found Iris' narration very frustrating to read. I felt like she was just a shell of a character. She was so objective in her point of view that it felt like she was describing more of other people's feelings in regards to her situation or life than what SHE actually felt. I had no idea if Iris like working at Royaumont, if she liked the bloke she started seeing, if she actually felt a kinship with Violet. I don't know, it all felt very superficial to me. I wanted to shake Iris and be like, FIND AN OPINION, what are we going on about?! She included anecdotes about the things around that had zero impact on plot progression. Thinking back, everything I remember reading about in Iris' story feels like there is a haze around it. The timeline isn't linear, it's is very confusing, and I have really no idea what the entire point of this aspect of the story was.
The Reveal I had read and loved all of Kate Morton's books and I felt like the author was trying to emulate that kind of story. You have a mystery that needs to be fit together, you had random scenes from an unknown POV with characters you are unsure of who they are. Then all is revealed at the end and I really felt it was rushed and contrived. I could think back and see the details that hinted but I wasn't invested enough in the characters to really care about the secrets at the end. I found it all a bit pointless to be honest.


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Detached notes
Andrew Basquille, Padraic Gilligan, and Eugene Murphy write:
Dear Friends,
Please tune in to see if #FinbarFurey (or @mundyirl) chooses our song #YestoYou on @RTETheHit - tomorrow Friday 23rd at 9:35 p.m. on RTE1.
On 23 June the BIB carried news from the UK Brookfield Knights agency about the new Cajun supergroup from Lafayette, Louisiana, the Revelers, for whom a tour in these islands was being prepared for March 2014. The agency now reports that dates for this tour were filled so quickly that a return trip by the Revelers later in 2014 is now being planned. Venue owners and event organisers who would be interested in booking them should let Brookfield Knights know. The band will be in Denmark this weekend, playing the big Tønder Festival.
The schedule of events at the Seamus Ennis Cultural Centre, Naul, Co. Dublin, updated to 28 Sept. 2013, can be seen here. Of particular interest to BIB readers is the show by Session Americana on 27 Sept.
Labels: Cajun, Media, Venues, Visiting bands


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Audio slideshow: When art and tech collide
When your business is a mere 48 hours old, you are not expected to have a business card - which is why most of the networking at the Art Meets Tech exhibition at east London's Whitechapel Gallery came by way of email addresses scribbled enthusiastically onto scraps of paper.
The event's organisers, 3 Beards, brought together more than 50 coders, hackers and artists with a simple brief to create art from data - the source of which was entirely up to the creators.
The BBC's Dave Lee met some of those behind the most interesting projects.
Audio slideshow production by Dave Lee.
Photography by Paul Clarke and Harry Metcalfe.
More information about the Data Necklace can be found here.
Publication date: 1 October 2012.


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1: Delhi- Shimla
Pick up from Delhi airport/railway station and check into the hotel at Shimla. Evening free for leisure & shopping. Come back to the hotel and enjoy your Dinner. Overnight stay at the hotel.
Day 2: Shimla
After breakfast proceed for wonderful day excursion to Kufri. Enjoy a walk through thick ceder woods to Mahasu Peak for amazing view of mighty Himalayas. Enjoy horse riding at your own cost. Enjoy your dinner and overnight stay at the hotel.
Day 3: Shimla- Dharamsala
After taking breakfast drive to Dharamshala. Check into the hotel and relax for the rest of the day. Enjoy your dinner and overnight stay at the hotel.
Day 4: Dharamsala
Today proceed for full day local sightseeing of Dharamsala. Visit Brejeshwari Temple, Bhagsu Nag, Meclodganj, Chamunda Mandir, Dal Lake and Kangra Fort. Return to hotel and enjoy your dinner .Overnight stay at the hotel.
Day 5: Dharamsala
Today you are at leisure. Enjoy panoramic views from the Dhauladhar mountains. Dinner and overnight stay at the hotel.
Day 6: Leave Dharamsala
Checkout from the hotel and drive to Delhi airport/railway station for your onward journey.


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|Allopatry is a Scrabble word. Scrabble point value for allopatry: 14 points.
|Allopatry is a Words with Friends word. Words with Friends point value for allopatry: 14 points.
Above are the results of unscrambling allopatry. Using the word generator and word unscrambler for the letters A L L O P A T R Y, we unscrambled the letters to create a list of all the words found in Scrabble, Words with Friends, and Text Twist. We found a total of 159 words by unscrambling the letters in allopatry. Click these words to find out how many points they are worth, their definitions, and all the other words that can be made by unscrambling the letters from these words. If one or more words can be unscrambled with all the letters entered plus one new letter, then they will also be displayed.
1. the occurrence of related organisms in separate geographical areas with no overlap
|Words that start with allopatry
|Words that end with allopatry
|Words that contain allopatry


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Happy Good Friday, y'all!
I'm so excited about Easter this year. It's truly become my favorite holiday and time of year. I'm obsessed with bunnies and Peter Rabbit and the Velveteen Rabbit and all things Easter, in addition to loving the spirituality of the season, and I'm really excited to host my immediate family for Easter supper this year! We'll go to Wheat's Aunt's house for Sunday dinner after Church, then Sunday afternoon, my family will come up and we'll color eggs and eat supper. I'm so excited about Elah's first real Easter! And can't wait for baby Kirbo to arrive so I can hit up after-Easter baby clothes sales for next year. ;)
Last year (or was it two years ago?) I DIY'd these sweet golden Easter eggs that I still use to decorate our table. Click over here for the DIY Golden Egg details!
This year, I used hosting as an excuse to treat myself to some pretty new Easter bunny plates from World Market that I'm obsessed with – totally rational purchase… right? I've already got the table set… thanks to these long-lasting flowers leftover from my baby shower!
I even have our brand new high chair for Baby K ready for Elah to test out! I LOVE our Svan Signet Complete high chair – my sister has the same one in white for Elah, and it's been so great that I registered for the mahogany version. We are so grateful to Wheat's parents for getting it for us! I love its design, but especially that it's not made in China, it's all hard wood, and it's great for babies ages six months to toddler. Thank you, Bruce and Nancy!
I got Elah a little Easter treat (a Jellycat bunny from Firefly in Thomasville), and she can borrow baby K's new Peter Rabbit utensils from on of my besties, Jessica and her husband Kevin (and kids, Chason Wheat and Raleigh Anne). Thank you, Jess!
I cannot wait to celebrate this holy holiday, but as excited as I am, I hope we all take time to remember why we celebrate.
For those of you with kids that are old enough, I saw this recipe for Resurrection Rolls over on Dixie Delights this week – they'd make for a fantastic activity for kids – and they look pretty delicious, too!
The marshmallows, symbolizing Jesus, are anointed with oils (butter) and spices (cinnamon and sugar) and wrapped in cloth (crescent rolls) and placed in the tomb (oven). When they rolled the stone away (10 minutes later at 400 degrees in a greased muffin tin per roll), He was not there for He has risen! Aka the marshmallow is GONE! Elah isn't quite old enough for this one, but I'm saving this away for future Easters. Until then, we'll color eggs and hunt them… aka put them in very obvious places for Elah to find them. I can't wait!
Happy Easter weekend, friends!


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Communication sent on behalf of Professor Malcolm Hooper
Because of the serious nature of the criticisms I received in a recent communication, I thought it necessary to place my response in the public domain.
Dear Mr Jameson
As you raise some important issues in your communication of 20th February 2011 about my initial response to the PACE Trial, I will reply in detail.
I am aware that you are an engineer and I am aware of your own position and of your hypothesis about what you refer to as "CFS", for example, I note that you believe CFS to be (quote) "a functional illness …which can be reversed by psycho-social rehabilitation treatments". I also note that you equate "CFS" with "persistent burnout", and that you believe (i) "the viral theories do not adequately explain why personality and mental attitude have been shown to be important in determining which patients contract CFS and which recover the most quickly", (ii) "Psychosocial treatments do result in recovery from CFS", (iii) "the patient's motivation and belief in treatment are likely to be important in recovery", (iv) "many CFS patients have a lack of confidence and motivation", (v) "it is likely that…CFS is simply a more severe form of burnout", (vi) "The most effective treatments appear to be rehabilitation programmes…which encourage the patient to re-integrate back into normal life", and that you postulate that "CFS…is essentially the same as 'burnout'…which persists long after the triggering HPA stressor have been removed due to factors such as negative mental attitude and loss of motivation" (http://www.mind-body-health.net/persistent_burnout_theory.html).
I will now address what you describe as my "serious errors". 1. You state that the PACE trial compared subsets using the CDC criteria. The criteria that are universally known as the "CDC criteria" are the 1994 Fukuda et al criteria. Indeed, the PACE Trial Identifier listed the 1994 CDC Fukuda criteria as the means of identifying the disorder and the Fukuda criteria are mentioned on page 81 of the 226 page Full Protocol (not to be confused with the shorted form of the Protocol that was published in BMC Neurology 2007:Mar 8:7:6: http://www.biomedcentral.com/1471-2377/7/6) and originally it was these international CDC criteria that were to be used by the Principal Investigators. However, on 22nd October 2004 the Chief Principal Investigator, Professor Peter White, wrote to the West Midlands Multicentre Research Ethics Committee (MREC) seeking substantial amendments to the Protocol and at section 2.1 of his application he substituted the Reeves et al 2003 for the 1994 Fukuda criteria, hence the criteria that are universally known as the "CDC international criteria" (ie. the 1994 Fukuda criteria) were NOT used to compare subsets in the PACE Trial. The criteria that were used (misleadingly described in the Lancet paper as "international criteria for chronic fatigue syndrome") were the Reeves et al 2003 criteria.
2. You state that the trial compared subsets using "the London criteria for ME (requiring postexertional malaise…"). The original intention of the PIs was to use the Ramsay definition of ME, and you will see from page 417 of "Magical Medicine" these were date-stamped by the MREC as received on 21st March 2003 (http://www.meactionuk.org.uk/magical-medicine.htm). Once again, however, Professor White amended the Protocol and he substituted what appears to be his own version of the "London Criteria" for the Ramsay definition. You will see from page 417 of Magical Medicine that the Ramsay definition required the following: fluctuation of symptoms from day to day or within the day; headaches; giddiness; muscle pain; muscle cramps; muscle twitchings; muscle tenderness; muscle weakness; pins and needles; frequency of passing water; blurred vision; double vision; increased sensitivity of hearing; increased sensitivity to noise; feeling generally awful, and muscle weakness after exercise.
In contrast, Professor White's version of the "London Criteria" specifically states on page 188 of the Full Protocol that neurological disturbances "are not necessary to make the diagnosis" and they further state that "the usual precipitation by 'physical or mental exercise' should be recorded but is not necessary to meet criteria". Notwithstanding this clear statement in the Full Protocol that postexertional malaise is not necessary to meet the London Criteria, the text of the Lancet article states that participants were also assessed by "the London criteria for myalgic encephalomyelitis (version 2) requiring postexertional fatigue" so there is a significant discrepancy that requires explanation by Professor White, since two such divergent criteria cannot both have been used in the PACE Trial (note that Professor White's "version 2" is dated 26.11.2004).
According to Professor White's version of the "London Criteria", there is no requirement for impairment of short-term memory and loss of concentration, nor is there any requirement for primary depression or anxiety disorder to be present (indeed, if depression or anxiety disorder are present, the Full Protocol states "This means if any depressive or anxiety disorder is present, the London criteria are not met"). This makes the fact that the PIs reported a 47% prevalence of mood and anxiety disorder at baseline particularly notable, because the PIs state that of the 641 participants, 329 (ie. 51.3%) met Professor White's version of the "London Criteria"; in other words, virtually everyone who did not have anxiety or depression met the "London Criteria" used in the PACE Trial, but Professor White's "London Criteria" in the Full Protocol (to which the PIs were obliged to adhere) do not require precipitation of symptoms by physical or mental exercise. Put another way, of the 53% who did NOT have anxiety or depression at baseline, 96.8% met Professor White's "London Criteria", but those criteria do not require the cardinal feature of ME to be present. This begs the question as to what disorder was being studied under the title of ME/CFS, because the clear distinction between Ramsay-defined ME and somatisation disorder has been significantly lessened by the PIs.
Whilst the Ramsay definition does exist (Postgrad Med J 1990:66:526-530), I would remind you that the "London Criteria" do not in fact exist and that the reference cited in the Lancet is to the 2004 Westcare Report, which simply said that they were "proposed" criteria. The "London Criteria" have no known authors; they have never been published; there is no methods paper which specifically describes them as a "case definition"; they have never been approved nor have they even been finally defined (there are various versions); they have never been validated and they are not on PubMed thus are not available for scrutiny so they cannot be accessed for comparison. This means that Professor White was essentially able to create his own version of the "London Criteria" as evidenced on page 188 of the Full Protocol. Your assertion that the London Criteria required postexertional malaise is thus incorrect despite the PIs having said in their Lancet paper that it was required, and this is an issue for Professor White to address ie. he needs to clarify whether or not he adhered to his own Protocol.
3. You state "there is nothing in the Oxford criteria that 'excludes people with neurological disorders' ". You may not be aware that one of the authors of the Oxford criteria, Professor Anthony David, clarified the issue of whether or not the Oxford criteria exclude people with neurological disorders: "British investigators have put forward an alternative, less strict, operational definition which is essentially chronic…fatigue in the absence of neurological signs, (with) psychiatric symptoms…as common associated features" (AS David; BMB 1991:47:4:966-988). The Oxford criteria (JRSM 1991:84:118-121) suggest that people with a neuromuscular disorder should be used as a comparison group, which rules out the inclusion of people with ME, a WHO classified neurological disorder since 1969.
The fact that the Wessely School do not believe or accept the WHO classification does not mean that ME is a somatisation disorder as they continue to assert despite the irrefutable biomedical evidence to the contrary. If their psycho-social model of ME/CFS were correct ie. if the symptoms are caused by deconditioning consequent to fear of activity, it would be expected that a programme of CBT/GET would be curative, yet the results of both the FINE and PACE Trials do not support the PIs' model. I note that you fail to reference Professor Wessely's statement that the PACE Trial interventions are "not remotely curative" made in his JAMA editorial of September 2001. Furthermore, the Oxford criteria specifically state "There are no clinical signs characteristic of the condition", a criterion which immediately rules out ME/CFS, since there are numerous characteristic, objective, reproducible, abnormal signs that are discernable by any reasonably competent physician. They include the following:
• labile blood pressure (this is a cardinal sign); low systolic BP <100 in 50%
• nystagmus and vestibular disturbance (vestibular dysfunction seen in 90%)
• sluggish visual accommodation
• fasciculation
• hand tremor
• neuromuscular incoordination
• cogwheel movement of the leg on testing
• muscular weakness
• marked facial pallor
• postural orthostatic tachycardia syndrome (POTS)
• positive Romberg
• abnormal tandem or augmented tandem stance
• abnormal gait
• evidence of Raynaud's syndrome and vasculitis (vascular signs cross dermatomes)
• mouth ulcers
• hair loss
• singular reduction in lung function (shortened breath-holding capacity seen in 60% of patients tested)
• enlarged liver (not usually looked for by psychiatrists).
4. You state that the PACE Trial did use an objective outcome measure ("6 min walking ability in metres"). As the only objective measure of outcome, this is completely inadequate as a measure of physical capacity. A single test is unlikely to reveal any abnormality and serial testing is essential because it is the second test that provides objective evidence of abnormalities in ME/CFS patients and of their inability to work. The reference provided by the PIs for the six minute walking test is Buckland RJA et al (BMJ 1982:284:1607-1608) but the paper itself cites McGavin CR et al (BMJ 1976:i:822-823), which draws attention to the difficulty of achieving reproducible results with such a test. Moreover, the Chief Principal Investigator himself, Peter White, has published evidence supporting the need for serial post-exercise testing (Immunological changes after both exercise and activity in Chronic Fatigue Syndrome: a pilot study. White PD, KE Nye, AJ Pinching et al. JCFS 2004:12 (2):51-66 ).
None of the interventions in the PACE Trial enabled participants to achieve anything like a normal walking speed for the full six minutes when compared with a healthy individual. It is regrettable that Professor White decided to abandon the use of an actometer, which would have provided unequivocal objective evidence of improvement or non-improvement. The only reported improvement on the six minute level walking test for those allocated to CBT was an increase of 21 steps, whilst for those allocated to APT (note that APT is not the same as pacing, as APT is a vehicle for incremental aerobic exercise and involves planning, achieving and sustaining targets) there was an increase of 20 steps, these improvements having cost the nation £5 million.
The NHS Choices website provides the following comment on the success or otherwise of the PACE Trial: "Compared with specialised medical care alone, CBT plus specialised medical care improved fatigue scores by 3.4 points on a 33-point scale, while GET plus specialised medical care improved scores by 3.2 points. Physical function score improvements were 7.1 for CBT and 9.4 for GET on a 100-point scale" (http://www.nhs.uk/news/2011/02February/Pages/therapies-moderately-improve-CFS.aspx).
The two favoured interventions (CBT and GET) had side-effects rates of 89% and 93% respectively and according to the PIs, "adverse events were common".
Rated on their 33-point and 100-point scales, participants improved on average only 10% and 8.25% with the two recommended interventions, which I believe hardly qualifies as even "moderately effective" as the PIs claim.
You accuse me of "doing potential damage to CFS patients by putting them off the only treatments that have been proven to be effective". I refute your allegation that I appear to be putting out deliberate misinformation, but you are of course free to carry out your threat to complain about me in any forum you choose, including to my University. However, if you exercise this option, be aware that you will need supportive evidence and that your own credibility will come under scrutiny.
Malcolm Hooper
See also: Professor Hooper's Initial Response to the MRC PACE Trial


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Luther Burrell has hailed Calum Clark ahead of the Saints flanker's first England Test today (Saturday).
Clark, who won both his club's players' and supporters' player of the season prizes last term, will win his first cap for his country in the World Cup warm-up match against France.
Saints flanker Tom Wood will skipper a side that also contains Kieran Brookes, while Alex Corbisiero is on the bench.
Burrell has been given the weekend off, with the England team largely made up of fringe players.
And the centre can't wait to see his club-mate wearing the red rose at Twickenham for the first time.
"He's hugely excited about it and he's a player that has put in so much effort last season to try and reach this achievement, and in his eyes it's massive," Burrell said.
"He was dying to get a cap and I'm so chuffed that he's able to get that now and has the opportunity to wear the rose and represent England at Twickenham.
"I'm really excited about watching him, it's going to be fantastic."
Clark was the outstanding player at Franklin's Gardens last season, making 31 appearances as Saints topped the Aviva Premiership standings for the first time.
And Burrell added: "The thing with Calum is that he just keeps his head down.
"He's been grafting, grafting and grafting and he's been playing well for Northampton, we know what he's about.
"He's a good leader on the field and he's been fantastic since coming in to the senior group.
"It's awesome that he's going to get his opportunity and put pressure on the coaches to select him.
"There's going to be strong competition due to the quality of players available."


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Blog that includes articles on Sci Fi & Fantasy motion pictures, automobiles, anime, comics, video games, previews, critiques, pinups of sexy aliens and idea art by the author of the DSNG SCI FI CHRONICLES. Cons: The factor I like least about my job is that I don't get paid enough to do what I'm able to do. This weblog is an experiment in progress. This dialogue board will provide all automotive instructors a spot to voice their questions, opinions and discover solutions to their educational questions. My hope is to supply a place for all instructors to study and give their knowledge freely.
When it was proclaimed that the Library contained all books , the primary impression was considered one of extravagant happiness. All males felt themselves to be the masters of an intact and secret treasure. There was no personal or world drawback whose elegant resolution did not exist in some hexagon. The universe was justified, the universe immediately usurped the unlimited dimension of hope.
The Service technician I talked to mentioned that the car memory may indeed be compromised, if the Battery was not modified out properly, so I made an appointment with them to stop by and get a new Battery put in. Now we have active research interests in car design and refinement, contemplating points comparable to automobile aerodynamics, powertrain, suspension dynamics, noise vibration and harshness, fuels, engine emissions and environmental influence.
This won't have an effect on your course history, your stories, or your certificates of completion for this course. As a result, the issue of delivering vehicles facilitated the introduction of the trucking idea utilizing 18-wheelers. All that was needed was a tractor and the truck, though one putting demerit of the whole thing was that the semi-trailer might only transport a single automobile … Read More ...


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How to Lose Fat Loss: Tips
Old School New Body Guide Review
Are you sick of weight loss products that never produced any results for you? Have you ever wondered why you are never able to shed the pounds despite a good diet plan? Studies have shown that people with similar weights and age groups respond differently to a set fitness regime.
Some people manage to lose weight quickly whilst other people don't notice any results. There are probably various factors accounting for this, including their genetic makeup, compliance with their regime, environmental factors etc. Old School New Body is a book written by fitness enthusiast Steve Holman who is an expert nutritionist with a background in biology and human physiology. It focuses on one major factor that has been overlooked by many other researchers and that is your gut bacteria.
Old School New Body eBook-How it's works?
As mentioned, this Old School New Body Diet book looks at the importance of the composition of your gut bacteria when it comes to weight loss. You have probably asked yourself why some people can just eat what they like but never seem to get any problems with their weight. They have probably never even went to a fitness exercise class! Well it is to do with how their body digests the food and how you metabolize the energy source. Your gut lining contains trillions of tiny microscopic organisms called Microbiota, which consists of both harmful as well as friendly useful bacteria. In layman's terms, friendly bacteria helps your body to digest and get rid of excess fat whereas the harmful bacteria does the opposite. It is a fine balance between the two types, usually 85% good bacteria to 15% harmful bacteria. Any imbalance between the two types of bacteria then we have a problem.
Old School New Body Meal Plan makes it impossible for the body to burn off excess fat and everything you eat is converted to fatty tissue. What's more the bad bacteria in products like sugar fine tunes your taste buds so that you crave more and more harmful foods. It is like a vicious cycle that would never end. Apart from avoiding harmful bacteria, antibiotics are probably the worst offenders. They kill off all the friendly bacteria in your gut, as well as crippling your immune system and making you more prone to disease. Bad bacteria is also associated with other side effects such as excessive bloating, reflux problems, depression and poor sleep. Scientists have discovered another worrying fact, and that is regarding how gut flora can be passed on in each generation. This Old School New Body Free Download probably explains the impending obesity epidemic and why more and more people are becoming overweight.
The next question would be how we can adjust this delicate balance and tip it in our favor. If we can increase the ratio of friendly bacteria in this ever constant battle then surely it would make our task easier. By learning how to give your gut bacteria a complete changeover, you can make a significant contribution to your weight loss dream. In this Old School New Body Free ebook, you find out exactly how to do this using a 12 week diet plan. Also included are tips on healthy eating and other lifestyle changes that will help further your cause. The result is less craving for bad foods, better immune system and sustained weight loss.


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Right to Information
Contact details of officers for addressing applications under Right to Information Act, 2005.
1. Applications seeking information under the Act may be sent along with the prescribed fee in Yemeni Riyals equivalent to Indian Rs. 10/- by cheque or cash favouring Embassy of India, Sana'a. It may be noted that information provided under the Act is available to the citizens of India only. Applications should be submitted along with documentary proof of Indian citizenship (like copy of passport). More information is available at http://rti.gov.in
2. It may also be noted that as per section 6(1) of the RTI Act, 2005, a person who desires to obtain information under the Act is required to submit the application to the Information Officer of the "concerned public authority". Applicants are, therefore, advised to send their requests under the RTI Act to the Embassy only when the subject matter can reasonably be presumed to pertain to the Embassy. While Section 6(3) provides for the transfer of an application by a receiving PIO to another (concerned) PIO, this is clearly meant to cover situations where the application is addressed to a PIO on the assumption that it has been directed to the PIO concerned. Where the information required obviously does not pertain to the Embassy, the application may be addressed to the concerned PIO directly.
3. The Government of India (Department of Post) has launched the e-IPO (Electronic Indian Postal Order) service to facilitate purchase of Indian Postal order electronically for paying RTI fee/cost of information on-line through e-Post Office Portal (https:/www.epostoffice.gov.in) of the Department of Posts, Department of Personnel & Training. The detailed instructions for using the e-IPO service for payment of RTI fee on-line are contained in DOP & T's OM No. 1/44/2009-IR dated March 22, 2013. (The RTI applicants may, therefore, pay the RTI fee/cost of information, also on-line using the said e-IPO service, for seeking information from Ministries/Departments in India. However, payment of RTI fee for RTI applications addressed to the Embassy, would continue to be paid through cheque or demand draft favouring 'Embassy of India, Sana'a as mentioned in para 1 above.


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Dr Rani Samuel is an experienced Clinical Psychologist and Author. She has been closely connected to Pastor Thamo and Mirolyn since 2002 and is honoured to submit to their spiritual oversight. Her insights and knowledge in the area of emotional healing and wellness is freely available on her website.Ranisamuel.co.za
Welcome to thamonaidoo.com. As you navigate through the resources on this website may you rediscover the magnificence of the Word of God and its profound clarity in this present Season.
About Thamo Naidoo
Thamo Naidoo has been in ministry since 1985. He is a graduate of the Bethesda Bible College, Full Gospel Church of God, South Africa and has earned a Master of Theology degree at the University of KwaZulu-Natal. He has planted two pioneering works in South Africa – River of Life…Read More
Messages View these messages as your starting point to the Apostolic Message. "The Mantle of Changing Seasons" is the recommended message to start your journey. These messages consist of multiple sessions and should be listened to as a whole. Gate Ministries Sandton downloads Gate Ministries Sandton (GMS) is the local…Read More
Gate Ministries
Gate Ministries Sandton (GMS) was formally launched at the Balalaika Protea Hotel, Sandton City, on the 19th of February 2012. It was birthed out of a divine mandate given to Thamo Naidoo. The directive was unequivocally simple and clear – a new season has dawned upon the church that must…Read More


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Monday, July 30, 2007
Good Ole Days
I looked thru some old pics last night and picked some to share. I will show more in the next few weeks. OK, this was not a good ole day, but it makes me so grateful for my lil boy! These are his NICU days. He was 1 month early (all 3 were) but he weighed in at a honking 7 lbs 12 oz! The nurses said "he's a newborn in his heart" about my big ole preemie. We finally got to hold him and I could not resist playing with all that hair! My lil rock star! This is what my lil hog looked like at the end of every marathon nursing session! This is Miss Molly on Christmas morning with her new power wheels. She is so cool! My boy following in Dad's proud footsteps. I have a few more sleepless nights ahead of me!
1 comments:
- Amy said...
oh! such a cutie! I luv those firefighter pictures! my DH is a firefighter!
- August 1, 2007 at 2:50 AM
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text: Presidential Image Gallery Presidents George WashingtonJohn AdamsThomas JeffersonJames MadisonJames MonroeJohn Quincy AdamsAndrew JacksonMartin Van BurenWilliam HarrisonJohn TylerJames K. PolkZachary TaylorMillard FillmoreFranklin PierceJames BuchananAbraham LincolnAndrew JohnsonUlysses S. GrantRutherford B. HayesJames A. GarfieldChester A. ArthurGrover ClevelandBenjamin HarrisonWilliam McKinleyTheodore RooseveltWilliam TaftWoodrow WilsonWarren G. HardingCalvin CoolidgeHerbert HooverFranklin D. RooseveltHarry S. TrumanDwight D. EisenhowerJohn F. KennedyLyndon B. JohnsonRichard NixonGerald FordJimmy CarterRonald ReaganGeorge H. W. BushBill ClintonGeorge W. BushBarack ObamaDonald Trump The Obama Family on Election Night November 04, 2008 Source: Obama for America On November 4, 2008, from left to right, President-elect Barack Obama, daughters Sasha and Malia, and wife Michelle, make their first appearance as America's next First Family. Obama's election as the 44th President of the United States and first African American President inspired more than 120,000 supporters to flood Grant Park in Chicago to celebrate his victory. ← Return to Barack Obama Gallery