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5 Tips for a Tasty Tailgate
Casual and diehard sports fans alike can all agree one of the best parts of game day is the tailgate. Whether you're heading to the game to take part in the action or tuning in on the big screen, you can light up the scoreboard this season with these tips for a fun, easy and downright tasty tailgate (or home-gate).
Start early.There's likely no easier way to send a tailgate spiraling out of control than to get a late start, which puts the party in a rush ahead of game time. Prepare early, and if you're heading to the stadium, leave yourself plenty of time to find the ultimate parking spot, light the grill and enjoy the atmosphere.
Keep it simple.A true tailgate experience starts with flavorful foods fit for a crowd, which calls for ready-to-go ingredients like smoked sausage. Because it's pre-cooked, just heat it up and pair with other simple ingredients, such as a hoagie bun and some peppers for an easy grilled smoked sausage and pepper hoagies.
Share the responsibility.Preparing shouldn't fall on one person's shoulders. Instead, ask each attendee to bring something useful for the entire group, such as plasticware, trash bags, napkins, cups, drinks and games.
Make it customizable.Especially if you're bringing a large group, creating a spread that allows for personalization can help ensure everyone leaves happy. Try creating deluxe nacho dogs with an abundance of topping options, giving guests full freedom to concoct their own creations.
Ensure an easy cleanup.When the tailgate is winding down and the game is about to start, it's almost inevitable there'll be a rush to pack up and head to the stadium (or the couch). Make things simpler and quicker by using disposable plasticware, plates and cups, and strategically placing trash bags in easily visible areas for everyone to clean up as the party continues, rather than scrambling to pick everything up at once.
Source: Family Features, Nathan's Famous/Eckrich. Reprinted with permission from RISMedia. ©2019. All rights reserved.


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Plants and NurseriesEdit
Butterfly Wonderland
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Take flight at one of the newest attractions in the Valley with a highly innovative, indoor rainforest environment featuring the largest butterfly pavilion in America. Great for all ages, stop by today for a truly memorable experience.
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[EVENT] Guide Dogs Charity Garden Party
What: Guide Dogs Charity Garden Party with Cambridge University One Health Society
Where: Clare College Memorial Court Lawns
When: 17th June 2:30 – 5pm
With promise of sunshine on Saturday, what better way to spend the afternoon than a Charity Garden Party where you get to cuddle PUPPIES in aid of Guide Dogs for the Blind! Complete with lots of food and drink, games and competitions, a charity raffle with some really generous prizes donated by local independent Cambridge businesses and more, all in our own beautiful College. With student entry just £6, it's an event you can't afford to miss out on!
For more details, please see our event www.facebook.com/events/1565176050220407/ or joinagora.com/events/16706/#/?_k=42oamf/.
It would be great to see a good Clare turn out!


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So, I was doing some research on the new Google Penguin updates, and I came across an article from Highrankings talking about a particular case of a well-meaning company getting bamboozled by an unethical inbound marketing agency. This really drove home just how important it is to find an SEO firm that is truly transparent.
Transparency in an inbound marketing agency goes beyond simply having an set pricing list. It means that you should never wonder, "What are these guys doing? Are they really helping me?" You should never ask questions of your SEO company and not get hard, factual answers back.
If you aren't getting those answers, there's a good chance you may be on your way to being taken for a ride. They may even be hurting your business far more than they're helping it.
Let's look at a few things to watch out for.
Guaranteeing Transparency In Your Inbound Marketing Agency
Hidden Fees:
This is one of the oldest scams in the book, but still unfortunately effective. It turns out, once it's time to sign on the bottom line, there are suddenly fees that weren't mentioned before then. Or, worse, the fees are buried in the fine print in hopes that don't see them.
Either way, this should be a sign that it's time to walk away from the table immediately. If they weren't up-front with you while courting your business, they probably won't be honest once you've signed either.
Unethical SEO:
It's not something that most above-board inbound marketing agencies even like to talk about, but there are a lot of "black hat" SEO techniques which might be effective in the short term, but will fundamentally hurt you in the long run. The article I linked to above talks about one of the most common of these, "splogs," which is a neologism for "spam blogs."
You've undoubtedly seen them. These are the blogs that are filled with junk content, or use autospinners to rewrite the same article dozens of times. No one wants to read them, but combined with an SEO push, they can briefly boost your hit counts... until Google notices what you're doing and your site stats plummet, often beyond recovery.
Most companies that engage in these practices will use euphemisms to try to cover them up, or dodge questions about their specific techniques. Your SEO company should be able to tell you exactly what techniques they're utilizing, without trying to slap a coat of white paint on the black hat they're wearing.
Not Enough Data:
Another common sign of a poor SEO company is that they can not, or will not, give you hard data showing the effectiveness of their campaigns. This isn't the 1960s. Any online marketing effort should be fully documented and have plenty of numerical proof showing direct links between their marketing and its benefits to you.
Similarly, you should also be wary of companies only showing certain pieces of data. Many of these firms love to brag about increases in site visits, for example, but suddenly get a lot quieter when you start asking about lead generation or (heaven forbid) actual sales figures resulting from their work.
Don't let your agency get away with cherry-picking data. They should be able to produce facts which demonstrate they truly are providing you a return on your investment. If they can't show that their ads are leading to more sales, it's time to go somewhere else.
Keep Asking Questions!
The key takeaway here is, if you are discouraged from asking questions, they're probably not working in your best interests. You need an SEO firm that will be transparent with you every step of the way, from pricing, to procedures, to final results.
Have you ever had dealings with an unethical SEO firm? Warn the world in our comments!


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Libya eastern parliament speaker accuses Turkey of supporting Benghazi bomb attack
The speaker of Libya's eastern parliament accused Turkey of supporting what he called terrorists who bombed a mosque in the eastern city of Benghazi last month and killed about 35 people, the Russian Sputnik news agency said.
"Terrorist organisations are behind this, unfortunately with support of foreign countries, with Turkey's support," it quoted Aguila Saleh Issa, the speaker of the Libyan House of Representatives as saying.
The House of Representatives was set up in 2014 and is based in the eastern city of Tobruk, near the Egyptian border, in opposition to the internationally recognised Government of National Accord (GNA) in the capital Tripoli.
Egypt backs the House of Representatives as part of its drive against what it sees as the influence of Muslim Brotherhood Islamists in the region.
Meanwhile, Turkey and its ally Qatar are accused of supporting Islamist factions in western Libya and armed groups fighting the forces of anti-Islamist strongman General Khalifa Haftar around the eastern city of Benghazi.
In the first week of January, Greek Coastguard said that they seized a Libya-bound ship carrying explosives from Turkey.


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Nebraska Dept. of Economic Development
This is the website for Nebraska's Department of Economic Development. Snitily Carr was tasked with refreshing the look of the site as well as improving the search-ability of the site while literally preserving hundreds of pages and news articles from their old site. I was involved in this project from start to finish. I developed wireframes as well as a number of design concepts until we landed on something that the group of client stakeholders were happy with. Once we Continue »
Nebraska In The News
Why is it that the when the great state of Nebraska make the international news it's because of something horribly embarrassing, like Ernie Chambers suing god, or the recently revised Safe Haven law, and now there is the apprehension of Valentine's Butt Bandit to add to the list. What a great day to be a cornhusker :P


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PPC Campaign Management
Don't dump hundreds of dollars on ad campaigns that don't convert, talk to an LA Consilium expert who'll help you structure a campaign for success.
Take it from us. There are right and wrong ways to do online advertising, a successful campaign will not only ensure leads but will save you money in the process. That's why investing in (PAY PER CLICK) PPC Campaign Management is vital to the long-term growth of a business.
Before our (PAY PER CLICK) PPC Campaign Management team takes on a project, we make sure your business has the fundamental elements of a successful campaign. Our experts conduct a variety of research and test to ensure your money is well spent: Keyword research, competitor research, sales funnel quality tests, website functionality tests, and consumer behavior analytics for the industry.
Successful online ad campaigns are categorized and measured by their ability to convert prospects into customers using the least amount of capital and resources possible. But what makes an ad campaign high converting and cost-effective? Many things in fact and it's due to the complex and inclusive nature of any marketing effort, but in essence, all online ad campaigns correctly implement their website, sales funnel, and audience targeting strategies.
And that's why our PPC Campaign Management service exists, to get it done right; it is not just about signing up to an ad network and pumping money into ads. It is reviewing landing pages, optimizing CTAs and understanding your audience's needs better than your competition. Our PPC campaign management team makes sure your campaigns are always converting and costing you less.
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Hope For Class Action
IMAGE SOURCE: Chattem SunSource Web site
The manufacturer GARLIQUE ® dietary supplement has lost its motion to have a consumer fraud case filed against it in a Florida court thrown out.
On Thursday, the U.S. District Court Southern District of Florida issued the ruling on behalf of consumer, James Wilson.
Wilson, of Jupiter, Florida, had filed the complaint in May charging the company misrepresented the effectiveness of the product in fighting cholesterol. An amended complaint was filed in September, and supplement maker, Chattem Inc. filed to have the case dismissed.
Smith and Vanture, LLP, a law firm based in West Palm Beach, would like to make this a class action.
Attorney Brian W. Smith (and an IB member) tells IB News "We are pleased with the court's decision to deny the motion to dismiss this case. GARLIQUE ® is a product that is a popular alternative to traditional medications for people that are battling cholesterol problems. We believe that consumers have a right to full disclosure about the effectiveness (or lack thereof) of the products that they purchase."
Chattem Inc., is facing four causes of action: Breach of Implied Warranty of Fitness for Particular Purpose; Breach of Express Warranty; Negligent Misrepresentation; and Intentional Misrepresentation.
Chattem, a Tennessee corporation, manufacturers a portfolio of over-the-counter health care products, toiletries, and dietary supplements, including GARLIQUE ®. An attorney for the company did not respond by publishing time, but is welcome to at any time.
Consumers are told the supplement has a beneficial effect on cholesterol levels and cardiovascular health. After all, that's what the product maker said in print, radio and television ads.
The product label says "#1 Pharmacist Recommended," "Guaranteed a World Leader in Garlic Potency," so with representations like that, how could he lose?
The label says:
"World leader in product potency
"Allicin yield — the amount of allicin that can be produced when the alliin and allinase in garlic combine — is an important measure of garlic's potency and effectiveness. Specially grown in rich fertile soils, the garlic used in GARLIQUE has the very highest allicin yield. It is processed with extreme care and attention, guaranteeing that the potency is preserved as it is ground into a fine ivory white powder. Independent laboratory testing proves that each GARLIQUE tablet yields at least 5000 mcg of allicin."
A Breach of Express Warranty means that the plaintiff purchased a product relying on the express warranty by the company, in essence a promise about the product, then the product fails to conform to those promises.
With sales of at least $300 million a year for Chattem Inc., upward of two million Americans may have taken GARLIQUE ® and relied on its promises, says Howard Rubenstein, co-counsel on the case.
Wilson was told by his doctor that he had elevated cholesterol. After trying a course of prescription medication he didn't like the side effects, his doctor suggested garlic supplements. So he shopped around and was sold on the wording on the label of GARLIQUE ®. It didn't hurt that broadcast personality, Larry King, has been touting it for years on the radio, as have numerous television and print ads.
The concern is that individuals may be dissuaded from taking Crestor or Lipitor, prescription drugs for cholesterol, and go for the natural product because of the promises.
"I think this product should be marketed differently. It should not be marketed in a manner people with high cholesterol should get off their medication,' says Rubenstein adding the problem is, "all of a sudden you have a heart attack."
The product box does include a disclaimer in small print, "These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease."
While misrepresentations on a dietary supplement label generally fall under FDA regulations, under the Obama administration federal pre-emption doesn't apply.
"Any state or a lawyer in any state can bring a suit for deception it doesn't require the involvement of the FDA," says Rubenstein.
GARLIQUE ® is a top seller for Chattem. Marketed under the SunSource umbrella, other products in the line include Melatonex, GARLIQUE ®, CardioAssist, and Omnigest. #
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Cost-Effectiveness of Implantable Pulmonary Artery Pressure Monitoring in Chronic Heart Failure
Author + information
- Received October 1, 2015
- Revision received December 11, 2015
- Accepted December 22, 2015
- Published online May 1, 2016.
Author Information
- Alexander T. Sandhu, MDa,b,c,∗ (ats114{at}stanford.edu),
- Jeremy D. Goldhaber-Fiebert, PhDb,
- Douglas K. Owens, MD, MSa,b,
- Mintu P. Turakhia, MD, MASa,c,
- Daniel W. Kaiser, MDa and
- Paul A. Heidenreich, MD, MSa,c
- aVeterans Affairs Palo Alto Health Care System, Palo Alto, California
- bCenter for Health Policy and Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University, Stanford, California
- cDepartment of Medicine, Stanford University School of Medicine, Stanford, California
- ↵∗Reprint requests and correspondence:
Dr. Alexander Sandhu, Center for Health Policy and Primary Care and Outcomes Research, 117 Encina Commons, Stanford University, Stanford, California 94305.
Objectives This study aimed to evaluate the cost-effectiveness of the CardioMEMS (CardioMEMS Heart Failure System, St Jude Medical Inc, Atlanta, Georgia) device in patients with chronic heart failure.
Background The CardioMEMS device, an implantable pulmonary artery pressure monitor, was shown to reduce hospitalizations for heart failure and improve quality of life in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) trial.
Methods We developed a Markov model to determine the hospitalization, survival, quality of life, cost, and incremental cost-effectiveness ratio of CardioMEMS implantation compared with usual care among a CHAMPION trial cohort of patients with heart failure. We obtained event rates and utilities from published trial data; we used costs from literature estimates and Medicare reimbursement data. We performed subgroup analyses of preserved and reduced ejection fraction and an exploratory analysis in a lower-risk cohort on the basis of the CHARM (Candesartan in Heart failure: Reduction in Mortality and Morbidity) trials.
Results CardioMEMS reduced lifetime hospitalizations (2.18 vs. 3.12), increased quality-adjusted life-years (QALYs) (2.74 vs. 2.46), and increased costs ($176,648 vs. $156,569), thus yielding a cost of $71,462 per QALY gained and $48,054 per life-year gained. The cost per QALY gained was $82,301 in patients with reduced ejection fraction and $47,768 in those with preserved ejection fraction. In the lower-risk CHARM cohort, the device would need to reduce hospitalizations for heart failure by 41% to cost <$100,000 per QALY gained. The cost-effectiveness was most sensitive to the device's durability.
Conclusions In populations similar to that of the CHAMPION trial, the CardioMEMS device is cost-effective if the trial effectiveness is sustained over long periods. Post-marketing surveillance data on durability will further clarify its value.
The treatment of heart failure costs more than $20.9 billion in total health care expenditures (1). Most of these costs are incurred from treating clinical decompensations of patients with heart failure that result in more than 1 million hospital admissions annually (1,2). The CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) trial, a randomized, single-blinded, multicenter trial, investigated the use of an implantable, wireless pulmonary artery pressure monitoring system to decrease hospitalizations related to heart failure (3). In this study, 550 patients with New York Heart Association (NYHA) functional class III heart failure and a hospitalization for heart failure within the previous year underwent pulmonary artery sensor implantation. Patients were randomized to a treatment group in which providers were given access to the pressure readings or a control group in which the provider could not access the pressure readings. The treatment group was found to have fewer hospitalizations for heart failure and improved quality of life.
Newer management strategies such as CardioMEMS (CardioMEMS Heart Failure System, St. Jude Medical Inc., Atlanta, Georgia) that reduce costly hospitalizations for heart failure may decrease the substantial clinical and economic burden of heart failure. However, the high device cost (listed as $17,750 with Medicare) raises questions regarding its value (4). We performed an independent analysis of the cost-effectiveness of this device in a cohort on the basis of the trial, as well as in subgroups defined by ejection fraction. Additionally, we performed an exploratory analysis of the device in an alternative, larger trial-based cohort of patients with heart failure by using the CHARM (Candesartan in Heart failure: Reduction in Mortality and Morbidity) trials (5).
Decision model
We developed a Markov model to determine the cost-effectiveness of the CardioMEMS device compared with usual care from a societal perspective in a CHAMPION trial cohort over a lifetime horizon. This cohort included adults (average age 62 years) with NYHA functional class III heart failure who were hospitalized within 1 year with preserved ejection fraction (21.7%) or reduced ejection fraction (78.3%). We used hospitalization and mortality rates from the CHAMPION trial (3). We performed subgroup analyses of cohorts with reduced ejection fraction (average age 60 years) and with preserved ejection fraction (average age 66 years) from the CHAMPION trial by using overall trial event rates and subgroup-specific rate ratios for each event from trials with larger sample sizes than CHAMPION (6–9). Subgroup-specific device efficacy was extracted from the CHAMPION trial (3).
In the model, patients had CardioMEMS device placement at the outset, which could involve a procedural complication or device deployment failure. In subsequent monthly intervals, patients could experience hospitalizations for heart failure, hospitalizations not related to heart failure, device complications, and all-cause mortality (Online Figure 1). Patients had an increased mortality risk during hospitalization for heart failure and for 2 months post-hospitalization. The model followed all patients over their lifetimes. We matched the mortality rates over the mean duration of the trial for the control arm of the CHAMPION trial (17 months). After the trial period of 17 months, all event rates are extrapolated. We extrapolated an age-based increase in overall mortality from a previous retrospective analysis (10).
Rate of hospitalization for heart failure and efficacy of the cardiomems device
We matched the trial rates of hospitalizations secondary to heart failure for each cohort. We modeled a declining rate of hospitalization over the CHAMPION trial duration. We modeled the CardioMEMS reduction in the rate of hospitalizations for heart failure on the reduction over the entire trial (hazard ratio [HR]: 0.63). We assumed that preventing a hospitalization prevented inpatient and 2-month post-hospitalization increases in mortality (11–13). We did not model any additional CardioMEMS-associated mortality reduction in the base case. For our base case, we assumed that the benefit of the CardioMEMS device would continue lifelong and examined shorter durations in sensitivity analyses.
Cardiomems device events
We modeled periprocedural complications as a composite of the procedure-related serious adverse events and major bleeding during the 30-day post-procedure anticoagulation period (3). We additionally modeled procedural placement failure and CardioMEMS-related serious adverse events that occurred after the initial month.
Quality of life and costs
We included quality of life estimates for the patient's baseline health, the use of the CardioMEMS device, hospitalizations, and complications by using utilities. We calculated utility values by converting the 6-month Minnesota Living with Heart Failure (MLWHF) questionnaire score for the control arm in the CHAMPION trial into EQ-5D scores (14). The difference-in-difference in EQ-5D score between groups from baseline to 6 months was applied as the quality of life benefit for the CardioMEMS device for the first year. The difference-in-difference between groups from baseline to 12 months was applied thereafter. The 6-month differences were used for the entire first year because 226 of 550 patient scores were missing at 12 months. Disutilities were applied for the initial procedure, hospitalizations, and complications. Comparisons of patient utility during and after a hospitalization for heart failure showed an 11% lower utility during hospitalization, for a decrement of approximately 3 days (15). These assumptions were tested in sensitivity analyses, including an analysis in which we alternatively assumed long-term utility change secondary to hospitalizations for heart failure (16).
We included all health care–related costs. Hospitalization costs were taken from the Agency for Healthcare Research and Quality (AHRQ) National Inpatient Sample (17), with physician costs calculated using the 2014 Medicare Professional Fees (Current Professional Technologies [CPT] codes 99212, 992213, 99222, 99223, 99254, and 99255) (18). Age-adjusted outpatient medical costs for patients with heart failure were taken from the literature (2). The cost of CardioMEMS implantation, in addition to the device cost, is the cost of the right-sided heart catheterization and angiography ($1,129) (from base Medicare 2014 Professional Fees, CPT codes 93451 and 93568) along with the fee for device placement, currently an unlisted fee, which we assumed would approximate the cost of inserting a temporary single-chamber cardiac electrode ($185, Medicare CPT 33210) (18,19). This assumption was made on the basis of selecting reimbursement for a simple intracardiac procedure, given that this is additional to catheterization and angiography reimbursement. We based the monthly cost of CardioMEMS management on the estimated time required to monitor the device by physicians and nurses and average provider wage ([20,21], Klein L, personal communication, November 2015). All costs were updated to 2014 U.S. dollars by using the medical component of the consumer price index (22).
Sensitivity analyses
We evaluated the effect of uncertainty in all model inputs (Table 1). We focused on device-specific uncertainties and characteristics of the patient population. Given the single clinical trial currently available, we varied estimates of the efficacy of the device extensively by adjusting the reduction in hospitalizations, the effect of the device on mortality, the effect on quality of life, and the duration of the device's effectiveness. With its recent market introduction, we also varied the costs of the device, implantation, and monitoring substantially. Given the large heterogeneous heart failure population, we also conducted analyses on a range of hospitalization costs, baseline utility values, and baseline hospitalization and mortality rates. This included an exploratory analysis of the intervention in a cohort on the basis of the CHARM trials, which was a lower-risk cohort with greater quality of life and lower event rates. This cohort included adults (average age 62 years) with NYHA functional class II (45%), class III (52%), and class IV (3%) heart failure, as opposed to patients in CHAMPION, who exclusively had NYHA functional Class III disease. We used published CHARM trial data to estimate hospitalization and mortality rates along with utility scores (5,6,23). We adjusted the rates to match the ejection fraction subgroup composition of the CHAMPION cohort and to include only patients with a previous hospitalization for heart failure. We estimated the device effectiveness needed to meet important cost-effectiveness thresholds in this cohort.
We performed a probabilistic sensitivity analysis by performing 10,000 simulations in which we simultaneously sampled from the distributions of each input parameter with each simulation (see the Online Appendix for details).
We discounted future costs and benefits at 3% annually and adhered to best practices (24,25). The main outcome measure was cost per QALY gained. Cost-effectiveness thresholds followed American College of Cardiology/American Heart Association (ACC/AHA) guidelines, with a threshold of <$50,000 indicating highly cost-effective and than >$150,000 not cost-effective (26).
Comparison with the CHAMPION trial results
In the first 6 months, modeled rates of hospitalizations per patient for the usual care and intervention groups of 0.44 and 0.29, respectively, matched those of the CHAMPION trial 0.44 (95% confidence interval [CI]: 0.36 to 0.53) and 0.32 (95% CI: 0.26 to 0.40). The modeled annual rates over the mean trial period for the 2 groups were 0.68 and 0.45, respectively, matching trial results of 0.69 (95% CI: 0.61 to 0.78) and 0.46 (95% CI: 0.40 to 0.53). The modeled annual mortality probabilities over the mean trial period for the usual care and intervention groups were 14.8% and 13.2%, respectively, matching the trial's 14.7% (95% CI: 11.7 to 17.9) and 11.9% (95% CI: 9.5 to 16.3). Further details are included in the Online Appendix.
Base case
In the CHAMPION trial cohort, the modeled CardioMEMS arm has a total of 2.18 hospitalizations per patient compared with 3.12 in the usual care arm of the trial, an absolute reduction of 0.94 hospitalizations over a patient's lifetime (Table 2). The CardioMEMS arm increased life expectancy by 0.42 years and quality-adjusted life expectancy by 0.28 QALYs. The CardioMEMS arm achieved its health benefits at an increased cost of $20,079. Taken together, the CardioMEMS intervention costs $71,462 per QALY gained or $48,054 per life-year gained.
Ejection fraction subgroups
Patients receiving usual care in the preserved ejection fraction subgroup had a longer average survival than did patients in the reduced ejection fraction subgroup (Table 2). The reduction in hospitalizations with CardioMEMS was greater for patients with preserved ejection fraction compared with those with reduced ejection fraction, which also resulted in lower incremental costs. With more QALYs gained and a smaller difference in costs, CardioMEMS cost $47,768 per QALY gained in the preserved ejection fraction cohort compared with $82,301 in the reduced ejection fraction cohort.
The base case used a device cost of $17,750. The device cost <$50,000 per QALY gained if the cost is <$9,798 in patients with reduced ejection fraction and <$18,657 in patients with preserved ejection fraction (Figure 1). Use of the device would cost more than $150,000 per QALY gained if it cost more than $34,418 in the reduced ejection fraction subgroup or $59,296 in the preserved ejection fraction subgroup. The cost of a hospitalization for heart failure ($12,832) was determined on the basis of the national average; however, there is significant hospital variation. In a large, urban, public teaching hospital with a higher predicted cost of hospitalization ($16,750), the CardioMEMS device costs $62,121 per QALY gained. In a small, rural, private nonteaching hospital with lower predicted costs of hospitalization ($8,341) the device cost becomes less favorable, $82,169 per QALY gained (Figure 2).
In the base case, we assumed a monthly cost of $68 to monitor the CardioMEMS device. This cost would need to be <$190 monthly for the device to cost <$100,000 per QALY and <$403 monthly for a cost lower than $150,000 per QALY.
Device efficacy
The efficacy of the CardioMEMS device is modeled by reduction in hospitalizations, the risk of mortality associated with hospitalizations, and the effect on baseline quality of life. Although CardioMEMS had a 0.63 HR for hospitalizations over the entire randomized period of the CHAMPIONS trial, the 95% CI was 0.52 to 0.77. Over this range, CardioMEMS costs between $52,556 and $120,143 per QALY gained. The effect of the CardioMEMS device on mortality is uncertain. In the base case, we assumed that prevented hospitalizations had an inpatient mortality risk similar to all hospitalizations for heart failure and that preventing these hospitalizations would also avert the associated increase in post-hospitalization mortality, which led to an 11% relative reduction in mortality in the CardioMEMS arm compared with usual care over the trial period. If we had instead assumed a 20% relative reduction, the value of the CardioMEMS device would improve to $55,378 per QALY gained. However, if preventing hospitalizations did not reduce mortality, the cost would be $159,984 per QALY gained. For the device to cost <$100,000 per QALY gained, the relative reduction in mortality must be at least 4%.
Although the CHAMPION trial followed patients for 17 months on average, we assumed a lifelong duration. If the effectiveness of the CardioMEMS device ceased after 17 months, its cost per QALY gained was $214,879. Cost per QALY gained declined as the duration of effectiveness increased, dropping for heart failure <$150,000 at 34 months and $100,000 at 72 months. In 2-way sensitivity analyses, we found that the device is much less cost-effective if its duration of effect is shorter in populations with lower monthly hospitalization rates (Figure 3).
Adjusting the periprocedural complication rate, chronic complication rate, or placement failure rate did not substantially alter our findings (see the Online Appendix).
The impact of the CardioMEMS device on quality of life did not substantially change our main findings (see the Online Appendix). Neither alternative assumptions of baseline utility nor duration of disutility from hospitalization substantially altered our results (see the Online Appendix). Adjusting long-term baseline utility on the basis of the number of heart failure hospitalizations also did not substantially affect our findings (see the Online Appendix).
Severity of illness
Baseline rates of hospitalization and mortality matched trial rates. However, individual health care systems will have heterogeneous patient groups with different rates of readmission and mortality. We found that decreases in the hospitalization rate and increases in the mortality rate both increased the cost per QALY of CardioMEMS, but the cost did not exceed $150,000 per QALY gained (Online Figure 2).
In the CHARM cohort, the usual care arm of the trial had greater survival (7.9 years), more QALYs (4.67), and fewer hospitalizations for heart failure (1.71) compared with the CHAMPION cohort. If the device had a similar effect on quality of life in the CHARM cohort as in the CHAMPION trial, the device would need to prevent 26.5% of hospitalizations for heart failure to cost <$150,000 per QALY gained and 41.1% to cost <$100,000 per QALY gained (Online Figure 3).
Time horizon
In the base case, we used a lifetime horizon. Over a 5-year horizon, which was used in the trial cost-effectiveness, we found a $15,029 difference in costs and a 0.11 difference in QALYs, yielding a cost of $138,466 per QALY gained (Online Figure 4).
Probabilistic sensitivity analysis
In the probabilistic sensitivity analysis, we found that 17.3% of simulations showed that CardioMEMS was the preferred intervention at a willingness-to-pay threshold of $50,000, 76.9% at a threshold of $100,000, and 95.1% at a threshold of $150,000 (Online Figure 5). Additional sensitivity analyses are available in the Online Appendix.
Our analysis demonstrates that the use of the CardioMEMS device is cost-effective in patients with NYHA functional class III heart failure and a history of hospitalization for heart failure in the preceding year. Our base case analysis finds a cost of $71,462 per QALY gained in a CHAMPION trial population. The device value is most sensitive to its durability and the association between the reduction in hospitalizations and survival. The device must provide benefits over at least 34 months to cost <$150,000 per QALY. With randomized data of 17 months and open-access data for an additional 13 months, the device's effectiveness over a longer period is unknown. Although hospitalizations for heart failure are associated with an increased mortality risk, it is unclear how preventing hospitalizations with CardioMEMS affects survival. The CHAMPION trial was underpowered to detect a mortality difference; a survival analysis submitted to the Food and Drug Administration demonstrated substantial uncertainty (HR: 0.8; 95% CI: 0.55 to 1.15) (27). We demonstrate that the device would need to reduce mortality by 4% to cost <$100,000 per QALY. Although this seems likely, it is possible that prevented hospitalizations may be lower risk, and mortality may be relatively unaffected. Future studies that follow hospitalization trends and refine estimates of the effect of the device on mortality can reduce the uncertainty regarding its clinical and economic value.
Our analysis indicates that the CardioMEMS device provides better value in patients with preserved ejection fraction. There are few evidence-based treatments available for patients with preserved ejection fraction; thus, the CardioMEMS device represents a rare evidence-supported intervention for this important group. Our model predicted greater value in this group because of the longer survival and increased device effectiveness in this group; however, the estimate of effectiveness in this group is made on the basis of only 119 trial patients and should also be refined with future research.
The incremental cost-effectiveness ratio found in the CHAMPION trial was more favorable than our estimate (3). The CHAMPION study, performed over a 5-year time horizon, found a larger difference in QALYs and a much smaller cost difference between the 2 trial arms ($4,282) to lead to an incremental cost-effectiveness of $13,379 per QALY. We do not have access to their assumptions to analyze these differences. The lifetime horizon used in our model captures longer-term benefits and costs and the impact of device durability.
The importance of the CardioMEMS device is tied to the scope of the problem. Health care expenditures secondary to heart failure are expected to rise from $20.9 billion in 2012 to $53.1 billion in 2030, with 80% of these costs attributed to hospitalizations for heart failure (28). These hospitalizations not only are costly but also are markers of a worsening clinical prognosis, associated with high rates of rehospitalization and mortality. Strategies to reduce this clinical and economic burden are needed. We demonstrate that the CardioMEMS device may be a cost-effective intervention for outpatient management of heart failure. However, our analysis also shows that the savings from reduction in hospitalization costs are exceeded by the intervention costs, which could thereby still have a large budgetary impact. We also illustrate that the value decreases in lower-risk patients; with the substantial heterogeneity in morbidity of patients with heart failure, ensuring that patients fit the trial criteria will be important. Although CardioMEMS implantation is a costly intervention that should be reserved for appropriately selected patients and still requires further evaluation, the value of this device compares favorably with that of other technologies used in similar patient groups, such as left ventricular assist devices (29).
Study limitations
First, a single trial has evaluated the intervention; the effectiveness seen in this trial should be confirmed in post-surveillance evaluation. Second, there may be treatment benefits that are not captured in our model, such as identifying patients who need to initiate advanced therapy. Third, although no serious device-related complications occurred outside of the procedural period, long-term safety data are not currently available. Finally, we attempted to capture additional costs of using the device by using the time required at a heart failure center, but the average national cost of the monitoring program is currently unclear.
This analysis shows that the use of the CardioMEMS device is a cost-effective means of improving quality of life and reducing rehospitalizations in patients with heart failure. It is a better value in patients with preserved ejection fraction, a group with few effective therapies. The cost-effectiveness of CardioMEMS is most sensitive to the duration of effectiveness; therefore, further research on the continued hospitalization trends of patients with the device will be important for future evaluations.
COMPETENCY IN MEDICAL KNOWLEDGE: In patients with NYHA functional class III heart failure and a hospitalization for heart failure in the preceding year, the CardioMEMS device reduced readmissions for heart failure and improved quality of life at a cost lower than commonly accepted U.S. willingness-to-pay thresholds. The device was cost-effective for both patients with reduced ejection fraction and preserved ejection fraction.
TRANSLATIONAL OUTLOOK: The clinical effectiveness of the device has been demonstrated only in a single randomized clinical trial with a mean follow-up of 17 months. Evaluation of the long-term rate of hospitalization for heart failure and the relationship between averted hospitalizations and changes in mortality in patients after CardioMEMS implantation will refine estimates of the value of the device. Additional data on the cost of maintaining and monitoring the device in the community will also inform future economic evaluations.
The authors thank Iris H. Ma, MD for her thoughtful comments on the manuscript draft.
For supplemental text, figures, tables, and references, please see the online version of this article.
This study was also supported in part by the Department of Veterans Affairs Quality Enhancement and Research Initiative 04-326. Drs. Sandhu, Owens, Turakhia, Kaiser, and Heidenreich were supported by the Department of Veteran Affairs. Dr. Goldhaber-Fiebert is supported by a National Institute of Health (NIH) NIA Career Development Award (K01 AG037593-01A1: PI: Goldhaber-Fiebert). Dr. Turakhia has consulted for St. Jude Medical, Medtronic, and Precision Health Economics. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Abbreviations and Acronyms
- New York Heart Association
- quality-adjusted life year
- Received October 1, 2015.
- Revision received December 11, 2015.
- Accepted December 22, 2015.
- American College of Cardiology Foundation
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- ↵Center for Medicare and Medicaid. Physician Fee Schedule. 2015. Available at: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/index.html?redirect=/PhysicianFeeSched/. Accessed January 5, 2016.
- St. Jude Medical. St. Jude Medical Reimbursement Guide. 2015. Available at: http://professional.sjm.com/resources/reimbursement/crm-ep/cardiomems. Accessed March 1, 2015.
- ↵
- Medical Group Management Association
- Occupational Employment Statistics. Occupational Employment and Wages, May 2014, 29–1141 Registered Nurses. Available at: http://www.bls.gov/oes/current/oes291141.htm. Accessed November 20, 2015.
- ↵United States Department of Labor, Bureau of Labor Statistics. Consumer Price Index. Available at: www.bls.gov/cpi. Accessed January 5, 2016.
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- Gold M.R.
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- ISPOR-SMDM Modeling Good Research Practices Task Force-1
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- ↵Food and Drug Administration. PMA P100045: FDA Summary of Safety and Effectiveness Data. 2015. Available at: http://www.accessdata.fda.gov/cdrh_docs/pdf10/P100045b.pdf. Accessed February 2, 2015.
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- Heidenreich P.A.,
- Albert N.M.,
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- Guglin M.,
- Rogers J.


text:
Overview of cryogenic valves
Overview of cryogenic valves:
The utility model is suitable for a valve which is suitable for medium temperature -40 DEG C to -196 DEG C and is called a low temperature valve.
Low temperature valve ball valve, gate valve, including low temperature low temperature, low temperature valve safety valve, cryogenic valve, cryogenic valve, cryogenic valve, cryogenic throttle valve, cryogenic valve, mainly for ethylene, liquefied natural gas plant, natural gas storage tank LNG LPG, receiving the base and the WeiXing Railway Station, air separation equipment, petrochemical gas separation equipment, liquid oxygen, liquid nitrogen, liquid argon, carbon dioxide cryogenic tank and tank, pressure swing adsorption device etc.. Output temperature of the liquid medium such as ethylene, oxygen, hydrogen, liquefied natural gas, liquefied petroleum products, not only flammable, but when the temperature gasification, gasification, the volume expansion of hundreds of times.
Liquefied natural gas valve material is very important, the material is not qualified, will cause the shell and sealing surface leakage or leakage; parts of the comprehensive mechanical properties, strength and steel can not meet the use requirements and even fracture. Liquefied natural gas leakage caused explosion. Therefore, in the development, design, development of liquefied natural gas valve process, the material is the first key issue.
After years of manufacturing, has accumulated a wealth of experience, from design, technology to manufacturing matures, and has developed a series of low-temperature valve products.
First, cryogenic valve product specifications and design parameters:
1 pressure level: 150, 300, 600Lb, 900LB, 1500LB (45MPa)
2 valve diameter: 15 ~ 1200 mm (1/2 ~ 48). 3 connection form: flange type, welding type, thread.
4 valve material: LCB, LC3, CF8.
5 working temperature: -46 centigrade, -101, -196 C, -253 C
6 applicable medium: liquefied natural gas, ethylene, propylene, etc..
7 drive: manual, bevel gear transmission, electric.
Two, cryogenic valve standards and product structure:
1 Design: API6D, JB/T7749
2 valve routine inspection and test: according to API598 standard.
3 valve low temperature inspection and test: press JB/T7749.
4 drive: manual, bevel gear transmission and electric drive device.
5 seat form: seat welded structure, sealing surface welding cobalt based carbide, to ensure the sealing performance of the valve.
6 the gate adopts elastic structure and the pressure relief hole is designed at the inlet end.
7 one-way sealed valve body marked with flow mark.
8 low temperature ball valve, globe valve, butterfly valve with long neck structure, in order to protect the filler.
9 ultra low temperature ball valve standard: JB/T8861-2004
Three, cryogenic valve material selection:
1 body, valve cover: LCB (-46 C), LC3 (-101 C), CF8 (304) (-196 C)
2 Gate: stainless steel surfacing cobalt base cemented carbide
3 seat: stainless steel surfacing cobalt base cemented carbide
4 stem: 0Cr18Ni9
Four, cryogenic valve manufacturing and testing:
Former Ze on the production of low temperature valve developed a strict manufacturing process and the use of special equipment, parts processing strict quality control. After low temperature treatment, the cooling medium parts into rough machining in a few hours (2-6 hours), to release the stress, to ensure the low temperature properties of materials, ensure the finishing size, to prevent the valve in the low temperature conditions, due to the temperature change caused by the deformation caused by leakage. Valve assembly and ordinary valves are different, parts need to undergo strict cleaning, remove any oil to ensure the use of performance.
Five, cryogenic valve test equipment:
1 low temperature valve test device
2 liquid nitrogen storage device
3 cryogenic treatment tank
4 low temperature test-bed to ensure the performance of the valve under low temperature conditions
5 other
Six, cryogenic valve test and inspection:
Low temperature valve for the main parts and low temperature treatment for each batch of sampling impact test to ensure that the valve does not crack at low temperature conditions, withstand low temperature medium impact.
The following tests are performed on each valve:
1 normal temperature shell strength test;
2 sealing test at normal temperature and low pressure;
3 low temperature and low pressure sealing test;
4 low temperature seal tightness test (with seal);
5 low temperature gas seal test to ensure that the whole cryogenic valve meet the standard requirements;
6 low temperature valve for the main parts and low temperature treatment for each batch of sampling impact test to ensure that the valve at low temperature conditions do not brittle crack, withstand low temperature medium impact;
7 low-temperature (cryogenic) valves were treated for hypothermia and impact test according to the corresponding material specification
8 engage in electrostatic function is more powerful, the valve body and stem or internal parts and the valve between the conduction resistance of less than 1 ohms.
Other parameters of cryogenic valve:
Body light, small size.
In order to reduce the heat loss of the valve body, especially in order to ensure the use of ultra-low temperature valve, specially designed into light weight, small size of the valve body. A low temperature fluid flowing through the valve shaft of the valve, the valve stem long form, can avoid the external heat of the gland is maintained at room temperature, to prevent lower lid seal performance. This length is the best length calculated and tested.
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text:
A standard policy insures the home itself and the things you keep in it.
Insurance protects you against loss if you have an accident.
Discover the perfect insurance options to meet your specific and unique needs.
Browse a variety of insurance options in order to find the right one for you.
Learn about different coverage options that fit your specific needs.
Finding insurance doesn't have to be difficult. We do the work for you.
Jeremy has been with Lone Star Insurance Agency since October 2018. He enjoys helping people and holds a license in Property & Casualty insurance.


text:
Sales and Marketing contact:
+91 75063-45599
9:30 AM - 6:30 PM (Monday - Friday)
Service and Technical support:
The term "cartoning machine" refers to a type of machine primarily designed for forming a carton, inserting the product and then closing the carton, which may be by flap insertion or by gluing. It is part of the larger family of forming-filling-closing machinery. It can be implemented in a fully or partially automated process.
The carton sealer is a packaging machine that can seal cartons semi- or fully automatically. Here, the carton sealer closes the carton not only by the folding the cover, but also when necessary, by using adhesive tape.
Call Videojet For:
Sales: +91 75063-45599
Service Support: 1800-103-4812
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Industry Insight: To Stop Newspapers' Slide, Empower Local Publishers
Here's a candidate for one accelerating tactic by big newspaper chains that appears to only make things worse: The elimination of local publishers.
The theory is that companies have built corporate leadership teams specializing in the different sectors of the business—advertising, circulation, news—and don't need the additional overhead of a well-paid manager pulling them together in every local market.
Instead, you increasingly see regional publishers in charge of three, four, even a dozen daily newspaper markets. The manager-to-staff ratio probably isn't that much different, considering how many newsroom and production jobs that have been cut over the past 10 years.
Tronc went even further in 2016, deciding it didn't need publishers at all. Across the board, it eliminated that layer, elevating the editor of each of its daily newspapers to an editor/publisher role, even though many had little to no background in the non-news portions of the business.
In August, after a year of plummeting print ad revenue and stalled digital growth, Tronc reversed course, at least in the case of the Los Angeles Times. It restored the publisher role there and hired former Yahoo interim CEO Ross Levinsohn.
An obvious concern in eliminating local publishers is that there's "no one home" in the communities you are serving—no one attending Chamber of Commerce dinners or being a member of the Rotary Club. If that sounds quaint and outdated, consider the mountains of evidence that community and reader engagement are key to digital transformation and reinventing newspapers' business models. Of course, that engagement is about a lot more than sending a suit to a chamber event. More on that in a minute.
But there are other major problems with the loss of local leadership.
It leads to corporate solutions for problems that don't exist. The forced rollout of products that won't work in a given local market, for example, or company-wide homogenization of content and design until local identity is erased. Before Gannett rolled out its USA Today insert into dailies across the country, who were the local publishers or editors saying that "more national news" was a top priority for their readers?
At the same time, local problems fester. Sure, the advertising, circulation and news staffs can report up to very talented corporate specialists in those areas, but what if the new newspaper business model requires native advertising and sponsored content solutions for local businesses? What if a reader revenue model can't be marketed and sold in the same way print subscriptions were and requires full partnership with the newsroom to pull off? Who will lead the staff in the changed thinking and through the ethical minefields inherent in this kind of transition?
Local publishers aren't necessary, one could argue, if a company views newspapers as fast food franchises: a single recipe, branding, marketing, and customer interface that they think will work in any community in the country. But good luck with that. Local news isn't fast food. And building trust and loyalty among readers and advertisers requires listening and treating a community as partners in what you do, not just as consumers.
But the alternative approach must go beyond simply restoring local publisher positions. One might as well save the money if you don't truly believe in engaging with local communities and building unique business models that serve them well.
And a difficult point of discussion is whether the specific people who operated under the old way are capable of being publishers who are empowered to engage the community and reinvent the business.
The newspaper industry's worsening financial results should cause companies to hit the reset button and reinvest in the job of local publisher. But it needs a new crop of leaders with a different set of skills and more diverse backgrounds.
If engagement with the community is paramount, we need publishers who are a part of, understand and look like the community. There's a strong argument to be made that community organizing is a more relevant background for the modern publisher than advertising sales.
We also need publishers with digital in their DNA, and we need to develop people on the news side with entrepreneurial skills and business knowledge, whether they become publishers or not.
Matt DeRienzo is executive director of LION Publishers, an organization that supports local independent online news publishers from across the country. He is a longtime former newspaper reporter, editor, publisher and corporate director of news.


text:
Combine a cookie of your liking and choose from an incredibly delicious list of ice cream flavors and create your own artisinal ice cream sandwiches at Cool Haus.
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text:
Rosemary water can help us reduce all those spots and redness that come out because of the cold or hormonal changes
Perfect, healthy, soft skin without imperfections on the face is the dream of many women . Sometimes we spend high amounts of money on beauty treatments that do not always offer us the expected result.
Do not worry, we give you simple and cheap skin remedies that you will love. They are very quick to prepare and you will find the ingredients without problems.
Tips to get perfect skin
As you know, our skin is also the reflection of our health. A skin without redness, well hydrated and with elasticity is a reflection of proper nutritionwhere we do not lack the right vitamins and minerals.
But it is not always easy to achieve that perfect skin, because of the effect of the weather, the sun, the wind or those hormonal changes that cause us small accesses of acne. Without a doubt, all this muddles that balance we all want to show off beautiful and healthy skin.
But do not worry, we will explain simple remedies for that day to day. By this we do not mean at all that you dispense with your usual creams . These remedies are a way to complement your beauty treatments in a simple and economical way. Let's go there.
1. Oatmeal and bicarbonate scrub
Indicated to do it once a week, no more. And what will we get? A luminous skin, young and without impurities. We will clean the complexion of dead cells, also activating its circulation. It is an easy and free remedy for any chemical agent, a suitable way to treat your skin and work it to surface your natural beauty.
To prepare it you need only two tablespoons of oatmeal, one of baking soda and a little water . You just have to mix everything, getting a kind of cream. The important thing is that there is a thick paste that we can apply on the skin.
Once applied, get a circular massage to exfoliate and remove dead cells, for at least 15 minutes. Then rinse with warm water. You will see how well you are doing!
2. Facial tonic with green tea
Very suitable to do in the morning or at night , thus cleaning our skin very well and promoting circulation.
We have only to prepare a cup of green tea, with two sachets. Once it has boiled and rested, put it in the refrigerator for a little while. When it is cold we take a cotton ball and we pass it through all the skin of the face , you will notice an immediate relief and the most toned skin.
3. How to eliminate redness
Sometimes we get small spots, redness that appear with seasonal changes, with cold or small hormonal changes. Nothing happens, we can solve it with a simple remedy based on honey and rosemary water . It is wonderful to reduce inflammation, treat, cure and regenerate.
No tienes más que hacer una infusión con tres ramas de romero con medio vaso de agua. Deja que llegue a ebullición y añade tres cucharadas de miel.
Cuando aún esté tibio -no caliente- aplícatelo con un algodón o una pequeña compresa en el rostro, dejando que actúe al menos durante 15 minutos. Después, enjuaga con agua y aplícate una crema hidratante. Te irá muy bien.
4. Tratamiento para los puntos negros
Who doesn't have any areas of the face with black dots ? In the nose above all, it is something normal and something that we always try to fight from a young age. Well, an ideal way to eliminate them little by little is a simple treatment based on natural yogurt and lemon .
No, you don't need more than two tablespoons of plain yogurt and one of lemon juice. We make a very homogeneous mixture and apply it in that most critical area . Leave on for about 20 minutes and then rinse with plenty of water. If you do it every night it will help you to have perfect skin. You should always use sunscreen.
5. Remove and relieve small facial scars
Sometimes, the acne leaves us those classic signals that do not go over time. Wounds that leave scars, skin imperfections that we usually hide with makeup and that bother us so much. How to soften them? What to do so that they disappear little by little?
An ideal treatment is rosehip oil . You can easily find it in natural stores and even perfumeries. It is not very expensive and you can find both creams, like the classic rosehip oil.
You only have to apply this treatment with cotton every day , making a small massage to reactivate the circulation and thus getting the oil to reach the epidermis well. You will notice how the scars are attenuated.
Remember that these treatments to show perfect skin will be effective if we are constant. Even the most expensive creams usually have these natural principles , so we can take advantage of these chemical-free tributes that our ancestors have used since ancient times. You will tell us!


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Here's what made my whole year:
I took my 2nd UY challenge of the year - the Bikini Body Challenge. A 6-week program for UY members. Mine kicked off on the 11th of July to the 20th of August. With every batch of the BBC, there's only < 20 girls at one time, so the number is small but the focus is high and intense.
Unlike the 9in6, you're meant to do 5 group classes, 5 days a week; focusing on cardio and building your cardiovascular health. The BBC includes 5 days of weight training and a strict diet of carb cycling with the usual high protein and lots of veggies. With a focus on strengthening and toning your muscle groups.
You pay a little fee of $700+ and you get 6 weeks worth of training program, weekly updates with Andrea who's our mentor for the challenge, access to the BBC facebook group and at the last week of the challenge, you get a little fun photo shoot with the rest of the girls in your group.
After your shoot is done and dusted - Andrea and the rest of UY coaches will choose a winner and prize them with $500 cash prize, for the best transformation mentally and physically.
When I found out about winning the BBC, it was on Eid al-Adha and I was finishing my essay. I was OVER THE MOON, jumping up and down. Smiling from ear to ear.
With Peter the photographer extraordinaire who is also a UY member!!! He is so nice and funny - made the shoot lots of fun for everyone.


text: We are Jasmine Sharp and Jenna Honey from King Edward VI Community College in Totnes. This week we were lucky enough to get a work experience placement at Plymouth University's School of Psychology with Jackie Andrade and Jon May. It started with a train ride at 9 o'clock from Totnes each morning from where we… Continue reading Our work experience


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The Vidyard Chrome extension allows you to create and share videos with your customers, prospects, and colleagues—all in just a few clicks.
You can also embed videos from your library on your website (or any application that allows you to add javascript to a webpage).
Simply copy the embed code for a video and paste it into the source code of your page.
If you have free Vidyard account, you can only embed individual videos—not playlists. Upgrade to a paid plan to embed playlists.
- You must have a Vidyard account
Select a video from your library
- Click on the Vidyard extension in the top, right-corner of your browser
- Click on the Videos tab, then select Go to Library
- Hover over the video you want to embed, then click Share
Copy the video embed code
With Vidyard Free and Pro accounts, you can only make a limited number of videos embeddable (5 and 20 embeds respectively). Upgrade your account to increase the number of videos you can embed.
- Click on the Copy embed code button
- If you have a free Vidyard account, toggle the embed option ON to make the video 1 of your 5 embeddable videos.
- Paste the javascript embed into the source code of your webpage or application


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'Bongo bongo land' slur MEP Godfrey Bloom stormed out of a TV interview saying he 'couldn't be bothered with it'.
The UKIP member was asked repeatedly on Channel 4 news about his claims that foreign aid is spent on 'Ray-Ban sunglasses, apartments and Ferraris'.
As he removed his microphones, Mr Bloom said: 'If you're not going to talk about serious issues, there's no point in continuing. Sorry, off you go. I can't be bothered with it.'
MORE: MEP Godfrey Bloom given free bongos after controversial remarks
Earlier, Mr Bloom, who holds the Yorkshire and North Lincolnshire seat, apologised for any 'genuine offence' over his remarks about the £1billion a month of aid being sent to 'bongo bongo land'.
At first, he refused to say sorry for the comment but he later issued a statement saying: 'I used a term which I gather could be interpreted as pejorative to individuals and possibly cause offence. Although quite clearly no such personal usage was intended, I understand from party chair Steve Crowther and leader Nigel Farage that I must not use the terminology in future.'
He earlier offered to apologise to the 'ambassador of bongo bongo land' in person.
BLOG: Godfrey Bloom tries to shock with 'bongo bongo land' remark – but remains repetitive


text: This subtle, fresh Cherry Rosé Cider blossomed among the twisted grape vines and pink sunsets of the Yarra Valley. 100% hand-picked Australian cherries, delicately blended to perfection, result in a pale blush cider, perfect for sipping slowly. Inspired by Rosé wine - gently swirl over ice and drink in the taste of the orchard.


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Efficient project management is crucial for the architect and construction business. Check out the software that helps build necessary procedures and analyze business data.
Architects' work is traditionally focused on accuracy and precision: avoiding calculation errors, being important in any activity, is vital in architecture. This is true for both creating models and for organizing work process. That is why digital tools that automate routine processes are being increasingly adopted by architecture bureaus and used in their workflows.
Software solutions not only help prevent employees from errors and inaccuracy: they also save valuable time and help properly organize work in any circumstances. Working on complex projects, finding individual solutions for clients, working from remote locations – all this involves using special tools that make work process more convenient and effortless. Here's a list of must-have digital tools for architects that simplify specific tasks and entire workflows for architect bureaus and self-employed specialists.
ARCHICAD is a building design suite that provides different tools for architects and designers. It includes all essential building information modeling (BIM) functions, such as 2D and 3D drafting, modeling, visualization etc. The tool combines several software applications integrated in a complex solution that covers all design needs of an architectural bureau.
ARCHICAD offers collaboration features that ensure convenient teamwork on a project for office employees and distributed teams. The tool allows to develop and implement projects of any scale, export the data in many commonly supported formats, and connect to other software tools for streamlining work on the concept and details.
2. Rhino
Rhino is a design and modeling tool for architectural bureaus, students and freelancing professionals. It can create, edit, render, and animate various objects of 3D models. The tool ensures accuracy in designing, prototyping, engineering and production of any object. It supports file formats compatible with other 3D-modeling, design, engineering, animation and rendering software, so you can collaborate on files created in this tool with your colleagues who work with other solutions.
Rhino is available for Windows and Mac. It doesn't require any special hardware and works fast even on ordinary machines. Being designed not only for professionals but also for beginners and students, it is easy to learn and use. What's more, it offers advanced functionality at an affordable price, which is important for freelancers and solo entrepreneurs.
3. Chief Architect
Chief Architect offers a wide range of tools and features for working on home design projects. It allows to create construction drawings, interior design projects, CAD details, and 3D models. Chief Architect offers product lines for both professional architects and DIY enthusiasts, and while solutions for any level of skills are available, both professional and DIY tools by Chief Architect have been reported to be easy to learn and use.
Chief Architect tools are available for Windows and macOS. There are also mobile apps available for Android and iOS. This way, the tools can be used on virtually any device: desktop, tablet, or smartphone.
4. Revit
Revit BIM software is one of indispensable tools for construction, structural engineering, and architectural design. It includes various features for design, modeling, planning and construction of buildings and infrastructure objects. Its features for conceptual design, visualization and analysis ensuring convenience at any step of work on an architectural project.
The tool supports collaboration on project files, which allows contributors from various disciplines to create local models with suggestions and improvements and collaborate on the centrally stored and shared project model. For more convenient work on architectural projects, Revit provides the ability to expand its functionality with add-ons and API access.
5. actiTIME
Architectural bureaus and self-employed professionals often bill their customers for time spent on work for them. That's why keeping accurate records of how much time has been spent on various activities is essential: it helps prevent under-billing and adds transparency and clarity to interaction with clients on how much cost has incurred and why.
Here's where actiTIME time management system helps: it ensures effortless timekeeping and provides exact data on work performed for each specific client, project and activity. actiTIME allows to review details and summarized data on any portion of work, analyze profitability of projects, and issue invoices for customers.
A helpful feature that architects would appreciate is the ability to log time from anywhere: working from remote locations is common for such types of activities as design, planning, construction etc. actiTIME mobile app provides accurate records of how much time has been spent on client's site. Its timer feature simplifies time recording even more: just start the timer upon arrival, and stop it when work is done.
6. ArchiSnapper
Managing architectural projects can turn into a nightmare without an easy and convenient tool. Planning and monitoring field works, taking into account every single detail, and making decisions on necessary changes is challenging, so using a special tool that automates and simplifies these tasks is a reasonable way to free up managers' time and prevent employees from overlooking important details.
ArchiSnapper is a project management tool designed specifically for architectural projects. It allows to organize work on a project in a convenient way, track progress, upload on-site photos, sketches and annotations, and stay updated on every work assignment within a project. The tool stores all data in the cloud, which ensures its integrity and availability from any device, from anywhere.
7. Elorus
For small bureaus and self-employed individuals, accounting and invoicing are one of the biggest struggles in their work routine. Having zero background in accounting and bookkeeping, it's not easy to organize finances and prevent billable hours from being missed. However, there are special tools that help small businesses and freelancers overcome this problem – and save valuable time.
Elorus is a smart and easy tool that helps create and send professional invoices, manage expenses, and handle costs. It also allows to accept credit card payments and provides tools for monitoring your business' performance. To avoid double data entry, you can integrate Elorus with other tools you're using in your workflow and enjoy hassle-free billing and invoicing.


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|All over India
|2+ years
|B.Sc (Engg.) B.E B.Tech
|Start Date:
|01-Jan, 1970
|End Date:
|01-Jan, 1970
Rail India Technical and Economic Service - RITES Recruitment 2018 notification has been issued for filling 07 Civil Engineer Jobs on a contract basis. Educational Qualification, Category wise RITES Engineer Vacancy details, Method of application, Selection Procedure and all other details of this RITES Jobs have been explained below. Are you interested in RITES Careers? If yes, Never wait for another chance, read this notification completely and ensure your eligibility. Interested candidates can apply for this RITES Engineering Jobs should apply online before 03rd October 2018 and Submit the hard copy of application form before 10th October 2018
Name of the Post - Engineer (Civil)
No of Vacancy - 07
Job Location - All India & Mauritius
Method of application - Online & Offline
Type of appointment - Contract Basis
Contract Period - Two Years
RITES Jobs notification no - 61/2018
Selection for this post will be made on the basis of Shortlisting, Written exam and Interview
Initially, the applications will go through the screening process and candidates will be shortlisted for the Written exam on the basis of Academic Performance & Interview.
Only the shortlisted candidates will be called for interview and the final selection list will be made on the basis of performance in the Written exam and Interview
Application fee: There's no application fee for this RITES Recruitment 2018
NOTE: List of documents that should be enclosed with the application form have been specified in the official RITES Recruitment 2018 notification.
Assistant Manager (P)/Rectt.,
RITES Ltd., RITES Bhawan,
Plot No.1, Sector-29,
Gurgaon - 122001
We have sorted out the most important details of this RITES Recruitment 2018 to bring it to you as a short notification. Apply as early as possible for this RITES jobs to avoid last minute rush. Stay Updated with all the Latest Civil Engineering Jobs by joining us in any of the social media platforms given below or by subscribing to our e-mail notification. Your suggestions and Queries are highly valuable to improve our service, Kindly type it in the comment box below. All the Best...
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Things to Factor When Hiring a Moving Company
Gone are the times when people used to spend the whole day moving from one place to another. Apart from being time-consuming, the processes were hectic. Since you could not manage to move alone, you ended up inviting people to help you move and relocate. These people were forced to sacrifice and free themselves from their daily routines. The only time you were comfortable to move was during weekends or off days from work. Nowadays, things have become better. At any time of your convenience, it is possible to relocate with the help of movers. But it is very difficult to confide in movers near you or those that promote their business online. You are required to be extra keen when choosing the best movers. In details, this article will expound on tips for finding an excellent moving company.
Think about cash before anything else. Bringing in more assets in your home makes your house small. Also, after your family grows, matters of space become an issue. You desire a better lifestyle after getting a promotion at work. The above are reasons that may make you move. Having cash will not only make your work easier but also efficient. It is good first to sit down and discuss the cost of moving all your items from your current location to a new place. Do not forget that rewarding movers fairly encourages them to do their job well.
Choosing to work with a moving company offers you not only reliability but also safety. Expensive furniture, machine, and tools are found in your home. You cannot afford to have your property handled recklessly by the movers. It is your desire to pack, relocate and even install your property in a new place without destroying any time. A moving company assures you safety for all your items until the process is finished. You can demand for compensation in case of any damage since your property is insured.
Think of speed and accessibility. So many movers are located near homes. Even in the online world, businesses of moving companies are so many. It is wise to hire movers that are located near you. Not only is it fast in contacting them, tracing them in future is very easy. It is very easy to identify their location and negotiate the time of relocation as well as other costs of moving. When it comes to packing all your stuff, unpacking and installing all your property in your new home, time should matter. Fast movers will help you move and settle in your new home quickly. Time is very precious and hence should be used well.
A good moving company has the required machines to carry out the moving process from the beginning to the end. An example would be a company having boxes and labelling those with related items while packing to make the process of unpacking easy.
Lessons Learned from Years with Storage


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Fire Safety Services has extensive passive fire protection experience. We carry out:
- Maintenance and repairs
- Replacements
- Fire stopping
- Integrity testing and sealing
- Fire rated partionings and ceilings
- Fire shutters
- Fire curtains
- Fire dampers
For more information on Fire Safety Services' passive fire protection services, please click through to the pages in this section.
Need some help?
If you would like to find out more about passive fire protection and how Fire Safety Services can help you and your business, call our sales team on 08000 234114 or complete the form for a call back:
Fire Doors & Passive Fire Protection Enquiry
Passive Fire Protection
Fire Safety Services installs specialist fire-stopping products, which enables us to provide our clients with the best in passive fire protection.
Integrity Testing
If you have a gas suppression system, Fire Safety Services is able to carry out a room integrity test in order to check the ability of the enclosure to retain an effective concentration of gas, which is a critical to the safe operation of the system.
Third Party Accreditation
Fire Safety Services are Third Party Accredited. It is evidence that an independent expert has assessed our products and services to certify we adhere to certain standards.
More about Passive Fire Protection on our blog
Our blog is designed to give you a greater understanding about fire safety and how our services can help you. All of our blog posts are written by members of our team who have vast experience in specific aspects of fire safety, so you can be sure that the information you are reading comes from a qualified source.
For posts specifically about passive fire protection click here.
Regional Coverage
Need further information or would like to speak to one of our sales department?
Call our head office on: 08000 234114 or email at
East Anglia
Covering: East Anglia & South East
East Midlands
Covering: East Midlands, North East & Scotland
West Midlands
Covering: West Midlands, South West, North West & Scotland
Covering: South & London


text: Are you thinking about selling your home? I am a Littleton Realtor servicing the areas of Centennial, Highlands Ranch, Parker, Denver, Lakewood and all surrounding Douglas County, CO areas. I will provide you with a free valuation of your home with absolutely no obligation. Please fill out the easy to use form below to tell me about your home. Please note your information will be kept strictly confidential and will only be used to help you with provide you with better real estate services. You will be contacted shortly and thanks again.


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In 2014, Terrible Posture released their roguelike first person shooter, Tower of Guns, to a surprising amount of fanfare. MOTHERGUNSHIP is not a true sequel to Tower of Guns, but there are some obvious similarities in this spiritual successor. Much like Tower of Guns, MOTHERGUNSHIP is a roguelike first person shooter. While Tower of Guns gave players a randomly chosen character story at the beginning of each procedurally generated run, Mothergunship opts for a more traditional campaign. Players take on the role of an unnamed recruit who is forced to fight his or her way out of an invading alien spaceship after their mission goes awry with little more than the guidance of a motley crue cast of witty and sarcastic characters that communicate via the recruit's communication lines. These little blips of dialogue stack the game full of goofy humor (such as when one character decides to decorate the hub for a birthday party) to lighten the mood what with all the brutal lava rooms, acid pits, murderous robots and really huge bullets whizzing by your head that are to come.
Once players successfully survive the tutorial mission and fight their way out of the ship they find themselves in a space station hub where in they can access campaign missions and side quests, as well as an armory for upgrading their mech suit and a moderately well hidden black market for better weapon upgrades. Choosing a mission allows players to select a limited number of weapons and mods that they can take with them for the mission before they start.
As the mission begins, players will find crafting stations in the very first room. These crafting stations allow for players to assemble the weapon barrels – everything from shotguns to lightning rods and spike ball launchers – along with various connectors and caps to modify their functionality. There's only a couple of rules for crafting your weaponry. The most important of which is that weapon barrels must always face forward. There are ample amounts of connectors available ranging from L shaped to 3 prong rows to 5 point boxes that can be stacked, rotated, and mounted in such obscene ways that you're guaranteed to be able to create a literal beast of a weapon if you're patient enough to master the crafting. The second is that the weapon barrel simply must fit. Different weapons are obviously differently sized, but the crafting mechanic is simple enough that you can scroll through your collection of gun barrels and wait until one that works shows up as a blue outline rather than a red one. The second important rule is that you must have enough energy available on that arm to actually fire the weapon you've created. Each weapon barrel and 'cap' (which serve as power boosters or weapon modifiers like lava) comes at an energy cost. Thankfully, the amount of energy you can expend per shot is split between each weapon arm, and they're both healthy sized amounts even in the beginning. This allows for the creation of some truly monstrous weapons with some serious firepower.
Once you've given up a sizable chunk of your field of vision to the massive arsenal strapped to your mech suit's arms, you can then proceed to make your way through the labyrinthian style alien ships. This is where MOTHERGUNSHIP returns to its roguelike form. The ships are sectioned off into various rooms, and as you clear each one of its bullet hell induced challenges you can then choose which room to proceed to next. Player beware, however, as there is no mini map or navigation guides on these ships. Once you choose a door to proceed through, the one behind you closes down. All paths eventually lead to the exit, but if you were hoping to backtrack and revisit challenge rooms, find a shop before moving on to the boss, or just hoping to grind out some XP by clearing more of the ship then you're just plain out of luck. Before entering a new room you the game does show you via hologram what the threat level of that room is, but only after it's already closed down access to the previous room you were in. This makes it difficult to judge which path you really want to take, and just leaves you stuck with what the game wants to throw at you reducing the choices regarding your path to nothing more than an illusion.
It's during these sequences where the game is loading up the next room that it also stumbles the hardest. There are noticeable performance issues at these loading points that results in screen tearing and jittery frames. Since a majority of the game's communication based cutscenes happen during these in between screens the stuttering does affect those moments, as well. The developers are aware that these performance issues exist and previously stated that a patch would be out on day 1. Unfortunately, at the time of writing this review, that patch is still not available on Xbox One. MOTHERGUNSHIP's other downfall is that is an inexplicable grindfest coupled with seemingly random difficulty spikes. Often times while running through side missions and even the main story quests the weapons you craft can leave you feeling like the ultimate, overpowered badass. Blasting through challenge rooms and taking on swarms of saw blade equipped enemies and giant Super Mario-esque bullets create moments of frantic tension, but then the difficulty spikes out of the blue and you find yourself defeated. Defeat in MOTHERGUNSHIP results in the loss of any weapon parts you've collected during your run, as well as the ones you took with you. Sending you back to the side missions or endless mode to hopefully grind out some better weapons and XP for mech suit upgrades that you didn't know you needed. There are coin and experience grinding modes built into the game, but they're locked away behind the final boss battle. Rendering them obsolete for helping to actually complete the game.


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Rustic country home decor is evocative of cottages and farms with old, handmade furniture and bucolic settings. Since the design schemes are simple, it does not cost much to decorate your home with rustic country home decorating. However, there are certain foundational elements you should incorporate in each room.
In rustic country style, wood furniture is the key. Select unfinished wood furniture made from oak or pine or from pieces of log or large pieces of twig or branches. It's okay to let the nails or pegs show with rustic furniture.
In rustic style home walls are simple, cheerful and bright. Keep the walls white or a bright, understated shade like cream or butter yellow. Stay away from bold colours like purple, fuchsia, lime green and black.
Wood floors are the most optimal choice for rustic homes, so remove all tiles or wall-to-wall carpeting. Add a few braided or embroidered throw rugs here and there if your floors tend to get cold.
Once you have completed with the walls and floors your accessories will greatly assist you in giving off a very country style appearance. Displaying simple items, such as old milk bottles, wicker baskets filled with apples, wire baskets, tin pitchers filled with wild flowers, simple porcelain dishes, wooden crates or accent tables with crackled paint become the finishing touches that truly convey your rustic design theme.


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Witch on Parole, Witch on Parole Book 1, Kay Latour
Witch on Parole, Witch on Parole Book 1, Kay Latour
Genre: sci-fi and fantasy
I love fantasy novels, and this sounded fun – and I did like it, just didn't love it.
I like Bryn, love the idea of the Frithjof, in fact I love the whole world setting Kay has created but where the story fell short for me was in depth, it felt quite light, surface based kind of story.
There would be some pretty serious issues come up for Bryn, but the way of solving them seemed to me to be a bit too convenient. I love magic in books but it needs to be in balance, its too easy to have a spell or potion that fits a solution to what seems like an unsolvable issue and that just doesn't work for me. I need my characters to have to struggle, to work for solutions and though Bryn does have to work hard here help too often comes this way, albeit from other sources and it just left me feeling a bit kind of cheated ;-).
But that's just me, could be perfect for you, its certainly something I've read in other stories that didn't work for me but have made best seller lists. We're all different and want different things from out reading.
Its a fun story, and of course first books in a new series have a tough task, delivering new characters, new world settings AND a new story. Sometimes the first in a series hasn't always hit the spot for me, but I've gone on to love further books, so I'll look for book two and read that before deciding this isn't a series for me.
Stars: three, a good intro to a new world though a little light in parts.
ARC supplied for review purposes by Netgalley and Publishers


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A th file extension is related to the Java Runtime Environment library.
Software that open th file
TH file extension - Javasoft Jre 1.3 library
What is th file? How to open th files?
File type specification:
The th file extension is associated with JRE (Java Runtime Environment) available for various operating systems and computer platforns, developed by Sun (now owned by Oracle).
The th file stores JRE library.
This th file type entry was marked as obsolete and no longer supported file format.
This type of file is no longer actively used and is most likely obsolete. This is typically the case for system files in old operating systems, file types from long discontinued software, or previous versions of certain file types (like documents, projects etc.) that were replaced in higher versions of their original programs.
The default software associated to open th file:
Company or developer:
Oracle Corporation
Java is a set of developing applications and specifications used to create software in Java programming language. Java is used on many computing platforms from desktop computers to mobile phones.
Java source code derives much syntax from C and C++ programming language but has a simpler object model. To run applications written in Java the Java runtime environment must be installed on a device.
List of recommended software applications associated to the .th file extension
Recommended software programs are sorted by OS platform (Windows, macOS, Linux, iOS, Android etc.)
and possible program actions that can be done with the file: like open th file, edit th file, convert th file, view th file, play th file etc. (if exist software for corresponding action in File-Extensions.org's database).
Unspecified and all other actions for computer programs working with th file - Javasoft Jre 1.3 library
Click on the software link for more information about Java. Java uses th file type for its internal purposes and/or also by different way than common edit or open file actions (eg. to install/execute/support an application itself, to store application or user data, configure program etc.).


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Siding Installation in Lancaster, PA
Having a new siding installation done on your home in Lancaster, PA is a great way to not only update the look of your property, but also make your home more efficient. P2000 is a product that Zimmerman's Construction uses to add value and reduce draftiness in your home.
P2000 ranges in thickness from 3/8" to 2" and has a much greater r-value coefficient than the traditional blue or black Styrofoam. After the old siding is removed, a layer of P2000 is added to the outside of the home. All of the seams are taped and the new siding is installed over the added insulation.
An Experienced Siding Company
Zimmerman's Construction is an experienced roofing and siding company in Lancaster, PA, serving all of the surrounding areas in Pennsylvania. We have installed many different types of siding that include the following:
- Standard vinyl,
- Shrinkage that affects flashing,
- and many styles of real wood siding.
All of these types of siding have different looks, options, and benefits and can be expertly installed by Zimmerman's Construction. We promise to leave your home looking brand new and give you and your family the protection they deserve in their own home.
Siding Repair Contractors in Lancaster, PA
Whether you need a new installation or just need a siding repair job, our team of professional siding installers can help. Whether Our siding company offers a variety of colors, materials, and styles. No matter how big the issue is with your siding on your home, we promise to leave your property's exterior looking brand new. We can fix many issues that derive over-time due to harsh weather conditions like missing panels, leaks, cracks, and more.Ask about our Specialty Exteriors!
Contact our Siding Contractors
If you're looking for siding contractor in Lancaster PA, give us a call at Zimmerman's Construction! Be sure to check out our locations including Mount Joy, Manheim, Lititz and Lebanon, PA. We are always available to answer any questions you may have about updating your home's exterior or provide you an estimate.
- Fully Insured
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The annual get-together in the Bavarian capital has meanwhile become a "must" for top international researchers in the field of diabetes and metabolic disorders. Leading experts and highly qualified young researchers from various disciplines in a personal and manageable ambience lend the science forum its unique nature.
The multidisciplinary program rises up to the primary challenge in modern diabetes research: multi-dimensional and clinically relevant approaches are closely examined and summarized. This year one special focus will be on the role of insulin-producing beta cells. The framework offers scientists, clinical researchers and biotechnology experts an opportunity for intensive discourse and interactions. In round table sessions, selected participants can discuss their scientific projects and ideas with leading experts.
The high concentration of international scientific leaders is characteristic of the conference organized by Prof. Dr. Matthias Tschöp and Prof. Dr. Heiko Lickert (both from Helmholtz Zentrum München and TU München): in past conferences, nearly half the participants came from abroad, representing more than 20 nations. Speakers and the audience are associated with distinguished research institutions, including universities such as Cambridge, Harvard and Yale. It is therefore no surprise that this conference has come to enjoy a reputation as the leading annual symposium in diabetes research.
The latest research results, some not yet published, presented by leading international researchers form the basis for an exchange of scientific information and networking. This is expected to lead to valuable synergies in the fight against diabetes. The fact that the WHO dedicated this year's World Health Day to diabetes shows how urgent this matter is.
The Helmholtz-Nature Medicine Diabetes Conference presents a number of prestigious awards each year. One of these is the Helmholtz Diabetes Award in recognition of the lifetime achievements of a senior leader in the field, which will be given to Sir Stephen O'Rahilly from Cambridge University this year. The Novo Nordisk - Helmholtz Young Investigator in Diabetes Award (HeIDi) will also be presented to one of the 20 nominated rising stars in research who will be presenting short lectures during the conference as they compete for this prestigious research prize. The the HelDi Award jury is a scientific panel consisting of independent scientists. The HelDi Award is sponsored by Novo Nordisk A/S.
You can find the preliminary program, including conference speakers and HeIDi nominees, and the registration information at the conference website: http://www.


text: Are You Prepared to Implement the New Lease Accounting Standard? Share With effective dates quickly approaching for private companies, now is the time to prepare for implementation of the new lease accounting standards. ASC Topic 842, Leases can create operational challenges as implementation teams grapple with the complexities of the new standard.DHG is ready to help as you navigate the transition to the new lease accounting standard. Visit dhg.com/services/assurance/leases for more information. Download PDF Updated: March 28, 2019 Share


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Tuesday, May 15, 2007
Ndugane's understanding
Those who are ignorant of history are doomed to repeat it. In my last post I examined the wars that have resulted from religious conflicts and likened them to the current affliction within our Anglican Communion. Now comes this for clarity. Archbishop Ndungane's speech at the Bishop's Forum in South Africa has an excellent history of the polity of the Anglican Communion and how it has and is changing. I commend this article for a better understanding of what is happening with the current demands of the Communique and the draft of the Covenant.
Posted by sharecropper at 2:00 PM
1 comment:
- Gerald T Floyd said...
Thank you for sharing Archbishop Ndungane's impressive analysis. I will also post a link it and credit you on my blog at http://creativeadvance.blogspot.com. It would be nice if Archbishop Ndungane's developmental, forward-looking view of the Anglican Communion would prevail among the primates. But as he experienced at Dar es Salaam, that seems unlikely. His temperate, hopeful words express the best of the Anglican Communion--and the magnitude of what will be lost if Peter Akinola gets his way.
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