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Chuncho Macaw Clay Lick (3 days)
Visit the Tambopata National Reserve and the Macaw Clay Lick for 3 days. Transport, lodging, and meals included.
- Price for Macaw Clay Lick (3 days): S/ 739 per person.
- Transport:
- Round-trip from the hotel, airport or bus terminal.
- Round-trip boat ride to lodge.
- Lodging at Monte Amazónico Collpa Chuncho Lodge:
- Private room with private bath.
- Meals:
- Breakfast (except on the first day).
- Lunch.
- Dinner (except on the last day).
- Entrance fee to the Tambopata National Reserve.
- Bilingual guide (Spanish and English).
- Drinks at the bar.
- Travel insurance.
- Health coverage.
- Tips (optional).
- Select the departure date on the calendar.
- Select the number of travelers.
- Click on "Add to cart."
- Pay an advance payment online of a percentage of the total price of the tour.
- Once the payment has been made, the reservation will be subject to confirmation depending on availability. If you would like to find out about availability before making the payment, send us an email at firstname.lastname@example.com.
- 30-liter backpack to carry only what is necessary for the 3-day tour.
- Comfortable clothes.
- Long pants.
- Long-sleeved shirts.
- Rain jacket and pants.
- Rain poncho.
- Hiking shoes.
- Water.
- Snacks.
- Hat to protect against the sun.
- Sunscreen.
- Insect repellent.
- Binoculars.
- Headlamp.
- Towel.
- Personal hygiene items.
- Ziploc bags or similar (to wrap up your clothes and prevent them from getting wet if it rains).
- Extra money for expenses not included in the tour.
Start: at 3:00 am at your hotel, airport, or bus terminal in Puerto Maldonado.
End: at 7:00 pm in downtown Puerto Maldonado.
Day 1: Trip to the Tambopata River - Monte Amazónico Collpa Chuncho. We will depart from the city of Puerto Maldonado in our 4x4 vehicle on a 2-hour trip to the Tambopata River. Here, at our point of embarkation, we will cross the river to the Monte Amazónico Collpa Chuncho Lodge, where we will stay for the next two nights. They will give us a brief welcome and we will settle into our rooms and have lunch.
In the afternoon, we will take a hike through the jungle, where we will be able to see different animals in their natural habitat and receive the corresponding information from our guide. Next, we will have the rest of the afternoon free until dinnertime, where we will go over the activities for the next day and then go to sleep.
Day 2: Macaw Clay Lick – Collpa Chuncho – Tambopata River Kayaking. We will start the day very early to go and visit the Macaw Clay Lick. We will take our boat and sail for around 1.5 hours. Along the way, we will see different animals and birds, such as capybaras, caimans, and if we are really lucky, even a jaguar.
We will set up in a spot at the Macaw Clay Lick to see the hundreds of parrots of all different species that come here to practice geophagy, or the eating of clay. According to scientists, this behavior is due to the supplementing of nutrients in these birds' diet, and also to the detox of certain foods ingested by macaws.
We will then go back to the lodge to eat breakfast and rest. Afterwards, we will take a walk through the botanical garden here, where we will be able to see different plant species while accompanied by a guide, who will tell us about the properties of each one.
After lunch, we will be able to kayak on the Tambopata River, an advantageous place for spotting animals because it is quieter. If we are lucky, we will be able to see some larger animals that inhabit this region.
At night, apart from eating dinner, we will be able to take a nighttime hike to listen to the sounds of the jungle, or just rest.
Day 3: Return to Puerto Maldonado. We will get up to eat breakfast and then take the boat to start our trip back. We will cross the river and then we will continue on in vehicle until arriving at the city of Puerto Maldonado to end our tour.


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The first of five competitive days of the rally raid in Abu Dhabi has ended today with the victory of the French-Spanish crew of Cyril Despres and Daniel Oliveras in the Mini John Cooper Works buggy from the X-Raid team.
Despres is nearly six minutes ahead of his closest pursuer Bernhard ten Brinke. The crew of Stephane and Andrea Peterhansel also in the MINI John Cooper Works Rally buggy rounded out the top three. No one could have imagined how the crews of Despres and Peterhansel would perform before the multi-day rally raid start – these crews have the new co-drivers.
Today the Russians Vladimir Vasilyev and Konstantin Zhiltsov have failed to set the pace of the ride they are capable of – under the Abu Dhabi scorching sun with the air temperature +39°C in the shade the BMW X3 CC engine started to overheat that naturally affected the power and the speed.
Vladimir Vasilyev, driver, "Today's special stage was full of various navigation traps, but this was not the main problem. The main problem was that our engine overheated and, driving to the next high dune, the emergency mode was activated. In Russia it's impossible to load the engine the same way as here, taking into account the ambient temperature and the loads experienced by the vehicle when overcoming the same sands. In fact, we have spent this day searching for the necessary settings".
The FIA World Cup for Cross-Country Rallies current holder Pole Jakub Przygonski finished the day in the fifth position, however, he complained about problems with the drive that he managed to resolve thanks to his teammate Martin Prokop. He helped the Polish crew and towed them to the finish line at the final five kilometers of the special stage. Prokop, in turn, complained about his health, experiencing problems with acclimatization.
On Monday the drivers will have to overcome a distance of a similar complexity: the length of the leg is 371 kilometers, 222 of them will fall on the special stage distance. The unpredictable nature of the sand track in Abu Dhabi has never allowed viewers to choose their favorite or decide in advance who would be able to reach the finish line first.


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*** (out of four)
Plenty of fictional creations have sprung from imagination to reality in the minds of movie characters. Look at the computer-generated woman in "Weird Science." Or, last month, the living teddy bear in "Ted."
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Or you can continue trying to change your significant other and see how that goes.
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TENNESSEAN GROUP / SEARCH: 5114 Stonewood Dr Smyrna, TN 37167
- 4 beds
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- Year Built: 2005
- Neighborhood: Stonewood Sec 1
Wonderful all brick home in highly sought after Stonewood Subdivision. Open concept with hard wood floors. Kitchen open to hearthroom. 2 beds down, 2 up with bonus. Light and airy! Private backyard with privacy fence. Covered back porch and extended concrete driveway. Sellers are motivated to locate to a larger home, their motivation is your gain! Please call Linda at 615-429-4629 for your private showing.
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Updated: 19th October, 2019 2:53 AM.
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AirCArgo AsiA-PACifiC • FEBRUARY-MARCH 2015 • Page 7 iiN the past, many un- der-performing com- panies have managed to slip under the radar and escape insolvency. With market condi- tions changing, these businesses need to change course if they want to avoid going under, warns rsM Bird Cameron. Andrew Beck, national head of turnaround and insolvency at RSM Bird Cameron said: "In 2014, many indebted companies were able to re- pay the interest on their debts but not able to reduce the actual debt itself. Neither could they invest in maintain- ing or updating equipment or make strategic investments. Low interest rates let these 'zombie' companies maintain their commitments to their financiers. As such, it is unlikely that these financi- ers will seek to enforce their security any time soon and this is how zombie companies will continue to battle on. The number of zombie companies may even increase, given there is no expected increase in interest rates in the near future." According Beck there are four signs that indicate a company may be heading for zombie status: 1. Covering the bare minimum. Companies that can only cover the bare minimum such as running costs and interest-only repayments. 2. Paying interest but not the debt. If a business is incapable of paying down the actual debt to an agreed timeline then it may already be a zombie. So, unless its operating practices improve dramatically, it is likely to become insolvent regardless of bailouts and support. 3. Put a hold on growth. Zombie companies generally are not able to in- vest in new business or hire new staff. When organisations need to put a pro- longed stop to growth and expansion, especially if market conditions are average, this can be a warning sign. 4. financiers will be reticent. When companies have reached the point where they are only covering interest and not paying off the actual debts, smart financiers and investors become more hesitant to continue funding the business. This may in turn lead to additional debt from alternate sources (e.g. creditors including the ATO) which may go largely unpaid if ACBPS reminder on licences ALL Customs Broker licences will expire on 30 June 2015. In April 2015, the Aus- tralian Customs and Border Protection Service (ACBPS) will send an "Application for Renewal of Customs Brokers Licence" package to each customs broker. To ensure that the renewal package is sent to the correct postal address, cus- toms brokers should check, by no later than mid-March 2015, that their contact details in the Integrated Cargo System (ICS) are up to date. Failure to renew a customs broker licence by close of business 29 June 2015, will result in the licence expiring. More information is available in ACBPN 2015/01 or you may contact Broker Licensing on (02) 6275 5784 or firstname.lastname@example.com. Warning signs that your supplier – or your customer - is heading for 'zombie' status the company is declared insolvent and will leave lenders and investors without their money. Beck said: "When an organisation consistently underperforms financial- ly and is doing the bare minimum to meet its financial obligations, it could be a sign that the business is about to reach zombie-status. "When this happens, there are two options. The first is to try to save the company with an overhaul of manage- ment practices and operational proce- dures. The second is to put an end to the cycle and shut down the business. Either way, a zombie company cannot be allowed to continue to wander aim- lessly, potentially taking others down with them."
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text: My practice today was somewhat slow and very, very restorative. That wasn't my initial plan. I wanted a strong sweaty flow to energise and challenge me this morning, but having been on an amazing three day teacher training course this week - which involved a lot of self practice - and having taught a few classes yesterday, this morning when I got to my mat...Read More


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***** Welcome to the Live Stream of the ALTO prototype events! *****
What you see in the Live Stream are cosmic ray events hitting our gamma-ray detector array prototype at Linnaeus University in Växjö, Sweden. However you see just 3 cosmic ray events per minute, while in reality we record about 200 events per second.
On the right panel you can see the signals detected in the prototype, each colour corresponding to a different detector. Time format is UTC.
The colour green is used to represent the signals seen in the large water Cherenkov detector on the left (Detector 0), while the colour red represents the signals seen in the large water Cherenkov detector on the right (Detector 1). The signals in orange represent those detected in the muon detector below the water tank on the left (Detector 4). The other signals are coming from smaller scintillator detectors located at the top and at the bottom of the water Cherenkov tanks.
You will notice that most of the events are coming from the left water and scintillator tanks, and this is due to the size of the scintillator box, which is larger than the others. We have a trigger logic "two-out-of-eight" meaning that we record the event only if there are two or more detectors "fired" by the cosmic ray. The "triggers" from the left water plus scintillator detectors dominate the event rate, due to the size of the scintillator box.
Most of the events we detect with this trigger condition are solitary muons generated by interactions of cosmic rays, mostly protons, with the nuclei of the atoms composing the atmosphere.


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Physician - Endocrinology
- Employer
- Wellspan Health
- Location
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- Posted
- Apr 05, 2019
- Closes
- Apr 04, 2020
- Ref
- 1983321
- Specialty
- Endocrinology
- Hours
- Full Time
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Members will explore how substance use and risk taking may arise from the circumstances of one's life or nature and how these behaviors relate to other life issues. Discussions will focus on how to assess harm, come to terms with ambivalent feelings about change, set harm reduction goals, and develop an individual plan for positive growth.
Thursdays, 6:00 – 7:30 p.m.
Mindfulness practices provide an opportunity to slow down, observe our moment-to-moment experiences non-judgmentally so we can respond in more effective ways. Mindfulness has been shown to increase self-compassion and enhances self-care capacities. By learning to attend to your experiences with greater acceptance, you will be able to navigate life's challenges with more ease. Join us to learn more about these simple practices and how you can apply them in your daily life. The group includes a combination of skills-based practice and discussion so that members can adapt the skills to suit their needs and goals.
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This specialized group is a safe space for people who are currently (or have a history of) being treated with Ketamine and are additionally interested in ongoing exploration and integration of their experiences with others who also share this unique experience. Off-label use of generic Ketamine to treat depression and other mental health disorders has been a long standing treatment to help those who have tried and did not receive benefits from other traditional treatments. Esketamine, a variation of Ketamine, has now become a prescribable medication for treatment resistant depression. Studies show that the combination of Ketamine therapy with psychotherapy enhances the intended effects.
Dates TBD – please contact email@example.com for more info.
This group aims to support members as they continue to navigate their relationship to psychedelics and their history of trauma. Other challenges related to mental health and substance use will also be explored, depending on the needs of the group. Interventions will be client centered, including structured discussions pertaining to developing concrete skills, self-empowerment and management of trauma related feelings and behaviors. Grounded in principles of harm reduction, this group will also help members clarify their motivations and intentions surrounding their psychedelic experiences to reduce potential risks.
Wendy Miller, PhD, Andrew Tatarsky, PhD
(starting Fall 2019)
Couples with low/no sexual desire or frequency, and/or desire discrepancy (in which one partner is more interested in sex than the other) who are interested in enhancing their sexual relationship and ready to embark on a journey to enhance their sexual experiences and relationships. The process will involve group therapy over 16 hours. Limit of six couples.
View our Psychedelic Program Groups.


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Avaya provides voice-over-internet-protocol (VoIP) phone system solutions for businesses of all sizes. Its IP office system can be deployed as an on-premise or a cloud-hosted solution. In this article, we cover Avaya reviews and pricing. Ready to get started? Visit its website.
Avaya Pricing
Avaya doesn't publish rates on its website, but according to a third-party website, the price is $25 per user per month for cloud-hosted systems. There's also a one-time fee of $500 to $1,000 per user for on-premise systems. Since Avaya's phone systems can be customized, rates are often different for each business.
Additionally, Avaya works with local resellers to sell and install their systems, which can also affect pricing.
Ready to get started with Avaya? Visit its website.
Top VoIP Software Providers 2019
Best For
Which VoIP Software Provider Is Right for You?
Summary of Positive Avaya Reviews
Users who gave Avaya a positive review said that the software is easy to install and use. Most of them are very happy that they can use it on different platforms. Some also commended the software for being a good tool for call management and specialist monitoring.
One user who gave Avaya a positive review on G2 mentioned that all of his colleagues are very happy with the system. He appreciates that set up is simple and that training is not required to get comfortable in using it. Lastly, he added that the platform streamlines communication and that he would gladly recommend the software to other users and businesses.
Summary of Negative Avaya Reviews
Users who gave Avaya negative review mentioned some seasonal lags in the software. They described that there are times that the phone restarts on its own. Others said that it is a bit pricey as compared to its new competitors.
"Avaya is a technology company and, like most technology companies, they are continuously producing newer and better software and hardware. Many customers complain of the high price vs purchasing obsolete equipment after just a couple of years of ownership. Perhaps this is a negative or perhaps this is a positive. It depends on how you view it."
—Travis Watts
Top VoIP Software Picks From Fit Small Business
6 Best VoIP Providers for Small Businesses in 2019: VoIP phone services are internet-based alternatives to traditional landline phones with features like auto attendant, voicemail, and customer relationship management integrations. We looked at a variety of VoIP providers and compared them on price, features, ease of use, and more to determine the top six, including the overall best VoIP for small business.
Avaya Features
Check out the list below of some of Avaya's features:
- Virtual receptionist
- Unlimited nationwide calling
- Ring and hunt groups
- Interactive voice recordings
- Call transfers
- Call center routing
- Compliance recording and 90-day storage
- And more
Avaya FAQs
How widely is Avaya used in the world?
Avaya's services are available are now available in 34 countries and is expected to expand its global footprint in the coming months.
What is a public cloud?
Public cloud is a cloud computing model in which services are delivered over the internet. This type of cloud is highly recommended to small and medium businesses (SMBs) as well as enterprises who aim to spin up projects or departments on a public cloud infrastructure.
Popular Integrations
Here is a list of some of Avaya's popular integrations:
- Salesforce
- Microsoft Dynamics 365
- TAPI Link lite
- TAPI Link Pro
- DevLink Pro
- Microsoft Lync
- Microsoft Outlook
Avaya Alternatives
Have you read these Avaya reviews and are still not sure if it's the right fit for you? Read our reviews of all top VoIP software providers.


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It's Day 28 and I weigh 136. I definitely cut down on my sugar intake this week. There is still 4 more days, I'm so excited at this point. My husband is actually flirting with me again. We went out last night and for the first time in years, I've notice him getting irritated when other men look at me! The last time that happened was when we just got married!
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Porter Ray - Watercolor: thrilling tracks from a gifted rapper - listen
Porter Ray
Sub Pop
Hip-Hop & Rap
That certain something in the water in Seattle when it comes to hip-hop has produced another winner.
Like Shabazz Palaces and THEESatisfaction – both of whom are represented on Watercolor – Porter Ray is more interested in following off-beam angles than adhering to a clearly defined straight and narrow path.
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A naturally gifted artist taking things to the next level.


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Business Begin Up Ideas
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text: After selling out of a few of our Ouds its time to launch a few more oils. The first is Oud Khusi (Orchid) distilled in 2015 from Timor Island of Indonesia. Our Indonesian line of Ouds have been loved by many and this is the next installment and what a beauty it is. The oil reminds me of a field full of Orchids and other wild flowers, but on a dark night. I get a fruity opening vibe, when i say fruits i dont mean Thai fruits but exotic fruits, when was the last time you smelt a fruity floral Indonesian oil? The fruits and flowers are there to begin and then make way for the perfect ammount of smoke in a drydown. The oil has a lovely deep golden hue with opening notes of exotic fruits, wild flowers, nectar, honey then the sweet green incense creeps through with a hint of spice and earth with a perfect wisp of smoke. The oil starts bright in profile and slowley gets darker and darker a very interesting scent progression indeed. If you enjoyed Al Sukr and Wahah then you will love this oil. Oh and of course there is that Borneo vibe with a hint of vanilla. Available on the forum before its official release with a discount 110$ shipped for 1ml high recovery vial. Drop me a PM to order a bottle


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Passed HIT-001
hisesa ■■■□□□□□□□Posts: 30Member ■■■□□□□□□□
I know this cert isn't very popular but I have a few years of healthcare I.T. experience behind me so I figured I'd go for it anyway. I'm not sure if it will help my resume or not, but at least it can't hurt.
jinnstar ■□□□□□□□□□ Posts: 5Member ■□□□□□□□□□I'm going to take this exam myself, any tips or study recommendations? I have the book, and have tried watching the CBT-Nuggets series, but honestly find the presenter irritating.
moe12 ■■□□□□□□□□ Posts: 65Member ■■□□□□□□□□I took this exam because I thought it was interesting. There are questions about HIPPA and privacy settings and such. Reading the HIT-001 exam prep book which can be found on Amazon will be enough to pass the exam. When taking the exam think of a hospital and how patient information security is critical.
Good Luck.
hisesa ■■■□□□□□□□ Posts: 30Member ■■■□□□□□□□I used the book by Joy Dark. I just read through it twice and then the night before the exam I went through the questions at the end of the chapters. It came with a dvd that had a practice test on it too. I have a lot of healthcare I.T. experience so the acronyms and the workflows came pretty easily. If you've used both the book and videos you should do fine, best of luck to you!!


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Book Details
- Publisher : Picador
- Published : 1995
- Cover : Paperback
- Pages : 368
- Category :
- Catalogue No : 24831
Also by Oliver Sacks
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Migraine is an age-old and often debilitating condition - the first recorded instances date back over two thousand years - affecting a 'substantial minority' of the population across the globe. In this book, Oliver Sacks offers at once a medical account of its occurrence and management; an exploration of its physical, physiological, and psychological underpinnings and consequences; and a meditation on the nature and experience of health and illness.
About the Author(s)
Oliver Sacks was educated in London, Oxford, California and New York. He is a professor of clinical neurology at Albert Einstein College of Medicine. He is the author of many books, including the bestselling The Man Who Mistook His Wife for a Hat and Awakenings.
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Members Events and information
The events detailed within this section are for members only.
They cover a wider range of walking areas than our guided
walks for the general public.
Quick Links -
The following establishment offers discounts
to Friends of DalesRail members on production of a membership
About Members
FDR has a history and culture of coach excursions, weekend
short breaks and week long holidays. These date back to when
our organisation was founded in 1980 and the DalesRail fully
integrated town and bus service, operated only on summer weekends
once a month. These were to hold the membership together and
provide the opportunity for collective walking as a group.
Coach excursions were scheduled as once per month events in
winter and in the summer, once per month on a weekend when
DalesRail did not operate.
When the Settle/Carlisle line was finally reprieved from
closure in 1989 and a regular year round passenger service
was established, we saw no reason why activities which had
given so much pleasure to members and had transported them
to areas not accessible by train, should be suspended. The
programme of events was merely adjusted to avoid a clash of
activities. Regretfully, for administrative and logistical
purposes, these elements of our events have to be restricted
to members of the organisation.
The coach trips, which were held monthly on Sundays, covered
almost anywhere within a 2 hour coach trip of Leeds. We regularly
visited areas such as the North Pennines, the Lake District,
Derbyshire, Lancashire and the North York Moors and Coast.
The weekend and longer holiday trips use either hotel or
youth hostel accommodation and have previously included visits
to Scotland, Wales and Ireland. There will normally be at
least three grades of walk put on each day. Details of future
trips can be found in the Holidays
Other forthcoming trips and activities are listed below -
you can also find detailed information in the Past
Events section.
Midweek Walks
for members only
First Thursday of each month
One walk only - 10/12 miles - moderate
ALL MEET AT 10.00 AM unless
otherwise stated
telephone Lynn Saleh on 01274 724888 for further details
District Walks
Unless otherwise stipulated
by the walk leader, the car share meeting
place will be at Gargrave Car Park at 8.00 am
If you wish to join the car share at Giggleswick station
at 8.15 am, please contact the walk leader in advance
telephone Merrilyn Hall on 07807 200 517 for further details
for members only
Annual General Meeting
at the Black Horse Hotel,
at 11.15 am (tea and coffee available
from 10.45 am)
Please see the members'
Newsletter or
Diane Taylor on 0113 293 1924 for further details


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Bradley Cooper has been seen out and about in New York City going to various talk shows to promote his new movie, A Star Is Born which features the one and only Lady Gaga. Most recently the American Snipper actor was photographed filming an interview with The Tonight Show Starring Jimmy Fallon on Wednesday night, October 3.
Sound off in the comments below!
Join the conversation


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Home Partnership are delighted to offer for sale this THREE DOUBLE BEDROOM semi detached family home with 24ft lounge/diner. Inside the property commences entrance porch, lounge/diner, modern fitted kitchen and inner hall all to the ground floor. Upstairs there are three bedrooms and a white bathroom suite. Outside the property is approached by a blocked paved driveway giving off street parking for two vehicles and leading to an INTEGRAL GARAGE. To the rear you will find an established rear garden. The property offers POTENTIAL TO EXTEND subject to the relevant planning consent and is within 0.3 miles of Brentwood Train Station. An internal viewing is strongly recommended to fully appreciate the size and potential on offer.Entrance porch
Entrance door, double glazed window to side, door to;Lounge/diner
24' 0" x 11' 2" (7.32m x 3.40m) Double glazed window to front and double glazed patio doors to rear, two radiators, feature fireplace, door to;Kitchen
11' 11" x 7' 11" (3.63m x 2.41m) Sink unit with mixer taps, fitted with a range of wall mounted and floor standing units with corian work surfaces, built in double oven, hob and hood, integrated dishwasher and fridge/freezer, cupboard housing washing machine, double glazed window to rear.Inner hall
Storage cupboard, stairs leading to the first floor.Landing
Double glazed window to side, loft hatch, door to;Bedroom 1
14' 11" x 9' 10" (4.55m x 3.00m) Double glazed window to rear, radiator.Bedroom 2
12' 11" x 9' 5" (3.94m x 2.87m) Double glazed window to rear, radiator.Bedroom 3
11' 3" x 8' 11" (3.43m x 2.72m) Double glazed window to front, radiator.Bathroom
White suite comprising panelled bath with shower above w.c, wash hand basin with vanity unit below, radiator, extractor, double glazed window to front.Outside
The front of the property is approached by and blocked paved drive and leads to the integral garage with electric up and over door.Garage
16' 6" x 8' 3" (5.03m x 2.51m) Electric up and over door, power and light connected, door to side.Rear garden
Patio area, steps leading down to lawned area, pathway to rear, access to front.
|Tax Band
|Taxable Sum
St.Thomas Gate
01277 218 821


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Karena Strella and James Martin on the traits that really promise great leadership.
Interview with Joseph W. Polisi, President of the prestigious Juilliard School.
Interview with Kendall J. Powell, Chairman and CEO, General Mills Inc.
Report on the Brazilian social entrepreneur Rodrigo Baggio.
An expertise on the role of the Chief Human Resources Officer.
Interview with Choo Chiau Beng, CEO Keppel Corporation.
Interview with Pius Baschera, Chairman of the Board of Directors, Hilti Corporation.
Lisa Blais and Laurence Monnery explain what makes proper talent assessment a powerful driver in creating diverse organizations.
Herminia Ibarra on how current success can actually work against fulfilling your potential.
Interview with Fred Swaniker, founder of the African Leadership Academy.
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Monday, March 13, 2017
Disney's Beauty and The Beast red carpet premiere coverage
Watch Disney's Beauty and The Beast Premiere Red Carpet as we welcome cast, filmmakers, and special guests to the red carpet premiere of Beauty and the Beast with Verizon.
Disney's animated classic takes on a new form, with a widened mythology and an all-star cast. A young prince, imprisoned in the form of a beast, can be freed only by true love. What may be his only opportunity arrives when he meets Belle, the only human girl to ever visit the castle since it was enchanted. "Beauty and the Beast" will be released in U.S. theaters on March 17, 2017.
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Advertising and Deals: What is the distinction?
Promoting and deals are a standout amongst the most imperative segments of a business' survival in the market. While both are reliant on each other numerous individuals mistake promoting for deals and the other way around which is a major misstep. Showcasing includes outlining an item as per the requirements of the market and clients, advancing the item through promoting and so on and setting up an aggressive cost for the item. Showcasing is a stage which drives deals. While then again the business procedure is your main event to effectively offer an item and get an agreement. Deals and advertising together is a piece of offering and one can't manage without the other. They can likewise be called exercises. The achievement of a business is basic to the accomplishment of these two imperative exercises.
Promoting is the foundation of an organization's future and take off platform for the deals. While the promoting procedure envelops the outline of the item, publicizing and so on the business procedure is the execution of the considerable number of endeavors which includes coordinate cooperation with customer either by in-person meeting or chilly calls or by systems administration. Be that as it may, there is dependably a progressing competition between the two, one guaranteeing dominancy over other. The showcasing individuals say they have a high ground since they think it is they who outlines the items, sets out the technique and furthermore creates instruments fundamental for deals. They say deals are the result of promoting and therefore ought to take after its bearings. The sales representatives probably won't consent to this view and might be direct inverse as they would like to think. They feel that it is the sales representatives who really pitches an item and convey cash to the business.
Be that as it may, numerous specialists trust that showcasing should assume an essential part among the two. An effective advertising effort makes deals simple and influences individuals to trust that it is really the sales representatives who are the prevailing pioneers. The most essential part of promoting office is to make open doors for the business division. Promoting drives deals and deals drives organizations' prosperity. Promoting resembles an existence bolster for deals, one who is continually backing up the business division and empowering them to effectively convey the final result. There shouldn't be a race to pick up matchless quality over another division yet a race to win the market and clients cooperating.
Numerous organizations join deals and promoting together yet in all actuality they have diverse targets. While the business division is keen on satisfying the necessities of what the client requested, the advertising office is really bustling contemplating what the market requests. The objective of the showcasing office is to predict how the market will take care of business in future. They should imagine their item taking into account the necessities of the market for next couple of years and be prepared to roll out plan improvements in their item appropriately.
It is vital that an organization incorporates their deals and showcasing office in an all around molded way. It is the right combination of these two critical elements that energizes the development of an organization. The deal individuals ought not be only regarded as the money authorities. Every division has its own particular part and ought to go as an inseparable unit in offering the result of the organization and ought to be the chief critical criteria.


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Assessment of Echocardiographic Left Atrial SizeHow Accurate Do We Need to Be?
Author + information
- Published online August 1, 2012.
Author Information
- Brian D. Hoit, MD⁎ (brian.hoit{at}uhhospitals.org)
- ↵⁎Correspondence and reprint requests:
Dr. Brian D. Hoit, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, Ohio 44106-5038
Certainty is the most vivid condition of ignorance and the most necessary condition for knowledge.
—Kedar Joshi (1)
Growing interest in left atrial (LA) size is motivated by the recognition of its importance as: 1) a predictor of cardiovascular morbidity and mortality (2); 2) a biomarker integrating the magnitude and duration of diastolic left ventricular (LV) function (3); and 3) a determinant of success of the various procedures available for the treatment of atrial fibrillation (4). Many laboratories continue to use 1- and 2-dimensional measurements of the left atrium despite the greater accuracy and stronger association with cardiovascular disease of the LA volume index measured by biplane 2-dimensional echocardiography (2DE). Many studies have demonstrated discordance between 1-, 2-, and 3-dimensional (biplane) LA measurements (5); misclassification of categorical severity is common and has implications for risk stratification and prediction of diastolic dysfunction (5). Inaccuracies owing to geometric assumptions and foreshortening of the LA cavity with biplane volume methods result in a considerable underestimation of LA volume compared with computed tomography (CT) and cardiac magnetic resonance (CMR) (6,7). These limitations are theoretically overcome by 3-dimensional imaging; indeed, reconstructive freehand 3-dimensional echocardiography (3DE) was shown to reduce (but not eliminate) the underestimation of CMR LA volume (8), albeit with greater variability than 2-dimensional methods. More recently, using 64-slice multidetector CT as a reference standard, real-time (RT) 3DE LA volume estimates were shown to be more accurate and underestimate volumes less than biplane 2DE (6), and in a small number of patients studied with CMR as the reference standard, RT3DE correlated better with less variability than biplane 2DE (7).
In this issue of iJACC, Mor-Avi et al. (9) prospectively validate RT3DE LA volume software (Tomtec 3D LA function, Tomtec Inc., Hamden, Connecticut) against 2DE biplane volume and CMR in 92 patients referred for clinically indicated CMR. Echocardiographic and CMR imaging were performed on the same day, and maximum and minimum LA volumes were compared. Correlation with CMR was greater for RT3DE than 2DE for both maximum (r = 0.93 vs. 0.74) and minimum (r = 0.88 vs. 0.82) volumes. 2DE systematically underestimated maximum and minimum volumes (biases of −31 ml and −16 ml, respectively), whereas biases with RT3DE were negligible (−1 ml and 0 ml, respectively). However, despite minimal biases with RT3DE, the wide limits of agreement indicate that the imaging modalities are not interchangeable. Using a threshold of 34 ml/m2 (a value that implies diastolic dysfunction) to define an abnormal LA size for all 3 modalities, overall agreement with CMR was better for 3DE than 2DE (kappa = 0.88 vs. 0.71) as was the agreement for classifying the LA as enlarged.
Although this is not the first study to validate RT3D LA volume measurements, it is important because it is the largest, is international in scope, and uses software customized for LA volume determination. However, it is unclear whether these results can be extrapolated to volume analysis using the widely available QLabs program (Philips Medical Systems, Andover, Massachusetts), which may underestimate volume because the software was designed for LV volume analysis and was applied to the left atrium. Curiously in this study, inter- and intraobserver variability of biplane 2DE and RT3DE were similar and approximately twice as great as CMR, and RT3DE test-retest variability was 11%. Although this variability may be clinically acceptable, it is surprising in view of previous studies that showed better test-retest variability (10) and better interpretative variability (2,7) with RT3DE than with 2DE. Such test performance is necessary to reliably detect changes in LA volume in response to treatments in individual patients.
A few cautions regarding the use of RT3DE LA volumes merit emphasis. Data extrapolated from biplane 2DE should be used cautiously if the American Society of Echocardiography–recommended LA volume cutoff of 34 ml/m2 is used in the diagnosis of diastolic dysfunction (9). It would have been interesting to see how often RT3DE reclassified the pattern of diastolic dysfunction in this study. Recently, Stefano et al. (5) found that LA size using 1-dimensional, 2-dimensional, and biplane 2DE had better predictive accuracy for moderate or severe diastolic dysfunction than for any degree of diastolic dysfunction alone, but the LA area from the 4-chamber view alone performed as well as biplane 2DE. Whether there is incremental value of RT3DE over 2DE techniques is uncertain; RT3DE maximum LA volume correlated poorly with worsening LV diastolic dysfunction measured with E/e′ (11).
Similarly, it is difficult to extrapolate cut points derived from the large body of outcome data that were obtained using biplane 2DE. Outcome data using RT3DE are scant. Suh et al. (2) found that RT3DE (also measured with dedicated Tomtec software) was a better predictor of cardiovascular events than biplane 2DE in a group of patients with severe LV dysfunction followed for approximately 1 year; unlike 2DE, RT3DE-indexed LA volume was an independent risk factor on multivariable analysis. Caselli et al. (12) also reported a better correlation with major adverse cardiovascular events when LA volumes were obtained with RT3DE than biplane 2DE in 178 outpatients followed for 45 months. Although these data need to be confirmed, they do suggest a clinically important incremental benefit of RT3DE.
Although there are considerable data that support the use of the maximum LA volume, theoretical considerations and a growing literature suggest that perhaps minimum LA volume should be the parameter of interest (11–14). For example, LA elastance measurements and atrial ejection force, which reflect the inotropic state of the LA, are closely related to the minimum LA volume. Moreover, minimum LA volume is measured at end-diastole after being exposed to LV diastolic pressure; indeed, minimum, not maximum, LA volume was a sensitive and specific measure that predicted an elevated pulmonary wedge pressure (13) and was a significant correlate of diastolic dysfunction (11). In addition, RT3DE minimum LA volume was the best independent predictor of major adverse cardiovascular events (12), and biplane minimum LA volume was a better predictor of new-onset atrial fibrillation and flutter than maximum LA volume, although reproducibility was worse (14). Thus, it is notable that minimum LA volume was reported in the current study. Although biases with CMR and RT3DE for maximum and minimum LA volumes were similar, correlations with CMR and limits of agreement were better for maximum volumes; unfortunately, variability data were not reported for minimum LA volumes.
An unresolved question is whether the LA appendage contributes meaningfully to LA volume measurement. Although most investigators exclude the appendage as recommended, other investigators have included the appendage in the analysis (2). Our previous work suggests that, especially at high LA volumes, the contribution of the LA appendage to overall volume cannot necessarily be ignored (15).
A concern with the current study was the apparent inability to derive functional LA volumes (i.e., volumes reflecting the reservoir, conduit, and booster pump functions of the LA), which should be possible theoretically from RT3DE volume-time curves of the LA and LV. LA reservoir function has been particularly useful as a powerful, independent predictor of new-onset atrial fibrillation and flutter in the community (16) and of post-operative atrial fibrillation (interestingly, minimum, but not maximum, LA volume was also predictive) (17). Recently, total LA emptying volumes and fraction, measures of reservoir function, were analyzed using RT3DE and were shown to be related to diastolic LV dysfunction (11).
Finally, it is pertinent to ask how much certainty is needed to conclude that the left atrium is enlarged, particularly when existing cut points are known to have predictive accuracy. Mor-Avi et al. (9) convincingly demonstrated that RT3DE more accurately measures LA volume than biplane 2DE. However, it is unclear whether the incremental benefit of RT3DE for LA volume measurement is valuable clinically. Stated another way, just how accurate do we need to be to be certain?
Dr. Hoit is on the Speakers' Bureau for Philips Medical Systems. Sherif Nagueh, MD, served as Guest Editor for this paper.
↵⁎ Editorials published in JACC: Cardiovascular Imaging reflect the views of the authors and do not necessarily represent the view of JACC: Cardiovascular Imaging or the American College of Cardiology.
- American College of Cardiology Foundation
- ↵Quotes by Kedar Joshi: Quotations—Superultramodern Science and Philosophy & Quotations–General. http://superultramodern.blogspot.com/. Accessed June 12, 2012.
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About the artist
Melanie Lewis is a second generation, Jewish native Texan. Born in Houston, she has been doing art since childhood. Her formal art education consisted of a drawing course and a general art course as an undergraduate at Newcomb College. She received her Jewish education from her family and from attending Houston's Congregation Beth Yeshurun, where she developed a love of the Saturday morning services.
Beginning in the 1970's, and for the next several decades, her involvement in art and Judaism became secondary to education and work. She retired in 2000 from working as a science educator in the Department of Biology at Southwest Texas State University (now Texas State University). But just prior to retirement, art and Judaism had begun taking on larger roles.
She became increasingly involved in Austin's Congregation Agudas Achim, (CAA). After being in a B'nai Mitzvah class there in 1988, she later served on the CAA Board of Directors, and these days, she attends daily morning minyan. In 1998, she began art classes at the Laguna Gloria Museum Art School (now The Contemporary Austin). By 2003, she rented studio spaces and began showing her art in Austin.
Melanie's art is mainly representational. Others have described her work as colorful, imaginative and enchanting. She works primarily with acrylic paint, and paints whatever interests her. Jewish topics and Israel have always been a part of her portfolio. She does portraiture, especially from old family photographs, works from photos of nature, still life, and photos of her travels to Israel.
Then in 2015, Melanie attended an art exhibit by Natalie Frank at the Blanton Museum in Austin, Texas, showing pictures ("feminist re-imaginings") of selected Grimm Fairy Tales. The connection of stories and art was the inspiration to create Faces of the Matriarchs, paintings and a book related to the matriarchs' stories in the Book of Genesis from the Torah (The Five Books of Moses).


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BRADFORD Bulls coach Steve McNamara is promising his side will be more than ready to face the threat of the Giants in Friday's big Super League XV opener at the Galpharm Stadium.
McNamara's men begin their 2010 campaign with a new half-back partnership in main signing Matt Orford and Brett Kearney, while they also have a new hooker in fellow Australian Heath L'Estrange.
That means the Bulls could struggle to make an early impact as they bid to improve dramatically on last season's bitterly disappointing ninth-placed finish.
But after Thursday's 18-16 pre-season triumph at top-flight rivals Hull KR in which Orford had a hand in all three of his side's tries, McNamara is relishing this week's trip to his former club.
"It's going to be a good match, and we can't wait," said McNamara, who was at The Jungle last Tuesday to see the Giants cruise to an eye-catching 28-10 triumph over Castleford Tigers' full-strength Super League side.
"We know it's going to be tough, every game in Super League always is, but we feel we're ready to play.
"We may have a new half-back combination and recruited several other players in other key positions.
"But they're all very smart and very good players.
"They've trained well throughout pre-season and will have benefited significantly from playing in last week's pre-season game.
"Like every team in the competition, we want to get off to a flying start and we know we'll be ready to play come Friday night."
McNamara does, of course, have good memories of his last visit to the Galpharm when the Bulls beat the Giants 28-18 in mid August.
But the former Huddersfield captain doesn't believe that result will count for anything in the two clubs' first competitive 2010 fixture.
"That means nothing at all," he argued.
"It's a new season and a new game between two teams who have made key changes in player personnel in the hope of being even stronger.
"We believe that's the case with us, and I think it could also be the case with the Giants.
"To be honest, I haven't researched Huddersfield too much, because the pre-season is obviously focused on us and making sure we prepare as well as we possibly can.
"But it's hard to ignore them and the way they've been progressing.
"They were great last season with their performances as they showed by reaching the Challenge Cup final and finishing third in Super League.
"And with the signings they've made, I'm sure they will be strong again this year. We know we're going to have to be at our best."