text:
We are testing a new beta website for gov.scot
go to new site
Register to receive email news alerts, daily digest, weekly roundup or Topic newsletters.
Andy MacGregor and Jennifer Mindell
The main focus of this chapter is cardiovascular disease ( CVD). It also presents findings about diabetes and hypertension. Future Scottish Health Survey reports will include more detailed explorations of both these topics; their inclusion in this chapter is a reflection of their status as major health burdens and risk factors for CVD.
CVD is one of the leading contributors to the global disease burden. Its main components are ischaemic heart disease ( IHD) and stroke. In this report, the term IHD is used interchangeably with CHD (coronary heart disease). IHD is the second most common cause of death in Scotland after cancer; in 2009, 15% of deaths were attributed to it and a further 9% were caused by stroke. 1 Prevalence of CVD is higher in lower social classes and deprived areas. 2 A number of the Scottish Government's National Performance Framework national indicators 3 have a specific focus on CVD and inequalities. Of most direct relevance here, and outlined in the 2009 Better Heart Disease and Stroke Care Action Plan, 4 is the aspiration to:
Reduce mortality from coronary heart disease among the under 75s in deprived areas
In 2007 the Scottish Government published Better Health, Better Care5, outlining its action plan for improving health and health care in Scotland. This set out how NHS Scotland's HEAT6 performance management system (based around a series of targets against which the performance of its individual Boards are measured) would feed into the Government's overarching objectives. The below HEAT targets also reflect this approach 7:
Achieve agreed number of inequalities targeted cardiovascular Health Checks during 2009/10
Achieve an agreed number of inequalities targeted cardiovascular Health Checks during 2010/11
The introduction to the CVD and diabetes chapter in the 2008 Report outlined the recent policy context for this topic, including a number of strategies and initiatives that have been introduced by the Scottish Government and NHS Scotland to help reduce the prevalence of these conditions. This information is not repeated here, however some recent developments relating to CVD and diabetes follow, as does an overview of the new topic covered in this chapter, hypertension.
Diabetes is a major risk factor for cardiovascular disease and people with a diagnosis of both conditions have significantly worse outcomes in terms of mortality and morbidity than those with a CVD diagnosis alone .8 Diabetes is an endocrinal condition characterised by raised blood glucose levels as a result of impaired insulin function. The condition takes two forms. Type 1 diabetes is caused by an unpreventable autoimmune destruction of the pancreatic cells that produce insulin and its onset is generally, but not always, early on in life. Type 2 diabetes is the more common form of the condition and is estimated to account for around 87% of all cases in Scotland. 8 It occurs when the body becomes unable to respond to insulin, or to produce it, or both. Type 2 diabetes is commonly associated with being overweight or obese. While its prevalence is more common in older age groups, its onset in childhood and early adulthood is increasing. Type 2 diabetes can be prevented, or at least delayed, in many instances.
The 2001 diabetes guidelines ( SIGN no 55), although in force at the time that the data in this report were collected, were superseded by guidelines (no 116) published in March 2010. 9 This covers screening, provision of lifestyle advice and evidence-based interventions (support for weight management, smoking cessation, increased physical activity, healthy eating, moderate alcohol intake), psychological support, regular screening for and management of complications (kidney disease, retinopathy, and diabetic foot disease), and cardiovascular disease prevention. A revised Diabetes Action Plan is due for publication later in 2010.
Blood pressure is the force of the blood pushing against the walls of the arteries. Each time the heart beats, blood is pumped through the arteries to all parts of the body. Blood pressure rises and falls throughout each heartbeat cycle. Systolic blood pressure ( SBP) is the highest pressure in each cycle, and is when the heart contracts and blood is pushed through the arteries. Diastolic blood pressure ( DBP) is when the heart relaxes between beats and refills. Blood pressure is characteristically expressed as two numbers e.g. '140/90' where the 140 is the systolic and the 90 is the diastolic pressure. 10 As well as genetic influences, blood pressure increases in response to dietary salt, alcohol, and obesity and is reduced by physical activity. 10 Damage to the circulatory system results from raised blood pressure - hypertension - which has a number of serious consequences for health. Hypertension is one of the most important risk factors for both ischaemic stroke (where a blood clot interrupts the blood supply to the brain) and for the less common but more serious haemorrhagic stroke (where bleeding occurs in the brain). Hypertension accounts for at least one-third of strokes. 11 In general, one-third of people who develop a stroke will die, one-third recover fully, and one-third remain disabled. Raised blood pressure also contributes to the risk of heart disease. One of the main modifiable determinants of blood pressure level is salt. 12 Reducing population salt intake by 3g daily would reduce SBP by 3.6-5.6mmHg in hypertensives and 0.8-1.8mmHg in normotensives and would result in a 13% reduction in strokes and 10% fall in heart attacks across the UK. 13 The current target is to reduce daily salt intake to less than 6g daily 14 through public education campaigns to discourage individuals from adding salt to their food, 15 and reducing the salt content of manufactured foods. 16
Monitoring diabetes and hypertension are the two most common reasons for patients visiting a practice nurse, accounting for around 80 and 120 contacts respectively per 1,000 registered patients in Scotland. 17
This chapter draws on a wider range of data than the equivalent chapter in the 2008 Report as it takes advantage of the combined 2008/2009 nurse sample data which include direct measures of blood pressure and blood analytes. To make room for these extra analyses the detailed socio-demographic analyses presented last year are not repeated. This chapter reports the prevalence of self-reported CVD conditions and diabetes, rates of potentially undiagnosed diabetes, and hypertension (measured during the nurse visit). Trends in specific conditions and measures in 1995, 1998, 2003, 2008 and 2009, are described and the relationship between various risks factors and CVD is also investigated.
9.2.1 Methods
CVD conditions
Participants were asked whether they suffered from any of the following conditions: angina, heart attack, stroke, heart murmur, irregular heart rhythm, 'other heart trouble', and (if they responded affirmatively) whether they had ever been told they had the condition by a doctor. For the purpose of this report, participants were classified as having a particular condition only if they reported that the diagnosis was confirmed by a doctor. Those participants who reported having a particular condition were also asked if they had it in the last 12 months.
Participants were asked whether they suffered from diabetes and, if so, whether they had ever been told they had the condition by a doctor. Only those who reported that the diagnosis was confirmed by a doctor were classified as having diabetes. Women whose diabetes occurred during pregnancy with no subsequent diagnosis after this were excluded from the classification. No distinction was made between type 1 and type 2 diabetes in the interview. In some previous reports rates for each type were estimated by examining the age of onset of the condition and whether a participant was on insulin therapy at the time of interview. 18 However, with increasing rates of type 2 diabetes in younger age groups, and increasing use of insulin to treat it, this classification method is no longer considered appropriate. Rates of potentially undiagnosed diabetes were estimated from non-fasting blood samples of glycated haemoglobin. This is described below.
There have been significant changes to both the definition and measurement of blood pressure since the survey began in 1995. These were discussed in detail in the 2003 survey report and are not repeated here. 19
The 2008 and 2009 surveys used the same measurement equipment (the Omron HEM 907) as used in 2003. The protocol for the measurement of blood pressure in adults remained the same as in all previous years; blood pressure was measured in participants aged 16 and over who took part in the nurse visit. Three blood pressure readings were taken at one minute intervals, on the right arm, with the informant in a seated position, after a five minute rest. Blood pressure of pregnant women was not measured. The detailed protocol for blood pressure measurement is contained in Volume 2 of this report.
The blood pressure levels reported in this chapter are derived from the means of the second and third measurements obtained (from those participants in whom three readings were successfully obtained).
Blood samples
A non-fasting blood sample was obtained from 387 men and 498 women in 2008 and 415 men and 488 women in 2009. Pregnant women, anyone with a history of fitting or convulsions, and those taking anti-coagulant medicines (such as warfarin) were excluded from giving a blood sample. Full details of the response to the blood samples in 2008 and 2009, including the proportion of valid measurements obtained for each analyte, can be found in Volume 2 of this report.
9.2.2 Summary measures of cardiovascular disease and diabetes
Any CVD condition / Any CVD condition or diabetes
Participants were classified as having any CVD condition if they reported ever having any of the following conditions confirmed by a doctor: angina, heart attack, stroke, heart murmur, abnormal heart rhythm, or 'other heart trouble'. 20 A second definition that includes diabetes as well as the above CVD conditions is also presented in the tables as 'any CVD condition or diabetes' so that the total prevalence of these conditions can be seen. The trend table reports the prevalence of any CVD, and any CVD or diabetes, in 1995, 1998, 2003, 2008 and 2009.
Ischaemic heart disease
Participants were classified as having IHD if they reported ever having angina, or a heart attack, confirmed by a doctor.
Ischaemic heart disease or stoke
Participants were classified as having IHD or stroke if they reported ever having angina, or a heart attack, or a stroke, confirmed by a doctor.
9.2.3 Classification of blood pressure levels
The most recent guidelines from the British Hypertension Society state that antihypertensive therapy should be initiated in people with sustained levels of systolic blood pressure ( SBP) >160 mmHg or diastolic blood pressure ( DBP) >100 mmHg; and that in people with levels of SBP between 140 and 159 mmHg and/or DBP between 90 and 99 mmHg, treatment should be decided on the basis of presence or absence of CVD, diabetes, other target organ damage (e.g. kidney), or an estimated CVD risk = 20% over 10 years. 21 The most recent guidance from SIGN concurs with the guidance for treating those with existing or high risk of CVD, 22 while separate SIGN guidance recommends the use of antihypertensive medication for people with a previous stroke or transient ischaemic attack ( TIA, like a stroke but lasting less than 24 hours) regardless of BP level. 23
These guidelines are not universally accepted 24. For example, the United States uses guidelines that are more restrictive so that 140/90 mmHg (irrespective of risk factor) is considered the threshold for treatment and target to achieve. 25 In 2003 the European Society of Hypertension and the European Society of Cardiology jointly recommended a threshold of 140/90 mmHg in general and 130/80 mmHg for those with diabetes. 26
This report continues to use the blood pressure definition that was introduced in the 1998 survey (140/90 mmHg), in accordance with the British Hypertension Society guidelines. 21
Adult participants were classified into one of four groups on the basis of their systolic ( SBP) and diastolic ( DBP) blood pressure and current use of anti-hypertensive medications as follows:
SBP<140 mmHg and DBP<90 mmHg, not currently taking any drug specifically prescribed to treat high blood pressure
Hypertensive controlled
SBP<140 mmHg and DBP<90 mmHg, currently taking a drug specifically prescribed to treat high blood pressure
Hypertensive uncontrolled
SBP³ 140 mmHg or DBP³ 90 mmHg, currently taking a drug specifically prescribed to treat high blood pressure
Hypertensive untreated
SBP³ 140 mmHg or DBP³ 90 mmHg, not currently taking a drug specifically prescribed to treat high blood pressure
For the purpose of this report, the term 'hypertensive' is applied to those in the last three categories.
9.2.4 Blood analytes
Glycated haemoglobin
Glycated haemoglobin (HbA 1C) reflects the level of glucose in the blood over the preceding two to three months, and is therefore a better indicator of diabetic control than a random glucose sample, that is affected by recent food or drink intake. Elevated glycated haemoglobin in people without diabetes is associated with increased mortality following acute myocardial infarction. 27 Levels rise in people with undiagnosed diabetes. In June 2009, an international expert committee recommended using levels of 6.5% or more to diagnose diabetes. 28 Levels of 5.7% or more have been proposed as a screening test for diabetes. 29 However, neither has yet been accepted within Scotland or the UK.
The latest SIGN guidelines for diabetes sets <7% as the HbA 1C target for good glycaemic control in people with diabetes, 9 consistent with indicator DM 23 within the Quality and Outcomes Framework ( QOF) for 2009/2010. DM 23, which replaces DM 20, gives GPs the target of 40-50% of their diabetic patients having HbA 1C <7%, a reduction from <7.5% within DM 20. 30,31 The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology ( ESC) and of the European Association for the Study of Diabetes ( EASD) recommends that HbA 1C be kept <6.5% to reduce cardiovascular risk. 32 For the purpose of this survey, a glycated haemoglobin value of 6.5% or above in people with no existing diabetes diagnosis was taken to indicate possible undiagnosed diabetes. The sample size for people with a diabetes diagnosis is too small to assess whether their condition is being adequately controlled so the chapter only looks at people with no such diagnosis.
Total cholesterol
Prospective studies have identified an increased risk of coronary disease associated with raised cholesterol concentration. A meta-analysis of all randomised trials of more than two years duration showed that lowering serum cholesterol confers clinical benefit as expressed in lower CHD mortality and total mortality risk, with the magnitude of benefit directly related to the degree of cholesterol reduction. 33 For the purpose of this survey cholesterol was considered to be raised at a level of 5.0 mmol/l or over. In 2000 the National Service Framework for Coronary Heart Disease suggested a total cholesterol target below 5.0 mmol/l for all patients with arterial heart disease or significant cardiovascular risk. 34 The QOF target for GPs relates to the percentage of patients with coronary heart disease whose total cholesterol is 5.0 mmol/l or below. 35 In 2005, the recommendations for defining and treating hypercholesterolaemia were superseded by the second guidance from the Joint British Societies, JBS2 .36 European guidance is based on assessing cardiovascular risk, using the SCORE tool, 37 while in Scotland the ASSIGN risk assessment tool has been developed to take better account of the risks associated with social deprivation and family history of CVD. 22SIGN Guidance advises the use of statins in people with pre-existing cardiovascular disease, diabetes, or estimated 10-year CVD risk of 20% or above, regardless of cholesterol level, or in those with total cholesterol of 8.0mmol/l or above. 9, 22, 23 The Scottish Government's 2009 Better Heart Disease and Stroke Care Action Plan also covers Familial Hypercholesterolaemia, a genetic condition in which affected people have very high cholesterol levels and high risk of premature cardiovascular disease. 4
High-density lipoprotein cholesterol
Studies have shown that high-density lipoprotein cholesterol ( HDL-cholesterol) is inversely and independently associated with the risk of developing CHD. 38,39 Furthermore, low levels of HDL-cholesterol are associated with a worse prognosis after myocardial infarction. 40 Protection against CVD by HDL-cholesterol is conferred in at least two ways. The first is that it transports cholesterol back from organs such as arteries to the liver for elimination, thus protecting the arteries from further atheromatous plaque formation. The second is by acting as an antioxidant. Increasing physical activity, decreasing alcohol intake, quitting cigarette smoking and losing weight can elevate HDL-cholesterol. Attention is generally recommended for HDL-cholesterol concentrations <1 mmol/l.
C-reactive protein
C-reactive protein ( CRP) is an acute-phase reactant which is synthesized in the liver in response to the pro-inflammatory protein interleukin 6 ( IL-6). It is therefore a sensitive marker of inflammation. Levels of these acute phase proteins have been related to risk of coronary heart disease ( CHD). Elevated levels of CRP are associated with increased risk of myocardial infarction ( MI) or sudden death among those with stable and unstable angina pectoris, 41 as well as with coronary heart disease in the elderly and coronary mortality among high-risk patients. The follow-up of the Multiple Risk Factor Intervention Trial ( MRFIT) has documented a strong relationship between levels of CRP and subsequent risk of CHD deaths among cigarette smokers. 42 However, it is more likely that these associations are due to confounding, with CRP unlikely to be causally related to CHD. 43 Although an American study raised the possibility that assessment of CRP may also provide a method of determining risk of future MI among apparently low-risk individuals, including non-smokers, 44 a review in 31 studies found that CRP was generally no more effective than the classical Framingham score in predicting CHD. 45 In the US, the first set of guidelines endorsing use of high-specificity CRP (hs CRP) in risk factor screening for CVD were produced in 2003, 46 but CRP is not currently included in screening in the UK, 36 nor is there a recommended CRP threshold in the UK.
This section reports findings from the 1995, 1998, 2003, 2008 and 2009 Scottish Health Surveys. It examines the trend over time in the prevalence of: any CVD, any CVD or diabetes, IHD, stroke, and IHD or stroke. Changes to the sample composition over the first three survey years mean that the total figures presented for adults between 1995 and 2009 are for those aged 16-64, the trend for all adults aged 16 and over is also shown for 2003 onwards.
The 2009 prevalence figures for men and women, for each of these conditions, are shown in Table 9.1 and are summarised below. The prevalence of any CVD or diabetes, IHD, and IHD or stroke was significantly higher for men than for women. Prevalence of all these conditions increased markedly with age. For example, rates of any CVD, and any CVD or diabetes were below 5% for men aged under 35, and women under 25, whereas more than half of men, and around four in ten women aged 75 and over had these conditions. Table 9.1
IHD or stroke
Any CVD
Any CVD or diabetes
9.3.1 Any CVD, and CVD or diabetes, 1995, 1998, 2003, 2008, 2009
The prevalence of any CVD in men aged 16-64 was 8.4% in 1995, 8.1% in 1998 and then increased to 9.7% in 2003 and has been fairly static since then (9.9% in 2008 and 9.5% in 2009). Among women aged 16-64 prevalence ranged between 8.5% and 8.9% between 1995 and 2003. More recently, it was 10.7% in 2008 and 9.0% in 2009. The overall pattern between 1995 and 2009 therefore appears to suggest trendless fluctuation, with a possible outlier in 2008.
In contrast, the prevalence of CVD or diabetes among men has now increased in every survey year, from 9.4% in 1995, to 9.7% in 1998, 11.1% in 2003, 12.2% in 2008 and to 12.6% in 2009. The statistically significant increase between 1995 and 2009 in the prevalence of CVD or diabetes is largely accounted for by increasing levels of diabetes over time. However, it is not possible to conclude the extent to which this trend represents an overall increase in the incidence of CVD and/or diabetes among men or improved diagnostic or survival rates for these conditions. As shown in Chapter 7, levels of obesity have increased in this period which will have contributed to an increased incidence of type 2 diabetes.
The prevalence of any CVD or diabetes among women followed a similar pattern to that for any CVD; the rate ranged from 9.6% to 10.2% in the three earlier surveys, was higher in 2008 (12.8%), and lower again in 2009 (11.1%). Table 9.1
9.3.2 IHD, stroke, and IHD or stroke, 1995, 1998, 2003, 2008, 2009
The prevalence of IHD among men aged 16-64 has been similar across all survey years (ranging between 3.2% and 4.1%) with no significant trend. The same was true for stroke (ranging between 0.7% and 1.2%) and IHD or stroke (4.2%-5.0%). For women aged 16-64 there has been a slight decrease in IHD over time (from 2.9% in 1995 to 1.9% in 2009). Prevalence of IHD or stroke among women of this age was consistent over time (ranging between 2.4% and 3.2%). The slight increase in stroke prevalence noted last year (from 0.5% in 1995 to 1.2% in 2008), does not appear to represent a clear pattern as the prevalence in 2009 was 0.9%. Table 9.1
9.3.3 Diagnosed diabetes
Doctor diagnosed diabetes was estimated in both 2008 and 2009. However, to explore this in more detail, data from both years have been combined to provide a larger sample. This means that the estimates for men, women and different age groups are more precise.
In 2008/2009, 5.0% of adults aged 16 and over reported that they had been diagnosed by a doctor as having type 1 or type 2 diabetes; this was more common in men (5.7%) than women (4.3%). However, below the age of 45, women had slightly higher prevalence rates than men. Prevalence of doctor-diagnosed diabetes increased with age, most notably from the age of 45 in men and from the age of 55 in women. 5.7% of men and 3.2% of women aged 45-54 had doctor diagnosed diabetes compared with 14.2% of men and 9.9% of women aged 75 and over.
The prevalence of doctor-diagnosed diabetes in men and women has increased significantly over time. Between 1995 and 2008/2009 prevalence increased among those aged 16-64 from 1.5% to 4.0% in men and from 1.5% to 2.9% in women. When all adults aged 16 and over were considered there also appeared to have been a significant increase since 2003 in doctor-diagnosed diabetes among men. In 2003, 3.8% of men aged 16 and over had doctor-diagnosed diabetes compared with 5.7% in 2008/2009. The difference between the corresponding figures for women (3.7% and 4.3%, respectively) was not significant.
The 2008/2009 estimates of doctor-diagnosed diabetes reported here are very similar to those in the 2009 Scottish Diabetes Survey. This estimated the prevalence to be 5.0% in men and 3.8% in women (4.4% of all adults, equating to 228,004 people). 47 Of these, 87% had type 2 and 12% type 1 diabetes. Both the Scottish Health Survey and the Scottish Diabetes Survey estimates are higher than the QOF prevalence estimate for 2008/09 of 3.9%. 48 However, there are known problems with comparing QOF prevalence estimates with other sources. 49Table 9.2
9.3.4 Possible undiagnosed diabetes
In 2008/2009 2.5% of adults aged 16 and over (2.9% of men and 2.0% of women) without a diagnosis of diabetes had glycated haemoglobin levels of 6.5% or above, indicative of possible undiagnosed diabetes. The highest prevalence was in those aged 65-74: 9.0% of men and 7.9% of women without a diabetes diagnosis had raised glycated haemoglobin levels.
Glycated haemoglobin was first measured in the survey 2003 when the prevalence of raised levels was 1.1% overall (1.2% for men and 1.0% for women). The 2008/2009 figures therefore suggest at least a two-fold increase in prevalence of raised glycated haemoglobin in both sexes since 2003, which was statistically significant. The increased prevalence in 2008/2009 was due to higher percentages of men aged 35-74, and women aged 65 and over, exceeding the 6.5% glycated haemoglobin threshold. No adults aged under 35 without a diagnosis of diabetes had a raised glycated haemoglobin level in either 2003 or 2008/2009. For each of the older age groups the percentage with raised glycated haemoglobin was higher in 2008/2009 than in 2003. Table 9.3
9.4.1 Blood pressure level
Table 9.4 presents the four levels used to classify hypertension. They distinguish between people with normal blood pressure who are not receiving any treatment for hypertension, and those with normal levels who are taking anti-hypertensive medication. They also distinguish between people with raised blood pressure who are receiving treatment, and those who are not. These latter two categories are important target groups in the population. The first includes people with poorly managed hypertension, and the second provides an estimate of the prevalence of potentially undiagnosed cases of this condition. It should be noted, when considering this last category, that not everyone with a one-off raised blood pressure measurement actually has hypertension on repeated measurement; the definition of hypertension is 'sustained raised BP'. Nor does everyone with BP 140-159/90-99mmHg warrant treatment, which is indicated for people with existing CVD, diabetes, damage from raised blood pressure (e.g. kidney disease), or at high risk of developing CVD.
Hypertension in 2008/2009
Looking first at all forms of hypertension (blood pressure of ³ 140/90 mmHg, or taking anti-hypertensive medication), in 2008/2009 34.6% of men and 30.4% of women aged 16 and over were hypertensive. With the exception of the 75 and over age group (where rates were similar), men were more likely than women to have hypertension in every age category; the difference was most notable in those under 35. Hypertension increased with age for both sexes. In women, the prevalence was relatively low in the younger age groups (1.5%-5.7%), and increased sharply for those aged 34-44 (11.2%) and 45-54 (30.2%). This was followed by a more than two-fold increase between the 45-54 and 65-74 age groups to 67.0%, and was similar in the oldest age category (70.2%). In men, rates were higher in the younger age groups than they were for women (12.4%-14.5%), but the increase with age followed the same general pattern. The most notable increase in rates of hypertension for men was observed between those aged 45-54 (32.4%) and 55-64 (52.4%), before peaking in the two oldest age groups (70.7% and 67.5%). Table 9.4, Figure 9A
Untreated hypertension was found in 20.1% of men and 14.3% of women aged 16 and over, which, as noted in Section 9.4.1, is a possible indicator of the level of undiagnosed hypertension in the population. For men under 45 and women under 55, untreated hypertension was far more common than controlled or uncontrolled hypertension. Untreated hypertension generally increased with age, and was highest in both men and women aged 55 and over. In men, the highest prevalence of untreated hypertension was found in those aged 75 and over (29.5%). Among women, the rates were highest in those aged 65-74 (26.6%).
The rates of successful and unsuccessful hypertension control were similar to each other. 8.3% of men and 8.2% of women had controlled hypertension (i.e. had a normal blood pressure level), 6.2% of men and 7.9% of women had uncontrolled hypertension, despite taking anti-hypertensive medication. Both increased with age, and around a fifth of men aged 55 and over, and women aged 65 and over, had controlled hypertension. Rates of uncontrolled hypertension were also highest in the oldest age groups (around a fifth), though women aged 75 and over had higher rates of this (28.8%). Table 9.4
Trends in hypertension 1998, 2003 and 2008/2009
This section compares blood pressure levels in 1998, 2003 and 2008/2009. Blood pressure categories use information about prescribed medications. As questions about medications were first included in SHeS in 1998 the trends in blood pressure levels exclude 1995. As adults aged 75 and over were not included in the 1998 survey the figures presented here are based on those aged 16-74. Table 9.4 also includes figures for adults aged 16 and over for 2003 and 2008/2009.
There has been an increase in the prevalence of hypertension among men aged 16-74 since 1998 (from 22.3% to 32.1% in 2008/2009). However, the rates in 2008/2009 and 2003 (29.5%) were not significantly different, which might suggest that the rate of increase has slowed or levelled off. Later figures in the series, for example from 2010/2011, will help to confirm whether this is the case. It is also worth noting, as the 2003 Report did, that the change in the measurement equipment used between 1998 and 2003 might have contributed to some of the increase in hypertension. 19
The same pattern was observed among women; although the increase since 1998 was smaller than it was for men, it was significant. In 1998, 21.2% of women aged 16-74 had hypertension compared with 26.7% in 2003 and 25.9% in 2008/2009.
The prevalence of successfully controlled hypertension among men aged 16-74 has increased steadily and significantly from 3.0% in 1998, to 5.3% in 2003, and to the current prevalence of 7.4%. The corresponding figures for women were 4.4%, 6.0% and 6.7%, respectively, which was also a significant increase.
The small increase in controlled hypertension among men has not been accompanied by falls in the levels of uncontrolled or untreated hypertension. Both of these have increased very slightly since 1998, though in both cases the 2003 and 2008/2009 figures were fairly close. For example, 15.6% of men aged 16-74 in 1998 had untreated hypertension, compared with 19.6% in 2003 and 19.3% in 2008/2009. As with the other categories, rates of untreated hypertension among women aged 16-74 have seen smaller changes over time (from 12.8% in 1998, to 14.8% in 2003 and 13.6% in 2008/2009). Table 9.4
9.4.2 Systolic blood pressure ( SBP)
Table 9.5 shows mean blood pressure levels. Mean SBP was 130.3 mmHg in men and 125.5 mmHg in women aged 16 and over. Mean SBP was higher in men than in women under the age of 65, but was slightly higher among women from the age of 65. Mean SBP increased with age, with the highest levels for both sexes found in those aged 65-74 (137.9 mmHg for men, 140.4 mmHg for women). Mean SBP then decreased slightly in those aged 75 and over.
Table 9.5 also compares mean SBP in 1995, 1998, 2003 and 2008/2009, for adults aged 16-64. Mean SBP in both sexes has been broadly similar in every survey year. Indeed, mean SBP was identical in 1995 and 2008/2009 for women aged 16-64 (121.7 mmHg), and was almost the same for men (128.3 and 128.7 mmHg, respectively). Table 9.5
9.4.3 Diastolic blood pressure ( DBP)
Mean DBP was almost identical in both sexes aged 16 and over (73.8 mmHg in men and 73.9 mmHg in women). Among men, mean DBP rose from 65.3 mmHg in those aged 16-24 to 78.0 mmHg in those aged 45-54, before decreasing steadily to 68.8 mmHg in those aged 75 and over. Among women the mean DBP increased from 70.3 mmHg in those aged 16-24 and then peaked in those aged 55-64, before decreasing to 68.6 mmHg in those aged 75 and over.
There was an increase in mean DBP among men aged 16-64 between 1995 (72.9 mmHg) and 2003 (74.6 mmHg), but the figure for 2008/2009 (74.2 mmHg) was very similar. Mean DBP in women aged 16-64 has increased slightly between each survey year, from 69.6 mmHg in 1995, to 70.5 mmHg in 1998, 73.5 mmHg in 2003, and 74.6 mmHg in 2008/2009. The differences in mean DBP between 1995 and 2008/2009 for both sexes were statistically significant. Table 9.5
9.5.1 Prevalence of risk factors amongst those with and without CVD conditions
This section presents the prevalence of a range of behavioural, biological and socio-economic risk factors known to be associated with CVD, separately for those with and without any CVD conditions (using the same definition as in Table 9.1). The figures in Table 9.6 are based on the 2008 and 2009 surveys combined. Many of the risk factors explored here are used in the risk assessment frameworks such as ASSIGN and Framingham.
The risk factors included in this analysis were as follows:
All these risk factors are known to be associated with CVD. Given that they are recognised risk factors, one might expect to find a higher prevalence of these among those with CVD than in people without the disease. However, as these data come from a cross-sectional survey conducted at one point in time, it is not possible to assess the direction of the association between these factors. In some cases, a lower prevalence of risk factors among people with CVD may, at least in part, be attributable to a diagnosis of CVD being followed by behavioural changes or medication. It is also possible that people with these risk factors may have been more at risk of dying than those without, leaving a residual CVD population with lower than average prevalence of these risk factors.
Smoking, alcohol consumption and physical activity
Smoking prevalence was more common among those without CVD than with, though the differences between the groups varied for men and women. For example, 26.8% of men without CVD were current smokers compared with 22.2% with CVD, whereas the equivalent rates for women were almost identical in the two CVD groups (24.9% without CVD and 23.8% with CVD). One possible explanation for this difference is that some people change their smoking behaviour after diagnosis. One way of exploring whether this is the case is to compare the rates of ex-regular smoking in people with CVD and without CVD. Those with CVD were much more likely than those without the disease to be an ex-regular smoker and this was especially true for men. 42.4% of men with CVD were ex-regular smokers compared with 20.9% of men without CVD. The corresponding figures for women were 28.5% and 19.8%, respectively. Table 9.6
Consuming alcohol in excess of weekly recommendations was more common among those without CVD than with, though the differences between the groups varied for men and women. In contrast, while men without CVD were more likely than those with to drink more than 21 units a week (29.6% versus 22.4%), the corresponding difference between women who drank more than 14 units was larger (20.8% versus 11.0%). It is likely that people who have been diagnosed with CVD will have had to make alterations to their smoking or drinking habits as a result of their condition.
Low activity levels were much more common in men and women with CVD than those without. Among men, 50.6% with CVD were inactive compared with 25.3% of those without. The corresponding figures for women were 53.1% and 30.0%, respectively. Almost two-thirds of men and almost three-quarters of women with CVD aged 65 and over were inactive compared with around half of those in the same age group without CVD. People who are physically inactive are at twice the risk of developing CVD as those who meet recommended levels of activity. Some people with CVD conditions may increase their levels of activity after receiving their diagnosis but others would become less active either due to concern or because symptoms of angina, pain in the legs on exercising, or breathlessness prevents exercise. Table 9.6
Overweight and obesity
Both men and women with CVD had a higher prevalence of overweight or obesity ( BMI of 25 kg/m 2 and above) than men and women without CVD. Among men, 77.6% of those with CVD were overweight or obese, compared with 66.5% of those without CVD. The corresponding figures for women were 68.8% and 60.2%, respectively. This might reflect the fact that obesity is a risk factor for CVD, or could be related to the above point that inactivity is more likely after a diagnosis of CVD (which could contribute to weight gain post CVD onset). Table 9.6
Family history
Both men and women with a family history of CVD (defined as one or both parents dying of CVD before the age of 65) were more likely to have CVD when compared with those without such a history. 17.0% of men with CVD compared with 9.8% without had a family history of CVD. The corresponding figures for women were similar, 17.7% and 11.8% respectively. Among men, this increased prevalence of family history of CVD in those with a diagnosis of CVD was observed in all age groups, but was most marked in those aged 16-64. In women the difference between those aged 45-64 was bigger than for the younger and older age groups. Table 9.6
Hypertension and diabetes
Hypertension was associated with being diagnosed with CVD in both men and women. 33.6% and 30.2% of men and women with CVD respectively had hypertension, compared with 24.8% and 20.7% of men and women without CVD. This is unsurprising, as a major indication for anti-hypertensive treatment is having existing CVD, so those with CVD are more likely to have their blood pressure checked and also to have raised levels treated.
There was a four-fold increase in men, and a three-fold increase in women, of having diabetes in the CVD group compared with those without CVD. 15.2% of men and 10.5% of women with CVD had diabetes compared with 4.0% and 3.2% of men and women without CVD respectively. Similarly, in addition to the increased CVD risk among people with diabetes, people with CVD are more likely to be tested for diabetes. Table 9.6
Blood lipids and c-reactive protein
Although the sample sizes are too small to look at the levels across different age groups, and the estimates for men and women with CVD will have wide confidence intervals, the overall patterns are generally clear. The prevalence of raised total cholesterol was lower in men and women with CVD than those without. This was much more marked among men: 32.9% of those with CVD had raised cholesterol compared with 60.5% without CVD. The corresponding figures for women were 56.5% and 62.3%, respectively. This decreased prevalence of raised cholesterol is most likely due to being prescribed drugs such as statins as well as, to a lesser extent, a change of diet after receiving a diagnosis of CVD. The equivalent analysis in 2003 also found the difference between those with and without CVD to be greater for men than women, however the size of the difference among men with and without CVD was greater in 2008/2009 than it was in 2003. This is most likely to be due to an increase in the use of statins since 2003, as has been seen in England, 50 probably in response to the QOF initiative, but a more detailed investigation than has been possible here must be carried out before such conclusions can be drawn.
Men with CVD had a higher prevalence of low HDL-cholesterol than those without CVD (19.0% compared with 8.1%). There was little difference in low HDL-cholesterol prevalence among women with and without CVD (3.3% and 2.7% respectively).
There was also an increased prevalence of high CRP in men with CVD compared with those without CVD (33.0% versus 17.7%). Women's CRP levels did not differ greatly between the two groups (22.8% versus 18.4%). Table 9.6
NS-SEC, income and deprivation
All the socio-economic risk factors had a higher prevalence in those with CVD compared with those without CVD. Men and women with CVD were more likely to live in semi-routine or routine households than those without CVD (50.0% versus 41.4% for men, 48.3% versus 40.7% for women). Similarly, men and women with CVD were more likely to be living in the lowest income quintile households, and in the most deprived areas, than those without. In each case, the difference between those with and without CVD was most marked in the 45-64 age group. For example, among men aged 45-64, 24.7% of those with CVD lived in the most deprived SIMD quintile compared with 15.7% of men of the same age without CVD. Whereas, the gap between men overall was quite small (21.0% versus 17.3%). This reflects the fact that those in worse socio-economic circumstances tend to develop, and die from, CVD at younger ages than their peers in more advantageous circumstances. Table 9.6
9.5.2 Prevalence of risk factors amongst those with and without IHD or stroke
This section repeats the same form of analysis as described above for any CVD, and looks at ischaemic heart disease and stroke, which are severe manifestations of CVD. As was mentioned in the previous section, caution is needed when interpreting the results as people with IHD or stroke may have amended their behaviours as a result of becoming ill and/or receiving such a diagnosis, may have been tested for additional diagnoses, such as hypertension or diabetes, and/or may be taking medication as a result of the diagnosis, such as statins or anti-hypertensive medication. Also note that the sample size for adults under 45 with IHD or stroke is very small so estimates are not presented here. Similarly, the sample size for those providing a valid blood sample and who had IHD or stroke is too small to permit comparisons for blood lipid and CRP levels.
Table 9.7 generally shows similar patterns to those shown for any CVD condition in Table 9.6. For example, the prevalence of exceeding weekly alcohol limits among both sexes is higher in those without IHD or stroke than those with these conditions. Conversely, low activity levels, being overweight or obese, and prevalence of diabetes, hypertension and a family history of CVD are all higher among those with IHD or stroke. It is notable that men and women aged 45-64 with IHD or stroke continued to be more likely to smoke after their diagnosis than those in the same age group without a diagnosis. The socio-economic risk factors were all associated with having IHD or stroke, with the differences between groups generally larger than was the case for any CVD. For example, 57.3% of men and 62.6% of women with IHD or stroke lived in semi-routine or routine households, compared with 41.2% of men and 40.3% of women without IHD or stroke. As with any CVD, socio-economic differences were the most notable in the 45-64 age group. Table 9.7
Logistic regression was used to estimate the independent effect of a range of factors associated with any CVD condition after each one had been adjusted for simultaneously. The factors investigated in the regression included a number of the behavioural characteristics explored in other chapters in this report, such as cigarette smoking, physical activity, alcohol consumption (drinking in excess of recommended weekly limits) and BMI, as well as the key socio-demographic factors of age, SIMD quintile, equivalised household income and both parental and household NS-SEC. Three additional factors of interest to CVD were also included: diabetes, family history of CVD and total cholesterol. Although data on other blood results ( HDL cholesterol, fibrinogen and C-reactive protein) and hypertension is also now available from two years of nurse visits, given that the missing values (i.e. those who did not participate in a nurse interview) for these largely overlap, the decision was taken to include only one of these variables in the regression model, in order to avoid problems relating to co-linearity. The regression was run separately for men and women using combined data for 2008 and 2009. 51 The factors found to be significant are discussed below. For more information about logistic regression models and how to interpret their results see the Glossary at the end of this volume.
The odds ratios of having any CVD condition among selected sub-groups for men and women are shown in Table 9.8. An odds ratio of less than one means that the odds of a given group having CVD are lower than that of the reference group. An odds ratio of greater than one means that the odds of that group having CVD are higher than for the reference group. Independent variables with a 'p' value of 0.05 or less are significant predictors of the dependent variable at the 95% confidence level. Reflecting the findings reported above, the odds of reporting any CVD condition increased significantly with age from 45 years onwards, with men and women over the age of 75 years having the highest odds of having CVD (12.8 and 6.2 respectively) compared with the reference category (those aged 16-24).
Area deprivation (as measured by SIMD quintiles) was significant for men, with those in the most deprived areas having higher odds of CVD than those in the least deprived. Although a similar pattern by SIMD was apparent in the odds for women, overall SIMD was not statistically significant in the model for women. Overall, equivalised household income was significantly associated with having CVD for women only, but the nature of the relationship was not clear.
A number of lifestyle factors were significantly associated with having higher odds of CVD. For both men and women, those who were ex-regular smokers had higher odds of having CVD (1.5 for men and 1.3 for women) than those who had never smoked. Weekly alcohol consumption was significant for women but not men, with women who consumed more than the recommended weekly limit having lower odds of CVD (0.7) than those whose consumption was within recommended weekly limits. Similar findings on smoking and alcohol consumption were found in the similar analysis presented in the 2003 Report, and in previous Health Survey for England analyses. They may reflect the fact that people may make changes to their lifestyle - such as giving up smoking and cutting down on alcohol - after a cardiovascular episode or diagnosis.
Low levels of physical activity were significantly associated with CVD for both men and women. Compared with those with high levels of physical activity (30 minutes a day on 5 or more days a week), the odds of men with low levels of physical activity (fewer than 30 minutes of moderate activity per week) having CVD were 1.4 times higher. For women, the odds were 1.7 times higher. As discussed in section 9.5.1 above, it is not possible from this cross-sectional data to ascertain the direction of the relationship between CVD and physical activity. It may be that some people with a diagnosis of CVD decrease their level of physical activity as a result. However, being physically active has been shown to contribute to a decreased likelihood of developing CVD over a lifetime. 52,53,54,55
Having doctor-diagnosed diabetes, shown to be a risk factor above, was associated with higher odds of having CVD even after other factors are controlled for. Men with diabetes had odds of 1.8 and women with diabetes odds of 1.9 compared with those without diabetes.
Finally, total cholesterol was significantly associated with the odds of having CVD. Men and women with raised cholesterol levels, of 5 mmol/litre or more have lower odds of having CVD than do those with lower cholesterol levels. As discussed above, this somewhat counter-intuitive finding, which has been replicated in earlier Scottish Health Surveys and in the Health Survey for England, reflects the fact that people with a diagnosis of CVD are now much more likely to be prescribed cholesterol lowering drugs (e.g. statins) than are people without CVD. Table 9.8
Page updated: Monday, September 27, 2010


text:
Ghost stories are a welcome experience in any medium. Like the original, F.E.A.R. 2: Project Origin is a painstakingly created game filled with eerie creaks, ghostly lighting, and hallucinatory interludes that turn the claustrophobic corridor shooter into something ghastly. The sequel continues where the original left off, digging into the origin story of Alma, the little girl behind all the terror and chaos in both games. You'll also get to play through the city of Aurora in the aftermath of the apocalypse that was unleashed at the end of the first game. Add in a substantial multiplayer mode and there are plenty of reasons to have Project Origin on your radar. For the official IGN review make sure to read Jason Ocampo's thoughts on the Xbox 360, PlayStation 3, and PC versions of the game.
So you're ready to lock horns with the supernatural, but aren't sure which platform to choose? Keep reading to see a detailed breakdown of all the key differences between the three different versions of the game.
Price Point
F.E.A.R. 2: Project Origin is available on PS3 and 360 for the standard price of $59.99. The PC version comes in at the less expensive $49.99. Some retailers are offering bonus loot in the form of a themed lithograph and a special dossier that details the first game from the point of view Genevieve Aristide. These extras should be available for all three versions of the game.

subset: commoncrawl


text:
This is the very expensive ( USD 1,100 + ) 80 Pfennig Germania stamp,with Sarre overprint, CTO. The upper right corner has a fault ( At first glance one could get the impression that the corner has been torn apart and repasted.
Looking at it closer this is not very likely as the borders are without fault. It rather seems that its because the paper is slightly uneven). One cannot see very clearly but it seems that some fault exists.
So the price for this item is only 35 %of the catalog price. ( Michel DEM 2,500 ) Clean cover in fine condition.
21 other shoppers have this item in their Cart or Wish List
We offer Vintage Postcards, Chinese Antiques, Autographs, Graphics and more. WORLD WIDE SHIPPING!!
Welcome! Your Shop for perfect Gifts, Vintage Collectibles and Unique Antiques. 2500+ Unique Objects to choose from.


text:
given that my vent session yesterday probably came off as a tad bit.. um.. negative, maybe?.. I decided I would write a sunbeam post.
this is partially for me, because lately I have felt myself slipping into a slumpy, slightly antisocial, rut in my life in general. a positive kick in the head might help. maybe. and it's also partially because my gorgeous, hilarious, super stylin friend, Erica (a.k.a. Rica.. que quiere decir "rich and tasty" in espanish. perfect.) nominated me as a "Kreativ Blogger." woop woop! (p.s. Rica, you nailed it when you said we laugh till we stop breathing. every time. it's my faaavorite.) so.. here it goes.
1. Copy the pretty picture and post it on your blog.
Idk what this is referring to. not gonna lie.
2. Thank the wonderful person that nominated you and link their blog.
3. Write 7 things about yourself we don't know.
1. I have had exactly 12 jobs. and I want a new one.
2. I basically like everything that is peach or guava flavored. just saying it makes my mouth water.
3. one time.. I had a gun pulled on me. while I was tracting as a missionary in Fort Myers, FL. he was an angry man. as you can see, however, I made it out alive.
4. I know an embarrassing amount about Disney movies. seriously. I own "Disney Scene It" every time. I'm the oldest of 5 kids, ok?
5. my favorite store is Target.. classy yet affordable, and therefore super dangerous to my bank account.
6. I am addicted to Bubble Breaker on my phone. whenever I have a dull moment, I pull it out. or when I'm on a phone call with a babbler at the crisis line. it helps my A.D.D. mind focus. and I just got a new phone exactly a week ago because the other one wigged out on me and stopped sending and receiving messages. and just since then my little counter says I've already played 303 games of it. oops.
7. I just barely stuffed tissues into the toes of my shoes because they are too big. and when heels this tall are too big, walking is almost impossible. this compressed tissue thing works like a charm.
I think I will skip the nomination part, except to say that I nominate any reader who would like to play this game.
and secondly, I'm going to add my own little dash of something extra to this post.. because I have not yet blogged anything about Thanksgiving. I really like Thanksgiving. it is delicious, but more importantly, it is important. it always seems to get leap-frogged because Christmas is just so dang awesome that everyone wants to sprint to it.
but it's also important to be thankful for what we have. Heavenly Father blesses us in a lot of little and big ways on a daily basis, and I would just like to take a moment to write a small list of things that make me feel blessed.
1. a wicked awesome family who thinks I'm funny and who loves me even when I'm ugly
2. alone moments in the car when I can turn up the music and sing at the top of my lungs
3. friends who are beautiful, hilarious, talented, and love me for me.. they're so cool that I sometimes think people just like me for my friends
4. the ability to create and appreciate creativity
5. hot milk steamers, cold fruit smoothies, peach rings, and grandpa's mashed potatoes
6. a closet full of cute things to wear
7. a warm house and a soft bed complete with my down comforter and my boyfriend–the electric blanket
8. hugs… big ones.
9. the fact that I have a job.. and cool co-workers
10. and more than anything else… my knowledge of the Restored Gospel of Jesus Christ, because it heals my soul and fills me with peace
happy holiday season guys, and I hope your snowflakes all have sunbeams shining through them.


text:
Aidan Coleman & Stephen McInerney
Madness, deception and betrayal are examined in Insight Shakespeare plays - King Lear. Containing the entire play, this comprehensive resource for students and teachers includes analysis of key themes and historical context, as well as a breakdown of vocabulary and language techniques. Group tasks and individual exercises stimulate discussion and encourage students to really engage with the play. Teachers are able to tailor their lessons to their students' interests and abilities, whilst addressing key elements of the Australian Curriculum for English.
Available Stock: 190
Full Description
The play, PLUS
The play, PLUS
- Fascinating historical and literary notes and illustrations that contemporary students can relate to, vocab banks, and summaries interpolated between scenes for easy reference
- Targeted activities build students' knowledge as they progress through the play
- Extension questions and activities for higher level exploration, discussion questions for group work.
- A complete resource for teaching the play, facilitating a successful and enjoyable experience with your students and Shakespeare!
- Numerous individual and group activities, extension exercises and discussion questions on each scene for teachers to choose from according to their students' interests and abilities.


text:
With more than 300,000 children's products - and 6,000 new ones just this year - the search for playful presents can be more exhausting than a ride on a brand-new scooter, more boggling than this year's three-dimensional puzzles. But for those in need of guidance, help is just a Nerf ball's throw away.
The Oppenheim Toy Portfolio, an independent consumer group, has released its ninth annual guide to children's products. The 2002 edition of "The Best Toys, Books, Videos, Music & Software for Kids" ($12) laments the plethora of "toys [that] are too loud and too bossy." To counter such overintrusive toys, the group ranks more than 1,000 products on a five-point scale.
It bestows Platinum Toy Awards - the highest honor - on several dozen gizmos, from classics such as Lincoln Logs to a three-foot-tall roller coaster. There are also more specific lists, such as "gender-free products," toys for children visiting parents' offices, group toys, and big-ticket items. Blue Chip Classic awards go to older products that are as engaging as ever.
The Oppenheims applaud this year's board-game selection, wider availability of powerful women figures, improved uses of technology, and diminishing emphasis on "grossness." They decry noisy, glitzy baby toys that intrude on natural curiosity, the "Zsa Zsa Gabor" emphasis on dress-up for "tweenage" girls, and technology that bosses children through play, rather than letting them invent scenarios of their own.
For weary parents in the thicket of blaring, blinking toys and holiday marketing hype, the guide brings a welcome voice of reason before toys meet their ultimate judges: the kids themselves.


text:
I'm a British Academy Postdoctoral Fellow at the University of Oxford working on human learning and decision-making. I'm based in Prof Chris Summerfield's lab in the Department of Experimental Psychology.
My fellowship has laid the foundations for an independent research programme to explore learning, decision-making and meta-cognition across risk domains. I'm also pursuing a range of related projects, from the compositionality of value representations to food decision-making, with internal and external collaborators.
Broadly, I'm interested in the cognitive mechanisms and the neural structures that support our decision-making abilities across a wide range of domains (from sensory, to sensori-motor to more cognitive decisions). I'm also interested in rationality/optimality, and hope that we are working towards a future where research will facilitate ameliorative interventions beyond narrow 'Nudges'.
Last updated 13.03.2018


text:
Foodbuzz 24, 24, 24: Cutting Edge Chinese Food at Singapore's Majestic Restaurant
In the heart of the Chinatown area of Singapore was an old faded hotel and restaurant known as the Majestic. I remember the building being one of those relics from the 1930's unkempt but with lots of potential. Our family used to go to the restaurant for good inexpensive Chinese food but certainly not a gourmet experience by any measure. In 2006 the hotel underwent a complete transformation into an incredibly stylish establishment with an equally modern restaurant. Decorated with custom designed furniture, chandeliers from the Mooi Weer Collection and sculpture by Cai Zhi Song, the restaurant is a modern Chinese art collector's dream. The food at the restaurant reflects this environment and was created by the modern Chinese master chef Yong Bing Ngen whom I had the opportunity to chat with last week. The restaurant has received numerous accolades since its opening in January 2006. In conjunction with the Foodbuzz 24, 24, 24 event I've arranged a dinner at the Majestic Restaurant.


text:
Sheridan Hancock, Rooms Manager from Base Auckland shares her story on an action packed 2 day Sea kayaking Tour Trip.
It's a common misconception that Auckland is just a gateway, and there's not much to do, but the trip I went on this weekend totally proved this wrong! The Auckland Sea Kayaks 2 day tour was one of the best things I have ever done in my home city. It was a physically active trip, with a nights camping on the stunning islands of the Hauraki Gulf. There was lots of sun, sea, good food and great company.
We set off on Saturday morning after packing up the supplies for our overnight trip into the kayaks. The first kayak leg was from St Heliers to Browns Island. It was a nice cruisy introduction of around an hour, before beaching on Browns Island and walking to the summit. This was only a short walk but provided stunning views of the harbour and East Auckland. The best part was when we got back to the beach our kayak guide Nic had laid out an amazing picnic lunch. Awesome healthy tasty sandwiches and even plunger coffee! After stuffing ourselves, our group of 5 made our way over to Motuihe Island. This was another easy 1.5 hour paddle with lots of sunshine and chatting on the way. When we beached on the white sands of Motuihe we carried our kayaks up to the Department of Conversation campground before stripping off and running into the water for a refreshing swim. Not a bad afternoon splashing around, exploring the island and setting up camp.
After pitching our tents and setting up with all the camping gear provided we sat around admiring the view and feeling very well exercised and sun kissed. We had a couple of hours to eat, drink and enjoy being on an island in the middle of the gulf before dinner. Dinner was an amazing Thai Green Curry and even a glass of wine followed by cake and custard for desert. It really helped having all food prepared and organised for us. After dinner we took off to explore the old Prisoner of War camp on Motuihe and as it got dark headed further into the island to try and spot some Kiwi birds. After trying our hardest to be quiet and hear our national icon in the bush, we headed to the beach where we saw 3 kiwis running across the shoreline – such an awesome feeling!!
Getting to sleep that night was easy and of course we woke up to boiled eggs and coffee in the morning, such great service! It was a little windier on day 2 but we got into our kayaks and paddled across to Rangitoto Island and then had a leisurely hike to the summit. It was fun with a little more wind and we managed to get nice and salty! After hiking to the summit and checking out the 360 degree views of Auckland and the Waitemata Harbour we headed back to our boats for our final picnic lunch.
The paddle back to St Heliers was perhaps the toughest of all because of slightly more wind and possibly because our shoulders were a bit fatigued! When we beached up on St Heliers it was a great feeling of satisfaction and achievement. It was such an amazing trip for people that like to be outdoors and get active.
I can't recommend this enough, the team at Auckland Sea Kayaks put on an excellent trip!


text:
Hello Crazies!
Recently I was given the privilege of a pre-release copy of "Spartan Fit!", the latest upcoming release of Spartan Race founder and now author, Joe De Sena.
If you got the chance to read his last book "Spartan Up!", you will love this new edition! If you haven't, I suggest grab a copy and prepare for this world of epicness bound in one place.
"Spartan Fit!" is something different, it is not your normal guide to healthier living, work out routines, meal options or inspirational quotes (though all of the above are included). This read has something for everyone, from the guy/girl who hasn't ran other than to their car in the rain, to the competitive athlete that's grinding day in and day out.
Anyone who is able to get through the 1st chapter and not feel that burst of adrenaline that happens when a spark of inspiration ignites, message me. We need to talk!
No, seriously…
Joe hit a home run with this one. Looking to get started and work your way into a healthier routine? How about just the casual training and a few good eats? Maybe, you're already a beast and struggling to find new exciting ways to test your limits? I can safely say, you will find something within these pages no matter your current level or lifestyle.
I can honestly say that after reading through it, I felt the need to get up and do more, be better and try harder. I haven't come across many reads that have that affect, I had to share with my fellow enthusiasts
That's my rant for today and feel free to get yourself a copy when its released!
Links below to preorder and a link to read the 1st chapter (Prologue that is not included is pretty badass too)


text:
International vacations increase during spring and summer months. As travelers begin making preparations, they can be reassured that Sprint has their international roaming needs covered with worldwide service that's EASY, AFFORDABLE, and WORRY-FREE.
As a frequent international traveler, I know firsthand the importance of being able to travel with confidence and stay connected while outside the U.S. This past year my travels included Germany, Hong Kong, Israel, Japan, Macau, Mexico, Netherlands, and Spain. In every destination I was able to connect effortlessly with family, friends, and colleagues.
Over the past few years, Sprint has shifted the international wireless service paradigm by automatically providing customers international roaming service with no additional monthly fee, no surprise charges, and no bill shock. Customers no longer need to fear using their wireless service while traveling abroad. Customers no longer need to consider buying a SIM card for the country they are visiting. There is no need to call Customer Support. There are no complicated set-up tasks.
Here's how it works:
- Reach your travel destination
- Turn on your smartphone
- Receive destination-specific text Welcome Messages from Sprint detailing available services and rates
- These messages ensure transparency and help each traveler manage use and cost accordingly. No surprises. No bill shock
- Enjoy your international service – no complicated steps required!
Sprint Global Roaming features the industry's largest low-cost service area, more than 185 featured destinations. Customers enjoy a consistent experience with free text, free basic data, and calls from only 20 cents per minute.
If customers need high-speed data while traveling abroad, they can select $5/day or $25/week passes on-the-fly directly from their smartphone with just a few simple clicks. No advanced planning is required and no account log-in is necessary. And Sprint high-speed data includes 4G/LTE where more than 95 percent of customers use data.
Sprint around the world! You're covered in popular places like Canada, the Caribbean, Mexico, and throughout the Americas. You can roam Europe visiting France, Italy, Spain and Russia (World Cup 2018 anyone?). Visit exotic destinations like China, Egypt, Hong Kong, India, the United Arab Emirates and Vietnam. Explore more of Africa across Kenya, Namibia, Rwanda, Tanzania, and Zimbabwe. And confidently journey to faraway places like Australia, Fiji, New Zealand and Japan.
There are plenty of things to worry about and plan for when traveling internationally. Your wireless service should not be one of them. By automatically enabling worldwide service for customers, Sprint eliminated international plan shopping and complicated device setup. With Sprint, international service is easy, affordable, and ready to roam the world with you.
For Sprint postpaid plans. Reqs. capable device. In select cities includes data at up to 2G speeds, SMS text (excl. audio, picture & video messaging) and Voice: 20¢/min. For a list of available roaming cities, visit sprint.com/sww. Not for extended international use; primary usage must occur on our U.S. network. Svc. may be terminated or restricted for excessive roaming.


text:
Scripture: 2 Chronicles 13:4,5
2 Chronicles 13:4,5 says, "Then Abijah stood on Mount Zemaraim, which is in the mountains of Ephraim, and said, 'Hear me, Jeroboam and all Israel: Should you not know that the Lord God of Israel gave the dominion over Israel to David forever, to him and his sons, by a covenant of salt?'" God not only gave the tithe to the Levites, but He gave dominion to all those who participated. This is a governmental connection that is often missed by students of the Word. There is a reason why David's mighty men became the exemplary warriors that they did. In King David's expression of the covenant of Sure Mercy, he emphasized the dominion side of the covenant. In the process of dominion is the full weight of God's Throne to back up His purpose for that mission. This meant the destruction of any person who was trying to thwart that purpose. The authority to go to war comes from the covenant of salt. The authority to pray judicial prayers comes from being one who is obedient to God in our resources and where we put them. The degree to which we do our part of a covenant seems to indicate the degree to which God will release His power in our behalf.


text:
Washington Post, August 3, 1978
HEADLINE: Washington's Big Mac Attack: Hungry Politicians Turn to RockBYLINE: By Nancy CollinsBODY:It wasn't your average party for one of America's most popular and successful rock 'n' roll bands.Normally when Fleetwood Mac is feted, the decor is more wall-to-wall denim than lip-to-lip three-pice suits.The crowd is younger, and and music is the No. 1 topic of conversation. Chocolate mousse and champagne are not served. And waiters in black tie do not wander around taking drink orders. The guest list Tuesday night was something special too: presidential assistants Hamilton Jordan and Tim Kraft, first son Chip Carter. White House media adviser Jerry Rafshoon. Majority Whip John Prademas (D-Ind.), Sen. Alan Cranston (D-Calif.), Rep. Tim Wirth (D-Colo.), California candidate for lieutenant governor Yvonne Brathwaite Burke and New Jersey Senate candidate Bill Bradley. "Six concerts by someone like Fleetwood Mac would pay for a whole campaign" said Mickey Shapiro, the band's lawyer, who himself cut his teeth working for Birch Bayh.And, indeed, that thought was not lost on the politicos circling beneath the hanging baskets of ferns at La Serre, a private Georgetown club. "Rumours" and "Fleetwood Mac," the group's last two albums have sold more than 20 million copies - without the benefit of a movie. Last night's Capital Centre concert, canceled at the last minute, was part of a 10-city tour - was sold out early, and the band is currently working on a new album which is practically a platinum guarantee.The Big Mac, as they say in L.A., is definitely hot.If politics breeds strange bedfellows, then nothing boggles the mind more than the marriage of politics and rock 'n' roll. The more restrictive campaign donations laws have made politicos suddenly give a little respect to Linda Ronstadt, the Big Mac. The Eagles, etc. Not that rock-meets-politics is a first-run engagement - the Capricorn-Carter-Walden precedent firmly established rock in the national political scene, and the president's surprise on-stage visit to Willie Nelson furthered the tradition.What is new is the frequency of rock-heavy-talks-it-over-with-political-heavy gatherings. The two cultures are slowly advancing from mingling to meshing.However, Tuesday's political soiree was as much a party for Fleetwood Mac as it was a tribute to the man who records them - Steve Ross, chairman of the board of Warner Communications, Inc. In June 1977 Ross, along with Arthur Krim, the independent Hollywood producer and powerful grandaddy of Democratic fund raising, put together Carter's successful $1,000-a-plate fund-raiser in New York. And since then, Ross is being touted by political insiders as Krim's heir apparent.The tall, patrician Ross denies the rumor, although Jordan says otherwise. "It was Arthur's idea for us to work with Steve," said Jordan, who described Ross a a "very good friend of ours. Arthur said we needed some new blood."And Kraft added that three weeks ago Ross organized a New York dinner with "30 affluent people" for himself. Jordan, Evan Dobelle, treasurer of the Democratic National Committee and Joel McCleary, deputy assistant to the president.La Serre filled up fast with smooth politicians and disco music blasting the background - politicos like Rep. Bob Krueger (D-Tex.), who excorted Carter's personal secretary Susan Clough. He admitted that he probably wouldn't know a Fleetwood Mac if he ran into one. "Have I heard of Fleetwood Mac?" said Krueger, who is currently running for John Towers' (R-Tex.) Senate seat. "Well, I've certainly heard of Steve Ross."Yvonne Brathwaite Burke, meanwhile, is a Fleetwood Mac fan, but her appearance at the party, she confessed, did have some ulterior motives. "No, I haven't asked Ross for a campaign contribution yet," she laughed. "But if I see him, I certainly plan to."Fleetwood Mac has done several benefits both for politicians and causes - Birch Bayh, the American Heart Association and Jacques Cousteau. (The band's bass guitarist, John McVie, is a serious environmentalist.)Last year the band helped bail out John Tunney after his losing Senate race piled up a hugh debt: "He'd just hit on rocky times," shrugged Mick Fleetwood, who was decked out in green velvet jeans, a blue-and-red polka dot shirt and pink satin vest. "I don't get wound up with what all these things are supposed to mean. Tunney had just tired to do something and failed, so we helped him out.""Last week Jerry Brown spent an hour and a half in my office talking to Chick Corea," said Shapiro. "I get as many calls from politicians as I do from record companies."But I'm no power broker," added Shapiro, who heard of the group through Bob Welch, a former Fleetwood Mac member. "A lawyer just doesn't wave a magic wand and hundreds of thousands of dollars float into the lap of a politician. That kind of thinking presumes the artist is a moron. Mick Fleetwood and John McVie (the band's founders) are brilliant. They make their own decisions."And the decision for a politician isn't an easy one.Darry Sragon, who was working for Bayh at the time the Fleetwood Mac concert was organized, said, "There are very few groups I would have recommended to Bayh for a concert. But Fleetwood Mac is straight in a loose kind of way. Of course, they're not exactly the Beach Boys of 1962, but they're not the Rolling Stones either.Fleetwood Mac is probably the only rock 'n' roll band qualified to compete with Washington's own ongoing saga of "Jimmy Carter, Jimmy Carter." The trials and tribulations of the Carterites-as-Washington-outsiders."Upstairs, Downstairs" with Midge Costanza, and the life and times of Hamilton Jordan are hard acts to contend with. Especially when Tuesday night's party added yet another episode to the Jordan legend."These days I'm not going to say anything unless I clear it first with Jerry Rafshoon," laughed Jordan just minutes before an unidentified man walked up to him and slammed a plateful of chocolate mousse in his face. This time, however, it was not Jordan who did the provoking. As soon as a friend fetched him a clean shirt, Jordan left.The band has been at it for almost 10 years. And their saga is one of rock 'n' roll's most complicated soap operas. In 1976, for instance, when the group began recording "Rumours," John McVie and his wife of eight year, Christine, one of the band's two female vocalists, were splitting up. At the same time, the band's other female singer, Stevie Nicks, was moving out on her boyfriend of six years, Lindsay Buckingham, the band's lead guitarist. Mick Fleetwood, meanwhile, was in the process of divorcing his wife, whom he has since remarried.Nonetheless, art won out, John McVie has since married again and the group remains together, because, says Fleetwood, "none of use hates each other."Besides Fleetwood and McVie, Christine McVie also showed up for the party, but she wasn't talking. Nicks and Buckingham were not there. Nicks was with her parents at an Eagles concert (her father, a former president of Armour Meats, now promotes the Eagles). Buckingham, though, was home sick, the result, John McVie said of "almost dying two days ago. Three hours before our Philadelphia concert, Lindsay had a seizure - a mild epileptic thing. It had nothing to do with drugs or anything like that. Anyway, the sound engineer saved his life - pulled his tongue out - and three hours later Lindsay was on stage. After the concert we checked him into the hospital for tests. He's okay now.""We did this tour to feel like a band again," said sound man Richie Dashut. "It's been eight months since we've played together. And being in a studio is like being in a submarine. It's close quarters os if you're not focused, you sink."If Fleetwood Mac was impressed with the White house turnout, it didn't show.Among the White House types, it was apparent that life has been a little tense since Peter Bourne's resignation and Carter's warning to his staff that anyone caught with so much as a joint would be out in the cold. At one point, Chip Carter walked over to presidential adviser Kraft, who currently shares a Georgetown house with Jordan and political pollster Pat Caddell.Grinning, Carter informed Kraft, "My old man told me I couldn't come over to your house anymore.""No, he didn't," smiled Kraft."Yes, he did.""Did not.""Did too.""Did not."Carter did say, however, that since his father was elected, he has not smoked marijuana. "The risk is too great," he said, adding, "but I don't think there is a drug orientation in the White House anyway. There's a rock 'n' roll orientation. And I'm into rock 'n' roll. But don't necessarily equate drugs with rock 'n' roll."All of the attention for Fleetwood Mac Tuesday night was obviously very pleasing to Ross, the silver-haired godfather of Warner Communications."All we have to do is have Fleetwood Mac and everyone in Washington shows up," laughed Ross, one of five Warner Brothers executives to fly in for the party. "Millions of politicians have called me about the band doing concerts for them, but I just give them Fleetwood Mac's number and let them decide. I guess when you have Fleetwood Mac, all you have to do is be audited."


text:
No trailer available :(
- Tweet
- Main Genre: Slasher | Released: 2004 | Runtime: 81 Mins
Movie Details
Welcome to your worst nightmare
Fifteen years ago, a group of young friends were playing a sandlot game of baseball. When one of them is called home for dinner the gang decides to let the creepy neighborhood fat kid join in. Once he is safely in "left field", the game continues. The first pitch is slammed over the fence and into the road. The fat kid excitedly chases. As the group taunts him and his efforts, they don't notice the truck speeding towards him. He is killed on impact.
Present Day:
The members of the old gang have all gone their separate ways except Dan and Lexy, they are living together. They all receive mysterious invitations to reunite at an old lodge up North. Thinking one of the group must have some "big announcement", they all arrive at the lodge, except one. He never makes it. What the group learns about the lodge, its caretaker and the real reason why they were "invited" leaves them fighting for their lives.
Directed by: Jeff Burton
Starring: Bill Vincent, Rick Kunzi, Johanna Lixey, Katrina Novak
Catalog/SKU #: BD9578
What people are saying...
You might also like...
Killer Weekend
Recycled Parts
- Action
- Best Selling
- Books and Comics
- Brain Damage Films
- Burning Moon Pictures
- Comedy
- Coming Soon
- Drama
- Foreign
- Horror
- Midnight Releasing
- Music
- New Release
- Non-Fiction
- Shock/Reality
- Video On Demand


text:
Climate change could have link with terrorism, UN chief Ban Ki-moon tells CBC
Social disruption could lead to more 'terrorist fighters'
UN secretary general Ban Ki-moon says the attacks in Paris can't overshadow efforts to reach a climate change agreement at next week's summit.
He also warns in an exclusive interview with CBC News of a possible link between climate change and terrorism.
- Government announces $2.65B to help developing countries fight climate change
- More special coverage on climate change talks
"When we do not address climate change properly it may also affect many people who are frustrated and who are impacted, then there is some possibility that these young people who [are] jobless and frustrated may join these foreign terrorist fighters," the UN chief said.
"There is a concern whether it may overshadow the climate change agreement and I think we have to move on this climate change agreement."
The secretary general praised the leadership of French President François Hollande, who travelled to Malta to hold a special session on climate change with Commonwealth leaders. Hollande was meeting with environmental groups Saturday, pushing for an ambitious global deal to reduce man-made emissions blamed for global warming.
"I highly commend the leadership of President Hollande, who has decided to carry on." said Ban.
Looking forward to working with Trudeau
Leaders and climate negotiators from 196 countries meeting at the UN talks from Nov. 30-Dec. 11 will try to hash out the broadest, most lasting deal to date to slow global warming.
Prime Minister Justin Trudeau, who is among leaders attending the Paris talks, has been in Valetta, Malta for the Commonwealth meeting, where he pledged his government would spend $15.3 million over four years to improve the lives of young people in Africa.
On Friday, Canada announced it will contribute $2.65 billion to the fund over the next five years.
Ban said he is looking forward to working with Canada's new leader.
- Trudeau toasts Queen in debut Commonwealth summit
- Commonwealth leaders meeting a 'training camp' for Paris
- Trudeau promises 'Canadian approach' to climate change
"I know there have been some differences between previous governments and the new government. I have been working closely with the previous government and I'm also looking forward to working even more closely with the new government led by Prime Minister Trudeau," he said.
"I expect that we can further strengthen our partnership in peace, stability and security."
Trudeau responded by saying climate change is a global problem.
"They remain connected issues in that the big issues of trade, economic growth or terrorism and security and climate have been woven in and out of all of our discussions," he said.
Trudeau added the Nov. 13 attacks that shocked France and killed 130 people have energized leaders converging for the climate talks.
"Leaders are massively expressing they are even more enthused and committed to attending the climate change conference in Paris because of the opportunity it offers to also stand in solidarity with Paris and with the people of France," he said.
Extra security
The climate talks opening on Monday are taking place under extra-high security after Islamic extremists killed 130 people Nov. 13 in the deadliest attacks in France in decades.
Later Saturday, French Foreign Minister Laurent Fabius is scheduled to symbolically hand over the "keys" to the climate conference to the UN climate change agency, which will oversee the two-week talks. Fabius and Hollande have travelled the world this year and used France's diplomatic weight to try to rally international support for a tough and binding deal.
The last global climate treaty, the 1997 Kyoto Protocol, required only rich countries to reduce emissions and the U.S., the world's biggest emitter, didn't take part.
The talks are happening with France in a state of emergency and thousands of troops and police fanned out to ensure security after the Paris attacks.
A big march by environmental activists was cancelled because of the security measures. Activists are still planning other small actions around France and other countries.
With files from The Associated Press
Popular Now
To encourage thoughtful and respectful conversations, first and last names will appear with each submission to CBC/Radio-Canada's online communities (except in children and youth-oriented communities). Pseudonyms will no longer be permitted.
By submitting a comment, you accept that CBC has the right to reproduce and publish that comment in whole or in part, in any manner CBC chooses. Please note that CBC does not endorse the opinions expressed in comments. Comments on this story are moderated according to our Submission Guidelines. Comments are welcome while open. We reserve the right to close comments at any time.


text:
Shore-based wave energy, diagram
C024/7695 Rights Managed
530 pixels on longest edge, unwatermarked
Request/Download high-res file
Uncompressed file size: 50.8MB
Downloadable file size: 2.3MB
Please login to use the price calculator
Credit: SCIENCE PHOTO LIBRARY
Release details: Model release not required. Property release not required.
Keywords: air, alternative, artwork, capital project, carbon, clean, cleaner, diagram, dioxide, electricity, energy, flow, future, gas, gases, generation, green, greenhouse, illustration, independence, independent, industrial, industry, infrastructure, investment, low, low-carbon, natural, no-one, nobody, onshore, pollution, power, pressure, pump, pumping, renewable, renewables, sea, shore, shoreline, technology, turbine, water, wave, wind, zero
Licence fees: A licence fee will be charged for any media (low or high resolution) used in your project.


text:
Exclusive Kristi Curiali Photos and Videos - Only at Aziani.com
The flirtatious and hot Kristi Curiali is so seductive & sensual in this glamorous photo set. She reveals her beautiful curvy body as she strips from her sexy black dress and thong panties. For all Kristi lovers, this is a must-see set!


text:
Cockeye BBQ – Warren
Shop Local Mahoning Valley
Cockeye is a kid from Ohio, who discovered the true American art of REAL BBQ after attending culinary school in Charleston, South Carolina.
In 2001 Erik Hoover started slow smoking pork out of a makeshift smoker he welded together in the backyard. A few years later – Cockeye BBQ was born in a KCBS competition field in southern Ohio. Now, we are bringing Cockeye's award winning barbeque ribs, pulled pork, chicken and brisket home to Warren.
Backyard parties and catering led us to this:
Cockeye BBQ – Warren, Ohio's first fast casual barbecue restaurant.
From the beginning, Cockeye has always been about authentic barbecue. We don't cut corners because there is no shortcut to great barbeque. We believe that barbecue done right is a tribute American ingenuity. We understand it's time, spice and love that work to create our signature flavors.
At Cockeye BBQ we choose to use high quality meats and source locally as much as we can. Our traditional barbeque is hand rubbed with our custom spice blend and smoked on site over hardwood for up to 14 hours. All of our sides are scratch made from family recipes and start with real, raw ingredients. We want to cook this way because it is what we believe in. You can feel confident knowing we put in the time so you don't have to. Cockeye BBQ is slow food… fast – from our family to yours.
- HOURS: Tuesday – Sunday 11am-8pm
Address 1805 Parkman Rd NW – Warren, OH 44485
Menu – Order Online – Website – Facebook


text:
Hey everyone, new user here! I discovered mead while playing Elder Scrolls: Skyrim, sounds nerdy as hell, but I would have never found out about mead had it not been for Skyrim. To make a real long story short, I had my first glass of mead at a trendy house bar that was in a neighborhood with a lot of little restaurants, book stores made from houses and turned into shops. A buddy of mine ordered it for me and I fell in love with the drink, it was so good, so sweet and I've been in love with the drink ever since, it was the blackberry mead from Redstone meadery in case anyone was wondering.
So here's my serious question about mead, I've been seeing these whiskey essences pop up lately, I've always want to try them, but it says they require 80 proof vodka to blend the essence with. But I got to thinking, I wonder if I could blend these whiskey essences with mead instead? The reason is, is I've developed health problems and I can't have hard liquor anymore (amongst other types of alcoholic beverages *besides mead thank the gods*), no more whiskey or anything like that. I miss the flavor of whiskey, and I'm wondering, has anyone ever tried to blend these whiskey essences with mead? I wanna try it, just once to see if it'll work, and I also wanna get one of those whiskey sticks and just let the mead take in the whiskey flavor and the oak to "age" the mead over night and part of a day to see what would happen. I know I can't keep mead out for very long, so I would drink it the day after I make it. Has anyone tried this?
I haven't done this, but I don't see why you couldn't. The higher alcohol of the vodka would extract the flavor more quickly/easily from the whiskey mix, but it should be doable with mead too.
I assume you mean mead that you're buying from a store. I don't know how long it would need, but definitely start with small amounts. You can always add more, but you can't take it back out. Might require some experimenting.
Adding a stick, or any other wood, would require more than a night to age. Weeks minimum usually. Unless this is something else that I'm not familiar with.
If you ever make your own mead, I would suggest aging it in a bourbon or whiskey barrel from a distillery. I've had a couple and they impart good flavors from these.
Hey thanks for the reply, and yes I mean adding whiskey essence to a bottle of mead I got from the store. I figured I would need to experiment with it, and adding small amounts of it since the mead is not 80 proof. I found these time and oak whiskey sticks, the vid said it take take 24-48 hours to "age" a whiskey, so I'm not sure if it's just a gimmick, or if it will actually work, so I figure, it couldn't hurt to try anyway (https://www.timeandoak.com/). It is definitely something I want to try for sure.
I wouldn't say its a gimmick, but you certainly won't be getting the full/best effect IMO.
There is a thread on here called "Wood Management" by Squatchy. Check it out if you want to read a ton about how oaking works with alcohol.
It does say they are designed to work with whiskey, which again, with a higher alcohol content, will extract the flavors from the wood more quickly. I think most people on here would advocate a slow extraction with a small amount of wood (something like 1-2oz per 5 gallons). This lends itself to more complex flavors as it pulls from deeper than just the surface of the wood. Of course it does depend on how its cured and toasted as well.
Certainly try it. But I would expect this to work like a punch in the face. It might not taste like whiskey either. I was expecting these to be some sort of whiskey infused stick, but these just look like oak staves, which might bring a different amount/balance to a mead than a whiskey.
I'll probably try to do it one of these days, I'll just get the whiskey essence and just forget the whiskey stick. It's something I wanna try, and if it works, great, if it doesn't work, then it was worth a try anyway. Thanks for the comments!
The stick is just a small spiral that was way over toasted. Nothing good comes from oak in a day or two. And nothing other than time will age anything. It's physics and chemistry and you can't change the time frame for that.
7 out of 4 people have a hard time using their hydrometer!
Thank you for starting this thread. Your ideas are brilliant.


text:
There are 11 other file types using
the AST file extension!
.ast - Adobe Photoshop color separation table
.ast - Astound multimedia data
.ast - Corel WordPerfect Office template file
.ast - ESwin wizard file
.ast - Ability Spreadsheet template file
.ast - Astrograv astronomy simulation file
.ast - ClarisWorks assistant file
.ast - Need for Speed Underground audio file
.ast - Technics Sx KN 6000 Keyboard all custom memory file
.ast - ActivTrak Session Track file
.ast - ASTree saved data
AST file - Audio stream file
What is ast file? How to open ast files?
File type specification:
The ast file extension is also related to a special audio format from Nintendo Gamecube and Wii consoles. Used to stream music.
The default software associated to ast file type:
Company or developer:
Nintendo Co., Ltd.
GameCube is 6th generation console produced by Nintendo.
Company or developer:
Nintendo Co., Ltd.
Nintendo Wii is a video gaming console produced by Nintendo. Wii is not just a gaming console, it's a reason to get together with your friends and family and play today's hottest games. Wii offers legendary Nintendo franchises like Mario, Zelda and Metroid, as well as all new classics like Wii Sports and Wii Play.
List of recommended software applications associated to the .ast 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 ast file, edit ast file, convert ast file, view ast file, play ast file etc. (if exist software for corresponding action in File-Extensions.org's database).
- Play ast file
ast file player - programs that play ast file - Audio stream file
Programs supporting the exension ast on the main platforms Windows, Mac, Linux or mobile. Click on the link to get more information about listed programs for play ast file action.
Other operating systems or devices:
Main software associated with ast file by default:
Nintendo GameCube
Nintendo Wii


text:
Three men will face trials in Carbon County Court on charges of theft of tolls valued at $3,600.
The theft took place in February 1983 at the Weatherly Steel Co., Weatherly.
William Davis, 27, of Drums and Frank Katona Jr., 21, of Hazleton were bound over for court on six charges after a preliminary hearing before District Justice Paul Hadzick of Beaver Meadows.


text:
Welcome! Thank you for attending the board's annual review and planning meeting. I know you are all very busy men, so if we can just take a few moments to get settled we can begin.
Kojikuro, how is your niece? Still lithe, chirpy, and sexually curious, I hope. Very good. She always reminded me of a beautiful songbird with a lady part.
Daisuke, yes, the robots will be bringing more coffee at the halfway point, so if you could…yes, thank you.
Gentlemen, thank you again for attending. We must address the failures of Fushitsu in the year 2007 and focus on preparing for 2008. You have all seen the sales reports for our American division, if not it's in the goldenrod binder in front of you. Please take a moment to familiarize yourself with the figures.
Sales of our adhesive amusements are down across the board in the United States. We continue to have zero-growth in the Colorforms sector, but more distressing are the declines we are seeing among several of our main product lines. Chief among these are the adhesive ribbons. Magnetic ribbons, down 78% since 2007 and permanently-adhesive ribbons continue their downward movement, shedding a further 22% in 2007.
To put it bluntly, we have been hemorrhaging ribbon sales since 2005. We must face the reality that Americans no longer support their own troops.
Kojikuro's ribbon research division had some success experimenting with incorporating various American flag designs into ribbons, but these were only a stopgap measure that got us through the first quarter. Sales among our various flag/troops ribbons are following a similar trend line to our yellow ribbons.
Daisuke, Osamu, your pink and red ribbons are also losing sales. Morasui, your reflective orange ribbon seemed to confuse and frighten consumers in the United States. We will be discontinuing it in 2008 and selling off our remaining stockpiles to a militia group in Sudan.
We must face the reality that all of our current product lines are in decline. 2007 was a bad year for Fushitsu, but there is no reason that 2008 must be the same.
Gentlemen, for the future hope of Fushitsu I would like to call attention to our all-time bestselling product line: Urinating Mischief Child.
Urinating Mischief Child, in all its incarnations, did something no other decal has done before or since...it created a recognizable branded character for the rear windows of American vehicles. True, UMC was so similar to a preexisting branded character that we were forced to pay out 87 million dollars, but that is beside the point. The point is revenue, and over his 11 year run UMC generated US 9 billion in sales.
UMC was instantly popular and provided longterm stability by remaining resistant to market saturation. Fushitsu offered over 800 different items onto which UMC could urinate, some sold as separate decals and other incorporated into the urination.
If you're feeling overwhelmed by dire climate change news, try taking action personally! You can make a difference in the world!
Urine? Or perhaps an abundance of crotch sweat? Either way, it's a good thing you're in a karate class. This is the ideal place to covertly get some airflow down there, speeding up the evaporation process by as much as 4%.
Nancy and the Banker are back!
Phridays return with a hot summer jam (from 1972)!
Install the Face Textures For Terrain mod, replacing all boring ground textures with faces
The Something Awful front page news tackles anything both off and on the Internet. Mostly "on" though, as we're all incredible nerds.
Copyright ©2018 Rich "Lowtax" Kyanka & Something Awful LLC.


text:
- Home
- Academics
- Admissions / Apply Now
- Tuition & Financial Aid
- Student Life
- Community & Business
- News & Events
- About JCC
Home / Faculty Student Association / About FSA / Who We Are
Who We Are
FSA membership consists of all students, faculty and staff of the College; along with two community members. The Association is led by an active Board of Directors consisting of College faculty and staff members, along with student representatives appointed, to represent each of these constituencies.
Board of Directors
FSA Board of Directors, 2017 - 2018
Genny Pond, President
Vacant, Vice President
Craig McNamara, Treasurer
Heather Makuch , Secretary
Vacant, Vice President
Craig McNamara, Treasurer
Heather Makuch , Secretary
Ty Stone, College President
Christopher J. Bastien, Community Representative
Craig MacNamara, ESML Division Representative
Dan Dupee II, Vice President for Administration & Finance
Greg McBroom, Technology Division Representative
Genny Pond, Science Division Representative
Leah Deasy, Liberal Arts Representative
Heather Makuch, Community Representative
Heather Makuch, Community Representative
Kim Honeywell, At Large Member
Ellen R. Mathews, Professional Staff
Pam Beyor, Board of Trustee
Student Board Representatives, 2017- 2018
FSA maintains a staff of 23 employees who work under the direction of a full-time Executive Director.
Location: Guthrie Building 2-014
Bob Santamoor, Executive Director
(315) 786-2353
Nicole Arcuri, Accounting Assistant
(315) 786-2354
Susan Walker, Account Clerk
(315) 786-2421
Y. Donna Yang, Human Resources Specialist and Administrative Assistant
(315) 786-6583
Roxy Silsby, Director of Childcare
Matthew Gorman, Resident Director Off Campus
Victoria Brown, Resident Director
Courtney Bauer, Administrative Assistant of Residence Life
FSA Documents
FSA Application
Click thumbnail to view document
FSA Flyer
Click thumbnail to view document
FSA Open Forum
Click thumbnail to view document


text:
Preston North End boss Darren Ferguson has revealed David Gray chose Deepdale over staying with Manchester United.
The Scottish fullback rejected new terms at United to move to Preston this week.
Ferguson told pnefc.net: "They offered him a new contract at United, so that's how much they rate him. The lad wanted a fresh start, he wanted to start playing first team football so were pleased to jump on that and it was done pretty quickly.
"He's got a good pedigree, he has been brought up at a fantastic club like United, he comes highly recommended, they think highly of him. He's got good character, good attitude, he came in and trained really well and fitted in straight away."
Need your Manchester United news fix? Click here for all United news and transfer rumours.