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Soil-transmitted helminths, such as Trichuris trichiura, are of major concern in public health. Current efforts to control these helminth infections involve periodic mass treatment in endemic areas. Since these large-scale interventions are likely to intensify, monitoring the drug efficacy will become indispensible. However, studies comparing detection techniques based on sensitivity, fecal egg counts (FEC), feasibility for mass diagnosis and drug efficacy estimates are scarce.
Methodology/Principal Findings
In the present study, the ether-based concentration, the Parasep Solvent Free (SF), the McMaster and the FLOTAC techniques were compared based on both validity and feasibility for the detection of Trichuris eggs in 100 fecal samples of nonhuman primates. In addition, the drug efficacy estimates of quantitative techniques was examined using a statistical simulation. Trichuris eggs were found in 47% of the samples. FLOTAC was the most sensitive technique (100%), followed by the Parasep SF (83.0% [95% confidence interval (CI): 82.4–83.6%]) and the ether-based concentration technique (76.6% [95% CI: 75.8–77.3%]). McMaster was the least sensitive (61.7% [95% CI: 60.7–62.6%]) and failed to detect low FEC. The quantitative comparison revealed a positive correlation between the four techniques (Rs = 0.85–0.93; p<0.0001). However, the ether-based concentration technique and the Parasep SF detected significantly fewer eggs than both the McMaster and the FLOTAC (p<0.0083). Overall, the McMaster was the most feasible technique (3.9 min/sample for preparing, reading and cleaning of the apparatus), followed by the ether-based concentration technique (7.7 min/sample) and the FLOTAC (9.8 min/sample). Parasep SF was the least feasible (17.7 min/sample). The simulation revealed that the sensitivity is less important for monitoring drug efficacy and that both FLOTAC and McMaster were reliable estimators.
Author Summary
Worldwide, millions of people are infected with soil-transmitted helminths, particularly in developing countries. Efforts to control these infections involve periodic mass drug treatment in endemic areas. Since these large-scale interventions are likely to intensify, monitoring of drug efficacy has become a key issue in order to detect the emergence of resistance. At present, the drop in infection intensity is under examination for monitoring the drug efficacy. However, studies comparing detection techniques based on infection intensities are scarce. Moreover, little attention has been addressed to their feasibility and their ability to estimate drug efficacies. We have compared different techniques for the detection of whipworm (Trichuris) in simian stool samples based on prevalence, infection intensities, feasibility and ability to estimate the 'true' drug efficacy. We have found that techniques often fail to detect low infection intensities and that not all techniques are appropriate for estimating infection intensities. The time needed to obtain a test result varied from 3.9 to 17.7 min/sample. Finally, accurate estimates of drug efficacy were only obtained in high pre-drug administration infection intensities. To conclude, along with accurate estimates of infection intensities, feasibility is a considerable criterion for the detection techniques used in drug efficacy monitoring programs.
Citation: Levecke B, De Wilde N, Vandenhoute E, Vercruysse J (2009) Field Validity and Feasibility of Four Techniques for the Detection of Trichuris in Simians: A Model for Monitoring Drug Efficacy in Public Health? PLoS Negl Trop Dis 3(1): e366. https://doi.org/10.1371/journal.pntd.0000366
Editor: Juerg Utzinger, Swiss Tropical Institute, Switzerland
Received: July 1, 2008; Accepted: December 17, 2008; Published: January 27, 2009
Copyright: © 2009 Levecke et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This investigation was supported by the Department of Virology, Parasitology & Immunology, Faculty of Veterinary Medicine (Ghent University). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Worldwide, infections with soil-transmitted heminths (STHs) such as Trichuris trichiura, Ascaris lumbricoides and hookworms (Ancylostoma duodenale and Necator americanus) are of major importance for public health, particularly in tropical and subtropical countries where climate factors combined with poor environmental, domestic and personal hygiene ease transmission [1],[2]. Current efforts to control STH infections involve periodic mass drug treatment of people, particularly of school-aged children, in all endemic areas [3]. Since these large-scale interventions are likely to intensify as more attention is addressed to the importance of these neglected diseases [4], monitoring drug efficacy will become indispensable in order to detect the emergence of resistance [5],[6] and/or identify confounding factors affecting the drug efficacy [7]. Thus far, the efficacy of anthelmintics has mostly been monitored qualitatively based on the cure rate. However, the fecal egg count reduction test (FECRT) is presently under examination for monitoring the drug efficacy quantitatively [8], implying the need for a sensitive detection technique which will allow the accurate estimation of the infection intensity based on fecal egg counts (FEC). Various techniques have been used for the detection of STH eggs, yet studies comparing detection techniques based on FEC are scarce. Moreover, little attention has been addressed to their feasibility for mass diagnosis under field conditions (poorly equipped laboratories and short of professionally trained personnel) and their ability to estimate the efficacy of administered drugs, in particular in different settings of pre-drug administration infection intensities.
The ether-based concentration method [9] and the Kato-Katz thick-smear technique [10] are the most commonly used techniques. The latter was initially designed for the diagnosis of Schistosoma eggs and not for STH such as Trichuris, Ascaris and hookworms. Due to the lack of other quantitative techniques and the importance of Schistosoma in public health, this method became also commonly used for the detection of STH [11]. However, this has important drawbacks when the objective of a study is to examine STH simultaneously. The most important one is the diverse clearing time of the different eggs of STH, eggs of hookworms in particular which impedes further standardization of this technique in large-scaled studies at different study sites [12],[13]. Utzinger et al. (2008) [14] recently evaluated the FLOTAC technique for the diagnosis of hookworms in stools of African schoolchildren. This quantitative technique, which has been recently described both for human and veterinary medicine [15], proved to be more sensitive than the traditionally used techniques. Other candidate techniques for monitoring drug efficacy are the McMaster technique, the precursor of FLOTAC, and the Parasep Solvent Free (SF). McMaster is a quantitative flotation technique which is commonly used in veterinary parasitology and can be easily performed without a centrifuge apparatus [16]–[18]. Parasep SF is a single use, disposable enclosed concentration technique recently developed by DiaSys Europe. In contrast to the traditional ether-based concentration technique, a fat dispersion chamber is used to separate the fat content, therefore reducing the need for chemical reagents in the field.
A study was conducted to evaluate the performance of different techniques for monitoring drug efficacy in Trichuris. To this end, the ether-based concentration technique, the Parasep SF, the FLOTAC and the McMaster were compared for the detection of Trichuris eggs in stool of nonhuman primates, focusing on validity, feasibility under field conditions and ability to estimate the 'true' drug efficacy using a statistical simulation. Non-human primates are an appropriate model, since these animals share the same STH and have a comparable fecal composition [19],[20].
Materials and Methods
Study design
The study was conducted at a Dutch sanctuary for exotic animals. All nonhuman primates involved belonged to the family of Old World monkeys and were representatives of barabary macaques (Macaca sylvanus), vervet monkeys (Chlorocebus pygerythrus), rhesus monkeys (Macaca mulatta), crab-eating macaques (Macaca fascicularis), Sunda pig-tailed macaques (Macaca nemestrina), grivet monkeys (Chlorocebus aethiops) and Hamadryas baboons (Papio hamadryas). The animals were housed in 22 groups of one to 15 animals. A total of 100 fecal samples were randomly collected by the animal caretakers on a single occasion in January 2008.
Detection of Trichuris eggs
Three grams of feces were suspended in distilled water and strained through a layer of surgical gauze to withhold large debris. After sedimentation for 1 h and centrifugation at 800 g for 5 min, the sediment was suspended in 3 ml of distilled water. An aliquot of 500 µl was randomly assigned to each of the four detection techniques.
Ether-based concentration technique.
The aliquots were suspended in 5 ml acetic acid (5%). The fat in the suspension was removed by emulsifying the sample with an equal volume of ether followed by centrifugation at 200 g for 2 min. The resulting supernatant (ether, debris and acetic acid) was discarded and 2 drops of diluted (1∶10) iodine were added to the remaining sediment. The stained sediment was thoroughly mixed, transferred onto a glass microscope slide and covered with a cover glass. Each sample was examined at a 100× magnification. The FEC were multiplied by 2 to obtain the number of eggs per gram of faeces (EPG) [21].
Parasep SF.
The Parasep SF was performed as described by the manufacturer (DiaSys Europe, Berkshire, England). The aliquots were added to 8 ml of 10% formalin and one drop of surfactant (Triton X-100) in the Parasep SF device. The suspension was well shaken and centrifuged at 200 g for 3 min. The supernatant was discarded and the sediment was processed by analogy with the ether-based concentration technique.
McMaster technique.
The aliquots were filled up to a volume of 7.5 ml with saturated salt and sucrose solution (density = 1.22), stirred thoroughly, and then 0.15 ml amounts were added to each of the 2 chambers of a McMaster slide. Both chambers were examined using a 100× magnification and the FEC was obtained by multiplying the total number of eggs by 50 [21].
FLOTAC technique.
A volume of 5 ml of a sucrose solution (density = 1.27) was added to the aliquots. The suspension was pipetted in one of the 2 flotation chambers of the FLOTAC apparatus. After centrifugation of the apparatus at 200 g for 5 min, the apical portion of the floating suspension was translated (top of the flotation suspensions was cut off transversally), followed by examining both grids corresponding to 2 different samples at a magnification of 100×. The total number of eggs was multiplied by a factor of 2 to calculate the FEC [15].
Assessment of the feasibility of the techniques
The feasibility of the 4 the techniques was evaluated on a total number of 90 samples randomly assigned to 3 experienced laboratory technicians. Each of the laboratory technicians processed a set of 1, 2, 4 and 8 samples. The time needed to prepare the samples and to clean the devices was measured six times for each set of samples. The preparation period started when the aliquots were distributed and ended when the sample was ready for examination. During the cleaning period all used materials were either disposed of, for single use components, or cleaned in the case of recyclable devices. Examination of the slides or chambers was timed individually for all samples. Each of the samples were examined with all techniques by the same laboratory technician.
The estimation of the 'true' drug efficacy
The estimates of the 'true' drug efficacies (TDE) by the quantitative techniques was studied in a statistical simulation in R (version 2.4.0, The R Foundation for Statistical Computing). To this end, difference between the TDE and the estimated drug efficacy (EDE) was examined in two strata with different pre-drug administration infection intensities. In this simulation, the TDE for Trichuris varied from 10 to 90% [22]. Because these values are likely to vary between individuals ('individual' TDE) an additional variation was postulated for each value of TDE, ranging from 1 to 5% (standard deviation) [7]. Only the positive samples of the quantitative techniques in the present study (a positive result at any technique) were included as pre-drug administration samples. These samples were stratified into a stratum with low pre-drug administration intensity (0<FEC≤50 EPG) and one with a high pre-drug administration intensity (FEC>50 EPG). The cut off of 50 EPG was used, since this was the highest detection limit of all the techniques. The samples in each strata were combined into 4 different sample sets of 100, 250, 500 and 1000 samples to examine the effect of sample size on the efficacy estimates. The individual post-drug administration infection intensities for each technique were obtained by multiplying the individual pre-drug administration FEC of each technique with (100%-individual TDE). The obtained individual post-drug administration FEC of each technique were corrected according the results of the validity. The estimated efficacy of each individual for each technique was calculated as the difference of individual pre- and post-drug administration FEC divided by the individual pre-drug administration FEC obtained by each technique. The difference between the TDE and the individual EDE (bias) for each detection technique, standard deviation, sample set was examined within each stratum of pre-drug administration infection intensities.
Statistical analysis
To assess the validity of the techniques both qualitative and quantitative aspects were compared. The agreement in qualitative test results between the 4 techniques was measured using the kappa statistic (κ) (SAS 9.1.3, SAS Institute Inc.; Cary, NC, USA). Both sensitivity and negative predictive value (NPV) were estimated for each method. To this end, a positive result at any technique was considered as a 'true' positive test result (specificity = 1, positive predictive value = 1). The agreement in quantitative test results was estimated by the Spearman rank correlation coefficient (SAS 9.1.3, SAS Institute Inc.; Cary, NC, USA). In addition, the Wilcoxon signed rank test was assessed to test for differences in FEC between the techniques. For this end, a Bonferroni pair-wise comparison procedure was performed and the level of significance was set at 0.0083. Furthermore, samples were subdivided according infection intensity based on guidelines of the WHO [23]. A linear mixed model was built using the Tukey pair-wise comparison test to evaluate the feasibility of the 4 techniques (SAS 9.1.3, SAS Institute Inc.; Cary, NC, USA). This model examined the differences in time taken for preparing and cleaning a sample between the different sample sets and the 4 techniques. The differences in time taken for the microscopic examination of the samples prepared by the 4 techniques and the effect of FEC on time taken were studied separately.
Ethical considerations
This study was embedded in a annual parasitological survey of the animals housed at the sanctuary for exotic animals AAP. No approval of the Ethics Committee was needed since all samples were randomly collected during cleansing of the enclosures and none of the animals involved were immobilized neither physically or chemically (European Convention for the Protection of Vertebrate Animals used for Experimental and Other Scientific Purposes, Strasbourg, 18.III.1986).
Technique validity
Agreement in qualitative results.
Of the 100 samples examined by the 4 different diagnostic assays, there were 30 positive based on the McMaster, 36 for the ether technique, 39 for the McMaster and 47 using the FLOTAC. There was a full agreement, either positive or negative, among all four tests in 82 samples. The observed agreement between the four tests varied from substantial (κ = 0.65, [95% confidence interval (CI): 0.73–0.94]) to almost perfect (0.89 [95% CI: 0.80–0.98]). The least agreement was found between McMaster and FLOTAC, the most between the ether technique and the Parasep SF. The test properties of the techniques are summarized in Table 1.
Agreement in quantitative test results.
The median FEC and the distribution of 3 different levels of infection intensity (low, moderate and heavy) for each of the 4 techniques are summarized in Table 2. The median value was the highest for the McMaster technique, but comparable to the median of FLOTAC.
Overall, there was a significant (p<0.001) linear correlation (Rs) in FEC between the 4 techniques, ranging from 0.85 to 0.94 (Figure 1). Although these Rs values were comparable, the concordance plots clearly illustrate a difference in level of agreement between the techniques. Only the FEC between the ether and the Parasep SF technique and between the McMaster and the FLOTAC were scattered around the dashed equality line (slope = 1). Other pair-wise comparisons showed a slope greater than 1, indicating that the technique in the x-axis is detecting fewer eggs than the technique in the y-axis. Both the ether and the Parasep SF techniques detected significant less eggs compared to McMaster and FLOTAC (p<0.0083). These plots also indicate that both the ether technique and the McMaster often fail to detect FEC of less than 50 EPG, while the Parasep SF failed to detect eggs in some samples with less than 5 EPG.
Technique feasibility
Preparation and cleansing of the samples.
Overall, the most time consuming method was FLOTAC (mean time 8.4 min/sample), followed by the ether (4.2 min/sample) and the Parasep SF technique 4.0 min/sample). McMaster (1.6 min/sample) was the least time consuming. Figure 2 describes the time needed to prepare and clean sets of 1, 2, 4 and 8 samples for each of the 4 techniques. Increasing the sample sizes significantly decreased the time per sample for FLOTAC, the ether and the Parasep SF technique. The most benefit was gained between sample sets of one and 2 samples, but there was also a decrease in average time between 2 and 4 samples. No significant beneficial effect was found between the sample sets of 4 and 8 samples. For the McMaster no significant difference between sample sets was found. The time period for preparation and cleaning of sample sets of 4 and 8 was equivalent for the ether, the Parasep SF and the McMaster techniques.
Examination of the samples.
Samples prepared by the Parasep SF (14.0 min/sample) were the slowest to examine, followed by the ether technique (5.4 min/sample) and the FLOTAC (5.1 min/sample). The McMaster slides (2.4 min/sample) were the quickest to read. Higher FEC for a particular sample significantly increased (p<0.001) the time for examining the sample for all techniques, except for McMaster. Figure 3 illustrates the visibility of the samples for the 4 detection techniques. It is apparent that the eggs were much more clearly visible for the McMaster samples, followed by approximate equivalence in the FLOTAC and the ether samples. Samples prepared by the Parasep SF revealed a high level of contamination with fecal debris.
Arrows indicate Trichuris eggs.
Combining the results of the preparation, examination and cleaning for the largest sample set (8 samples), revealed that McMaster was the most feasible of all the techniques. On average, a test result was achieved within 4 minutes (mean time 3.9 min/sample). The ether technique (7.7 min/sample) and the FLOTAC (9.8 min/sample) were comparable in feasibility. The Parasep SF was the least feasible, as almost 18 min (mean 17.7 min/sample) was required for complete processing of the sample.
The estimation of the 'true' drug efficacy
Based on FLOTAC, a total of 47 positive samples of which 23 had a FEC of no more than 50 EPG were included in the simulation. Additional samples were randomly chosen to add to the strata (2 for the low pre-drug administration infection intensity stratum, 1 for the high pre-drug administration infection intensity stratum), resulting in two subsets of each 25 samples. Each subset was combined 4, 10, 20 and 40 times to obtain the different sample sets of 100, 250, 500 and 1000, respectively. Both the ether technique and Parasep SF were withdrawn for further analysis, since these detection techniques resulted in significant lower FEC compared to FLOTAC and McMaster. Based on the results of the validity for McMaster, the individual post-treatment FEC were corrected using the following conditions. At first, all positive post-drug administration samples which had no more than 5 EPG were negative for McMaster. Samples with a FEC of more than 5 EPG, but no more than 50, were positive with a probability of 0.40 and the FEC was set on 50 EPG if positive. The FEC was rounded off to the nearest multiple of 50, in all other cases. Although FLOTAC revealed to be 100% sensitive, positive samples with no more than 2 EPG were positive with a probability of 0.40 and FEC was set on 2 EPG if positive. In all other cases, the FEC was rounded off to the nearest multiple of 2.
Figure 4 describes the bias (difference between TDE and the individual EDE) in 2 strata with different pre-drug administration infection intensities. Overall, there is a large bias in estimating the drug efficacy when low pre-drug administration infection intensities were included. The mean bias in the stratum including FEC not higher than 50 EPG ranged from −20.8 to +16.1% for FLOTAC and from −45.0 to +20.0% for McMaster. Moreover, this bias is likely to change over TDE. Low TDE (≤60.0%) were overestimated and high TDE (>60.0%) were underestimated. This is in contrast to the stratum where only FEC higher than 50 EPG were considered, in particular for FLOTAC which resulted in an accurate estimation of the TDE (median = 0.0%, range = −0.6; +0.7%). The differences for McMaster varied from −6.4 to +2.3% (median = −1.1%), and decreased with the TDE-values of at least 50% (median = −0.3%, range = −3.6; +2.1%). In average, McMaster resulted in higher efficacies than FLOTAC, since the bias was more negative than the efficacy estimated by FLOTAC in the majority of the 'true' drug efficacies in both strata.
Both the different standard deviations and sample sets did not affect the estimates of both techniques (Figure 5), since the bias remained unchanged over the different standard deviations and sample sets.
In the present study, four techniques were compared for the qualitative and quantitative detection of Trichuris in stools of nonhuman primates, as well as their feasibility for mass diagnosis under field conditions. In addition, their ability to give accurate estimates of the 'true' drug efficacy was studied based on a statistical simulation. Overall, the observed prevalence of Trichuris in these animals was 47% (95% CI: 37–57%) and remained unchanged when the test results of the 4 techniques were combined. Although the test properties might be overestimated due to the absence of a diagnostic 'gold' standard, it is clear that FLOTAC is the most sensitive technique, followed by the Parasep SF and the ether-based concentration technique. McMaster is the least sensitive, because it often fails to detect low FECs due to its relative high detection limit (50 EPG). Multiple comparisons of the 4 techniques revealed a linear correlation in FEC. Nevertheless, both the Parasep SF and ether techniques are likely to be less appropriate for an accurate estimation of FEC, since the McMaster and the FLOTAC detected significantly more eggs.
The time taken for preparing samples and cleaning between samples was the lowest for the McMaster. FLOTAC was the most time- and labour-consuming technique over the different sample sets and therefore seems to be less feasible in large-scale studies. Samples obtained by the Parasep SF protocol were the hardest to examine, because of the large amount of fecal debris recovered with the eggs. This resulted in decreased clarity and a much greater length of time required to examine the samples. McMaster slides were examined at the highest speed. The most important reasons explaining the difference in time required for reading between McMaster and the other techniques are the surface of the slides (McMaster: 1 cm2 versus other techniques: 3.24 cm2) and the detection limit (McMaster: 50 versus other techniques: 2), as FEC had no significant effect on the time needed to examine the samples using McMaster. Moreover, McMaster slides were likely to be less contaminated by fecal debris, since only a small proportion of already diluted samples was examined. Overall, McMaster was the most feasible and does not need any centrifuge apparatus, in contrast with the other techniques, which clearly emphasizes its usefulness in poorly equipped and often short-staffed laboratories.
Estimating drug efficacies should be done on samples with high FEC (>50 EPG), as including samples with lower FEC may result in a significant bias. As a consequence, sensitivity as a criterion for detection techniques for monitoring drug efficacy is less important. FLOTAC resulted in the most accurate estimates of TDE in the stratum of high FEC. However, the bias when using McMaster is minimal (median = −1.1%) and is comparable to FLOTAC if the TDE (median = −0.3%) is at least 50%.
Although the results presented in this study were obtained from stool of nonhuman primates, these will also be applicable in human parasitology. These animals not only share the same STH species with humans, they also have a similar fecal composition [19],[20]. Moreover, the prevalence of Trichuris is comparable to those of previous epidemiological studies in pre-school children, where in average 39% of the subjects were infected [3]. Furthermore, the distribution of the FEC found in these animals was similar. Based on WHO guidelines, 23.4% (FLOTAC) to 30.0% (McMaster) of the Trichuris infections fell into the moderate FEC range, where this was roughly 25% in Zanzibari infants [13].
Not including the Kato-Katz method in the present study is a major shortcoming. However, the present study suggests that McMaster is likely to be more feasible. The microscopic view is clear and all parasites can be examined simultaneously, which is in contrast to the Kato-Katz technique due to a different clearing time of the different STH. Based on previous study where both FLOTAC and Kato-Katz were compared for the detection of hookworm [14], we expect that both the sensitivity and the FEC of the Kato-Katz will be comparable to McMaster.
McMaster is commonly used for both diagnosis and drug efficacy monitoring programs of gastrointestinal parasites in livestock, including Ascaris and hookworm [16]–[18],[24], but its usefulness in detecting these STH in public health still needs to be confirmed by further studies in endemic areas where also A. lumbricoides and hookworms are present.
In conclusion, this study indicates that McMaster holds promise as the method of choice for monitoring drug efficacy, since sensitivity appeared to be a less important criterion. It is a quantitative technique which can be easily performed under field conditions and gives reliable estimates of TDE which are at least 50%.
Special thanks to Andrew Kotze, Marco Albonico, Antonio Montresor and Johannes Charlier for the revision of the manuscript. The authors also acknowledge the donation of the Parasep SF by NV Laméris SA (Aartselaar, Belgium) and the FLOTAC apparatus by Giuseppe Cringoli.
Author Contributions
Conceived and designed the experiments: BL JV. Performed the experiments: BL NDW EV. Analyzed the data: BL. Wrote the paper: BL JV.
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text:
Controlling dor Creating Wind
Today I tried to create or control wind. No luck at all actually. I attempted say wind, making windy noises, and making various appropriate gestures. Nice try I guess?
In other news, yesterday I learned that you really should cut away from yourself. I chopped my finger pretty badly with my recently sharpened kershaw. Also: I did a presentation on Go today and I think it went well. Two people spoke to me after the presentation and one of them asked if we could play together some time. Exciting!Posted Mon, Oct 1, 2007

subset: commoncrawl


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WEST PALM BEACH -- A 42-year-old West Palm Beach man underwent emergency surgery for multiple stab wounds Sunday night in Good Samaritan Hospital, as police interrogated another man charged with assaulting him. The victim was listed in serious condition.
Police were withholding the identity of the victim pending notification of his family.
Detective Jack Chappell said police had arrested the alleged assailant, Alberto Espinoza, 25.
The stabbing occurred at 5:45 p.m. in the 900 block of Alabama Street, where the two men lived, Chappell said. He said it stemmed from a dispute between the men.


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ColourSelect a Length to see the available Colours.
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OWEN COUNTY, KY (FOX19) - The Kentucky Division of Water has lifted the boil water advisory that was in place for the remainder of Kentucky American Water's Owenton system customers, excluding customers north of Poplar Grove to the City of Glencoe.
Nearly 2,000 Owen County residents were left without running water for almost a week after a water main break occurred in last Monday's freezing temperatures.
Customers in Eagle Hill should continue boiling for 3 minutes any tap water that is to be used for cooking or drinking until further notice.
For customers still without service, officials say they are "encouraged" by the progress water is making as it travels through the pipe system towards water-less areas.
Copyright 2014 WXIX. All rights reserved.


text: President Obama says that race relations have improved on his watch, which seems obviously untrue. 2014 will go down in history as the year when there was a racist under every bed. Grabien has assembled these clips from the past year, in which 39 things are claimed to be racist. It would be funny if the Democrats' stirring up of racial conflict were not having tragic consequences:


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When I got to work today I turned everything on, took care of some business, then returned to the computer, the screen was blank and the power button on the moniter was off. I pushed the button, nothing and I remember seeing the screen light up before I left my desk.
Keyboard lights on, light on the tower is lite, but no light on the moniter power button.
Next I unplugged the moniter power supply for a few seconds and plugged it back in and presto the screen lite up. Later in the day, blank screen. Same thing unplug, replug but now it will only stay on 60 seconds. Three times of this and I give up. It is quitting time.
Now I'm home,
Any help will be greatly appreciated.


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AFP Canada Leadership Posts
A Great Adventure Ahead!
by Vivian Smith, CFRE, Vice Chair, AFP Membership Services Division
I sense a great adventure ahead. Our profession is becoming recognised as a desirable and fulfilling career, and the Association of Fundraising Professionals is leading the way in convening conversations about the sector and the role philanthropy plays in strengthening community. Read more.
AFP Canadian Council Website Welcome
by Karen Mercier, CFRE, AFP Canadian Council Chair
The AFP Canadian Council was established to support the mission and strategic objectives of AFP in Canada and includes membership from fundraising professionals from across the country. It serves to work in partnership, and not replicate, the roles and activities of the Canadian AFP Chapters and AFP International. Read more.
AFP Canadian Council Overview
Derek D. Fraser, CFRE, Past AFP Canadian Council Chair
(Feb. 25, 2014) The AFP Canadian Council was established to support the mission and strategic objectives of AFP in Canada. The Council builds a strong, unified presence and voice for Canadian fundraising professionals both in AFP International and in Canada. It complements, not replicates, the roles, mandates and activities of the Canadian chapters and AFP International (AFP IHQ). Read more.
Mapping Out a Path to Your Future
Tania Little, CFRE, Vice Chair, Professional Advancement Division, AFP
(Feb. 25, 2014) Many fundraisers in my peer set chanced upon the profession through volunteerism or learned "on the job" how to adapt previous skills acquired through other jobs. Whether choosing at a post-secondary level or coming into a second career; there are a myriad of education and training opportunities available to facilitate the development of highly effective and ethical professionals in the social profit sector. As an AFP member, you are part of a network of 30,000 professional fundraisers, ready to help you along the journey. Read more.


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Intramuscular stimulation involves inserting acupuncture-style needles into muscles to relieve pain and long-term muscle shortening, as Physical Medicine & Injury Rehabilitation explains. The procedure involves stimulating spinal reflexes that cause muscles to contract briefly and then relax to reset the muscles to the normal resting length.
Providers commonly use intramuscular stimulation as an alternative therapy in conjunction with chiropractic care, massage or physical therapy, according to Physical Medicine & Injury Rehabilitation. The procedure focuses on repairing shortened muscle bands that are deemed trigger points and become tender.
Providers often use intramuscular stimulation to treat chronic myofascial pain, but they also use it to treat elbow tendonitis, back pain, sciatica, hip bursitis and shin splints, according to Physical Medicine & Injury Rehabilitation. Some medical professionals recommend intramuscular stimulation to treat plantar fasciitis, achilles tendonitis, patellofemoral pain, and cervical and lumbar strain.
The duration and frequency of intramuscular stimulation varies based on the extent of the patient's condition, the amount of scar tissue present and the patient's rate of healing, as explained by Active Sports Therapy. The rate of healing is often reliant on the age of the patient and the condition of the nerves. Some patients may require multiple treatments, but pain that is relatively recent in origin may require a single treatment.


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About Robert Kushner
Robert Kushner participated in the early development of the Pattern and Decoration Movement in the 1970s, and is known for championing a decorative style of painting. "I never get tired of pursuing new ideas in the realm of ornamentation," he said. "Decoration, an abjectly pejorative dismissal for many, is a very big, somewhat defiant declaration for me." Artisanal objects the artist discovered in his travels abroad—particularly Japanese screen doors, Islamic patterns, and Uzbekistani embroideries—strongly affected the development of his organic plant forms, grid-based compositions, and use of bold colors and gold leaf. He was also strongly influenced by Henri Matisse, Georgia O'Keeffe, Gustav Klimt, and the French Nabis painters. Since the 1980s, flowers and leaves have become Kushner's signature motif.
American, b. 1949, Pasadena, California


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Executive Master of Business Administration
Executive MBA Program
Space is a new and diverse industry that is evolving rapidly, as a transition from publicly funded space activities towards the "New Space Economy" is taking place. It is an industry that brings together scientific as well as practical applications influencing our daily life and the economy at large. This space EMBA is designed to support individuals involved in this enterprise who want to further develop their careers and their businesses.
Specifically, the course aims to provide participants with the following skills:
1. Application of accounting, financial, economic, management and marketing principles in space organizations, to solve business problems.
2. Ability to relate this theoretical knowledge directly into the workplace.
3. In-depth understanding of the specific policy and legal frameworks governing space activities.
4. The ability to use effective business management techniques in an international environment.
5. The opportunity to generate and communicate ideas in an intercultural environment.
6. The skills to access and use business information efficiently and accurately.
7. Experience in marketing and the development of business plans to suit a range of market situations.
8. A basic knowledge of accounting principles.
9. Understanding of international space business and the specificities of the modern space economy.
10. Knowledge of the specific space project management techniques developed in the space sector.
11. The opportunity to apply learning and research skills to produce, as part of their final thesis, a thorough analysis of a business situation.
12. The ability and confidence to get more from themselves and from others, having enhanced lifelong learning skills and personal development.
Program Overview
True to the ISU tradition, the Executive MBA intends to provide excellence in the training of space leaders in an uncompromising manner. The modular nature of the program allows high-value professionals to remain dedicated to their relevant tasks while investing in their careers and future potential by joining a like-minded class. At the same time, the 9 residential weeks during an 18-month period allow the absorption of the relevant material and the creation of a balanced curriculum that seeks to exceed expectations and provide all the necessary skills for doing business in the space sector.
The traditional MBA core elements are taught in an interactive and applied manner, while coupled with elements of a Master's in Public Administration, necessary to incorporate a pragmatic understanding of the space sector. True to ISU's interdisciplinary nature, this program provides at the early beginning an overview of the technical characteristics and also significant team-building skills for the bonding of the group.
The Benefits
ISU's Executive MBA:
- Requires only a limited presence at residential courses, hence minimum absence from the working place (9 residential weeks)
- Offers distance learning capabilities during the interim periods
- Provides faculty from space industry and institutions
- Merges the classical MBA skills with a practical implementation of space elements and applications.
The inputs of space operators and the space industry, in general, have been sought, and already now SES, the world's leading telecom operator, is providing effective support to the program.
The Modules
The program is largely based on 2-week Modules. While benefiting from online assignments in the interim periods that aim to maintain the coherence of the group and absorption of material and without interfering with the professional obligations of the participants. These Modules take place in different parts of the world; each Module benefiting from local core-competencies and experiences while enjoying the functionality and continuity of an integrated degree.
Admissions criteria
Applicants will be admitted on the basis of their academic and professional achievements and must have earned a bachelors degree or equivalent.
Preference will be given to applicants:
- having a minimum of five years relevant experience
- having a proficiency in English
- demonstrating focused career perspectives in the space sector or similarly complex area.
In the case of applicants who are sponsored by their organization's human resources department, selection will be performed in cooperation with that department.
Admission procedure
Applicants selected by the Human Resources department of their organization shall submit the following documents to ISU either directly or through their HR department:
- A Curriculum Vitae
- A certified academic record, transcript or mark sheet
- A proof of language proficiency in English.
Non-sponsored applicants should submit the above items plus those listed below directly to ISU:
- An essay explaining the reasons why they wish to attend the course
- Two letters of recommendation
- A declaration of professional experience.
Tuition fees
This program is currently under review. No further information is available.
This school offers programs in:
- English
Last updated December 27, 2017


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Publication Abstract
Authors: Huo J, Du XL, Lairson DR, Chan W, Jiang J, Buchholz TA, Guadagnolo BA
Title: Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
Journal: Am J Clin Oncol 38(3):235-41
Date: 2015 Jun
Abstract: OBJECTIVES: To examine the patterns of utilization of radiation therapy, chemotherapy, surgery, and hospice at the end-of-life care for patients diagnosed with metastatic melanoma. METHODS: We identified 816 Medicare beneficiaries toward who were 65 years of age or older, with pathologically confirmed metastatic malignant melanoma between January 1, 2000, and December 31, 2007. We evaluated trends and associations between sociodemographic and health service characteristics and the use of hospice care, chemotherapy, surgery, and radiation therapy. RESULTS: We found increasing use of surgery for patients with metastatic melanoma from 13% in 2000 to 30% in 2007 (P=0.03 for trend), and no significant fluctuation in the use of chemotherapy (P=0.43) or radiation therapy (P=0.46). Older patients were less likely to receive radiation therapy or chemotherapy. The use of hospice care increased from 61% in 2000 to 79% in 2007 (P=0.07 for trend). Enrollment in short-term (1 to 3 d) hospice care use increased, whereas long-term hospice care (≥4 d) remained stable. Patients living in the SEER (Surveillance, Epidemiology and End Results) northeast and south regions were less likely to undergo surgery. Patients enrolled in long-term hospice care used significantly less chemotherapy, surgery, and radiation therapy. CONCLUSIONS: Surgery and hospice care use increased over the years of this study, whereas the use of chemotherapy and radiation therapy remained consistent for patients diagnosed with metastatic melanoma.
Last Updated: 14 Sep 2018


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In order to maintain a safe environment for students, staff, and visitors, a quarterly safety inspection will be conducted by the Custodial Maintenance Coordinator, or another qualified individual(s). Inspection results shall be reviewed with the site/department administrator, and a "correction plan" will be established for any identified safety concerns.
School/Department Safety Evaluator
- The Custodial/Building Maintenance Coordinator, or another qualified person, will conduct the site inspection.
- The 4J School/Department Safety Inspection Checklist(pdf) will be used as a guideline in conducting the inspection process.
Inspection Frequency
- Each 4J work site must conduct one safety inspection during each of the four quarters identified below:
Quarter #1 – July 1 to September 30
Quarter #2 – October 1 to December 31
Quarter #3 – January 1 to March 31
Quarter #4 – April 1 to June 30
- The annual safety inspection performed by the 4J Safety Specialist(s) (Matt Cornwell), and WHA Insurance Loss Control Consultant may count as one of these quarterly inspections.
- A reminder will be sent each quarter to all schools and departments that need to complete an in-house safety inspection.
Supervisory Review of Inspection Results
- Review the completed inspection form with the school/department administrator, and develop a plan for correcting all identified safety concerns.
- In the event that safety concerns are identified during the quarterly inspection, corrections need to be made in a timely manner. In the event that safety concerns are not corrected in a reasonable period, then the matter should be referred to the site administrator. The administrator or designee should contact a Safety Specialist at Facilities Management, or Human Resources if additional assistance is required.
Correction Plan for Safety Concerns
- Determine the potential danger posed by each safety concern. If the item poses an immediate threat of injury then it should be corrected immediately. Otherwise, determine a reasonable length of time for correcting each item.
- Submit any work orders required to "fix" the problem, and indicate it is a "safety inspection item." In addition, you will also want to immediately follow up with Matt Cornwell (x7433), or Doug Lemonds (x7432), 4J Safety Specialists, on high priority safety issues.
- Monitor to make sure the identified safety item(s) are corrected.
- Report any delay or problem in resolving safety concerns to your building or department administrator.
Record Keeping
- A copy of all completed inspections, including a list of the safety concerns identified, and a description of the actions taken to correct the problem will be forwarded to Human Resources. Human Resources will maintain the "official" file for all 4J quarterly inspections.
- It is recommended that schools and departments maintain copies of their quarterly inspection results for use in tracking and resolving identified safety concerns.
If You Need Assistance
If you need assistance conducting your quarterly inspection or developing a plan to correct safety concerns, please contact Matt Cornwell (x7433), Doug Lemonds (x7432) in 4J Facilities Management, or Human Resources (x7673).
(Revised June 21, 2017)


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The 'Cloud' is an Internet-based platform for many business tools, including POS system software. When you use the Cloud for your computing needs, you data is stored onto an Internet-based platform rather than on the hard-drive of your computer or other device. As many companies do rely on Cloud-based platforms for their business operations and their point of sale software, you may wonder if you should switch to this type of software. This article lists off a few advantages and disadvantages of using Cloud-based POS software, so you can make an informed decision for your company.
The main and most important advantage of using Cloud-Based POS Software is how easy-to-use and accessible it can be. You can reach your business sales transactions data anywhere and anytime you have Wi-Fi. Even better, you can use a Cloud-Based system on the go with a mobile device and ring purchases or show items to a customer in person outside of your boutique or business hours if needed; possibly boosting sales and retaining more clients in the long-term. However, what happens when your Internet connection goes down? The necessity of having an Internet connection to operate Cloud-based POS system software is both its biggest advantage and inconvenience. If your place of work does not have a Wi-Fi connection available or has internet connection problems, you might want to stay away from Cloud-based software. Investigate software which offers offline options -- that way if your Internet stops working, your cloud POS doesn't.
Price-Efficiency and Effectiveness
Cloud-Based POS software can significantly reduce the amount of funds you allocate to your POS system software. Its price goes up to a few hundred dollars, at most, compared to a few thousand dollars for traditional POS system software. Additionally, most cloud-based POS software will not force you into staying in a contract, so you can switch from one system to the other without paying fees or penalties. If you will not be using the POS very much, you can opt for a per-transaction fee and will be charged only when you actually make a sale. If you know your volume of sales will be more important, many Cloud-based software offers per-month or per-year subscriptions. Software updates will be usually done automatically on your device and for free, avoiding additional costs to keep your equipment up to date. However, make sure switching from your existing POS to cloud-based system software will not force you to pay extra fees and penalties from stopping your current subscription or service.
Because your POS data is stored entirely online, you don't have to worry about your POS system software being accessed by fraudulent entities Additionally, the information is also backed-up on the Cloud so your data will never be lost if your hardware stops working. Your downtime will be reduced, which can avoid loss of profits and clients. However, some business owners prefer keeping their data 'in the house.' Whether you chose to store your data 'on the cloud' or keep it at your place of business depends on how comfortable you feel with each type of POS system software. If you don't feel comfortable about storing your data online, don't switch to a Cloud-based system just yet.
Clouds-based system software have many advantages for business professionals on the go, looking for more flexibility and accessibility for their point of sale. It is also a great option for smaller businesses.


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Today has been a historic day for the Republican Party, after Senator Ted Cruz (R-TX) and Ohio Governor John Kasich dropped out of the Presidential race.
Conservative businessman Donald J. Trump is now the presumptive nominee, and is about to face Hillary Clinton.
Now, former candidate Mike Huckabee shared publicly his future with the GOP and with Donald Trump. Huckabee is ready to get to work and do whatever it takes to put Trump in the White House.
This is incredible!
I will be all in to help him defeat Hillary Clinton and I call upon all fellow Republicans to unite in defeating Hillary and abandoning and repudiating the hapless "Never Trump" nonsense. The dirty little secret is that the Never Trump movement was more about providing high dollar work for the political consultants than stopping the disaster of an Obama third term which is the result of electing Hillary Clinton.
While Huckabee doesn't agree with Trump on every issue, he's certain that Trump is far more qualified to be President than Hillary and her big government worldview:
We will go to Cleveland with a presumptive nominee, and we will realize that whatever squabbles we have among people in the GOP, it's nothing compared to the chasm between us and the socialist, big government approach of the Democrats.
This is an important message that the Republican establishment must hear. Governor Mike Huckabee is telling Republicans that it's time to put aside differences and elect Trump. This election is too important to hand over to the Democrats. After all, the future of America is at stake!
What do you think about Mike Huckabee's big announcement? Please leave us a comment (below) and tell us.


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Stand-Alone Water Disposal Facilities (SWD's) are scaled-back versions of Full Service Terminals for deep well injection of produced and wastewaters. Our network of water disposal wells discard fluids safely and responsibly.
Engineered oilfield landfills meet your solid waste disposal needs from drill cuttings to remediation work – and anything in between. To ensure safety and environmental responsibility at our sites, each landfill cell has a high-quality, multi-layer liner, liner protection system and environmental monitoring programs.
SECURE Energy Services is a leading integrated crude-by-rail service provider. Our Full Service Rail Terminals (FSRTs) transport crude products via rail to end users on behalf of Canadian oil producers. With pipelines running at full capacity, our FSRT services provide an alternative solution to producers who are looking to get their product to market in a timely and safe manner.
As part of SECURE's long-term growth strategy, we are expanding commercial and transportation related opportunities in an effort to provide additional services to our customers.
The growth and development of SECURE's commercial and transportation business will increase cashflow, increase asset value and contribute to the Canadian transportation system of oil and gas production.
SECURE's Drilling and Production Services division is committed to offering innovative products and services to enhance our customer's performance and productivity of their drilling, completions and production operations.
We provide extensive watercourse crossing services to inspect or repair pipelines and perform remedial activity. We understand the critical nature of watercourse crossing activity within a body of water. SECURE Energy Services has experience working in extreme climate and challenging terrain, and can develop customized solutions to meet the needs of any site and project scope.
SECURE Energy Services has the capability to complete all aspects of environmental design and construction from landfill construction, leachate collection system installation, pond construction, liner installation and bentonite slurry wall construction. Our experience includes installing several types of liner, including HDPE, PVC and RPE.


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Jun 15, 2012
The idea in this series is to show beautiful and inspiring houses. Houses that are remarkable for its design, elegance, elements, concept or simply because they are beautiful. So if you like architecture, interior design and beautifully designed houses, you are at the right spot. Check out this week beautiful house and stay tuned for more...
The Lai Residence in Kaohsiung City, Taiwan is a project by PMK+Designers. This two-story penthouse apartment embodies many of PMK's ideas about integration between space, architecture, urban living, and spirituality into everyday life. We couldn't find the designer's website and their Facebook page doesn't have a lot of informations, but the images are stunning, check it out.
This penthouse is breathtaking. Spaces, materials and decoration are elegant, clean and modern, creating an amazing apartment. Definitely a great place to live! ;)
Check out PMK+Designers Facebook page for further images from this and other projects. See you next time.
We found this house at Contemporist.
Photos by Joey Liu.


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Get ready to enroll
There are two simple steps you can take before November 1st to ensure a smoother enrollment. First, if you have not accessed your account in the last 90 days, reset your password online or call our Customer Service Center at 855-PLANS-4-YOU. Second, make an appointment with a certified Broker or Assister – appointments fill up fast! Get help »
Estimate savings and preview plans
Before applying for financial help and purchasing a plan, get an estimate of your potential savings and out-of-pocket costs, as well as preview 2019 plans. Last year, Coloradans receiving financial help protected their health and finances for just $136 per month, on average. Come back November 1st to enroll or renew your plan. See how much you can save! Learn more »
New to Connect for Health Colorado?
If you are wondering if you still need health insurance, the answer is "Yes!" Did you know the average cost of a 3-day hospital stay without health insurance is $30,000? Getting covered doesn't have to cost an arm and leg. Customers who qualify for financial help are saving an average of 80% on their monthly premiums. Learn More »


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Eichholtz Gates Wall Lamp
Product Code: EI5841
Round, industrial gunmetal finished wall lamp from Eichholtz.
The Gates Wall Lamp features a round, wall mounted base with two screws to attach.
It has a protruding support arm and base that holds the light source in place.
This includes subtle and intricate line detailing with a turning switch on the bottom.
The wall lamp will make a contemporary addition to your entrance hallway, dining room or lounge.
Requires: 1 x 40 (max) E27
Note: Bulb not included.
About The Brand
Eichholtz is the epitome of luxury living… our collection of furniture, lighting and accessories from Eichholtz is your go-to style destination for that elusive interior piece. From timeless Luxe glamour to hotel boutique Chic, the inspirational Eichholtz collection spans a host of iconic interior styles and can be found in some of the world's most prestigious hotels and residences.
Why shop with Houseology
Houseology is not only the UK's premier online interior design store - it is an emporium of design ideas, advice & inspiration and a platform of tools & technology designed to make your interior design decisions and calculations easy.


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Sunday, 18 April 2010
The Craft Barn Competition day 4
6 comments:
- Anne said...
Cor!!!! I've been on holiday all week so I've missed all this and I'm just catching up! This is fabulous Michelle - all your pages are amazing and I love the colour combo you chose! Superb stuff!!! Hugs xx
- 18 April 2010 at 15:28
- Sandra Hall said...
You are going to end up with a great mini book Michelle... those birds on your journal block are a great idea and very effective!
x x
- 19 April 2010 at 00:53
- craftimamma said...
I've been away too Michelle. Last weekend to Ally Pally and this weekend to Graphicus the same as you. I don't know how I didn't see you because I was there both days. I would love to have said hello.
Anyway, I'm catching up on my fave blogs and these pages for your mini album are lovely. I like everything about them from the elements you have used to the colours.
Lesley Xx
- 19 April 2010 at 18:54
- Katy said...
Lovely Michelle, pretty colours too.
- 19 April 2010 at 20:42
- lisa said...
Hi Michelle. Glad you had a great time at Graphicus. I think I'd have to save for years before I dared go see Glenda. Her stamps are just TOO tempting. Thank you for your lovely comments!!
I love this mini book, every page is dazzling. You've picked my favourite colours and the elements work perfectly. It's a lovely thing to treasure for the future.
Hope you have a lovely week.
- 19 April 2010 at 21:29
- peata said...
lookin good!
- 20 April 2010 at 10:53


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Recent Cities — ShootTokyo
I just got back from recent trips to Ho Chi Minh City and Melbourne Australia. Both are places I haven't been to in a really long time. I was last in Ho Chi MInh was on a trip to Vietnam and Cambodia with my dad. It has changed and developed so much since that time. It has been even longer since I have been to Melbourne.
I was pretty busy with work in Vietnam. I got out for a short walk but it was so hot that I didn't stay out that long. I would struggle to be a street photographer in Vietnam.
Today's Configuration: Leica M Monochrom with a Summilux 28mm f/2.0
No responses
Q: Why does JPGMAG drag the competitions on so much.
A: Do you know?


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Angelica Painting Set
Make a big change fast with these ingenious painting ideas and chic paint color combinations from our Painting Collection. This painting brings a soothing atmosphere to your wall. This painting is not only pleasant to look at but will add a calm and peaceful vibe to your home. Also, variable designs are on our site, choose the right painting to fit your home.
Dimension -
70cm W x 100cm H
Frame Design -
Black ONLY


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Liv Hnilicka
Liv Hnilicka is a Midwest based performer, writer, comedian, and advocate for TBLG identified people. As a graduate of Second City, she has performed at Annoyance Theatre, UIC, Depaul, and MCA. She also was a regular contributing artist to Chicago's underground drag and burlesque communities, collaborating with organizations like Chances Dances, Salonathon, and Northern Lights. She also loves her puppy Madame Chang and roasted brussels sprouts.


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Forbes Young is a nationwide firm of Accountants in your locality to provide an excellent accountancy and taxation service. We place great importance on building client relationships, specialising in contractor limited companies. Speaking directly to a partner in the firm, we can offer you experienced and qualified advice.
Visit website · Telephone: 0161 935 8264
FreeAgent will use your personal details to inform the accountant. FreeAgent will not use your personal information to contact you. Note that FreeAgent does not guarantee the service of any one of the listed accountants. By submitting this form you indicate that you have read and agreed to FreeAgent's Terms of Service and their data and privacy policy.


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Free PDF Downloads for Soft Furnishings/Instructions
Sew Good Book Shop
For my Sewing for Fun Students - Sewing techniques and easy projects.
Tuesday, 21 December 2010
Seasons Greetings
Season's Greetings
Good Wishes
for a
Fabulous New Year
to all my readers.
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Christmas Greetings
End of Term - Show and Tell
I have also put this post onto my other blog as I know I have different readers for each. It is the only post that is the same, so if you haven't popped over to Pretty Goods yet, click
to see lots of other posts about what I do and what I've done!!
End of Term - show and tell!
Last week the Learn to Sew students I teach
(with Kent Adult Education Service)
completed their first 10 week course.
Diane surrounded by her handiwork.
I have been so pleased with their progress, and couldn't wait to photograph them with all their 'makes'.
Seven ladies enrolled, all with no, or limited sewing experience. Some had borrowed machines, others had their own, but were unsure how to use them, and one bought in a 80 year old hand operated singer to do her sewing on.
Jackie at her sewing machine.
I usually like to run my classes like a workshop, with students choosing what they want to make, but with beginners a little more structure is needed. So I started the course by showing how to wind a bobbin and how to thread the machine, then a little sewing practice on scrap fabric. Not too much of this though, it's much better to learn by making something useful.
We started with lined shoulder bags - lots of straight sewing and a buttonhole; moved onto simple cushion covers with a zipped opening across the centre back;
then a cushion with a frill and instructions to follow
(click for a link to my other blog and a tutorial for this cushion); a piped cushion cover, with a hidden zip in the piped seam and some machine appliqué on a lavender bag.
Nicole, ready to sew.
A few of the students wanted to try other things. Appliqué on a wash bag; aprons, shopping bags - and Kate, a
complete beginner wanted to make
boxed and piped cushion covers for a rocking chair (yikes!!) - but hey! look at her achievement.....
Didn't Kate do well?
Two students made a lined bag with a flat, stiffened bottom and another finished the course by making an apron with a curved pocket on the front.
Their enthusiasm was great and all the students made other items at home, using the patterns and instructions used in class.
Some more pictures of all their work:
Diane's cushions made from vintage and re-used fabrics, and a tweed bag from an old skirt.
Diane, using her hand operated singer to attach piping to a cushion front. She has done really well to produce more items at home.
Nicole, showing off her frilled cushion.
Alison, with her roomy, flat bottomed shopping bag.
Jackie's cushions, bag, shoe bag and appliquéd lavender sachet.
Kate, at her new Janome, with all her makes.
Kate really got into applique - her daughters now have some fab T-shirts decorated by mummy!
Kate's cushion matches her box cushions.
I'm so pleased with all their achievements, and looking forward to them returning next term, along with some new beginners.
Well Done Ladies!!
My soft furnishing students also completed the first term of a 30 week course, and here are a couple of my long term students with their fabulous cushions.
A trio of Union Jacks by Rose. Aren't they fabulous?
Rose, with her cushions.
Jill loves using this gorgeous linen fabric from
Ada and Ina
, and combined it with some pretty cotton she brought back from a holiday in Japan.
The printed fabric strip conceals a zip opening!
The other side of Jill's cushion.
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Fellow applicants must be physicians, who are ABMS board certified or board eligible in a primary specialty (e.g. Internal Medicine, Anesthesiology, Pathology, Pediatrics, Surgery, Radiology etc.) upon starting the fellowship. Board eligibility is typically obtained by successfully completing a residency program in the US or Canada. Unfortunately we cannot accept applications from those who will not be Board certified or eligible.
Applicants must be a United States citizen or have a United States permanent resident status. Visas are not sponsored. The Clinical Informatics Fellowship will accept one (1) fellow per year with the first fellow to begin in July 2017.
Application Process
Application Deadline:
The application process will start in August 2016. Application Deadline: The deadline to submit a completed application is October 31st, 2016. Only fully completed applications will be considered.
Applicants must complete both the Masters in Applied Clinical Informatics application at https://medschool.vanderbilt.edu/ and the Clinical Informatics Fellowship applications.
Interested parties should 1) indicate their intent to apply to firstname.lastname@example.com and 2) complete an online application no later than Nov 15. When choosing the Program within the online application please make the following selections:
Program to which you are applying: Medicine-Non MD
Program: Master of Science in Applied Clinical Informatics
Degree: MSACI
For questions regarding the MSACI application, please click here.
Additional REQUIRED Documents:
Personal Statement – please use the questions below to guide your personal statement in the online MSACI application:
Please address the following four questions, taking no more than two double-spaced pages in length total:
Describe the reasons why you are seeking to complete a two year fellowship in Clinical Informatics
Explain why you want to be a fellow in the Vanderbilt program.
Describe your prior experiences in Clinical Informatics or related technical fields.
Describe your research experience and interests in Clinical Informatics, and suggest a project idea(s) that you would propose to work on as a fellow.
Curriculum vitae (upload with MSACI application)
Medical school transcripts (upload with MSACI application)
Copy of residency graduation certificate or letter from program director describing anticipated graduation
Copies of all Board Examination scores as well as USMLE steps 1, 2, 3 scores
Three (3) Letters of recommendation on organization letterhead. (request letter through MSACI All letters of recommendation should address the applicant's desire to train in a Clinical Informatics fellowship. One letter must be from the residency program director or department chair and one letter must come from a faculty member or associate who can speak to the applicants interests / background in Clinical Informatics.
For additional questions about the Fellowship program, please contact Elisabeth Hudson at firstname.lastname@example.com


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Recent Parolees
For information on adopting Scarlet, please contact the HOPE Program by CLICKING HERE or calling . You can complete an application online by clicking here
March 13, 2015
"This week Scarlet and I have been doing a lot of outside activities. She's been doing a lot of exercising and running around and having fun. She loves to play with her Frisbee. She is a loving and wonderful dog that loves to be rubbed and shown affection. She is extremely sweet and loving once she gets to know you and would make someone or a family extremely happy. Scarlet has impeccably good manners. She has absolutely no issue at all obeying any command. She will do whatever is asked of her and is a very wonderful dog."
March 6, 2015
Scarlet has improved tremendously since she first came to the program. She met two new people this week and within 10 minutes was laying on her back getting her belly rubbed!
Feb. 28, 2015
Scarlet was outside a lot this week, playing in the snow with her tug toy and frisbee. She does like to bark at new people but has improved to the point all you need to do is say 'quiet' and she stops. She has great manners and is an overall great dog!
Feb. 20, 2015
Scarlet has getting very good at controlling herself when meeting new people. She just takes a little longer to get used to new surroundings and new people and shows that once she does, she's an extremely loving and smart dog! She's great with all of her commands and walks well off leash. Scarlet is just waiting for someone to be able to give her the love and provide the patience she needs in her forever home!
Feb. 14, 2015
Scarlet has come a very long way with her behavior. Her good manners are wonderful and will do anything you ask her to. She's very obedient, loving and loyal and wants to be someone's companion. Once she warms up to you she'll be one of the best dogs you ever met.
Feb. 7, 2015
Scarlet continues to work on meeting new people and warms up to them after a few minutes. She continues to do well with her commands.
Jan. 22, 2015
Scarlet has been working on not barking at new people and has been making progress. She's not mean to them, and once she has a chance to sniff them and realize they aren't trying to harm her she relaxes and is fine. Scarlet has excellent manners and is well behaved.
Jan. 22, 2015
Scarlet continues working on her mat training and making sure she understands it's her safe place. She's been doing really well with this exercise and has shown that with a little effort she can be taught anything. She's extremely smart and treat motivated, which makes training her fun and exciting.
Jan. 16 2015
This week Scarlet revisited loose leash walking. She did very well and was rewarded by playing with her favorite tug toy, which she loves to do! Scarlet would make a loving, loyal dog for a family with older children.
Jan. 10, 2015
Scarlet continues to work on her behavior when meeting new people and is making great progress! Scarlet loves the snow and spending time playing in it. Her handler says she has excellent manners.
Jan. 3, 2015
This week Scarlet's handler has been working on recall and making progress when meeting new people and has calmed down considerably.
Scarlet does great with agility! She knows 'jump over' and 'go under' the bars on the course.
Dec. 26, 2014
Scarlet continues to make progress. Scarlet's overall behavior is very good, she just has to learn to remain calm when meeting new people. She also does well with other dogs as long as they aren't overly assertive toward her.
Dec. 20, 2014
Scarlet continues to do well and her recall has improved from a 2 to a 10. She knows her 5 major cues well: sit, down, stay, leave it, and no. She's a fast learner and everyone calls her the unit dog as she loves people and attention.
Dec. 13, 2014
Scarlet's handler says "This week Scarlet did very well. She is very warm and friendly towards everyone." She shows no resource guarding and plays a little rough but all in fun. She is showing so much progress she'll soon be ready for the dog park. Scarlet also does very well on the obstacle course and can jump over and go under the cross bar on command.
While Scarlet can be apprehensive when first meeting new people, given a chance, she warms up quickly.
Dec. 6, 2014
Scarlet learned the 'leave it' command this week! Her handler says she's very smart, listens well and has good manners. She has a lot energy and would be perfect for a family with active children and a yard.
Nov. 28, 2014
This week Scarlet has been working on 'focus training' to help keep her from getting overly excited when there are a lot of people around. Scarlet's handler adds that 'she is pretty good with her manners and all of her commands. She loves to play outside with a ball, frisbee and tug toys and doesn't know her own strength sometimes!'
Scarlet would make a wonderful family dog, she just needs a little time to warm up to new people first. She also passed her Canine Good Citizen test with flying colors! Way to go Scarlet!
Nov. 21, 2014
Scarlet's handler says "she's very good with people, other dogs, and her toys. She's also very friendly and wants to do nothing but play." She does well with her commands and loves to have belly rubbed She's very smart and doing great after only four weeks. Scarlet knows how to speak on command and does very well on the agility course.
Scarlet would do well with a family that can give her attention and plenty of love, and be wonderful with children.
Week Three
Scarlet continues to do well. She's very lovable and is opening up to more people. She loves to be rubbed!
Week One
Scarlet is doing extremely well and has been getting used to new people and her new environment. She warms to people quickly, especially when she's treated with care and love. She's a perfect people dog and likes to get to know you first before she fully opens up. Scarlet has very good manners and understands all basic commands, is a quick learner and very smart. She loves to sleep on her back which is very cute and she's an absolute sweetheart. Scarlet would make a great addition to any family!


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New Delhi: Out-of-favour India opener Gautam Gambhir today said both he and current India Test captain Virat Kohli are aggressive individuals who are passionate about cricket.
Gambhir said his characteristics are similar to Kohli and both of them share a common goal, i.e to give their best for their respective teams on the field.
"When you are playing against an opposition you want to go out there and win a game and for that you have to be aggressive. As a leader you want your team to play as you are. Both of us are aggressive and passionate individuals and want to do well for our respective teams," Gambhir said.
"Even if we have difference of opinion there is nothing wrong in it. We both have same ambition that is to make our country proud and try to win each and every game as possible and try to contribute in the team's success. There is nothing personal about it.
"This is what professional people do. We are pretty good friends on and off the field," he told NDTV.
Gambhir and Kohli had a verbal duel during the 2013 IPL match between their respective teams -- Kolkata Knight Riders and Royal Bangalore Challengers.
Also this year, Gambhir had apparently kicked a chair during the celebration of KKR's victory over Kohli's RCB and was later fined 15 per cent of his match fee for breaching the Indian Premier League (IPL) Code of Conduct.
"There was nothing personal in the IPL fight with Virat. If I play against Virat again and need to be aggressive, I will," said Gambhir.
Following Gambhir's selection for 3rd Test against New Zealand, where he played under Kohli's captaincy in whites for the first time, the opener only had good things to say about his captain.
"Virat leads the team by example," he said.
(With PTI inputs)


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Say hello to Sofia Ashraf.
You might not know her name just yet, but you should remember it. Because Ashraf is the most bada** Indian rapper out there. And she wants to take down big companies for alleged environmental pollution in her homeland.
This former-creative-at-Ogilvy-&-Mather-turned rapper has released a video openly criticizing Unilever, one of the largest clients of her former employer. The video comes as part of the petition asking Unilever to take responsibility for mercury poisoning in the city of Kodaikanal, India.
"[Unilever's thermometer] factory operators did not give its workers any protective equipment or information about the disastrous impact that mercury has on health," the petition explains. " [They] also dumped toxic mercury around their plant, and this has not been cleaned up in the 14 years since this plant was shut down."
Ashraf is not happy, and she wants big companies to know it.
One of the best part about her rap song is that it's set to Nicki Minaj's "Anaconda."
"Kodaikanal won't," she raps. "Kodaikanal won't. Kodaikanal won't step down until you make amends now. Uniliver came and left devastation as they exposed the land to contamination. They set up a thermometer factory where workers handled toxic mercury. They dumped their waist in the local shrubbery. Now that's some toxic chic."
Tell 'em, girl.
The New Indian express reports, that the current "death toll stands at 45 workers of the now-defunct Unilever factory besides 12 of their children," not to mention other serious illnesses among numerous members of the Kodaikanal community.
"But this is real," she continues rapping...
... and she means every word.
Make sure to watch the entire video below.
This is hardly the first time that Ashraf has taken the lead on an important cause, Kombini reports.
Check out her being absolutely badass in the video from 2008.. More power to you, Ashrad.
Like this? Please share by clicking below.
(H/T: Konbini, Economic Times, The New Indian Express)


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In his essay Über Anmut und Würde [On Grace and Dignity, 1793], Schiller continues to explore notions of outer and of inner beauty, building on his definition in the Kallias letters of beauty as "Freiheit in der Erscheinung" [freedom in appearance]. Looking for an objective principle of beauty and making the case that reason can be seen, Schiller goes beyond Kantian moral philosophy – and also beyond the mere aesthetic, concerning himself with moral and anthropological aspects of beauty as well. Having studied Kant's Kritik der Urteilskraft [Critique of Judgment, 1790] in some detail, Schiller sees his enquiry …
Fricker, Christophe. "Über Anmut und Würde". The Literary Encyclopedia. First published 31 January 2007
[https://www.litencyc.com/php/sworks.php?rec=true&UID=21607, accessed 21 October 2018.]


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- What: Borderlands
- Where: Green Man Gaming
- Current Price: £2.99
- Borderlands PC price comparison
- Borderlands Review
Let's get right to business; if you haven't played this game you are missing out on a real treat. Gearbox's FPS/RPG hybrid has been dropped to the price of a pint by Green Man Gaming, and because several retailers are currently out of stock it means you will make a saving of over £4 in comparison to the next best offers from Base and its affiliates. Borderlands follows the travels of 4 treasure-seeking "Vault hunters" on the desolate world of Pandora. Choose your class, your skills, your favourite from millions of randomly generated guns, and then head out into the wastes to shoot convicts, wildlife, and anything that is generally trying to rip you a new one. While the game has enough to keep a solo player entertained the real experience comes from the 4 player co-op. At £3, it's quite the bargain. Thanks to owlattack89 @ HUKD!
PLEASE NOTE: You must install the Capsule software from GMG for this purchase, and this edition is not compatible with DLC from other retailers.


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Retailers are pulling out all the stops for Super Saturday
Kohl's To Open Stores For 170 Hours Straight.
Thanksgiving shoppers line up at a Kohl's department store in Sherwood, Arkansas, in this AP file photo. WASHINGTON • Kohl's on Tuesday announced a bid to win the holiday shopping dollars of procrastinators and night owls: The department store plans to stay open for 170 straight hours, starting Thursday at 7 a.m. and wrapping up at 6 p.m. on Christmas Eve.Kohl's KSS -3.31% will keep its doors open for more than seven days straight before Christmas in a move that shows just how tough the holiday season has been for retailers.For those who want to do their Christmas shopping online, Walmart said they can order up to Dec. 20 for standard delivery and as late as Dec. 22 for rush deliveries.
This is not the first year Kohl's has stayed open around-the-clock in the run-up to the holidays, but the chain is getting an even earlier jump on the offering this year, which starts on Dec. 17 after launching on Dec. 19 the previous year. While Kohl's made big strides in its e-commerce over Black Friday weekend, saying it had its biggest online days that week, it is a department store that relies heavily on apparel sales (Kohl's gets 60% of it business from apparel), a segment that has been hurting because of the record mild temperatures in the Eastern half of the country since Thanksgiving. Super Saturday, the busiest shopping day before Christmas, also happens to be the last day for guaranteed-by-Christmas delivery for many merchants. (Danny Johnston, AP File) CLEVELAND, Ohio — With the Christmas countdown ticking into single digits, retailers are extending their sales, deepening their discounts and keeping their stores open 'round the clock to pull still-reluctant shoppers into their stores for Super Saturday. What's more, Amazon AMZN -0.78% has been enjoying a banner holiday season, despite valiant efforts by Target TGT -1.99% and Walmart WMT -2.19% and Kohl's, among others, to improve their e-commerce.
Record-shattering warmth throughout the Northeast — including the warmest temperatures in 120 years in Cleveland — have hit retailers especially hard, said Bill Kirk, chief executive and co-founder of Weather Trends International Inc., a business weather analytics company in Bethlehem, Pennsylvania. But the marathon hours also likely reflect the intensity of the fight for shoppers' dollars this holiday season, especially for a chain that saw only a modest sales increase in the previous quarter as unseasonably warm weather weighed on sales across the industry for items such as coats and boots. Sales are especially slow when compared to the epic cold and snow last November, which drove sales of cold winter merchandise up 50 percent to 500 percent at full margins, he said. Penney JCP -5.84% for instance opened stores at 3 p.m. on Black Friday, showing that retailers have been willing to sacrifice some of their profit margin to win sales.
The big losers are Northeast winter merchandise firms and retailers whose stores are concentrated in the Northeast, but the winners are consumers who are saving 40 percent on heating bills, home improvement centers that specialize in outdoor projects, restaurants and movie theaters. Gregg Welter, the district manager for Kohl's stores in the Washington, D.C., region, said his stores were busier in the wee hours of the morning last year than he expected they'd be.
Kohl's reported comparable sales rose 1% last quarter, a performance it is under pressure to improve on if it wants to convince investors its turnaround has legs. The International Council of Shopping Centers estimates that with an average of 44 percent of their holiday shopping left to do, 112.8 million shoppers will hit stores and shopping centers on Saturday to shop, dine, see a movie and/or attend a holiday event.
For example, stores such as Best Buy, Sears and Dick's Sporting Goods kicked off their in-store Black Friday sales on Thanksgiving Day, but closed for several hours overnight before picking up the action again early Friday morning. We have one day of 'cold' weather this Saturday, but that can't move three months of excess inventory." — Best Buy is offering free expedited two-day shipping on select products through 9:30 a.m.
It is the time of year when shoppers begin to get anxious about whether they have enough gifts and whether the goods they ordered online will arrive in time. The retailer has also trumpeted its "buy online, pick up in store" program and its revamped mobile site, which it says should make it easier to browse and buy online. Customers who buy those items as gifts can give the recipients instructions on how to redeem their free one-on-one appointments with a Geek Squad Agent.
— Fannie May Confections Brands, which has a chocolate factory and store in North Canton, has a "buy two, get one free" offer on pre-wrapped boxes of chocolates valued at $24.99 each, through Christmas Eve. — Ikea is taking 50 percent off all soft toys on Saturday and Sunday, plus making a $1 donation to children's education through UNICEF and Save the Children for every soft toy purchased. Kirk, of WeatherTrends, said: "Retailers have so much excess inventory they will be giving away until mid-Spring… furthering the pain of three quarters in a row of all the wrong weather — record warm Fall, Winter, and then cold Spring." "We don't think we get the weather back in sync with retailers' selling seasons until Summer next year, which will be hot/dry in the North with a positively epic 2016 hurricane season in the south."
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text: Walther P22 in FDE For Sale from Jay's Guns & Accessories IV | Positive feedback: 100% View | Verified Seller | 491 Completed Sales View Sellers Items /UserImages/26038/906347309 12551678.jpg Description: This brand new Walther P22 is a semi-automatic pistol which fires the .22 LR round. It has a 3.42" threaded barrel and FDE finish. This includes 2 10-round magazines, fiber optic front sight, 2 backstraps, hardcase, lock and manual. Read More Condition: New In Box Brand: Walther Caliber: .22 Long Rifle Location: FL Trades Accepted: Yes. Read More Hours of Operation: Tuesday through Sunday 10:00am to 6:00pm (Range Closes at 5:30p.m.) Central time Closed on Mondays Shipping Notes: See Description Read More Share Item Item #: 906347309 Stock No.: 16826 Jay's Guns & Accessories IV Seller Since: Aug. 2005 Seller Level: Verified This seller is an FFL City: Panama City State: FL Price: $419.99 Buy It Now Add To Cart Please Login/Register to Order Login or Register to buy Shipping: $25.00 (or FREE in-store pick up!) Accepted Payment Methods: Returns: Only if Defective Send Message to Jay's Guns & Accessories IV You must login or register to send a message to this seller. Contact Seller as Guest Message To Seller Email * That Email Address is already in use. If you typed your email correctly, you are already registered and you should login or click here for the password recovery system. First Name * Last Name * Phone * Address 1 * Address 2 City * State * -State- AK AL AR AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY Zip * Already have an account? Login Your Recently Viewed Items


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Forgive me; my head is racing. It's not often I hear about a financial move so monumentally stupid that I'm blitzed by potential story titles. But when the Associated Press reported that desperate Philadelphia Eagles fans were borrowing against their homes for game tickets, I struck headline gold:
Philly's Financial Idiocy
Egad, Eagles Fans!
Winning the Super Bowl of Stupidity
Diehard Fans; Dunderheaded Finances
Robbing Peter to Play Ball
As one financially challenged follower told the Associated Press: "Sometimes the cards are maxed out, and you gotta do what you gotta do." What he had to do was apply for a $4,000 home equity line of credit to pay for a Super Bowl package.
How about this option: If you can't afford it, you don't gotta do it.
If you think I'm being overly harsh, let me remind you of something: Legend has it that these people once booed Santa Claus off the football field. If anyone can handle tough love, it's Philly fans. But don't expect bankers to dole out the tsk-tsks. Said one to the AP about fans taking out these lines of credit: "If I had any equity left in my house, I probably would, too." And this from a mortgage banker: "Some people don't care if it costs them $100 more a month" on their mortgage to pay off the loan. "But I'll stand by it, if they want it."
Of course he will. A home equity line of credit is a classic in the mortgage broker's playbook; today's small loan can add decades to a homeowner's payoff schedule. And it is the right choice in some circumstances. It doesn't take much to persuade customers to play ball these days, particularly with soaring home values and down-to-earth interest rates.
It is true that a home equity loan, mathematically speaking, can be a better bet than borrowing on your credit card. If you pay only the minimum amount due, a $4,000 Super Bowl package on plastic at 14% interest will take 20 years to pay off and nearly double the price. Mortgage interest, on the other hand, is often tax-deductible -- two magic words to cash-strapped football fans.
But the justification is hardly worth it, particularly when you learn what's really at stake. Credit card debt is what they call "unsecured debt" in biz-speak, while home equity debt is the opposite -- "secured debt." It's like a security deposit for the lender. That means if you lose your job or have some sudden financial emergency and can't cover your home-equity loan, your house is on the line. Try hosting a Super Bowl party from the trunk of your car.
Go ahead and lose your tempers, Philly fans. Boo Santa Claus, orphans, red shirts, puppies, and your grandmother at the first sign of New England Patriots leanings. Bring it on. Just don't bet the house on your home team.
Have you ever been blinded (and then bankrupt) by love? Financially sideswiped by a boneheaded money mistake? Me, too ! Let's commiserate. Email me (at email@example.com ) the stupidest financial mistake you've ever made, and I'll send a Fool ballcap to the biggest loser. C'mon, take one for the team. I promise to use only pseudonyms when I retell your story.


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Tag: Black Friday
News Release FOR IMMEDIATE RELEASE Media Contact: Kristin Mickelson Phone: (608)754-2821 ext. 5044 Email: firstname.lastname@example.com Gobble Gobble Gobble! Blain's Farm and Fleet Stores to Close Thanksgiving Day and Re-open Black Friday, November 25th, at 6:00AM. Wishing Everyone a Safe and Happy Holiday! Blain's Farm and Fleet stores will close for business on Thanksgiving Day and reopen on Black Friday, November 25th, at 6:00AM. We wish all our associates, friends and(…)
As a second-generation family-owned company, Blain's Farm & Fleet understands the values and traditions of family. That's why our stores are closed on Thanksgiving, and will reopen with great Black Friday Early Bird specials at 6 AM.


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Bird of Light
The Bird of Light is as stated in the Secret Memo Menu, The Dark Dragon's opposite. He was removed from the game before release.
His connection of to the Egg of Light is unknown. Could he have hatched from it? Could he have laid the Egg? No one knows.
[edit] Memo Description
- That of the Dark Dragon is in the Anithesis. (That is the Dark Dragon's Antithesis?)
- Darkness and Light.
- Despair and Hope.
- Destruction and Creation.
- That is what it is.


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29/12/2011, 12.20 Rumors
SIG Strasbourg signs big man Alexis Ajinca
Il centro firma per la stagione
SIG Strasbourg made official the signing of Alexis Ajinca. The big man didn't make the team in the NBA and decided to return to France.
Ajinca signed a contract for the season. The center has played two games in Pro A this season during lockout scoring 21ppg and grabbing 10rpg with Hyeres-Toulon's jersey.
© Riproduzione riservata