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Bel Canto Virtual Choral Village 2020
July 27, 2020 @ 10:00 am - July 31, 2020 @ 5:00 pmGet Tickets — $200
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The Virtual Choral Village is a one-week online summer program for youth in grades 7 – 12 in the Lehigh Valley and beyond. Each day starts at 10:00 AM and ends at 5:00 PM, Eastern Standard Time
The purpose of the program is to intentionally bring together young people within and beyond our region to learn about each other and to process the stories of Spring 2020 through music-making, conversing, drum circles, improvising, and creating.
Choral Village is led by accomplished musicians who are devoted to promoting and developing self-confidence, empathy, and leadership in young people.
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Subscribe to our newsletter to get concert announcements, Choir and Bel Canto news, updates about our Festival and guest artists, special offers and more. Simply fill out the form and you'll get regular updates about The Bach Choir of Bethlehem delivered straight to your inbox!
—The Morning Call, May 2018
"From anguish to elation, and just about everything in between, pretty much describes the vast emotional landscape covered in Friday evening's concert at Packer Memorial Church presented by the Bach Choir of Bethlehem. Splendid musicianship, rousing choruses, and the sublime voices of the soloists turned grief into joy and sorrow into triumph."
—The Morning Call, March 2018
"The oft-quoted phrase 'a drumroll, please' aptly applies to the opening of Rutter's exultant Gloria, which provided a dramatic finale to the program. What a thrill to hear those punchy, syncopated brass lines accompanying some really polished and vibrant singing. The "Domine Deus" section sported some lovely soprano voices in addition to many demanding, multi-part choruses –— some with up to eight parts. There was a miraculous blend of tone and balance throughout."
—The Huffington Post, 2017
"The performance was one of integrity, movement, passion and weight. The effortless virtuosity and stylistic homogeneity of the combined forces in the chapel's stone sanctity, allowed Bach's music to sing out with infectious, exhilarating enthusiasm."
—New York Arts, 2015
"The audience was thrilled by this outstanding performance of a Bach Cantata by seasoned experts immersed in the composer and informed by Greg Funfgeld's wisdom and enthusiasm...The Bachs [J.S.B and C.P.E] could not have been better served, not to mention two English Renaissances, as well as our own time. It went beyond mere intelligent programming and committed performance, enriched by a deep sense of the mutual nourishment of music and faith."
—The Wall Street Journal, May 2015
"Nestled in the Pennsylvania countryside, on and around the bucolic campus of Lehigh University, the Bethlehem Bach Festival, under the artistic direction of conductor Greg Funfgeld, is in its 108th season and going strong. If it has flaws, they are like those that distinguish a fine emerald from the perfect clarity of a fake...their choral sonority is so rich you can feel it in your bones."
—The Whole-Note - Toronto, June 2015
"Two days later I am Newark bound again, with a head full of the history of a town I previously had no awareness of, and with a heart full of the music of Bach, presented in a context that felt less like a festival than a glorious friendship between a great composer and the orchestra, conductor and choir at the heart of an extraordinary town."
—The Washington Post, March 2013
"The Bach Choir of Bethlehem, founded in the 19th century, has gained international recognition through its annual Bach Festival, tours and recordings. The more than 100 vocalists displayed clean tone, excellent pitch and blend, and kept good tempo even in the most stressful numbers…outstanding, energetic and crisp. The orchestra was a collection of top freelancers from around the Eastern Seaboard including several from Washington… baritone Dashon Burton, was the standout. He has a clarion instrument that projects well throughout his range…a splendid dramatic performance. Soprano Rosa Lamoreaux was also excellent, expertly modulating her silvery tone for the various roles she took…This was the choir's big night, though, and it gave great pleasure…"
—Gramophone, November 2012
"A handsome account of Bach's St. John Passion on this new release confirms that the Bach Choir of Bethlehem doesn't rest on anything resembling laurels. Greg Funfgeld has trained his singers to articulate words crisply, dance lightly when the music must move and blend elegantly. Funfgeld brings a sure sense of phrasing, texture and pacing to the narrative, and the Bach Festival Orchestra—mostly modern instruments, with viola da gamba, violas d'amore and portative organ supplying period flavors—are cohesive and nimble. Charles Daniels stands out as a poetic and powerful Evangelist, William Sharp as a warmly inflected Jesus and Julia Doyle as a shining champion of the soprano arias."
—New York Times, September 2011
"The Bach Choir of Bethlehem sang a Brahms motet ("Lass Dich Nur Nichts") with all the polish and fervor it brought to cantatas by its namesake."
—The Morning Call, October 2011
"..inspired program of hope, optimism and comfort …disarmingly powerful…overflows with jubilation"
—BBC Music Magazine, May 2010
"America's venerable Bach Choir of Bethlehem makes its Analekta debut on a disc brimming-over with festive D major trumpets-and-drums brilliance…Julia Doyle and Daniel Taylor heading up a distinguished solo line-up."
—The Morning Call, May 2010
"Conductor Greg Funfgeld coaxed a lovely rich chamber orchestra sound from the Bach Festival Orchestra strings...The hauntingly beautiful voices of Taylor and Zsigovics—she in her festival debut—melted together like two precious metals, hers of bell-like clarity, his a more complex alchemy, with a sheen like liquid mercury."
—Minnesota Public Radio Review, December 2009
"As I listen to The Bach Choir of Bethlehem with Greg Funfgeld conducting…I find it hard to believe this is an all-volunteer choir but it's true…a well polished vocal ensemble, and a true level of musicianship and understanding of the choral music of Bach."
—Wall Street Journal May, 2007
"…an American musical treasure… they sing with a fervor and a level of musicianship that carries one away—from bass to soprano, the supple strength and solidly integrated tone of this amateur choir reflects the most admirable qualities of the European-American tradition of choral song."
—New York Times, May 2007
"By all accounts the chorus remains as vital an institution as ever…The B-Minor Mass performance was rousing, committed and touching…Bach's 'St. Matthew Passion' too was ardently and lovingly performed…"
—The American Organist, January, 2004
"This is Bach at its finest. The conductor, orchestra, soloists, and chorus are eminently capable of the nuances of the rich harmonic texts …spirited and vivacious…It is not likely to get any better than this on this side of the Atlantic."
—The Times, London, July 2003
"America's venerable Bach Choir of Bethlehem sang Bach and Mendelssohn with good-natured and ruddy-cheeked elation. And their centerpiece was a BBC/Bach Choir co-commission, the world premiere of Libby Larsen's I It Am, a jubilant cantata based on the writings of Julian of Norwich…this highly coloured and disarmingly unsophisticated work came from, and went straight to, the heart."
—The Scotsman, Edinburgh, July 2003
"The Bach Choir of Bethlehem…had their audience enthralled…The choir knows and loves this work – and it shows…transatlantic magic."
—Early Music News, California, October/November 2002
"Nearly one hundred strong, the Bach Choir of Bethlehem tempers its power and energy with the intimacy of a much smaller group. It also blends seamlessly with the excellent modern-instrument Festival orchestra which Greg Funfgeld conducts with an obvious knowledge of, and sensitivity to, modern performance practice."
—American Record Guide, November/December 2002
"…the Choir and Festival Orchestra, under their director, Greg Funfgeld, perform these three cantatas beautifully and convincingly. The work of the soloists is excellent, too…Excitement, dedication, power—all things that we hear more and more seldom in Bach cantatas—lend distinction to this beautiful and well-produced recording."
—Musical America, May 2001
"Sheer jubilance…exceptional elegance and grace…radiant performance…Having heard the Bethlehem Bach Choir pour its heart into the master's vocal music, one will never listen to it in quite the same way again."
—American Record Guide, November/December 2000
"The Bethlehem Bach Festival is one of the most venerable musical institutions in the USA, with an unmatched tradition of introducing Bach's music to our shores. Greg Funfgeld…has revitalized this Pennsylvania institution, and Dorian is doing well to document its vibrancy in a recording series… genuine honesty and intelligence informs this performance…Funfgeld has forged a fine body of singers and players…tightly disciplined ensemble …rousing spirit and sacred joy aplenty. This recording will not disappoint."
—Philadelphia Inquirer, December 2000
"…intoxicating but precise choral sound that reminds you why choruses grew this large in the first place. The elemental power is startling…the Bethlehem approach under Greg Funfgeld isn't anachronistic, but meets the historically enlightened approach halfway…We know from Bach's often irritable correspondence that he campaigned for more singers. The Bach Choir of Bethlehem gives him all he could have wanted. Maybe this is "in-his-dreams" Bach."
—The Washington Post, May 1999
"…a performance that confirmed my belief that this is one of the finest large amateur choruses in the United States."


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Boring Subcontractor Opportunities
Taladrado Contratistas, La Perforación Contratistas: Se habla Español
Lakeland Directional Boring Subcontractor Opportunities | Subcontractor Opportunities Opportunity AheadBoring Subcontractors Opportunities
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Are you a horizontal directional driller or auger boring contractor looking for subcontractor work? We have ongoing open drilling projects available across the continental US.
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Upbeat and optimistic pop rock. Features mandolin, glockenspiel, energetic electric guitars and driving beats. Ideal for feel-good corporate, business or commercial projects.
YouTube users: My royalty free music is protected and registered with ContentID and you may receive a 'matched third party content' notice on your video. This is perfectly normal, your channel's standing will not be affected in any way and your videos will not be removed.
To clear a copyright claim from your video (if you are a YouTube Partner trying to monetize your video, for example), simply visit this page, enter your details and video link and copy/paste the contents from your purchased License Certificate into the message box and submit. Claims are removed within 24 – 96 hours and you'll receive a message once this has been completed. (You may want to keep your uploaded video listed as 'Unlisted' until this has been completed).
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A colourful drawing of a multi coloured rooster, part of a set of six.
This button is made from porcelain. Its circle shaped and is approximately 38mm in diameter and 2mm thick.
My ceramic buttons can be hand washed or machine washed on a gentle cycle. To prevent the buttons knocking against hard surfaces, turn the garment inside out and place in a washing bag or pillow case.
Please be aware that there could be very small variations in size due to clay shrinkage – this should not more that a millimetre or two even in the largest size. Every button is hand made so there may also be variations in shape, pattern, colour and finish. If you order more than one button from the same range we will always send you the best matching set. Some of our patterns contain many different colours, if you want a set of buttons featuring more of one colour than another, please add a comment to your order and we will select the best buttons to meet your request.
Chicken Black Large Circular Button£4.00
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Life Estate Reserved
You may desire to leave your home or farm to YMCA of San Francisco at your death but would also like to receive a current charitable income tax deduction. A life estate reserved might offer the solution you need!
Benefits of a life estate reserved
- Receive a federal income tax deduction for the value of the remainder interest in your home or farm
- Preserve your lifetime use and control of your home or farm
- Create a life estate based on more than one life. This will preserve the use of the property for you and a loved one, such as a spouse or dependent child
How a life estate works
- You deed your home or farm to YMCA of San Francisco. The deed will include a provision that gives you the right to use your home or farm for the rest of your life and that of any other life estate party named in the deed.
- You and YMCA of San Francisco sign a maintenance, insurance and taxes (MIT) agreement to explain that you will do your best to keep the property in good condition and that you will maintain property insurance and pay the property taxes.
- When the owners of the life estate have passed away, your home or farm will belong to YMCA of San Francisco. We will use or sell the property to further our charitable work.
Contact us
To learn more about a life estate, please contact us. We would be happy to assist you and answer your questions.
Life Estates Work for Spouses Too - The life estate can last for your life or based on your life and that of another person, such as a spouse or loved one.
Mortgage Debt - It is possible for you to make a gift of your property even though there is a mortgage upon the residence.
Maintenance Issues - You will be responsible for the maintenance, insurance and taxes on the property, just as you were prior to creating the life estate.
Life Estates Are Flexible - If, at some point in the future, you are no longer able to live independently in your home, we may be able to help you use your life estate to create a lump sum cash payment (with a joint sale) or create an income stream (using the life estate to fund a charitable remainder trust or charitable gift annuity).


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Project Members
- Diana Schackow
A grammar of Yakkha
The aim of this project was the linguistic documentation and description of Yakkha, a Tibeto-Burman language spoken in East Nepal.
Yakkha belongs to the Eastern branch of the Kiranti languages, its closest relative being Belhare. According to the last census in 2001, there are 14.000 speakers, but the number seems optimistic, and Yakkha is not passed on to the next generation. The language is characterized by complex morphophonology and an intricate verbal person marking system with various scenario-based alignment splits. The basic word order is SOV, and phrases are typically head-final. Another area of special interest is the highly multifunctional system of complex predication in Yakkha, covering diverse semantic domains, such as spatial orientation, temporal specification and argument structure.
The goal of the project was threefold: to produce a grammar, a dictionary and an annotated corpus of recorded texts of various genres. The grammar focuses on morphosyntactic topics such as complex predication, argument structure, clause linkage and grammatical relations.


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Ole Originals
Ole Originals - Vancity T-Shirt (Boys)
All our soft, vintage feel T-shirts are printed with care in our small studio in the heart of Vancouver, BC. Each print is hand-pulled on one single-head manual press using light-weight ink so the print matches the softness of the shirts.
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- Slightly heathered Jersey
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Our shirts are just slightly more on the fitted size and flatter almost any body type. If you're not sure what size to get or if you're in-between sizes, order the next size larger. (Measurements below are garments laid flat!)
*Our sizing is very consistent; however, shirts can still range in size by up to 1"
*For best results machine wash warm or cold & hang to dry or tumble dry low


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Paybis Review: A Comprehensive Guide
Introduction to Paybis
Have you ever wondered where to buy, sell, or exchange cryptocurrencies with ease? You have come to the right place! This Paybis review will provide all the information you need about this popular cryptocurrency exchange platform. Paybis is user-friendly and supports a variety of cryptocurrencies. It also offers payment methods and competitive fees. The platform provides a seamless user experience and smooth transaction.
This article will provide all the information you need about this popular cryptocurrency exchange platform. Paybis is a user-friendly platform with a wide range of supported cryptocurrencies and payment methods, offering competitive fees and a smooth user experience.
Table of Contents
- Introduction to Paybis
- Getting Started with Paybis
- 2.1. Register
- 2.2. Verification Process
- Supported Cryptocurrencies and Payment Methods
- 3.1. Cryptocurrencies
- 3.2. Payment Methods
- Fees and Limits
- 4.1. Transaction Fees
- 4.2. Deposit and Withdrawal Limits
- User Interface and Experience
- 5.1. Website Design
- 5.2. Mobile App
- Security and privacy
- Customer Support
- Comparing Paybis to Other Exchanges
- 8.1. Paybis vs Binance
- 8.2. 8.2.
- Both the pros and cons
- Refer to Paybis
- Tips to Maximize Your Paybis Experience
- Paybis' Role in the Cryptocurrency Ecosystem
- The Future of Paybis
- Conclusion
- Frequently Asked Questions (FAQs).
Getting Started with Paybis
To start using Paybis, you'll first need to register and verify your account. Let's take a closer look at these steps.
Registration Process
Visit the Paybis website to sign up and click the "Sign Up" button in the upper right corner. The next step is to create a password and provide an email address. After you have completed this step, you will receive an email confirmation to activate your account.
Verification Process
Before you can start trading on Paybis, you'll need to verify your identity. This process is necessary to comply with Know Your Customer (KYC) and Anti-Money Laundering (AML) regulations. To complete the verification process, you'll be asked to provide personal information such as your full name, date of birth, address, and a valid ID document (e.g., passport, driver's license, or ID card). In most cases, the verification process is quick and can be completed within a few hours.
Supported Cryptocurrencies and Payment Methods
Paybis provides a wide range of cryptocurrency and payment options to meet different user needs. Let's get into the details.
Paybis supports several popular cryptocurrencies, including Bitcoin (BTC), Ethereum (ETH), Litecoin (LTC), Ripple (XRP), Bitcoin Cash (BCH), Stellar (XLM), and many more. This broad selection allows users trade and invest in a variety of digital assets based on their risk tolerance and preferences.
Payment Methods
Paybis' key advantage is its wide range of payment options. You can choose from bank transfers, credit and debit cards (Visa or Mastercard), and electronic wallets such as Skrill or Neteller. This flexibility enables users to fund their accounts and make transactions conveniently and efficiently.
Fees and Limits
Understanding the fees and limits associated with using Paybis is crucial for a seamless trading experience.
Transaction Fees
Paybis charges competitive fees for its services. The fees vary depending on the payment method and the type of transaction. For example, purchasing cryptocurrencies with a credit or debit card typically incurs a higher fee compared to using a bank transfer. Paybis clearly displays its fees on the website, making it easy for users to understand and calculate their transaction costs.
Deposit and Withdrawal Limits
Paybis has established limits for withdrawal and deposit transactions in order to protect the platform and ensure regulatory compliance. These limits are dependent on the verification level of the user and the payment method chosen. Generally, fully verified users enjoy higher limits, while unverified users face lower limits. It's worth noting that some payment methods, like credit cards, may have lower limits due to additional restrictions imposed by the card issuer.
Paybis strives to offer a seamless, intuitive user experience for new and experienced traders.
Website Design
Paybis' website was designed to be user-friendly. The clean and straightforward layout makes it easy to navigate, with all essential features easily accessible. Users can quickly locate the "Buy" and "Sell" buttons on the main page, making it simple to initiate transactions.
Mobile App
Although Paybis doesn't have a mobile app at the moment, its website is mobile-responsive so that any device can access it. This allows users to trade cryptocurrencies on-the-go without compromising on functionality or convenience.
Privacy and Security
Paybis is committed to privacy and security. We have implemented various measures to ensure that your funds and personal information are protected.
The platform employs advanced security features such as two-factor authentication (2FA), which adds an extra layer of protection to users' accounts. Additionally, Paybis complies with strict regulatory requirements, including GDPR, to ensure users' data privacy.
Paybis also uses secure and reputable wallets to store cryptocurrencies, minimizing the risk of hacks and theft. It is recommended that users keep their digital assets in private wallets. This is especially important for long-term storage.
Customer Support
Effective customer support is essential for any cryptocurrency exchange platform, and Paybis delivers in this regard. Users can access the platform's support team through live chat, email, or phone. The website also has a comprehensive help center and FAQ section, providing answers to common questions and issues.
Comparing Paybis to Other Exchanges
It is important to evaluate different platforms before you choose a cryptocurrency exchange. Paybis should be compared to other exchanges for its support of cryptocurrencies, payment methods, fees and user interface. Paybis is a viable option on the market because it performs well in all these areas.
Paybis vs Binance
It is important to compare the features of Paybis and Binance when deciding which platform will best suit your needs. Let's look at the key points of comparison.
- Supported Cryptocurrencies: Binance offers a broader range of cryptocurrencies compared to Paybis. With hundreds of digital assets available for trading, Binance caters to users looking for a more diverse selection.
- Payment MethodsPaybis offers more options for fiat currency transactions. It supports credit/debit cards and bank transfers as well as electronic wallets such Skrill or Neteller. Binance primarily supports credit/debit card purchases and bank transfers.
- Fees: Binance is known for its low trading fees, which can be even further reduced by using the platform's native token, Binance Coin (BNB). Paybis offers competitive fees, but they may be higher than Binance, especially for credit card transactions.
- User Interface. Paybis is a simple and intuitive interface that makes it a great choice for beginners. Binance offers a more advanced trading interface that might be better suited for experienced traders.
- Customer Support: Both platforms provide responsive customer support, but Paybis tends to have a more personalized approach, with live chat, email, and phone support options. Binance mainly relies on a comprehensive help center, FAQs, and email support.
Paybis vs Coinbase
Paybis and Coinbase are both popular cryptocurrency exchanges, but they cater to different user needs. Here's a comparison of the two platforms:
- Cryptocurrencies Supported: Coinbase has a lower number of supported cryptocurrencies than Paybis. Both platforms offer digital assets such as Bitcoin, Ethereum and Litecoin. Paybis offers additional options like Ripple, Stellar (XRP), and many more.
- Payment Methods Both Coinbase and Paybis allow users to purchase cryptocurrencies with credit/debit cards or bank transfers. However, Paybis also supports electronic wallets like Skrill and Neteller, providing more flexibility in funding transactions.
- Fees Coinbase's fees are higher than other exchanges. Paybis charges lower fees for transactions that involve bank transfers or electronic wallets.
- User Interface Both platforms are user-friendly and easy to use. They are suitable for beginners. However, Paybis may be slightly more straightforward for users who are new to the cryptocurrency space.
- Customer Support: Paybis provides a range of customer support options, including live chat, email, and a comprehensive FAQ section. Although Coinbase offers email support as well as an extensive help centre, it does not have the Live Chat feature like Paybis. This may result in longer response times for customer inquiries on Coinbase.
Pros and Cons
Let's now look at the main features of Paybis.
- Large range of supported cryptocurrency
- Multiple payment methods
- Competitive fees
- User-friendly interface
- Secure and private measures
- Supportive and responsive customer service
- No dedicated mobile app
- Credit card transactions may have higher fees and lower limits
Paybis Referral Program
Paybis offers a referral program that allows users to earn rewards by inviting their friends to join the platform. When a referred user completes a transaction, the referrer receives a commission. The commission is a percentage of the transaction fees paid by the referrer. The more users you invite, the higher your potential earnings.
Tips to Maximize Your Experience with Paybis
To get the best possible experience on Paybis, consider the following tips:
- Stay in the know: Keep abreast of market news and trends to help you make informed trading decisions.
- Diversify you portfolio by investing in a variety cryptocurrencies to spread risk, potential returns and diversify.
- Use limit orders: Utilize limit orders to buy or sell cryptocurrencies at specific price points, allowing you to take advantage of market fluctuations.
- Monitor fees Be aware transaction fees and select the most cost-effective payment method whenever possible.
- Protect your account with two-factor authentication Use strong passwords to secure your account.
Paybis' Role In the Cryptocurrency Ecosystem
Paybis is an integral part of the cryptocurrency ecosystem. It provides a safe and user-friendly platform to buy, sell, and exchange digital assets. Paybis' accessibility, wide variety of supported currencies and payment methods contribute to the adoption of digital currency and the expansion and growth of the cryptocurrency market.
The Future of Paybis
Paybis will likely grow and adapt to the changing cryptocurrency landscape. The platform may introduce new cryptocurrencies, payment methods, and features to enhance the user experience further. Paybis will continue to be a popular platform for crypto traders and enthusiasts by being attentive to their needs and focusing on security and user-friendliness.
In conclusion, Paybis is a reliable and user-friendly cryptocurrency exchange platform that offers a wide range of digital assets and payment methods. With its competitive fees, robust security measures, and responsive customer support, Paybis is a solid option for both new and experienced traders looking to buy, sell, or exchange cryptocurrencies.
Frequently Asked Questions (FAQs
- Is Paybis safe for trading cryptocurrency cryptocurrencies? Paybis has strong security measures in place and adheres strictly to regulatory requirements to protect users' funds.
- Does Paybis have a mobile app? Paybis does not currently have a dedicated mobile app. However, their website is mobile-responsive and can be easily accessed from smartphones and tablets.
- What payment methods does Paybis accept? Paybis supports various payment methods, including credit and debit cards (Visa and Mastercard), bank transfers, and electronic wallets like Skrill and Neteller.
- Are there deposit and withdrawal limits on Paybis? Yes, Paybis imposes limits on deposit and withdrawal transactions based on users' verification level and the chosen payment method. Fully verified users typically enjoy higher limits than unverified users, and some payment methods may have additional restrictions.
- Can I use Paybis without completing the verification process? While you can create an account without verification, you'll need to complete the verification process to deposit, withdraw, and trade cryptocurrencies on Paybis. This is necessary for the platform to comply with KYC and AML regulations.
Other Searches
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|By Admin1 (admin) on Saturday, May 10, 2003 - 9:15 am: Edit Post
|By Admin1 (admin) (pool-151-196-181-108.balt.east.verizon.net - 18.104.22.168) on Friday, April 08, 2005 - 6:27 pm: Edit Post
When this story was posted in April 2005, this was on the front page of PCOL:
Read the stories and leave your comments.
Peace Corps Online The Independent News Forum serving Returned Peace Corps Volunteers
The Peace Corps Library
Peace Corps Online is proud to announce that the Peace Corps Library is now available online. With over 30,000 index entries in 500 categories, this is the largest collection of Peace Corps related stories in the world. From Acting to Zucchini, you can find hundreds of stories about what RPCVs with your same interests or from your Country of Service are doing today. If you have a web site, support the "Peace Corps Library" and link to it today.
RPCVs and Friends remember Pope John Paul II
Tony Hall found the pope to be courageous and capable of forgiving the man who shot him in 1981, Mark Gearan said the pope was as dynamic in person as he appears on television, Maria Shriver said he was a beacon of virtue, strength and goodness, and an RPCV who met the pope while serving in the Solomon Islands said he possessed the holiness of a man filled with a deep love and concern for humanity. Leave your thoughts here.
Friends of the Peace Corps 170,000 strong
170,000 is a very special number for the RPCV community - it's the number of Volunteers who have served in the Peace Corps since 1961. It's also a number that is very special to us because March is the first month since our founding in January, 2001 that our readership has exceeded 170,000. And while we know that not everyone who comes to this site is an RPCV, they are all "Friends of the Peace Corps." Thanks everybody for making PCOL your source of news for the Returned Volunteer community.
This Month's Feature Stories - only on PCOL
Dream Come True - Revisiting India after 34 years
The Coyne Column: Read Winning Vanity Fair PCV Essay
Tomas Belsky's paintings inspired by service in Brazil
RPCV reunites with friend after 40 years
RPCV reviews "Los Heraldos Negros" by Cesar Vallejo
Photo Essay: Taking it to the Streets
April 3, 2005: This Week's Top Stories
Ralph White suspended for opening locked gates 2 Apr
The Coyne Column: Events in Kyrgyzstan 2 Apr
Timothy J. O�Brien suggests Korea increase publicity 1 Apr
Danielle Wain deals with dry areas in Uganda 1 Apr
Chris Matthews says Schiavo's Dad having "Good Time" 1 Apr
Chris Dodd to reintroduce workers protection act 1 Apr
Steven Lawry named president of Antioch College 31 Mar
Matt Sesow shines light on grief and pain of war 31 Mar
Kinky Friedman Preps for Gubernatorial Run 30 Mar
Police travel to Tonga with RPCV 28 Mar
Randall L. Tobias speaks at PC Headquarters 28 Mar
NBC apologizes to Turkey for West Wing episode 28 Mar
Jim Doyle proposes domestic partner benefit 27 Mar
University to name library auditorium for Elaine Chao 26 Mar
Rockefeller says every young American should serve 26 Mar
Chris Shays calls Republicans "party of theocracy" 25 Mar
Norm Coleman to visit South America 25 Mar
April 3, 2005: RPCV Groups in the News
Houston RPCVs sponsor "Around the World in a Day"on April 6 25 Mar
Vasquez to visit DePaul University on April 6 22 Mar
Henry McKoy speaks at Clemson University April 6 1 Apr
Minnesota RPCVs need Photos for Exhibition 24 Mar
Maryland RPCVs eat crab cakes in Annapolis 17 Mar
Connecticut RPCVs held fundraiser on March 5 3 Mar
RPCVs: Post your stories or press releases here for inclusion next week.
Crisis Corps arrives in Thailand
After the Tsunami in Southeast Asia last December, Peace Corps issued an appeal for Crisis Corps Volunteers and over 200 RPCVs responded. The first team of 8 Crisis Corps volunteers departed for Thailand on March 18 to join RPCVs who are already supporting relief efforts in Sri Lanka, Indonesia, Thailand, Malaysia, and India with other agencies and NGO's.
RPCVs in Congress ask colleagues to support PC
RPCVs Sam Farr, Chris Shays, Thomas Petri, James Walsh, and Mike Honda have asked their colleagues in Congress to add their names to a letter they have written to the House Foreign Operations Subcommittee, asking for full funding of $345 M for the Peace Corps in 2006. As a follow-on to Peace Corps week, please read the letter and call your Representative in Congress and ask him or her to add their name to the letter.
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Chiropractic is one of the most widely used health services today. It has gained increasing acceptance as a treatment for back and neck pain, and it is covered by many health insurance plans. Millions of people would report that chiropractic spinal manipulation has brought them relief. Nonetheless, at present the research record for its effectiveness is inconclusive at best.
History of Chiropractic
Daniel David Palmer founded chiropractic in 1895, after an experience in which he apparently believed he cured a man's deafness by manipulating his back. He opened the Palmer School of Chiropractic and began teaching spinal manipulation. This college still exists today, with a fully accredited program.
One of Palmer's first students was his son, Bartlett Joshua (B.J.) Palmer. It was B.J. Palmer who truly popularized the technique. Later, Willard Carver, an Oklahoma City lawyer, opened a competing school. He believed that chiropractic physicians needed to offer other methods of treatment in addition to spinal manipulation. This opened a schism in the chiropractic world that still exists today. Followers of Palmer and his methods focus only on spinal adjustments, an approach called "straight" chiropractic. Those who, like Carver, use various approaches to healing are called "mixers." Mixers may use vitamins, herbs, and any other treatment methods they find useful (and are allowed to practice by law).
Medical treatments in the 19th and early 20th centuries were not based on scientific evidence of effectiveness, and chiropractic treatment was no exception. It became a widespread technique long before there was any real evidence that it worked. Chiropractic schools utilized all of their profits and resources to further develop programs for training people in chiropractic techniques—not for verifying the theory and practice of chiropractic. However, in the 1970s, proper scientific research into chiropractic began to draw interest. In 1977, the Foundation for Chiropractic Education and Research (FCER) established a program to train chiropractic researchers. Since then, efforts have been made to fund scientific trials testing the effectiveness of chiropractic techniques and to establish a scientific foundation for the practice.
Forms of Spinal Manipulation
There are many different chiropractic techniques in use today, some with proprietary names such as the Gonstead and Maitland techniques. In general, most involve rapid (high-velocity) short (low-amplitude) thrusts. Manipulation may be purely manual or mechanically assisted. For example, some chiropractors use an "activator"—a small metal tool that applies a force directly to one vertebra.
In addition, some chiropractors use a related therapy called spinal mobilization. This method involves gentle, extended movements (low-velocity, high-amplitude), rather than the "back-cracking" of classic chiropractic spinal manipulation.
How Does Chiropractic Spinal Manipulation Work?
Since its origin, chiropractic theory has based itself on "subluxations," or vertebrae that have shifted position in the spine. These subluxations are said to impede nerve outflow and cause disease in various organs. A chiropractic treatment is supposed to "put back in" these "popped out" vertebrae; for this reason, it is called an "adjustment."
However, no real evidence has ever been presented showing that a given chiropractic treatment alters the position of any vertebrae. In addition, there is as yet no real evidence that impairment of nerve outflow is a major contributor to common illnesses, or that spinal manipulation changes nerve outflow in such a way as to affect organ function.
More recent theories suggest that chiropractic manipulation may relieve pain by "loosening" vertebrae that have become relatively immobile rather than by changing their position. In addition, the movements associated with manipulation may alter the response patterns of nerves in the central nervous system—including both the spine 1 and brain— 74 leading to pain relief.
What Is Chiropractic Used For?
Chiropractic spinal manipulation is widely used for the treatment of back pain, neck pain, and headaches, whether acute or chronic. It is also frequently tried for pain in other areas, such as the shoulders, knees, and jaw, as well as for breech birth positioning of a baby, infantile colic, frequent colds, and many other conditions.
Some chiropractic physicians promote "comprehensive chiropractic care" as a means of staying healthy. This approach may include diet, exercise, and supplements, along with regular chiropractic manipulation.
What Is the Scientific Evidence for Chiropractic Spinal Manipulation?
Chiropractic spinal manipulation has been evaluated scientifically to determine its efficacy, as well as its costs comparative to other forms of health care. However, the evidence is not compelling in either case.
Although there is some evidence that chiropractic spinal manipulation may be helpful for various medical purposes, in general the evidence is not strong. There are several reasons for this, but one is fundamental: Even with the best of intentions, it is difficult to properly ascertain the effectiveness of a hands-on therapy like chiropractic.
Only one form of study can truly prove that a treatment is effective: the double-blind, placebo-controlled trial. (For more information on why such studies are so crucial, see Why Does This Database Rely on Double-blind Studies?) However, it isn't easy to fit chiropractic into a study design of this type. Consider the obstacles: What could researchers use for placebo chiropractic treatment? And how could they make sure that both participants and practitioners would be kept in the dark regarding who was receiving real chiropractic manipulation and who was receiving fake manipulation?
Because of these problems, all studies of chiropractic manipulation fall short of optimum design. Many have compared chiropractic treatment against no treatment. However, studies of this type cannot provide reliable evidence about the efficacy of a treatment. If a benefit is seen, there is no way to determine whether it was caused by chiropractic manipulation specifically, or just attention generally. (Attention alone will almost always produce some reported benefit.)
More meaningful trials used some sort of unrelated fake treatment for the control group, such as phony laser acupuncture. However, it is less than ideal to use a placebo treatment that is so very different in form from the treatment under study.
Better studies compare real chiropractic manipulation against sham forms of manipulation, such as light touch. Studies of this type are a definite step forward. However, it is quite likely that the practitioners at least unconsciously conveyed more enthusiasm and optimism when performing the real therapy than the fake therapy; this, too, could affect the outcome.
It has been suggested that the only way to get around this problem would be to compare the effectiveness of trained practitioners to actors trained only enough to provide a simulation of treatment; however, such studies have not been reported.
Still other studies have simply involved treating people with chiropractic spinal manipulation and seeing whether they improve. These trials are particularly meaningless; it has been long since proven that both participants and examining physicians will at least think that they observe improvement in people given a treatment, regardless of whether the treatment does anything on its own.
Finally, other trials have compared chiropractic manipulation to competing therapies, such as massage therapy or conventional physical therapy. However, neither of these therapies has been proven effective. When you compare unproven therapies to each other, the results cannot possibly prove that any of the tested treatments are effective.
Given these caveats, we discuss below what science knows about the effects of chiropractic.
Besides effectiveness, another important consideration is cost of care. There are many aspects to the cost of treatment, including number of visits to the chosen provider, cost of evaluation procedures such as x-rays, insurance reimbursement versus patient out-of-pocket expense, and costs for missed work time.
However, it is difficult to develop accurate cost-comparison figures because there are many complicating factors in research on the subject. For example, one approach is to simply identify people with similar injuries who choose one treatment or another and add up the total cost. Unfortunately, the results of such a study can be misleading. People with more or less severe back pain might tend to choose different forms of treatment; if those with more severe pain usually chose surgical treatment, this would tend to inflate the comparative costs of conventional care and make chiropractic seem less expensive.
Another potentially complicating factor is that, to a great extent, insurance companies control utilization of treatment. If they are less inclined to authorize chiropractic visits, people who choose chiropractic care might find their care cut off more rapidly than others who choose, say, physical therapy. This too would lead to artificially low costs of chiropractic treatment compared to physical therapy, skewing the results of the study.
These problems could be solved by conducting a study in which researchers randomly assign participants to certain treatments, with the length of treatment determined entirely by the treating physician. Unfortunately, studies of this type have not yet been conducted.
Back Pain
Chiropractic spinal manipulation is one of the most popular treatments for acute and chronic back pain in the US, and it may in fact provide at least modest benefit. However, as yet, research evidence has failed to find chiropractic manipulation convincingly more effective than standard medical care.59-60,80
Chiropractic does seem to be more effective than placebo, if not by a great deal. For example, a single-blind controlled study of 84 people suffering from low back pain compared manipulation to treatment with a diathermy machine (a physical therapy machine that uses microwaves to create heat beneath the skin) that was not actually functioning.11 The researchers asked the participants to assess their own pain levels within 15 minutes of the first treatment, then 3 and 7 days after treatment. The only statistically significant difference between the two groups was within 15 minutes of the manipulation. (Chiropractic had better results at that point.)
In another single-blind, placebo-controlled study, researchers assigned 209 participants to one of three groups: a high-velocity, low-amplitude (HVLA) spinal manipulation; a sham manipulation; or a back-education program.12 Although this has been reported as a positive study,10 most of the differences seen between the groups were not statistically significant. In addition, because almost half the participants dropped out of the study before the end, the results can't be regarded as meaningful.
Unimpressive results were also seen in a well-designed study of 321 people with back pain comparing chiropractic manipulation, a special form of physical therapy (the Mackenzie method), and the provision of an educational booklet in treating low back pain.13 All groups improved to about the same extent.
Several studies evaluated the effectiveness of chiropractic manipulation combined with a different kind of treatment called mobilization, but they too found little to no benefit.16-18
On a positive note, one study of 100 people with back pain and sciatica symptoms (pain down the leg due to disc protrusion) found that chiropractic manipulation was significantly more effective at relieving symptoms than sham chiropractic manipulation.72
Several studies have found that chiropractic is at least as helpful as other commonly used therapies for low back pain, such as muscle relaxants, anti-inflammatory medication, soft-tissue massage, conventional medical care, and physical therapy.21-25,58,61-63,76 For example, a large, well-designed study found chiropractic manipulation more effective than general medical care and exercise therapy.63
A specific method of manual spinal manipulation called thrust was associated with significant improvements in pain and disability scores when compared to mechanical manipulation and standard medical care. The randomized trial included 112 adults with low back pain who were treated for 4 weeks and followed for 6 months. The effects of the intervention were most noticeable at 4 weeks, but became less apparent at 3 and 6 months.84
Note: Physical therapy, the main conventional therapy for back pain, also lacks consistent supporting evidence.64,69-71 For example, in one large study of people with back pain, a single session of advice proved equally effective as a full course of physical therapy for back pain.64
Neck Pain
As with back pain, despite the widespread use of chiropractic spinal manipulation for neck pain, there is as yet no reliable evidence that it works any better than other therapies, particularly over the long-term .30,31,65,82 Of the limited number of studies performed, most have failed to find manipulation (with or without mobilization or massage) convincingly more effective than placebo or no treatment. One large study (almost 200 participants) found that a special exercise program (MedX) was more effective than manipulation.32
However, a study reported in 2006 showed that a single high-velocity, low-amplitude (eg, chiropractic-style) manipulation of the neck was more effective than a single mobilization procedure in improving range of motion and pain in people with neck pain.73 And a 2010 systematic review, including 17 randomized trials, found mixed results for the benefits of manual therapy (including manipulation and mobilization) combined with exercise.81 According to these researchers, high-quality studies showed manual therapy plus exercise to be more effective than exercise alone in the short-term, but there was no difference over the long-term.
Upper Extremity Pain
Patients often seek out chiropractic for painful conditions affecting their upper extremities (eg, shoulder, elbow, forearm, wrist, hand). A recent search and analysis of all published studies examining the effectiveness of chiropractic for these conditions revealed mostly case studies, an unreliable source of evidence.75 The few uncovered controlled trials were of insufficient quality to draw any reliable conclusions about the effectiveness of chiropractic for painful conditions of the upper extremity.
Tension Headaches and Cervicogenic Headaches
Many people experience headaches caused by muscle tension, neck problems, or a combination of the two. Because these so-called tension headaches and cervicogenic headaches (caused by neck problems) overlap, we discuss them together here. Chiropractic spinal manipulation has shown some promise for these conditions, but the evidence remains incomplete and somewhat contradictory. In a controlled trial of 150 people, investigators compared spinal manipulation to the drug amitriptyline for the treatment of chronic tension-type headaches.5 By the end of the 6-week treatment period, participants in both groups had improved similarly. However, 4 weeks after treatment was stopped, people who had received spinal manipulation showed greater reduction in headache intensity and frequency and over-the-counter medication usage than those who used the medication. The difference in the amount of improvement between the groups was statistically significant.
In another positive trial, 53 people with cervicogenic headaches received chiropractic spinal manipulation or laser acupuncture plus massage.6 Chiropractic manipulation was more effective. However, a similar study of 75 people with recurrent tension headaches found no difference between the two groups.7 Other, smaller studies of spinal manipulation have been reported as well, with mixed results.8
In a controlled trial, 200 people with cervicogenic headaches were randomly assigned to receive one of four therapies: manipulation, a special exercise technique, exercise plus manipulation, or no therapy.9 Each participant received at least 8 to 12 treatments over a period of 6 weeks. All three treatment approaches produced better results than no treatment, and approximately the same effect as each other. However, these results prove little because, as noted earlier, any treatment whatsoever will generally produce better results than no treatment.
A review of 5 randomized trials with 348 patients found that spinal manipulation was more effective than medication ( amitriptyline ), manipulation with placebo, sham manipulation with placebo, standard treatment, or no treatment. However, there was no significant difference in headache pain or intensity when comparing spinal manipulation to soft tissue therapy with placebo laser.83
Migraine Headaches
There is some evidence that chiropractic manipulation may provide both long- and short-term benefits for migraine headaches.
In a double-blind, placebo-controlled study, 123 participants suffering from migraine headaches were treated for 2 months with chiropractic manipulations or fake electrical therapy (electrodes placed on the body without electrical current sent between them) as placebo.2 The study lasted a total of 6 months: 2 months pre-treatment, 2 months of treatment, and 2 months post-treatment.
After 2 months of treatment, those receiving chiropractic manipulation showed statistically significant improvement in headache severity and frequency compared to the control group. Furthermore, these benefits persisted to a 2-month follow-up evaluation.
Chiropractic manipulation also produced relatively prolonged benefits in another trial as well. In this study, 218 people with migraine headaches were divided into three groups: manipulation, medication (amitriptyline), or manipulation plus medication.3 During the 4 weeks of treatment, all three groups experienced comparable benefits. During the follow-up 4-week period, however, people who had received manipulation alone experienced more benefit than those who had been in the other two groups.
However, a study of 85 people with migraines compared spinal manipulation against two other treatments: manipulation performed by a non-chiropractor and mobilization.4 The results showed no difference between groups.
Other Conditions
Chiropractic has been evaluated for many other conditions as well, but the results as yet provide little evidence of benefit.
Infantile Colic
Infantile colic is a common and frustrating problem. Although chiropractic manipulation has been promoted as a treatment for this condition, there is as yet little evidence that it offers specific benefits.
In a single-blind, placebo-controlled trial, a total of 86 infants either received three chiropractic treatments or were held for 10 minutes by a nurse.33 While a high percentage of infants improved, there was no significant difference between the two groups.
Another trial compared spinal manipulation to the drug dimethicone.34 While chiropractic proved more effective than the medication, dimethicone itself has never been proven effective for infantile colic, and the study did not use a placebo group. For this reason, the results of this study indicate little about the effectiveness of chiropractic treatment for infantile colic.
Premenstrual Syndrome
A small crossover trial of chiropractic for PMS symptoms found equivocal results.35
A small trial compared real and sham Activator-style chiropractic treatment in people with phobias and found some evidence of benefit.36
In two controlled studies comparing spinal manipulation to sham manipulation for treatment of people with asthma, the results showed equal improvement for participants in the two groups.37-39 These results suggest that the benefits were most likely caused by the attention given by the chiropractor, and not due to the spinal manipulation itself. However, one of these studies has been sharply criticized for using as a sham treatment a chiropractic method perfectly capable of producing a therapeutic effect.40 This could hide real benefits of the tested form of chiropractic. (If the "placebo" treatment used in a study is actually better than placebo, and the tested treatment does no better than this "placebo," the results would appear to indicate that the tested treatment is no better than placebo, and, hence, ineffective.)
Dysmenorrhea (Menstrual Pain)
A single-blind, placebo-controlled study of 138 women complaining of menstrual pain compared spinal manipulation to sham manipulation for four menstrual cycles and found no differences between the two groups.41
High Blood Pressure
In a study of 148 people with mild high blood pressure, use of chiropractic spinal manipulation plus dietary changes failed to prove more effective for reducing blood pressure than dietary changes alone.66
A single-blind, placebo-controlled trial compared real and sham chiropractic (Activator technique) in 46 children with bedwetting problems, but failed to find a statistically significant difference between the groups.42
Weak evidence hints that chiropractic could be somewhat helpful for adolescent idiopathic scoliosis (curvature of the spine that occurs for no clear reason in adolescents).68
What to Expect With Chiropractic Treatment
Depending on the condition, chiropractic treatment is usually conducted two- or three times per week, for a month or more. Chiropractic is also sometimes used on an as-needed basis, or in a once- or twice-a-month maintenance form. For many chiropractors, x-rays are essential at the first visit and at some follow-up visits.
Each session involves hands-on manipulation following the methods of whatever manipulation technique the practitioner chooses to use. Sometimes other modalities may be used as well, such as massage or hot or cold packs.
Chiropractic physicians may also provide general wellness counseling and prescribe herbs or supplements.
Safety Issues
Chiropractic manipulation appears to be generally safe—rarely causing serious side effects.43-46 However, a temporary increase of symptoms may occur relatively frequently.67 Other side effects include temporary headache, tiredness, and discomfort radiating from the site of the adjustment.
More serious complications may occur on rare occasions. These are primarily associated with manipulation of the neck. Articles have been published that document a total of almost 200 cases of more serious complications associated with neck manipulation, including stroke, vertebral fracture, disc herniation, severely increased sensation of nerve pinching, and rupture of the windpipe.47-56 More than half of these reports involve some form of stroke, often due to a tear in a major blood vessel at the base of the neck (the vertebral artery).
Although attempts have been made to determine in advance who will experience strokes following chiropractic, they have not been successful.56 Thus, stroke must be considered an unpredictable, though rare, side effect of chiropractic manipulation of the neck. To put this in perspective, however, the rate of complications from chiropractic is extremely low. According to one estimate, only one complication per million individual sessions occurs.30 Among people receiving a course of treatment involving manipulation of the neck, the rate of stroke is perhaps one per 100,000 people; the rate of death is one per 400,000.57 By comparison, serious medical complications involving common drugs in the ibuprofen family (non-steroidal anti-inflammatory drugs, or NSAIDs) are far more common. Among people using them for arthritis, NSAIDs result in hospitalizations at a rate of about four in 1,000 people, and death at a rate of four in 10,000.57 To put it another way, the rate of complications with these common over-the-counter drugs is perhaps 100 to 400 times greater than with chiropractic.
Certain health conditions preclude spinal manipulation, such as nerve impingement causing severe nerve damage, or significant disease of the spinal bones.
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61. Giles LG, Muller R. Chronic spinal pain: a randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine. 2003;28:1490-1502.
62. Hoiriis KT, Pfleger B, McDuffie FC, et al. A randomized clinical trial comparing chiropractic adjustments to muscle relaxants for subacute low back pain. J Manipulative Physiol Ther. 2004;27:388-98.
63. UK BEAM Trial Team United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. BMJ. 2004 Nov 29; [Epub ahead of print].
64. Frost H, Lamb SE, Doll HA, et al. Randomised controlled trial of physiotherapy compared with advice for low back pain. BMJ. 2004;329:708. Epub 2004 Sep 17.
65. Gross AR, Hoving JL, Haines TA, et al. Manipulation and mobilisation for mechanical neck disorders. Cochrane Database Syst Rev. 2004;1:CD004249.
66. Goertz CH, Grimm RH, Svendsen K, et al. Treatment of hypertension with alternative therapies (THAT) study: a randomized clinical trial. J Hypertens. 2002;20:2063-2068.
67. Hurwitz EL, Morgenstern H, Vassilaki M et al. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine. 2005;30:1477-1484.
68. Rowe DE, Feise RJ, Crowther ER, et al. Chiropractic Manipulation in Adolescent Idiopathic Scoliosis: A Pilot Study. Chiropr Osteopat. 2006 Aug 21. [Epub ahead of print]
69. Koes BW, Malmivaara A, van Tulder MW, et al. Trend in methodological quality of randomised clinical trials in low back pain. Best Pract Res Clin Rheumatol. 2005;19:529-539.
70. Bisset L, Paungmali A, Vicenzino B, et al. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med. 2005;39:411-422.
71. Hayden JA, van Tulder MW, Malmivaara AV, et al. Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med. 2005;142:765-775.
72. Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J. 2006;6:131-137.
73. Martinez-Segura R, Fernandez-de-Las-Penas C, Ruiz-Saez M, et al. Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: a randomized controlled trial. J Manipulative Physiol Ther. 2006;29:511-517.
74. Schmid A, Brunner F, Wright A, Bachmann LM. Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation. Man Ther. 2008 Mar 1. [Epub ahead of print]
75. McHardy A, Hoskins W, Pollard H, et al. Chiropractic treatment of upper extremity conditions: a systematic review. J Manipulative Physiol Ther. 2008;31:146-159.
76. Wilkey A, Gregory M, Byfield D, et al. A comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic. J Altern Complement Med. 2008;14:465-1473.
80. Juni P, Battaglia M, Nuesch E, et al. A randomised controlled trial of spinal manipulative therapy in acute low back pain. Ann Rheum Dis. 2008 Sep 5.
81. Miller J, Gross A, D'Sylva J, et al. Manual therapy and exercise for neck pain: a systematic review. Man Ther. 2010;15(4):334-354.
82. Martel J, Dugas C, Dubois JD, Descarreaux M. A randomised controlled trial of preventive spinal manipulation with and without a home exercise program for patients with chronic neck pain. BMC Musculoskelet Disord. 2011;12:41.
83. Posadzki P, Ernst E. Spinal manipulations for tension-type headaches: a systematic review of randomized controlled trials. Complement Ther Med. 2012 Aug;20(4):232.
84. Schneider M, Haas M, Glick R, Stevans J, Landsittel D. Comparison of spinal manipulation methods and usual medical care for acute and subacute low back pain: A randomized clinical trial. Spine (Phila Pa 1976). 2015;40(4):209-217.
Last reviewed September 2014 by EBSCO CAM Review Board
Last Updated: 7/17/2015
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DX6e 6-Channel DSMX Transmitter with AR620
- Patent-pending gimbal design with spring configuration switch
- Includes Full Range AR620 DSMX Receiver
- DSM2/DSMX Wireless trainer link
- Virtually unlimited model memory-transmitter stores up to 250 models and only populates the model list with models the user has configured
- Airplane, Helicopter, Sailplane and Multirotor programming
- Built-In Telemetry
- 7 airplane wing types and 6 tail types
- 2 swashplate types
- 4 sailplane wing types and 3 tail types
- Multirotor flight mode setup
- 7-point throttle curves for airplanes and helicopters
- 7-point pitch and tail curves for helicopters
- Cross-platform model sharing with other Spektrum transmitters
- 4 AA batteries included
- EN328 compatible
Being on a budget doesn't have to mean you have to settle for less than the best. The Spektrum DX6e gives you the unbeatable response of DSMX® technology, the simplicity of Spektrum™ AirWare™ programming software and many other features you can't find on other "budget" radios.
Feature Details
Airplane, Helicopter, Sailplane and Multirotor Programming
The DX6e comes equipped with the programming you need to fly almost anything. And because it's based on the same Spektrum AirWare software used in most other Spektrum transmitters, you can share model setups with just about any Spektrum user you meet.
- 7 Wing Types: Normal, Dual Aileron, Flaperon, 1 Aileron 1 Flap, 2 Aileron 1 flap, Elevon A, Elevon B
- 6 Tail Types: Normal, V-Tail A, V-tail B, Dual Elevator, Dual Rudder, Dual Rudder/Elevator
- Flap System with Elevator Compensation
- 3 Flight Modes
- Dual Rates and Expo
- 7-Point Throttle Curve
- 3 Preset Mixes: Rudder-to-Aileron/Elevon, Aileron-to-Rudder, Elevator-to-Rudder
- 4 Programmable Mixes – Normal or Curve
- Gyro
- 7-Point Throttle Curve
- 7-Point Pitch Curve
- 7-Point Tail Curve
- 2 Swash Plate Types: Normal, 3-Servo 120˚
- 3 Flight Modes + Throttle Hold
- Dual Rates and Expo
- Cyclic-to-Throttle and Swashplate Timing Mixes
- 4 Programmable Mixes – Normal or Curve
- 4 Wing Types: Single Aileron, Dual Aileron, 2 Aileron 1 Flap, 2 Aileron 2 Flap
- 3 Tail Types: Normal, V-Tail A, V-Tail B
- Camber System
- Camber Preset
- 5 Flight Modes
- Dual Rates and Expo
- Dual Rates and Expo
- 4 Preset Mixes: Aileron-to-Rudder, Aileron-to-Flap, Elevator-to-Flap, Flap-to-Elevator
- 4 Programmable Mixes – Normal or Curve
- Multirotor Channel Inputs – ALT (Altitude), ROL (Roll), PIT (Pitch), YAW
- Multirotor Checklists and Warnings
- Simplified Multirotor Flight Mode Setup and Switch Assignment
250-Model Memory
The enormous capacity of the DX6e's on-board memory means you will rarely, if ever, need to juggle models between transmitter memory and your SD card. The model memory menu is easy to navigate too. Only memory slots with model settings saved to them will appear. You won't have to scroll through empty slots or move models around if one is deleted.
Built-In Telemetry
The built-in telemetry feature can give you real-time information on things like battery voltage, signal quality, motor temperature and more.* You can also program alerts that let you know when specific telemetry values reach or exceed limits you define.
* Requires telemetry sensors and a telemetry-enabled receiver.
Patent-Pending Gimbal Design with Spring Configuration Switch
The DX6e's patent-pending gimbal design lets you change gimbal spring configurations simply by moving a slider switch on the back of the transmitter. No tools are required. Just select the spring configuration that matches the mode you are using and model type you are flying. That's it.
There are four spring configurations to choose from:
- Normal Throttle for Modes 2 and 4 (Air, Heli and Sailplane Model Types)
- Spring-Centered Throttle for Modes 2 and 4 (Multirotor Model Type)
- Spring-Centered Throttle for Modes 1 and 3 (Multirotor Model Type)
- Normal Throttle for Modes 1 and 3 (Air, Heli and Sailplane Model Types)
The slider switch is protected by a hinged cover that prevents you from accidentally changing spring configurations in flight.
Wireless Trainer Link
The wireless trainer link gives instructors the option to wirelessly ''buddy box'' with another DSMX/DSM2® transmitter. Once bound to another transmitter, ModelMatch™ technology will allow the DX6e to re-link without having to go through the bind process again.
Includes Full Range AR620 DSMX Receiver
The Spektrum AR620 air receiver is a full-range, 6-channel sport receiver with DSMX/DSM2 compatibility and a compact footprint that's streamlined to fit in a wide range of models. More than just a simple box that connects your servos, the AR620 features an internal antenna design that delivers a whole new world of installation ease that includes a higher-level of durability and convenience while maintaining superior full-range performance for your electric or engine powered aircraft.


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To get your company listed in this directory Click here
Results : 6
men and women clothes, clothes. sports articles, shopping
costume jewellery, jewellery, shopping
jewellery, shopping
jewellers, jewellery, shopping
kitchen furniture, home. do-it-yourseft. garden. cleaning, real estate - décoration - construction
Enchantingly situated on the Golden Square on the Place du Casino
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Nestled on a peninsula, Beach Hotel is an authentic jewel of the twenties
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Ideally located the Metropole offers an environment glamour and sensual
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More than an hotel, more than a resort: a new concept to discover in Monaco
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/ Le Thalès
Area : 374 m²
Price :10 500 000
Product details
Parc Saint Roman - New apartment - Luxurious building
/ Parc Saint Roman
Area : 83 m²
Price :3 550 000


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Trincomalee City to Sigiriya City Private Transfer
Trincomalee City to Sigiriya City Private Transfer
Aanbieding Uitverkocht
Normale prijs €70,95 EUR
Normale prijsEenheidsprijs per
(SKU: LK42232000) Arrange a private transfer by taxi cab from the Trincomalee to Sigiriya. The sri lanka airport taxi cab service is conducted by English-speaking chauffeur-guides who are friendly, punctual and put your safety first above everything else. Enjoy a comfortable and hassle-free experience by having your own private vehicle and chauffeur drive you from the Trincomalee to Sigiriya. Estimated travel time is 2.44 hour(s) and estimated travel distance is 218 KM. Depending on the weather and traffic, your chauffeur will take the best route available on the day.
- Pick-up within the city limits of Trincomalee and drop-off within the city limits of Sigiriya.
- Meet-and-greet at meeting point/hotel lobby and free 60 minute waiting time.
- Transport in an private, air-conditioned vehicle.
- Vehicle Type: Passengers 1 to 2 using Standard Car, 3 to 5 using Standard Van, 5 to 8 using Large Van and 8 to 15 using Mini Coach.
- Service of an English-speaking chauffeur guide.
- 24/7 online assistance by dedicated, support team.
- 500ml bottled mineral water per person.
- Airport entry charges and parking fees.
- Highway tolls.
- All taxes & service charges.
- Extra stops
- Baby seats / Booster seats
- Capacity to carry special/over-sized luggage (e.g. Surf Boards, Golf Bags etc.)
- Transport for differently abled passengers
- Transport for pets
- Airport arrival/departure transfers FAQ
- Guide to vehicle fleet and capacity (e.g. Car, Van, Bus specifications)
Also available on:


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Acceptable use policy
This acceptable use policy ("Policy") sets forth the general guidelines and acceptable and prohibited uses of the 192.168.64.2/lat20 website ("Website" or "Service") and any of its related products and services (collectively, "Services"). This Policy is a legally binding agreement between you ("User", "you" or "your") and Latitude 20 Vacation Rentals ("Latitude 20 Vacation Rentals", "we", "us" or "our"). By accessing and using the Website and Services, you acknowledge that you have read, understood, and agree to be bound by the terms of this Agreement. If you are entering into this Agreement on behalf of a business or other legal entity, you represent that you have the authority to bind such entity to this Agreement, in which case the terms "User", "you" or "your" shall refer to such entity. If you do not have such authority, or if you do not agree with the terms of this Agreement, you must not accept this Agreement and may not access and use the Website and Services. You acknowledge that this Agreement is a contract between you and Latitude 20 Vacation Rentals, even though it is electronic and is not physically signed by you, and it governs your use of the Website and Services.
Prohibited activities and uses
You may not use the Website and Services to publish content or engage in activity that is illegal under applicable law, that is harmful to others, or that would subject us to liability, including, without limitation, in connection with any of the following, each of which is prohibited under this Policy:
- Distributing malware or other malicious code.
- Disclosing sensitive personal information about others.
- Collecting, or attempting to collect, personal information about third parties without their knowledge or consent.
- Distributing pornography or adult related content.
- Promoting or facilitating prostitution or any escort services.
- Hosting, distributing or linking to child pornography or content that is harmful to minors.
- Promoting or facilitating gambling, violence, terrorist activities or selling weapons or ammunition.
- Engaging in the unlawful distribution of controlled substances, drug contraband or prescription medications.
- Managing payment aggregators or facilitators such as processing payments on behalf of other businesses or charities.
- Facilitating pyramid schemes or other models intended to seek payments from public actors.
- Threatening harm to persons or property or otherwise harassing behavior.
- Purchasing any of the offered Services on someone else's behalf.
- Misrepresenting or fraudulently representing products or services.
- Infringing the intellectual property or other proprietary rights of others.
- Facilitating, aiding, or encouraging any of the above activities through the Website and Services.
System abuse
Any User in violation of the Website and Services security is subject to criminal and civil liability, as well as immediate account termination. Examples include, but are not limited to the following:
- Use or distribution of tools designed for compromising security of the Website and Services.
- Intentionally or negligently transmitting files containing a computer virus or corrupted data.
- Accessing another network without permission, including to probe or scan for vulnerabilities or breach security or authentication measures.
- Unauthorized scanning or monitoring of data on any network or system without proper authorization of the owner of the system or network.
Service resources
You may not consume excessive amounts of the resources of the Website and Services or use the Website and Services in any way which results in performance issues or which interrupts the Services for other Users. Prohibited activities that contribute to excessive use, include without limitation:
- Deliberate attempts to overload the Website and Services and broadcast attacks (i.e. denial of service attacks).
- Engaging in any other activities that degrade the usability and performance of the Website and Services.
Defamation and objectionable content
We value the freedom of expression and encourage Users to be respectful with the content they post. We are not a publisher of User content and are not in a position to investigate the veracity of individual defamation claims or to determine whether certain material, which we may find objectionable, should be censored. However, we reserve the right to moderate, disable or remove any content to prevent harm to others or to us or the Website and Services, as determined in our sole discretion.
Copyrighted content
Copyrighted material must not be published via the Website and Services without the explicit permission of the copyright owner or a person explicitly authorized to give such permission by the copyright owner. Upon receipt of a claim for copyright infringement, or a notice of such violation, we will immediately run full investigation and, upon confirmation, will notify the person or persons responsible for publishing it and, in our sole discretion, will remove the infringing material from the Website and Services. We may terminate the Service of Users with repeated copyright infringements. Further procedures may be carried out if necessary. We will assume no liability to any User of the Website and Services for the removal of any such material. Your notice must include the following:
- Identification of the copyrighted work claimed to have been infringed, or if multiple copyrighted words at a single site are covered by a single notification, a representative list of such works at that site.
- Identification of the material that is claimed to be infringing or to be the subject of infringing activity and that is to be removed or access to which is to be disabled, and information reasonably sufficient to permit us to locate the material.
- Information reasonably sufficient to permit us to contact you, such as an address, telephone number, and, if available, an e-mail address.
- A statement that you have a good faith belief that use of the material in the manner complained of is not authorized by the copyright owner, the copyright owner's agent, or the law.
- A statement that the information in the notification is accurate, and under penalty of perjury that you are authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.
- A physical or electronic signature of a person authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.
If you believe your copyright is being infringed by a person or persons using the Website and Services, please send a report of the copyright infringement to the contact details listed at the end of this Policy.
You take full responsibility for maintaining reasonable security precautions for your account. You are responsible for protecting and updating any login account provided to you for the Website and Services. You must protect the confidentiality of your login details, and you should change your password periodically.
We reserve our right to be the sole arbiter in determining the seriousness of each infringement and to immediately take corrective actions, including but not limited to:
- Suspending or terminating your Service with or without notice upon any violation of this Policy. Any violations may also result in the immediate suspension or termination of your account.
- Disabling or removing any content which is prohibited by this Policy, including to prevent harm to others or to us or the Website and Services, as determined by us in our sole discretion.
- Reporting violations to law enforcement as determined by us in our sole discretion.
- A failure to respond to an email from our abuse team within 2 days, or as otherwise specified in the communication to you, may result in the suspension or termination of your account.
Suspended and terminated User accounts due to violations will not be re-activated.
Nothing contained in this Policy shall be construed to limit our actions or remedies in any way with respect to any of the prohibited activities. We reserve the right to take any and all additional actions we may deem appropriate with respect to such activities, including without limitation taking action to recover the costs and expenses of identifying offenders and removing them from the Website and Services, and levying cancellation charges to cover our costs. In addition, we reserve at all times all rights and remedies available to us with respect to such activities at law or in equity.
Reporting violations
If you have discovered and would like to report a violation of this Policy, please contact us immediately. We will investigate the situation and provide you with full assistance.
Changes and amendments
We reserve the right to modify this Policy or its terms relating to the Website and Services at any time, effective upon posting of an updated version of this Policy on the Website. When we do, we will revise the updated date at the bottom of this page. Continued use of the Website and Services after any such changes shall constitute your consent to such changes.
Acceptance of this policy
You acknowledge that you have read this Policy and agree to all its terms and conditions. By accessing and using the Website and Services you agree to be bound by this Policy. If you do not agree to abide by the terms of this Policy, you are not authorized to access or use the Website and Services.
Contacting us
If you would like to contact us to understand more about this Policy or wish to contact us concerning any matter relating to it, you may send an email to email@example.com/lat20
This document was last updated on July 12, 2020


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I'm Going To Be A Grandma Shirts Style Shirts T shirt. I'm Going To Be A Grandma Shirts. I'm Going To Be A Grandma
Welcome to our shop!
I'm Going To Be A Grandma Style Shirts T shirt. Welcome to my shop blinkvero, home of the funniest and popular tee's online. Your new style shirts I'm Going To Be A Grandma will be a great gift for him or her. I use only quality shirts such as Fruit of the Loom or Gildan. TSalty Surf Clubhe process used to make the shirt is the latest in ink to garment technology which is also eco-friendly.
Style Shirts For Womens Description :
– An I'm Going To Be A Grandma dressed in cloth of gold.
– Our shirts is made of brand "GILDAN / Fruit of the Loom" 100% preshrunk cotton, high-quality, comfortable, heavyweight and standard fit.
– Our Tshirt will be printed using high performance digital printing technology in full color with durable photo quality reproduction (4000 x 4000 pixels).
– 6.1 oz. 100% Heavyweight Cotton.
– Durable Screen Print Graphics. Colors on graphics are reasonably close to the pictures shown in this ad but may vary slightly in tone as the pictures are for demonstration purposes only.
– Washable in cold water and low to medium dryer settings. (washing instruction: Turn the garment inside out before washing and drying).
|Adult Size
2XL Man / Unisex, Adult-2XL Women, Adult-L Women, Adult-M Women, Adult-S Women, Adult-XL Women, Adult-XS Women, L Man / Unisex, M Man / Unisex, S Man / Unisex, XL Man /Unisex, xs man / Unisex
Black, Blue, Blue Navy, Cream, Forest Green, Gray, Green, Light Blue, Orange, Pink, Purple, Red, Red Maroon, sky blue, White, Yellow
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