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One creative way that can get started investing found in real estate is toward use a lease solution. The biggest advantage pertaining to using lease options to finally invest in real house is –control. This strategy of investing, basically is giving the investor the appropriately to possess — happen to be in control of — and profit from a single property without owning the product.
A truthful estate let option transaction is the combination most typically associated with two records and documents.
The rent money part attached to the understanding is even the vendor agrees in which to let your lease all their property, and additionally you spend them book for some stated interval of moment. During your lease period, the home owner can certainly raise some of the rent, rent or lease it if you want to anyone else, or move the material goods to folks else.
The answer part out of the legally binding contract represents all the right somebody purchased time for buy your current property within the future, for a brand new specific costs. If owners decide to help exercise an option within order to buy, the specific owner gives you to industry it to allow them to you by going to the arranged price. Typically the option half of this contract obligates the company to auction off to a person during all of the option length of time — but yet it achieves not obligate you when you need to buy. A person are mainly obligated – make lodging payments like agreed throughout the the mortgage payments period.
When all lease pick contract could be described as written but structured properly, it will probably provide extraordinary benefits in addition advantages with regard to the speculator. If your lease remedy includes this "right on sub-lease", a investor can also generate a functional positive monetary flow basically renting an property up to a renter for each duration akin to his lease, or rent option the entire property to be able to a tenant-buyer for cash evolve and forthcoming profits. Where the mortgage payments option include a "right of assignment" the people who trade could determine the arrangements to a new buyer when a high-speed profit.
Lease tactic real real estate investing, typically is a flexible, low risk, highly utilized method in investing why can make implemented on little you can no dough.
High Leverage
It was highly geared because your company are in a very position to benefit from control within a property and cash from things now–even though you can not own the site yet. Usually the fact that a majority of you should never own it, also restrictions your own liability as well as the personal reputation. Only however, if you settle to put money into the place by workout your "option to buy", would families take identify to each property.
Little that will help no money
The valid estate trader's cost to finally implement one specific lease collection contract containing the driver requires limited to basically no money out doors Rules of Renovation pocket, because in which is negotiable approximately investor also owner. Also, there are perhaps a mixture of avenues the technique fee can be a specific set of. It are able to be organised on exclusive installment plan, balloon collection or all the other agreeable plan between each parties. This particular option subscription can essentially be by means of little seeing that $1.00.
In purchase order to secure and protected the territory for find at a brand new later date, tenant-buyers quite often pay that non-refundable opportunity fee involved with approximately 2%-5% of the actual negotiated long lasting purchase monetary value to each seller. Acquire on the manner in which the capital lease contract option statement is ready and structured, the rehabber could almost certainly use usually the tenant-buyer's product fee hard earned money to be charged any fee to be paid to a owner.
Lease choosing real est investing is truly a varied method amongst investing towards the the requisites of most of the agreement, choose payment amounts, payment dates, installments, eagerness rate, awareness only payment, balloon payments, purchase amount and further terms probably are all discussed between company and opportunist. Responsibilities of a both occasions are aside from that negotiable. Needed for instance, assuming that the buyer and seller doesn't have to have to group in the most important capacity connected a landlord, he were able to specify about the capital lease contract option accord that tenant-buyer will you should be responsible because of all child maintenance and so repairs and furthermore the moderne seller probably will remain accountable for for associated with major maintenance.
Financially Minimized Risk
It would be low jeopardize financially, simple fact if generally property does not work out to return up ample amounts in evaluate to do a profit, you get the acquired the excellent to opposite your brain and make it easy for the "option to buy" expire. In addition if an individuals tenant-buyer wants not of buy most of the property, the person have are making money by the actual positive per month cash run from some tenant-buyer's renting payments, and in addition upfront non-refundable option bit of a fee.


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Marry! She is Garolina in the flesh! I could never say no to those green-blue eyes. And her love for the people of Amnos Os is only surpassed by her mother's. She makes my heart bleed, young Annise. My baby girl. Though she is more womanly with every waking moment.
Albert is sweet on her - any blind man could see that! He's a gentleman, no doubt, but is he worthy?
Is he worthy?
He certainly isn't a prince. Born of Garolina's maid-servant. She was unmarried and little more than a child herself. There were complications during birth, and she died that night. I took pity on him. He was such a happy child, unaware of the circumstances of his birth. Sir Freowine raised him to the Knights' Code.
He isn't a prince, but he is a gentleman.
But he isn't a prince. No royal blood flows through him anymore than a chicken!
Nay, he is not worthy. Nought but the highest of kings is worthy of Annise!
"Father, I am going with Albert to the courtyards." A flurry of emerald green skirts and honey blonde hair storms into my library.
I look up. She stops just in front of my desk, and her face softens into a childlike grin, the seal of her jests.
"Please, do I have permission?"
I carefully consider my choice of words. After my decision, I cannot let them together alone until I speak to him.
"'Tis a strange thing that you should ask. I have nearly finished my duties for now. I myself shall be seeking the fresh air." Her face drops. I can tell she wants time alone with him. "Pray, wait and I shall join you both."
"Thank you, Father." But she's saying something else with her eyes.
We walk by the lake. The late afternoon sun dyes the ripples gold, and Annise, her keen eyes shining with a fire, must sing of it. Albert walks silently on my left. I have been strategically seperating them both. Annise doesn't seem to mind too much, but Albert is rather unsuccessful at hiding his sulking emotions.
"Is not the day fine?" Annise's melodic voice rings out. "Father! Albert! The sky is bright, the grass is fresh. Does not the breeze kiss your face?" She laughs and runs ahead. Then she stops abruptly, spinning on her heel. "Come, be merry!"
I look at her, slightly shaking my head. A partially surpressed chuckle escapes. She half-heartedly skips back to us, but the fire has left her eyes.
"You are both being awfully sullen." She falls back into place and is silent. I look back at her.
"Sweeting, you know well I cannot run as a young buck anymore. I have matured into a magnificent stag, but I do not run."
She remains silent. It seems she inherited her mother's stubbornness as well.
But it is not long and she's singing again. She speeds up, and spins back to face us, continuing her pace backwards.
"Albert, at least you may join me." I glance across at him. His sour expression is melting into his charming smile, as he abandons me for my daughter.
I can still see them. They caper up the path, almost in a dance.
Maybe he is worthy of her. There is only one way of finding out.


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Fukushima Rememberance: Saturday, March 11, 2017. Walk with Jun-san and the Peace Walkers. Meet Saturday, 10:30 am at Croton Train Station. Proceed to Peekskill Riverfront Green. Program afterwards at 1:45 pm at Peekskill Presbyterian Church. The latest details are as follows: Water Walk for Life (UPDATED 1/7/17) Dates: Sat. March 4th thru Sat. March 11th, … Continue reading
Yearly Archives: 2016
"To Save the Planet Go Renewables" by Marilyn Elie
Letter to the Editor NYT Re: Commentary, December 22, 2016 To Save the Planet Go Nuclear "Every time new fossil energy replaces nuclear, we are locking ourselves in to a more carbon heavily energy mix for years to come." … Continue reading
The Fight to Stop Cuomo's $7.6 Billion Nuclear Bailout Continues!
Over the past several months, Gov. Andrew Cuomo has been hatching a secret deal to force New Yorkers to spend $7.6 billion in order to bail out Exelon, a wealthy Chicago corporation. Gov. Cuomo has refused to publicly disclose the full details of his plan, but we know that our hard-earned money would be used … Continue reading
"Nuclear Plants Closing Early Leave Decades of Toxic Waste Stranded"
"Midway between San Diego and Los Angeles, the San Onofre Nuclear Plant waits to be dismantled. After more than 40 years of protests, lawsuits and safety scares, its two concrete-encased reactors, jutting from the pristine California coastline, are powered down and its massive steam turbines, once deafening, are quiet. For the activists who fought to close … Continue reading
"Trump Advisers Eye Reviving Nevada Yucca Nuclear Waste Dump"
"The long-stalled plan to stash radioactive waste at Nevada's Yucca Mountain is set to be revived with the arrival of President-elect Donald Trump in Washington and the departure of the project's most ardent Senate opponent, Harry Reid. Two people familiar with Trump's transition planning say the issue is actively being discussed by advisers as a … Continue reading
"Trump Team Memo Hints at Big Shake-Up of US Energy Policy"
"Advisers to President-elect Donald Trump are developing plans to reshape Energy Department programs, help keep aging nuclear plants online and identify staff who played a role in promoting President Barack Obama's climate agenda. The transition team has asked the agency to list employees and contractors who attended United Nations climate meetings, along with those who helped develop … Continue reading
Rick Perry to Lead the Department of Energy
"WASHINGTON — Rick Perry, President-elect Donald Trump's choice for energy secretary, has close ties to the Texas oil industry and corporate roles in two petroleum companies pushing for government approval of the proposed 1,200-mile crude oil pipeline that has stoked mass protests in North Dakota. Perry's current position as board director at Energy Transfer Partners … Continue reading


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BY WINNIE McCROY | When CEO Chris Whittle opened up the $75 million Chelsea campus of Avenues: The World School in 2012, it was the realization of more than five years of planning. Now, with the school having wrapped up its second year, Chelsea Now takes a look at the immersive bilingual educational facility.
"We think all schools are different, and that doesn't necessarily mean better or worse," said Whittle. "For example, we are the only top-tier school in the city that has this immersion program. Different schools have different strengths, and this happens to be ours."
Whittle revolutionized the charter school movement when he founded Edison Schools. His educational philosophy focuses on identifying each student's passion and giving them a deep understanding in that area. Because private schools are not regulated by the Department of Education, they don't have to follow the same curriculum as public schools.
Avenues: The World School (avenues.org) was the largest private school building project in the history of the city. Ultimately, the plan is to create "a unique and dynamic educational village — one school with 20 or more campuses in major cities in Asia, Europe, Africa and North and South America."
Paris, London, São Paolo and Mumbai are among the announced locations. By 2016, the Beijing campus will be open, and students can begin taking advantage of the study abroad option. The school will feature 2,000 dorm rooms for both local students and for those across the world who want to study in China.
As part of their planned scale-up to 1,630 students in four years, Avenues' inaugural class started out with just 740 students. Last year, they had 1,100 students, and next year, there will be 1,300, including their first class of 11th graders. Eventually, the school will cover students from pre-K through 12th grade.
Within Avenues' 10-story building (at 10th Ave. & 25th St.), there are actually four schools: a nursery school, a lower school, a middle school and a high school — each with a double-story commons area with couches and chairs, flooded with natural light and overlooking the High Line. Class size is 18 students, and outside of well-appointed classrooms are high-definition virtual "bulletin boards," programmed by the classrooms to allow for student exhibits.
Long before Avenues opened, Jay Van Buren and his wife were hired to work on the school's website. Longtime marketers, the Brooklyn couple brought a healthy dose of skepticism to what the school said about itself — but were soon sold on the idea, and applied to get their son Theo into the school.
Avenues ended up hiring Katie Van Buren as director of the school's Innovation Lab, and Theo will start pre-K in the fall. He began his language immersion in nursery school, and his parents are thrilled that he has taken to singing a song from "Frozen" in Chinese.
Abby Brody, Director of the Avenues Lower School, was also involved with the school before it opened. In fact, she was the first hire. She was teaching at a private school on the Upper East Side and found herself frustrated over the static curriculum there. She decided to start her own charter school to create "citizens of the 21st century."
After chatting with Whittle, she scrapped her idea within two days, and signed up to be part of a "best practices school." She was overjoyed to discover that Avenues wasn't afraid to make changes. Most private schools, asserts Brody, "are very scared of change. They don't want to look weak in front of the parents." Avenues' conscious favoring of evolution entrenchment is, Brody believes, an important element of what sets the school apart — and encourages collaboration between parents and teachers.
"They're risk takers," said Brody of the faculty. "Even though our kids are from wealthy families, they are coming in with a culture that values humility. The parents know the mission statement, and the teachers build a community based on a bigger self-awareness, that kids should know when to be a leader and when to be a follower. They realize that there's a world beyond New York City."
While mapping out the curriculum they envisioned, educators constantly refer to Avenues' mission statement, which includes sharing prosperity through financial aid, providing faculty support and advancing education as an effective, diverse and accountable school. The mission also addresses the idea of graduating emotionally unafraid global citizens, while nurturing a sense of humility — something that could be difficult for children of extremely wealthy parents.
Whittle said that Avenues initially achieves this by spending a tremendous amount of time carefully choosing who they admit, not only to be sure they can handle the rigorous, bilingual curriculum, but making sure that families understand how things work at Avenues.
"We want our kids to welcome everyone. We want there to be a culture of respect, and we want there to be safety — not just in a physical sense, but also in an emotional sense," said Whittle.
The Van Burens love the school's mission statement and how they use it as a touchstone in internal discussions. They can sense the happiness it has created in their son, saying, "Theo was jumping up and down on the day that spring break was about to be over. He loves the school as much as we do!"
Parent Paul Spencer said his daughter Willa was also thriving at Avenues. Watching the school under construction, he likened it to a ship being readied for its maiden voyage, saying, "We were very happy to be its first passengers. It was exciting that they were taking on this experiment. My feeling was that if they make mistakes, they can correct them."
When Avenues first opened, issues arose — such as the impact of celebrity students like Suri Cruise, the variety of food offered in the school cafeteria, and safety concerns about the homeless individuals in the area.
"In opening a school this size, which has a staff of well over 200, there are always going to be issues, and food in any school is always a topic of conversation," said Whittle. "So in our early days we worked through it, because different students had different health needs. But we did that very nicely and it's no longer an issue."
And although they don't comment on individual students, regardless of how famous their parents may be, Whittle said that they select families that will be part of the community, saying, "we would not be growing the way we are if there were not a positive experience happening."
"I haven't noticed anyone getting any special treatment or attention," said Spencer. "In fact, whenever I've seen Suri and Katie — who obviously takes a personal interest in her daughter — she's often the one who picks her up and drops her off. The two of them seem pretty much like any other parent and child, doing the same things the rest of us do."
Another concern came via a now infamous exchange known as "the butt crack e-mail," in which a parent complained that her child had witnessed the bare posterior of one of the local street people.
Paul Spencer said that like most Avenues parents, he and his wife were "appalled" by the negative publicity of parents complaining about the food, or the "unsavory characters" in the neighborhood. He said that while every school has helicopter parents, focusing on the concerns of a few had created a distorted view of Avenues.
"The pros hugely outweigh the cons," said Whittle. "This is one of the most vibrant and rapidly developing neighborhoods in the city. Two things we particularly like about it is that for an arts program, we couldn't be located in a better place. I laugh sometimes when I go to the art studios and they're empty, because students are out and about, visiting the galleries. We love the connection to the Chelsea art community."
Whittle also appreciates the Silicon Alley element, with tech companies Google and Quirky both nearby, noting that Avenues is developing a variety of connections with these firms. And then there is the High Line.
"The High Line is terrific, particularly with the opening of the third section," said Whittle. "It's a great way for parents to walk their kids to school without crossing streets. You can walk eight to ten blocks in either direction without worrying about stoplights."
The Van Burens take that trek with their son Theo several times a week, and said that, "as far as safety and security, there have been no problems. There's a crossing guard at the corner who makes sure the kids get across okay."
And that butt crack email? "New York is New York. It has its issues and it always will, but that's just urban life," said Whittle. "Both the parents and the students in the community are fine with that."
What most distinguishes Avenues from other private schools is their immersive language program. Students learn all subjects, from math to music, in either Spanish or Mandarin Chinese until they are 10 years old, resulting in true fluency, then take conventional language instruction.
David Berney and his wife Lynn have three children at Avenues: a daughter who is entering pre-K, a son in second grade and a son in third grade. They love the language skills the program affords their kids.
Whittle said that by all accounts, the immersion program is working excellently, but noted that some changes were made in how it was organized. When they first opened, students would spend half a day in their immersion classroom and half a day in their English classroom. Teachers found it laborious to shuffle students around, and after a pilot program, the procedure was altered. Now, students spend one day learning in English, and the next day learning in their chosen immersion language. Parents and teachers alike are thrilled about the change.
The Van Burens agree, saying that their son didn't seem to mind the change from half-day language sessions to every other day, and that teachers found it allowed them to have more continuity. They love how the immersion program is giving their son a leg up, citing a study that found learning another language aids in the ability to think creatively.
"That too is part of what goes into creating a new school," said Jay Van Buren. "They aren't relying just on what it's always been. They try new things to see what works. For example, the older kids use the Harkness table method, where they learn by sitting around a table and discussing things, and that goes back decades. Avenues is taking some things that are old and some that are new and using the best of everything. The whole approach is focused on trying to ask the question, 'What is the best quality education now?' "
David Berney echoed this sentiment, noting that he and his wife Lynn are impressed by how teachers and administrators constantly listen to students and parents, and then make adjustments. They are fascinated by the degree of fluency their three children have gained in such a short time. When they take the kids to Flushing, Queens, they can read street signs in Mandarin, and talk to the many Chinese residents in the area.
This prompted the Berneys to speak with administrators about keeping their kids' language skills sharp over the summer break. Last year, they worked with the school to arrange online chat sessions between students and teachers. Now Avenues has an online summer language program that allows students and teachers to Skype in Chinese or Spanish.
"It worked so well last summer, we expanded it significantly this year," said Whittle. "You will literally see kids out on a beach somewhere Skyping in Mandarin with their teacher!"
The Berneys point to this interaction as proof that when parents have ideas that can benefit everyone, the school is responsive. The Spencers love it as well, saying that their eight-year-old daughter Willa loves using her Mandarin language skills whenever possible. They recently connected with a couple in Columbia County who run a Chinese restaurant.
"We set up play dates with their kids, who speak Mandarin but don't read or write it," said Spencer. "There was even a funny moment when Willa was showing their 12-year-old son how to spell something in Mandarin, and what a character meant."
A year's tuition for Avenues costs about the same as tuition for any other private school in the city — about $45,000 per year with fees (except for those students who receive financial aid).
"Everyone pays the same tuition, and we have no idea who gets financial aid," said Lynn Berney. "It's all the same, whether you are super wealthy or struggling to make every penny count. We know that we're not going to be nickel and dimed for everything. It's how it should be. Everyone should have the opportunity to get the same education, regardless of their socioeconomic background."
Avenues doesn't ask for or accept any additional funding from parents. In fact, that's how Whittle planned it all along. Prior to opening Avenues, he gathered $75 million in investments — $60 million to rehab the 100-year-old former warehouse into a school, which they have a 48-year lease on, and $15 million for pre-opening expenses, including teacher recruitment, curriculum design and more.
"Our policy is, and will continue to be, that we don't do capital campaigns," said Whittle. "We don't do annual funds, we don't do any fundraising for core programs or to increase faculty pay. All those things we do out of standard tuition and don't expect parents to do anything beyond that."
As a for-profit entity, they provide the capital for all of the school's needs. If they need new computers, they'll buy new computers. If they need a new gymnasium (they don't — their current gym is stunning), they'll buy a new gymnasium. This eliminates the constant browbeating of wealthier parents to support the school financially, and it takes out of the equation the ability for deep pockets to make up for student's shortcomings, as is sometimes the case at other schools.
"It completely levels the playing field," said Whittle. "We don't care if your parents are billionaires. Money is not a factor in how a family or student is treated. The only two areas we will let parents do fundraising in is to increase financial aid and scholarships, or to fund 'research and development' into new learning strategies that would be beyond what the school could typically cover," he said. "But the core thing here is that there is never going to be any arm-twisting of parents for extra money."
Spencer likes the optional fundraising, saying that scholarships could help Avenues with "the same problem that most private schools in New York suffer from: a lack of diversity. It will probably take a little while to resolve that."
The school currently has about 10 percent of students on financial aid, with an agreement reached with Community Board 4 to pro-rate the aid to children from Chelsea first.
When Chelsea Now first profiled Avenues: The World School, we asked Whittle if the school would churn out scholars to help populate Harvard University and other Ivy League Schools. Even then, he warned that those schools were prohibitively competitive, and not ideally suited for every student's needs. He maintains that Avenues is more concerned with graduating contributing citizens of the world, rather than a generation of future kingmakers. Avenues parents also seem to be okay with this.
"If you want your child to grow up with a worldview and international experience and language skills, then we're a terrific choice. If that's not important, there are schools that are better for you," said Whittle.
"That's a big part of Avenues going forward," said Whittle, referring to the school's global expansion student exchange plans. "Even before our campuses open in all the other cities, we want to offer all sorts of study abroad programs."
The Berneys look forward to the day when their children are old enough to take advantage of this exchange program, saying, "It would be great for them to have the opportunity to live with another family, to be there and use their language skills and still get an Avenues education, knowing that the style and programs will be consistent throughout Avenues schools around the world."
For now, they are just trying to get through the rest of the summer. When Lynn Berney arrived 45 minutes before dismissal on the last day of school, she could hardly believe what she saw. "Rather than being happy about the last day of school, they were all crying, hugging their teachers, giving them little gifts they made in art, and bawling. There has not been a single day in two years that our kids tried to get out of going to school. And I've heard this from other parents as well. This is truly what it is all about."
Spencer echoed these sentiments, saying that when the school started, its theories were very appealing to him — but over time, it was the connections that made the most impact.
"Willa got there and all of the teachers were warm and loving. The way they hugged her and lifted her up, how she was so excited to go to school every day — that was a pretty good combination to have," said Spencer. "We are not tiger moms and dads, not helicopter parents. To me, it's less about what's going to get her into Harvard or Goldman Sachs, but that's she's taking a real joy in learning, that she is really happy to be there."


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Design Description:
If youre PATTEN , then this shirt is for you! Whether you were born into it, or were lucky enough to marry in, show your strong PATTEN Pride by getting this limited edition Let PATTEN Handle It shirt today. Quantities are limited and will only be available for a few days, so reserve yours today.100% Designed, Shipped, and Printed in the U.S.A. NOT IN STORE
If you do not utterly love this design, you'll be able to SEARCH your favorite one by means of the use of search bar on the header.


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I am getting really really anxious about my upcoming trip. We are going to the Philippinesto visit Les' family. Don't get me wrong I am excited to meet his family & think it will be a great experience. But I am worried about the pregnancy. Of course I have talked to a doctor at work about the safety and he said it was fine,t hat it wouldn't increase my risks of anything happening. I still worry. And then of course I have been so sick. The flight is 20 hours which scares me too. I am pretty anxious when it comes to flying & now the worries of a blood clot & not to mention the vomitting....ugh it has been awful the last few days. I see the doctor before we leave so I will make sure I get a prescription for Diceltin. I am also going to make sure to get an ultrasound before we leave; partially because I want to hear the heartbeat for my own peace of mind and of course to make sure everything looks good before we leave! My other worry, of course is the food. Not that I have an appetite lately, or I have been eating much. I am so worried about the food that will be there. I have had food poisoning twice before, and was even hospitalized for it once. I will just be super cautious, bottled water only, no milk, no meats, just rice, fruits & veggies, oh & I plan on bringing, literally a suitcase full of healthy snack foods. I just have to try to relax about everything. I think an ultrasound will really help to ease my nerves!
I feel terrible most of the time. I told Les it like a constant & permanent hangover. I have a fuzzy headache, I"m exhausted, my body feels run down, my broken ribs KILL (from the vomiting) I have little appetite, when I do get hungry & manage to eat, I throw it up. As long as my baby is OK in there! All of our family is getting pretty excited about the baby. We went shopping yesterday & I bought some Christmas clothes & a blanket for baby. Of course it was all super cheap & on sale, so in the baby closet they go for next year!
Baby, mommy loves you so! Please grow big & strong in there! We can't wait till August when we get to meet you! We are so blessed to have you on the way!


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National Lilac Publishing, LLC is a business branch of Adams and Davis, LLC.
Starting with print children's books in 1989, the company currently publishes the following websites:
Micro Eco-Farming: The how-to hub for actual small eco-farming practices such as building alternative beehives or setting up a roadside stand. Also includes in-depth profiles of prospering micro eco-farms across the country.
Great Group Activities: For communities everywhere looking for how-tos, inspiration, or replicable ways people can come together for meaningful group activities.
Living in the Country (& Local Farm Living): New technology now allows a different demographic to move to rural locations and earn a living from a rural home in ways never available before. This site provides articles on community and family living for those who live in the country and/or operate local small farms -- or plan to.
Small Town Living: The demographic for small towns is changing as well. This site provides articles for those living in or hoping to move to a small town in America. Includes profiles of actual small towns.
Coming soon!
eBooks for fiction writers!
Our first release:
Build 100 Worlds: 100 fantasy fiction writing ideas, inspirations and story starters. (From enchanted lands to lost alternate histories to astounding future realms.)
by K.B. Adams
For permissions, contact via the form below starting your inquiry with "RE: NATIONAL LILAC"


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Can you name all these vintage starlets? I had to look twice as some of them have a different hair color or are just really young!
Ok, so here are the answers: Starting from the top is the very young Barbara Stanwyck, then we have a brunette Carole Lombard, next is Rita Hayworth in her teenage brunette days, and lastly is the young Lana Turner.


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The association of self-injurious behaviour and suicide attempts with recurrent idiopathic pain in adolescents: evidence from a population-based study
The association of self-injurious behaviour and suicide attempts with recurrent idiopathic pain in adolescents: evidence from a population-based study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.
Child and Adolescent Psychiatry and Mental Health
, 9:32
New insights in non-suicidal self-injury: a condition for further study study
BackgroundWhile several population-based studies report that pain is independently associated with higher rates of self-destructive behaviour suicidal ideation, suicide attempts, and self-injurious behaviour in adults, studies in adolescents are rare and limited to specific chronic pain conditions. The aim of this study was to investigate the link between self-reported idiopathic pain and the prevalence and frequency of self-injury SI and suicide attempts in adolescents.
MethodsData from a cross-sectional, school-based sample was derived to assess SI, suicide attempts, recurrent pain symptoms and various areas of emotional and behavioural problems via a self-report booklet including the Youth Self-Report YSR. Adolescents were assigned to two groups presence of pain vs. no pain for analysis. Data from 5,504 students of 116 schools in a region of South Western Germany was available. A series of unadjusted and adjusted multinomial logistic regression models were performed to address the association of pain, SI, and suicide attempts.
Results929 16.88% respondents reported recurrent pain in one of three areas of pain symptoms assessed general pain, headache, and abdominal pain. Adolescents who reported pain also reported greater psychopathological distress on all sub-scales of the YSR. The presence of pain was significantly associated with an increased risk ratio RR for SI 1–3 incidences in the past year: RR: 2.96; >3 incidences: RR: 6.04 and suicide attempts one attempt: RR: 3.63; multiple attempts: RR: 5.4 in unadjusted analysis. Similarly, increased RR was observed when adjusting for sociodemographic variables. While controlling for psychopathology attenuated this association, it remained significant RRs: 1.4–1.8. Sub-sequent sensitivity analysis revealed different RR by location and frequency of pain symptoms.
ConclusionsAdolescents with recurrent idiopathic pain are more likely to report previous incidents of SI and suicide attempts. This association is likely mediated by the presence of psychopathological distress as consequence of recurrent idiopathic pain. However, the observed variance in dependent variables is only partially explained by emotional and behavioural problems. Clinicians should be aware of these associations and interview adolescents with recurrent symptoms of pain for the presence of self-harm, past suicide attempts and current suicidal thoughts. Future studies addressing the neurobiology underpinnings of an increased likelihood for self-injurious behaviour and suicide attempts in adolescents with recurrent idiopathic pain are necessary.
KeywordsPain Adolescents Self-injury Suicide attempts Download fulltext PDF
Autor: Julian Koenig - Rieke Oelkers-Ax - Peter Parzer - Johann Haffner - Romuald Brunner - Franz Resch - Michael Kaess
Fuente: https://link.springer.com/


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My garden nestles in the heart of Southsea, a tiny patch of personal paradise, just a yard to other people's eyes I expect.
It doesn't boast a lush, green lawn, nor have any tall, majestic trees whispering their ancient tales in the breeze.
But my little garden is supporting our precious planet.
Your critical eye may be drawn to the rickety wooden shelving unit which stands under the jasmine bush. But to my more important visitors, the bees, this is an exclusive hotel with a driveway of lavender bushes, a roof garden full of nutritious thyme and easy access crocuses (to make light work for these little miracles) and only a short flying distance to the revered honeysuckle!
You may also find the ivy too wild and unkempt for your liking, but for my honey bees it is the place to be for their crucial, autumnal gathering of pollen and nectar.
And if you love the bees pop into Cumberland House Museum where they have a whole hive of bees that fly in and out through a hole in the wall.
Why not join us at southseagreenhouse.co.uk?


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SAN FRANCISCO (CBS.MW) -- Janus Capital Group jns Wednesday named fund industry veteran Girard Miller as chief operating officer, ending a lengthy search. The Denver-based mutual fund giant said its search for a chief investment officer continues, focusing on candidates who also can be the firm's president. Miller, 52, will oversee all of Janus Capital's day-to-day operations except investment management and institutional sales divisions. For the past decade Miller has been CEO of the ICMA Retirement Corporation, a Washington-based firm that manages retirement plans for state and local governments. Prior to that he was a senior vice president at Fidelity Investments in Boston. Janus Capital shares fell 22 cents, or 1.3 percent, to $16.84 on Wednesday.
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Hi girls
I was recently sent an email about a site called findabeautysalon which gives you a list of different beauty salons in your area of the US. They are currently running a giveaway to win a years worth of free salon and spa treatments which is amazing and if I was a US citizen I would definitely be entering because everyone loves a bit of pampering especially when its free. All you need to do is go to http://www.findabeautysalon.com/giveaway and enter your name and zip code. Its that easy so go try your luck and if you win please think of me whilst your being pampered. Whilst your on the site why not have a look at the salons nearest you or just click here.
Good luck girls


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If you're looking for "I Spys," dating or LTRs, this is your scene.View Profiles
Looks like the governor wants to bring his failed moral crusade into Vermont's living rooms - using cannabis around children? I'm assuming he's going to check up on that AFTER sending police with body armor and machine guns into our homes? That's the way the "war on marijuana" has been fought - it's not the cute cartoon figure at the top of this page.
What about using alcohol around children? I guess the gov. doesn't care so much about that. Alcohol, which is a primary driver of domestic violence and abuse. Thank God we here in Massachusetts have the referendum process and were able to vote the state and it's militarized police right out of our private homes.


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Our Story
El Sol Mexican Cafe' & Bakery was founded over 30 years ago by Daniel and Beatriz De La Cruz in Chandler, Arizona. Initially salsa was made in their kitchen and sold to friends and family.
El Sol Foods new manufacturing facility was built in 2005 by the granddaughter, Marisol and her husband Ryan Bullock, to keep up with consumer demands of there fresh salsa.
Ryan Bullock and his wife
Marisol opened the current
El Sol manufacturing facility.
Family owned & Operated
Today, we are still a family-owned and operated business that stays true to our roots. El Sol Fresh Salsas are hand crafted with fresh produce using a small batch, cold process that guarantees homemade fresh authentic Mexican flavors in every bite. Our Salsas can be found in the fresh service deli front counter, fresh deli wall or cooler case in most major retailers.
World Record Holder
Did you know that El Sol holds a Guinness world record?


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The Cruz Suede Boots by Antoine & Stanley feature a suede upper with an elastic gusset. Full leather lining along with a rubber sole. This casual suede Chelsea boot can be easily worn and has swag written all over it for this winter. - Suede upper - Leather lining - Rubber sole - 2.7cm heel height SKU: AN166SH60PRF
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This being the first day since I started this blog, which is chiefly aimed at tackling my occasional writer's blocks, I've decided not to leave it untouched. So here I am taking a break from finishing up a rough draft of the pages of the graphic novel that I intend to take to a meeting on the 19th. Rosh, my colorist, and the closest I have to a brother, just walked by muttering "I just realized that the only woman the Hulk can do it with is the Elastigirl"
My letterer/girlfriend/love of my life (definitely not in that order) seems to be in bit of a mess post an episode involving blood, guts, and mutilated body parts, the gory details of which you can read in her journal, if you have the stomach for such stuff. Which means I'm gonna have to do a rough version of the lettering as well; which in turn means, I've got my hands full for the next ten days. So I'm gonna have to put my short-story 'Jaque and Jill' on hold for a bit. Let me apologize to all of you who are eagerly waiting to read the rest
I have posted some of the doodles that were done during the sketching session a La Café coffee-day last night . Maybe sometime today, I will be posting a picture that Rosh took of the strange visitor (which, to my great disappointment, was later found to be, as wikipedia tells me, a lesser indian civet, and not a denizen of wonderland) that came out of a burrow in the neighborhood. Good day to you all!
Tuesday, 8 December 2009
Day 1
Posted by Kish at 00:37
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The Changeling
Gregor the Huntsman
Man of few words, knows the local woods
Int:2 Pre:-1 Com:-1 Str:1 Dex:1
Size: 0 Age: 26 Decrepitude:0 Confidence:0
Virtues & Flaws:
Keen Vision +1, Warrior +1, Sharp Ears +1, Mute -3
Basque: 5, Area Lore 2, Concentration 2, Athletics 2(15), Awareness 3, Brawl 1, Stealth 3, Survival 3, Craft (Bowery/Fletcher) 3, Craft (Leatherwork) 3, Hunt 4, Music (flute) 3, Ride 2,
Swim 1
Bows 4, Thrown Weapon(Knife) 3, Single Weapon (knife) 3,
Ash Hunting Bow, Hunting Knife
Patrice Theo found and met Gregor the Huntsman while scouting locations for the Covenant. Walking through the woods, Patrice heard the Gregor playing his flute and approached him. By his friendly, but silent demeanor, Patrice quickly deduced that Gregor was mute.
Gregor proudly scrawled out his name in the dirt and henceforth became know to the Covenant as Gregor the Huntsman.
Gregor has proven a boon in his knowledge of the local woods. Besides providing ample game for the Covenant, he serves as its main scout and guide.
Loyal since before the founding, Gregor is a trusted member of the Covenant despite no one knowing anything of his past. He seems content here. And with his literacy limited to the single word: Gregor, most seem content to let his past be the past.


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https://babyshower101.com/wp-content/uploads/2018/05/47-Messages-to-Write-in-a-Baby-Shower-Card.jpg 1280 1920 Lori Lab https://babyshower101.com/wp-content/uploads/2018/04/baby-shower-101.png Lori Lab2018-05-01 08:55:592018-10-12 01:12:0647 Messages to Write in a Baby Shower Card
47 Messages to Write in a Baby Shower Card
Messages to Write in a Baby Shower Card So, you got an invitation to a baby shower. You have gone through the registry, ordered the gift and it will be at your front door within a matter of days.You have mapped out the address, you know…
https://babyshower101.com/wp-content/uploads/2018/04/Sock-Monkey-Party-Supplies-Dinner-Plates-8.jpg 1500 1500 admin https://babyshower101.com/wp-content/uploads/2018/04/baby-shower-101.png admin2018-04-19 09:43:522018-04-19 12:30:34The Best Baby Shower Themes for Boys
The Best Baby Shower Themes for Boys
You may be wondering what the best baby shower themes for boys are, below you will find just that. So, your baby boy is almost here.
https://babyshower101.com/wp-content/uploads/2018/04/Baby-Shower-Devotional-Verses.jpg 408 612 admin https://babyshower101.com/wp-content/uploads/2018/04/baby-shower-101.png admin2018-04-15 00:43:032018-04-18 04:01:07The 17 Best Baby Shower Devotional Verses
The 17 Best Baby Shower Devotional Verses
From the time the announcement is made that a new baby is on the way, the new mom begins her journey toward motherhood. She spends time preparing, planning, and nurturing for the blessed bundle that's on the way.
https://babyshower101.com/wp-content/uploads/2018/04/invitations.jpg 1500 1500 admin https://babyshower101.com/wp-content/uploads/2018/04/baby-shower-101.png admin2018-04-11 12:56:422018-04-11 13:02:13Twin Baby Shower Ideas
Twin Baby Shower Ideas
What could be more joyous or life-changing than having a baby? How about having two babies? And while nothing could be more wonderful than having twins, that means you are going to need two of everything from double the diapers to double the car seats.
https://babyshower101.com/wp-content/uploads/2018/04/Dr-Seuss-Baby-Shower-Ideas.jpg 640 960 admin https://babyshower101.com/wp-content/uploads/2018/04/baby-shower-101.png admin2018-04-05 09:27:132018-04-11 11:56:55Dr Seuss Baby Shower Ideas
Dr Seuss Baby Shower Ideas
The Ultimate Dr. Seuss Baby Shower Ideas Want to make your baby shower into Seussville? For a fun and clever shower theme, the artwork and phrases from Dr. Seuss make for an excellent atmosphere. Colorful and tongue-in-cheek, Dr. Seuss parties…


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Guided tour and lunch buffet at Villa Tiepolo-Passi in Treviso
Duration: approx. 3 hours Location: Treviso
This tour was already booked by 6 people
Why choose this experience?
|To discover a splendid example of a Venetian Villa thanks to an exciting guided visit
|For the lunch buffet on offer, prepared using local produce and recipes selected from the long-established cuisine of Villa Tiepolo Passi
|To take a walk in the centuries-old park and enjoy the fascinating landscape of the surrounding countryside
A special event is awaiting you at Villa Tiepolo Passi Carbonera in Italy: guide and lunch buffet combined in a single enthralling half day!
After the guided tour of this magnificent example of post-Palladian Venetian Villa, built according to the style of a great representative of the 1500s, Vincenzo Scamozzi, you will enjoy a sumptuous lunch buffet prepared with locally-grown produce, homemade especially to delight the guests of the villa!
The guide will reveal to you the yesteryear atmosphere of Villa Tiepolo Passi from the very start of the visit: walking through the elegant inner halls finely decorated by artists of the seventeenth century and afterwards in the elegant gardens of the villa, you will experience the authentic charm of this noble manor house.
Your experience at Villa Tiepolo Passi in Treviso, Italy, with tour and brunch will start from the main part of the building, the manor house, built in Venetian baroque style: here you will be told the story of the powerful Tiepolo family, one of the founding families of the Venetian Republic, who built the villa between the 16th and 17th centuries.
The visit, starting from the ground floor, winds along the rooms and halls embellished with Sansovino-style ceilings and stuccos where you can admire a unique picture gallery by Frigimelica; it will then continue in the ballroom on the main floor, richly frescoed by Antonio Cerva Bolognese with mythological allegories set against fake architectures decorated with paintings in line with the seventeenth-century fashion.
The guided tour and lunch at Villa Tiepolo Passi in Treviso will continue to the outside into the grand Selese watched over by busts of the philosophers Democritus and Heraclitus that gaze at the sun rising and setting on 21st December, unmistakable symbolic references to the agricultural function of the villa. Afterwards, walking through a magnificent Italianate garden stretching out from the front of the building, you will admire a two kilometre long panoramic view. Leisurely walking among the neat square shapes of the box hedges you will admire the central stone fountain, fish pond and statues by Giovanni Torretto (Antonio Canova's maestro).
The tour will continue in the romantic English-style park that stretches over two hectares on the left and right sides of the Italianate garden, adorned with caves and mounds and more than 40 different species of centuries-old trees. You will then reach the family chapel. This small private chapel, dedicated to Our Lady of the Rosary, was decorated in the last quarter of the eighteenth century by Giambattista Canal (Canaletto's nephew) and was granted plenary indulgence by Pope Pius VI.
At the end of the guided visit in a few minutes you will then reach Tesa dei Tiepolo, a charming country house part of the villa's farmstead where you will have the opportunity to appreciate the refined hospitality of the owners who have rediscovered, with the local produce, the secrets of the rich food of the villa and have combined them with influences from across Europe and the old-time recipe books of the area. The menu includes freshly baked bread and focaccia, rich servings of raw and cooked season vegetables, delicious sorbets (the one made with the lemons of the lemonade is a delight), a selection of cakes, Venetian mixed fry, organic comfitures and the delicious quince bon bon.
Blending tradition and innovation, here is a sophisticated combination of sweet and savoury flavours from the chef of Villa Tiepolo Passi (the menu changes every week according to product seasonality and availability).
A selection of breads and focacce home made
seasonal cooked and raw vegetables
rustic pies
pasta and cereals
chef's fritolino
loin carpaccio or Treviso pork butt
cheeses from the Marca's diaries
selection of pastries and desserts including apple fritters, fruit tarts, chocolate or cream donuts
different flavours of fruit sorbets (lemon, figs, pears, watermelon)
lemon sorbet (prepared with lemons from the limonaia of the villa)
Still spring water at 13° ad lib, with mint or lemon
Additional dishes on request
coffee, tea
milk and pasture butter
homemade organic comfitures
biscuits and croissants
quince bon-bon
The hospitality offered by the Passi family, who acquired the villa in the mid-nineteenth century out of matrimonial inheritance and still live there today, is proof to a clear desire to safeguard a glorious past, reminiscent of a strong and fruitful bond with the surrounding areas.
This tour represents a unique opportunity to enjoy a guided tour and lunch at Villa Tiepolo Passi in Treviso! You will have the opportunity to discover a special place and enjoy a new, unique and original experience. The tour will take you back into a bygone world that is still alive and tangible, and the buffet lunch will seal your 'journey' through the rediscovery of ancestral flavours! Discover the history and traditions of our land in an elegant and culture-packed atmosphere.
Do not miss this opportunity to visit Villa Tiepolo Passi Carbonera in Treviso with brunch included! Book now this exclusive tour, followed by an authentic brunch prepared with local produce and traditional recipes... an unmissable experience in the world of the Venetian villas!
The guided tour and buffet lunch at Villa Tiepolo Passi in Treviso are waiting for you!
Important info
from 1 March to 30 November (From December to February on request and according to availability).Departure point:
Villa Tiepolo Passi in Carbonera, Treviso.
Departure time
11.00 am
Languages available
Full: €38.00
approx. 3 hours
Before booking, please be advised that it is compulsory to print a paper copy of the voucher issued at the end of the online reservation and bring it with you the day of the tour.
No credit or refunds will be given in the case of a NO SHOW (if you don't show up at the meeting point at the time indicated on your voucher).
This is a collective tour, which means there might be other participants going on the tour with you.
In exceptional cases and/or reasons of force majeure that may prevent the tour already purchased to run regularly (i.e. acts of nature, strikes, exceptional closures, serious unexpected events or health problems experienced by the person in charge with the service after which it is really impossible to find a substitute), the tour might be cancelled. The customer will be notified of this as soon as possible and will be asked to choose between postponing the tour on the first date available or receiving a prompt refund of the price paid for the tour, if the cancellation policy of the service itself allows a refund.
Departure point map
Check dates
Other tours
Castello di Roncade: tour and wine tasting
Duration: approx. 1 hour and 30 minutes
Location: Roncade
- Per person
- € 30.00
Excursion to Murano and Burano Islands with Fish Lunch
Duration: approx. 4 hours/4 hours and 30 minutes
Location: Venice
- Per person
- € 59.00
Food and wine private tour of the Prosecco Wine Road from Venice
Duration: approx. 8 hours
Location: Treviso
per service
starting from
- € 130.00


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House for sale in Osen, Silistra
Property situated in the village of Dobromirka, Sevlievo Municipality, Gabrovo Region. The village is located in North-Central Bulgaria at the foot of the Balkan Mountains, 20 km from the town of Sevlievo, 35 km from Veliko Tarnovo and 40 km from Gabrovo and the nearest ski resort.
The property is located at the outskirts of the village, between two parallel roads and at the same time it is on walking distance from the village's center. The property comprises of a well kept two-storied house, 2000 sq. m. of land (in rectangular shape), two farm buildings and a drive-in.
The house is in good condition and offers two rooms and a corridor on the first floor and another two rooms and a corridor on the second. Both floors are connected trough internal stairs. Internal bathrooms could be added on both floors.
Both farm buildings are suitable for conversion – one of them is two-storied, brick built, and the other – single storied made out of stones.
There is a water-well in the garden, the water from which could be used for watering the garden, filling up a swimming pool or as an alternative water supply for the house.
Water and electricity are connected to mains, Internet and Digital TV could be connected too.
The property is:
- 20 km from the town of Sevlievo;
- 20 km from the town of Pavlikeni;
- 32 km from Veliko Tarnovo;
- 35 km from the town of Gabrovo;
- 190 km from Sofia city - the Capital of Bulgaria.
|For renovation, Regulated Plot of land, Outbuildings, In hunting area, Rural Properties,
|Brick built


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This product is a 100w LED Multibay with a lumen output of 12,000. It can be used as an LED High bay for high ceilings, but it also has a compact design allowing it be used as an LED Low bay. Perfect for warehouses, car parks, factories, sports halls and also can be used in the food industry as the lense is made from polycarbonate instead of the standard glass lense. This Product is an LED alternative to a 150w Metal Halide fitting giving you a 33% wattage reduction. This product comes with a 120° beam angle but has interchangeable optional lenses to concentrate the light output down to 60° or 90°. The LED Multibay comes complete with a Meanwell 3 in 1 dimmable driver & Philips SMD 3030 Chips. This High bay has a hanging bolt eye on the back and comes complete with hanging chain for mounting. Also featured is a safety cable which helps with easy and reassuring installation. It comes complete with a 5 year warranty and average life of 50,000 hours. Energy Rating A* Dimensions: 300mm x 181mm Click here to see our Datasheet
Manufacturers Part No (where applicable) : 833921
This product is available for just £99.08
at Lamp Shop Online Ltd


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Brand Label: Sophie Blake
Available for Purchase Online at AHAlife for $145.00Pin It
The brilliant cuff is the just the right piece for adding a touch of edge to any outfit. The handmade brick chain detailing gives this piece an urban feel, especially when paired with boyfriend jeans and a tee. Its solid weight feels good on your wrist, yet it's casual enough to wear every day.
Shop other brand label items from Sophie Blake on FashionStylist.com.
This item was published for sale online by AHAlife on January 9, 2017 12:21 pm and last updated by us November 26, 2018 2:43 pm.
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- Case report
- Open Access
- Open Peer Review
Primary gastric actinomycosis: report of a case diagnosed in a gastroscopic biopsy
© Al-Obaidy et al.; licensee BioMed Central. 2015
- Received: 7 April 2014
- Accepted: 9 February 2015
- Published: 26 February 2015
Primary gastric actinomycosis is extremely rare, the appendix and ileocecal region being the most commonly involved sites in abdominopelvic actinomycosis. Herein, we report a case of primary gastric actinomycosis. The diagnosis was made on microscopic evaluation of gastroscopic biopsy specimens. To the best of our knowledge, this is the third case to be reported in the literature, in which the diagnosis was made in a gastroscopic biopsy rather than a resection specimen.
Case presentation
An 87-year-old Saudi male on medication for cardiomyopathy, premature ventricular contractions, renal impairment, hypertension, and dyslipidemia, presented to the emergency department with acute diffuse abdominal pain, abdominal distension, constipation and vomiting for two days, with no history of fever, abdominal surgery or trauma. The patient was admitted to the hospital with an impression of gastric outlet obstruction. Based on radiologic and gastroscopic findings, a non-infectious etiology was suspected, possibly adenocarcinoma or lymphoma. Gastroscopic biopsies showed an actively inflamed, focally ulcerated atrophic fundic mucosa along with fragments of a fibrinopurulent exudate containing brownish, iron negative pigment and abundant filamentous bacteria, morphologically consistent with Actinomyces.
Althuogh extremely rare, primary gastric actinomycosis should be considered in the differential diagnosis of radiologic and gastroscopic diffuse gastric wall thickening and submucosal tumor-like or infiltrative lesions, particularly in patients with history of abdominal surgery or trauma, or those receiving extensive medication. A high level of suspicion is required by the pathologist to achieve diagnosis in gastroscopic biopsies. Subtle changes such as the presence of a pigmented inflammatory exudate should alert the pathologist to perform appropriate special stains to reveal the causative organism.
- Actinomycosis
- Gastric
- Grocott's
- Gram
Actinomycosis is a chronic suppurative granulomatous inflammation caused by anaerobic, filamentous, Gram-positive bacteria of Actinomyces species, most often Actinomyces israelii. There are three main forms of actinomycosis, namely, cervicofacial (31%-65%), abdominopelvic (20%-36%) and thoracic (15%-30%) [1-4]. In abdominopelvic actinomycosis, the appendix and ileocecal region are the most commonly involved sites (65%) [2,3,5-7]. Primary gastric actinomycosis is extremely rare, with only 23 cases reported to date [5,6,8-20]. Herein, we report a case of primary gastric actinomycosis. The diagnosis was made on microscopic evaluation of gastroscopic biopsy specimens. To the best of our knowledge, this is the third case to be reported in the literature, in which the diagnosis was made in a gastroscopic biopsy rather than a resection specimen [6,8].
Case presentation
Clinical and laboratory findings
The patient was then managed conservatively in the hospital. A third gastroscopic biopsy two weeks later revealed chronic atrophic gastritis with no Actinomyces detected, and the patient appeared in a good health status. A plan was set up to start him on the appropriate antibiotic therapy for actinomycosis with follow up gastroscopy after one month. However, the patient chose to continue treatment somewhere else. So he was discharged on his request and never showed up again in our institution.
Actinomycosis in human is most commonly caused by Actinomyces israelii [1,3,21-26] which is an endogenous commensal present in the oral and GI-tract flora [9,10,12,22,27]. Actinomycetes typically invade injured mucosa with opportunistic infection occuring if there is a break in the mucosal barrier. Factors that precipitate intra-abdominal actinomycosis include GI surgery, inflammation, and visceral perforation [28,29]. However, in most cases of gastric actinomycosis, it has been impossible to trace the mechanism by which Actinomyces had reached the gastric wall [30]. Our patient had no past history of abdominal surgery or trauma. However, he was on prolonged medication for non-ischemic cardiomyopathy, premature ventricular contractions, renal impairment, hypertension, and dyslipidemia. Such extensive medication may have caused physical or functional gastric mucosal damage that facilitated entry of the organisms into the gastric wall. Numerous drugs, acting through various mechanisms, have been associated with gastric mucosal damage [31]. Age related mucosal atrophy may have also contributed to diminished mucosal resistance.
The rarity of gastric involvement by actinomycosis has been attributed to the high lumenal acidity of the stomach. As a result of the low gastric pH, the organisms may be killed or growth is inhibited [9].
The usual presenting clinical manifestations of gastric actinomycosis are low-grade fever, epigastric pain, weight loss, and upper GI bleeding [1,3,10,12,20]. One patient developed symptoms of gastric outlet obstruction [19]. The duration of symptoms ranged from two weeks to several years [3,8,9,11,19]. Our patient presented with acute diffuse abdominal pain, abdominal distension, constipation and vomiting for two days duration, with no history of fever. The clinical impression was that of gastric outlet obstruction.
There is no specific radiological or endoscopic appearance for gastric actinomycosis. CT findings have mostly demonstrated an infiltrative lesion with diffuse gastric wall thickening. The appearance suggested adenocarcinoma or lymphoma of the stomach [2,20,32]. In our case, contrast CT-scan showed a significantly distended stomach with thickened wall and abnormal configuration. Similar to radiologic studies, the endoscopic findings of the disease may simulate a gastric neoplasm and include submucosal tumor-like or infiltrative lesions and, occasionally, mucosal ulceration [13]. A non-infectious etiology was initially suspected in our patient based on radiologic and endoscopic findings, possibly adenocarcinoma or lymphoma, and the gastric outlet obstruction subsequently interpreted as functional due to absence of peristaltic movement consequent to infiltration of the gastric wall by actinomycosis. An associated paralytic ileus due to acute pancreatitis may be an alternative explanation for the obstruction as suggested by elevated serum lipase and amylase levels. Such obstruction may have also contributed to the gastric localization of the actinomycosis, so that the clinical manifestations may be a consequence of acute pancreatitis with secondary gastric overinfection by Actinomyces, facilitated by the mucosal damage.
Because of the submucosal localization of the inflammatory process, gastroscopic biopsy specimens usually reveal nonspecific inflammatory changes [3,14,18,19]. In most cases, the diagnosis was made after surgery and histopathological examination of the resected specimen [9,12,19,20,22]. Only two cases have been reported in which the diagnosis of gastric actinomycosis was made on microscopic evaluation of a gastroscopic biopsy specimen [6,8]. In our case, the diagnosis was, likewise, established through histologic examination of gastroscopic biopsies in which abundant PAS, Grocott's, and Gram positive rod-like and filamentous bacteria, morphologically consistent with Actinomyces were identified. The presence of a brownish, iron negative pigment in the fibrinopurulent inflammatory exudate (that was also visible endoscopically) alerted us to the possibility of actinomycosis which was established by appropriate special staining that revealed the microorganisms. It is well known that the main sources of natural pigments are plants and microorganisms, including Actinomycets [33].
Culturing is negative in most cases of gastric actinomycosis (>76%) [19,24,25]. In our case, culturing yielded only Streptococcus viridans, another endogenous aerobic/anaerobic facultative commensal present in the oral and GI-tract flora [34]. Despite the negative culture, the typical morphology of the organisms in tissue sections confirmed by positive Grocott, PAS and Gram staining was considered sufficient for the diagnosis of Actinomyces infection with no necessity for culture confirmation.
Most anaerobic bacteria recovered from clinical infections are found mixed with other anaerobic organisms [35]. Polymicrobial infections are known to be more pathogenic for experimental animals than are those involving single organisms [35]. Whether Streptococcus viridans, known to be an organism of low virulence, had contributed to the gastritis in our case remains unclear.
Primary gastric actinomycosis is an indolent infection. If the disease is recognized, the prognosis is good because antibiotic treatment, particularly penecillin is very effective [4,19]. Our patient received 2 doses of IV levofloxacin and 3 doses of IV metronidazole and appeared in a good health status, two weeks after diagnosis.
Althuogh extremely rare, primary gastric actinomycosis should be considered in the differential diagnosis of radiologic and gastroscopic diffuse gastric wall thickening and submucosal tumor-like or infiltrative lesions, particularly in patients with history of abdominal surgery or trauma or those receiving extensive medication. A high level of suspicion is required by the pathologist to achieve diagnosis in gastroscopic biopsies. Subtle changes such as the presence of a pigmented inflammatory exudate should alert the pathologist to perform appropriate special stains to reveal the causative organism.
Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.
The authors acknowledge Dr Amani Al Nemer, Assistant Professor, Microbiology Department, University of Dammam for reviewing the results of H & E and special staining of micro-organisms in tissue sections. The authors also acknowledge the services of Mr Shakir Ahmed and Mrs Maria Rosario Lazaro from the histopathology laboratory of the University of Dammam, Saudi Arabia for conducting the histology technical work.
Authors' Affiliations
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The strong views of a county councillor on drivers in Aylesbury is featured in this week's round-up of the Herald letters page.
We have been very frustrated at the attitude of motorists ignoring the signage covering the pedestrianisation aspect of the town centre.
Until we put 'road closed signs' at the Upper Street to support the removable bollards, taxi drivers were seen manoeuvring between them.
So unless a police officer is on hand, what are we supposed to do apart from taking the licence plate number and reporting it to AVDC.
I, among many others, have taken licence numbers of the taxi drivers who are the biggest culprits of this abuse.
They have been spoken to by AVDC; it works for a while but then goes back to normal.
The police, when they are in town, speak to all motorists that choose to ignore the signage but they have other priorities other than spending all day in town.
I have been to many towns who have similar arrangements to ours but they do not have the same problem of motorists' ignorance.
Many of these towns do not have any barriers at all, people just respect the signage.
This problem seems unique to our town.
Our plan is to pedestrianise the whole of the town centre; that will stop all but essential vehicles using the town as a cut through and will add to the safety that we have achieved with what we have done to date
May I suggest that anyone who sees a taxi abusing the pedestrianised area should take the licence plate number and report it to AVDC Licencing Department.
Ordinary motorists are causing a civil offence that only the police can take action on.
Councillor Brian Roberts
Bucks County Council
I must take issue with Mr Oliver regarding the woes of Aylesbury's traffic problems as far as Tring Road are concerned (Bucks Herald, April 29, 2015)
I can understand his frustration and commend him on his constant struggle in emphasising the importance of the need for major and urgent road alterations for the town rather than just allowing roads to be built through new housing developments (a good example being the link road between Oxford Road and Bicester Road) only to build houses on what could have been part of a dedicated bypass for the town, the traffic now causing much frustration to people living there. The majority of the HGVs using Tring Road, which represents approx 10 per cent of all vehicles using the road, are not all delivering goods or stopping in Aylesbury!
Most are passing through the town and using the A41 from Watford M25 to Bicester and Oxford to the M40 and A34 as a rat run to and from all points north, south, east and west of our town.
One good example being the numbers of 3663 vehicles using Tring Road throughout the day, suggesting that the majority are travelling to points in south east from Banbury where they have a large distribution depot.
Although Arla are based here close to the town, their vehicles I would suggest do not deliver directly in to our local shops; their main delivery points are for their milk containers delivering into the processing plant at Aston Clinton and once processed the finished product is then delivered countrywide to central depots of the mainly major supermarket chains around the whole of the UK.
That having been said, Tring Road has approximately 760 Arla traffic movements per day passing the front doors of residents living there, approximately one every two minutes, 24 hours per day 365 days of the year.
The only respite that one can see at the moment locally is that of the new road between Berryfields and Buckingham Road; but no doubt that will once again be converted to accommodate residential housing?But back to Tring Road; yes it was announced some five or six years ago to be an area of very high pollution around the Oakfield Road and King Edward Avenue area that should have been addressed urgently within one year.
The only thing that has been done is for the goal posts to be moved by moving the monitoring equipment half way between the above and Parton Road – if wrong please accept my mis-information in advance. The advent of traffic lights at that junction will only have exacerbated that situation I assume.
It is now time for our planners to really find a way of overcoming this situation rather than putting the main road through yet another residential development, only to end once again passing through the town's very centre.
Answers please from the planners?
This new road would not alleviate the problem as far as Tring Road is concerned unless a weight limit of 7.5 tonnes was introduced for vehicles of above limit.
Dennis Thomas
Tring Road, Aylesbury
With reference to Councillor Mark Winn's letter in last week's Bucks Herald, I would reply as follows:
As a Bedgrove councillor he should know better than to refer to Bedgrove Park as a park.
It is not a park in the conventional sense of the word but covenanted public open space that was given "for the benefit of the whole and every part of the Bedgrove Farm Estate" and I would add that this open space land was not conveyed as a sports ground.
Councillor Winn expounds on the parking overflow that is taking place around Bedgrove Park at the weekends, when football is played by adults and children and, as a result, he wants to expand the car park in front of the Bedgrove Pavilion.
What he fails to understand is that, under the Open Spaces Act 1906, you cannot cover more than 20 percent of this open space and with the Pavilion Road, car park, Bedgrove Pavilion, former tennis court (now used for football practice at the rear of the pavilion), caretaker's house and garden, children's play area, MUGA, kickwall, football pitches, etc, the district council is currently contravening this statute.
The problem is not the lack of parking but the number of football matches that are being played simultaneously and this is because of bad management and organisation by whoever is responsible for the bookings. When six football matches are taking place at the same time, plus the use of other facilities, of course, this will generate extra traffic and can easily be avoided by better planning and not by contravening the Open Spaces Act.
What Mark Winn does not appear to understand is that this covenanted open space was given for the Bedgrove Farm Estate residents, of every age, "to walk over and enjoy, without let or hindrance."
This is stated in a letter from Mr Robert Janes, who was the managing director of H C Janes Limited, and whose family donated this open space land. A copy of this letter is in the possession of the legal division at the AVDC.
I am not alone in thinking that the district council is not only contravening the Open Spaces Act but is also not upholding the letter and spirit of the conveyance of this covenanted public open space, to which they are signatories in title.
In addition, Mark Winn wants to enlarge the car park and install five mini pitches.
Where does he think people are going to walk and, in good weather, sit down with their family and/or friends to have a picnic?
This open space land is for people of all ages to walk over and enjoy and not just for children and teenagers.
Name and address supplied
I write in response to the article dated April 22, 2015, Bucks Herald, Mr Lee Seagrove, Achilles Tendon.
The story of my right Achilles Tendon took five months to diagnose.
On May 30, 2014, I suffered a sharp onset of pain in the right lower leg and had to buy a walking stick to get home. June 5 and 9 I attended appointments with the GP.
By July 13 I was still in great pain and presented myself to A&E Stoke Mandeville, where I had X-rays. There was no fracture and no comment was made about my Achilles.
On July 22 I went back to the GP. I asked for an appointment to see physiotherapist and on September 9 a physiotherapist diagnosed a complete rupture of the Achilles tendon within minutes of seeing me, using the simple "Simpson Test".
In October I was referred to Nuffield Orthopaedic Centre, where it was confirmed the injury was a ruptured Achilles tendon. I was advised as the injury had been left so long an operation was not a sensible undertaking.
Through using a walking stick to alleviate the pain of the right leg it has caused problems with my left leg.
I now have to wear orthotics in both shoes and no high heels.
So if you see me plodding along with a floppy foot, you know why.
Barbara Bateman
Address supplied
I would like through the Bucks Herald to thank those who came to my assistance when I fell opposite the Waterside Theatre in Aylesbury on April 30. A group of kind people helped me by calling an ambulance, borrowing a chair for me to sit down, producing from nowhere a glass of water and a bottle of water to take with me and helping me mop up a large amount of blood.
A kind lady also telephoned my husband so he was able to come to collect me.
All the help was much appreciated; I was probably too dazed to do more than stumble out my thanks.
When the ambulance arrived, which it did very quickly, the paramedics too were helpful, cheerful and reassuring and I thank all three of them .
Judith Power
Address supplied
I have read your article regarding Berryfields school being too small for those in the estate resulting in them not getting a school place.
Interesting reading.
Did you also know that children living in Buckingham Park also did not get in to their local school because the school is not big enough either!
How can companies build these schools and houses and not use commonsense to build them in relation to one another and the needs of the community.
Lucky for my son, he was allocated a school which we are happy with.
However one reason we bought on Bucks Park was because of the school.
He attends the nursery and has made good friends, as many of them have, but now they are getting separated because the school is too small.
Other families have not been so lucky; schools they are not happy with and different to siblings.
Just thought I'd inform you of the same issue with Bucks Park CoE school.
Name and address supplied
As Ramadan approaches, Muslims who have diabetes may be thinking about fasting and from this year the religious observance in the UK will become increasingly longer during the summer months.
These prolonged fasting periods could exceed 17 hours which can be dangerous or cause health problems, particularly for people who manage their diabetes with insulin and certain medications as they may be at risk of dehydration and extreme high and low blood glucose levels.
This can potentially mean experiencing symptoms which can include feeling shaky and blurred vision.
So people with diabetes who make the choice to fast during this period should eat food that is absorbed relatively slowly – such as basmati rice, pitta bread, chapattis and dhal – before they begin the fast.
These types of foods and fruits and vegetables can help keep blood glucose levels more even during the fast.
It's important to check blood glucose levels more frequently than usual so that people can, if necessary, break the fast if their blood glucose level drops too low.
Many Muslims think that testing blood is considered breaking the fast, but this is not the case.
It's also a good idea to break the fast with a handful of dates and a glass of milk or water and to choose healthier options such as vegetables and fruit. They should also try to eat these kinds of foods again towards the end of the feasting period, just before sunrise, and they should drink plenty of sugar free fluids to avoid dehydration.
Muslims with diabetes who are deciding whether to fast during Ramadan should speak to their Imam and healthcare professional or call the Diabetes UK Careline on 0845 120 2960.
This will help them get the information they need to make the decision that is right for them.
Sylvia Lambe
Diabetes UK
We are writing to pass on our thanks for the wonderful efforts of staff at our local Co-op store who raised cash for our charity by dressing up in Easter costumes.
Workers at the supermarket in Wedgewood Street recently raised £125 for Headway Aylesbury Vale by wearing Easter bunny outfits, donning Easter ears and asking for donations. They also held a stall in aid of us.
We are thrilled that the staff and customers thought to do this for us and are very grateful for their generosity.
Headway, which supports survivors of acquired brain injury (ABI), only moved last year to purpose-built premises in Fairford Leys, so it's wonderful to see that our new neighbours are already backing us so enthusiastically.
There are some 1,500 survivors of ABI in the Aylesbury Vale alone so this type of fundraising is vital if we are going to give them the help they need.
Anyone else who wants to know more about supporting Headway should contact me on 01296 415469 or email: email@example.com
Karen Styles
Manager, Headway Aylesbury Vale


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MMMMM----- Recipe via Meal-Master (tm) v8.04 Title: Tomato, Caper, Olive, And Blue Cheese Salad Categories: Polkadot, Epona, Salads, Vegetables, Cheese/eggs Yield: 2 Servings 6 lg Tomatoes, sliced 2 tb Balsamic vinegar 5 tb Olive oil 1/3 c Halved pitted Kalamata -olives (I used the plain -old Green olives) 1/3 c Crumbled blue cheese 2 tb Drained capers Fresh basil leaves Arrange tomato sliceds on large platter. Drizzle with vinegar, then oil. Sprinkle very lightly with salt and generously with pepper. Sprinkle with olives, blue cheese and capers. Garnish with basil leaves. Serves 6 as a side dish, or 2-3 as main course I tried this recipe last night (it's from the August issue of Bon Appetit), and loved it, even tho' I normally don't like fresh tomatoes.... * The Polka Dot Palace BBS 1-201-822-3627 Posted by EPONA on 07-15-95 MMMMM
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