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JAG: I'm promoting a show in Edinburgh on Thursday... (desperate-last-ditch-promo-attempt-centric)
Sorry about this...
Lineup is:
Loch Awe (http://soundcloud.com/we-the-plural/i-will-drift-into-10-000)
Adam Stafford (http://wisebloodindustries.bandcamp.com)
Reverieme (http://reverieme.bandcamp.com/album/melodies)
It's at Sneaky Pete's, doors open at 7pm and it should be really good fun. Tickets are £5 on the door or £3.50 (+bf) from here http://www.wegottickets.com/event/133681.
It also happens to be my birthday, so...

subset: commoncrawl


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Inflation Group Says U.S. Cities Will Be Like Egypt in Four Years
The National Inflation Association has issued a chilling new advisory in which it warns that the inflationary time bomb being created by the policies of the Federal Reserve will lead to American cities experiencing similar chaos currently unfolding in Egypt by 2015.
Egyptian dictator Hosni Mubarak has been in power for three decades and in that time has managed to handle all manner of threats to the stability of his regime. But it was the huge unrest sparked by soaring food prices that finally led the Egyptian people to launch a revolution which is likely to see Mubarak forced out of office for good.
"Food inflation in Egypt has reached 20% and citizens in the nation already spend about 40% of their monthly expenditures on food. Americans for decades have been Read more…


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2018 Chevrolet Traverse FWD 4dr LS w/1LS
V6 Cylinder Engine
City 18/Hwy 27 Estimated By E.P.A. - Actual Mileage May Vary
Dealership Information
Drive Away Autos
5715 North Fwy
Houston, TX 77076
Visit Drive Away Autos online at driveawayautos.com to see more pictures of this vehicle or call us at 713-691-3600 today to schedule your test drive.
- Air bags, frontal and side-impact for driver and front passenger, driver inboard seat-mounted side-impact and head curtain side-impact for all rows in outboard seating positions (Always use safety belts and the correct child restraints. Children are safer when properly secured in a rear seat in the appropriate child restraint. See the Owner's Manual for more information.)
- Alternator, 170 amps
- Daytime Running Lamps, LED
- Defogger, rear-window electric
- Door handles, body-color
- Door locks, rear child security
- Engine control, stop-start system
- Floor covering, color-keyed carpeting
- Front wheel drive
- Glass, deep-tinted
- Headlamps, high intensity discharge
- Horn, dual-note
- LATCH system (Lower Anchors and Top tethers for CHildren), for child safety seats
- Liftgate, rear manual
- Mirror, inside rearview manual day/night
- Rear Seat Reminder
- Rear Vision Camera
- StabiliTrak, stability control system with traction control
- Steering wheel, urethane
- Suspension, Ride and Handling
- Teen Driver mode a configurable feature that lets you activate customizable vehicle settings associated with a key fob, to encourage safe driving behavior. It can limit certain vehicle features, and it prevents certain safety systems from being turned off. An in-vehicle report gives you information on your teen's driving habits and helps you to continue to coach your new driver
- Tool kit, road emergency
- Wiper, rear intermittent with washer
- Wipers, front intermittent with washers
- Engine, 3.6L V6, SIDI, VVT (310 hp [232.0 kW] @ 6800 rpm, 266 lb-ft of torque [361 N-m] @ 2800 rpm)
- E10 Fuel capable
- Traction Mode Select
- Axle, 3.49 final drive ratio
- Battery, heavy-duty 600 cold-cranking amps
- GVWR, 6160 lbs. (2800 kg)
- Brakes, 4-wheel antilock, 4-wheel disc, 17" front and rear
- Wheel, spare, 18" (45.7 cm) steel
- Tire, compact spare, T135/70R18, blackwall
- Active aero shutters, upper and lower
- Moldings, Black bodyside
- Moldings, rocker, Black
- Mirror caps, Black painted
- Mirrors, outside heated power-adjustable, Black, manual-folding
- Seating, 8-passenger (2-3-3 seating configuration)
- Console, front center with 2 cup holders, covered storage bin with storage and removable tray
- Steering column, tilt
- Display, 3.5" driver instrument information, monochromatic
- Compass display, digital
- Windows, power, with driver and front passenger Express-Down
- Air conditioning, tri-zone automatic climate control with individual climate settings for driver, right front passenger and rear seat occupants
- Sensor, humidity and windshield temperature
- Umbrella holders, driver and front passenger doors
- Visors, driver and passenger illuminated vanity mirrors, covered
- Lighting, interior with theater dimming, cargo compartment, reading lights for front seats, second row reading lamps integrated into dome light, door-and tailgate activated switches and illuminated entry and exit feature
- Cup holders, 10 total
- Chevrolet Connected Access with 10 years of standard connectivity which enables services such as, Vehicle Diagnostics, Dealer Maintenance Notification, Chevrolet Smart Driver, Marketplace and more EFFECTIVE WITH SALES STARTING 5/1/2018 (Limitations apply. Not transferable. Standard connectivity available to original purchaser for ten years from the date of initial vehicle purchase for model year 2018 or newer Chevrolet vehicles. See onstar.com for details and further plan limitations. Connected Access does not include emergency or security services. Availability and additional services enabled by Connected Access are subject to change.)
- Passenger Sensing System sensor indicator inflatable restraint, front passenger/child/presence detector (Always use safety belts and


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After making its presence felt in the southern market with Hyderabad and western market with Ahmedabad, the bandwagon of Global Panorama Showcase has now moved to North India with the fourth edition of GPS Chandigarh. With a reinvented format, the organisers have concised the plan of the show from three days to two days. Harmandeep Singh Anand, Co-Founder & Managing Director, GPS, said that the same format will be followed in other GPS cities like Kolkata and Kochi, while the format followed in Ahmedabad will continue in Pune, keeping in mind the better understanding of markets in different cities. "With four new EDWIN programs this year, travel agents in Chandigarh have a chance to experience all four different destinations and learn more knowledge about them. Our core motto with EDWIN programs has always been to empower and educate the travel trade so that they can grow their business manifold. GPS will keep working hard to provide best networking opportunities to all the attendees," Anand said further.
Day 1 of the show started with GPS app workshop and announcement of EDWIN for year 2019, in destinations like Tanzania, Zanzibar and Ladakh. EDWIN on Jalesh Cruise is also in line, apart from Europe tour on coach by Red Tours and Europe tour by rail by Amigo Travels, in plans this year. Day 1 comprised product presentations and knowledge sessions by exhibitors throughout the day, followed by the welcome dinner in the evening. Day 2 of the show is totally dedicated to B2B meetings throughout the day, followed by gala dinner. GPS is hosting over 150 buyers from different places around Chandigarh for the show.


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Complete Story
Three Tips for Facilitating Virtual Meetings
Virtual meetings have become indispensable for many associations
Thanks to a wide range of technology tools, virtual meetings are now a reality for many associations. Communication barriers that once prevented people from interacting or collaborating online in real time are a thing of the past, and virtual meetings that bring together remote staff, member volunteers, and vendors have become routine.
But virtual meetings are different from the face-to-face variety in many ways. For online collaboration to succeed, participants need to communicate differently than they would if everyone were gathered in the same room together. Here are three tips to help you facilitate effective and productive virtual meetings.
Remember the Personal Touch
One of the biggest challenges of an online meeting is that you can't read attendees' body language when they're connected virtually. But this doesn't mean that virtual meetings should feel less inclusive or personal.
Please select this link to read the complete article from ASAE.


text: Hermès Hermes Vintage The Piano Black porosus crocodile Audrey Hepburn 60s €4,990.00 What a style and elegance... I love this Hermès piano bag, the structure, the shape, the quality. A real treasure !!! Black porosus crocodile leather, Gold Hardware finishing. Calf leather lining, Original mirror Marked: Hermès Paris Size: 22 x 14 x 5 cm - 8 2/3 x 5 1/2 x 2 in. Condition: Excellent condition (see pictures), no damage, very very slight wear at metal. International shipping with Cites and expert certificate.


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This thing is 1300 dollars cheaper than the Model 3 in Mexico, which means Chevrolet is selling an econo-box, FWD, lame as fuck electric car for almost the same price as a cool, RWD, luxurious Model 3.
Yes, it has a bit more range, but it must be fucking impossible to move these when the MSRP is 42,000 dollars! Also known as 1.2 Stinger GTs.
We don't get a Federal Tax credit for EVs or hybrids here, but that didn't stop Chevrolet from adding a ridiculous mark-up to the Bolt from the very begining. Above the 40k price levels, no one is pinching pennies, and I really think that the arrival of the model 3 here, along the very competitive pricing will prove to be a problem for the Bolt, and the 3er hybrid, and the A4.
I sat in a Model 3 Long Range today and it feels every bit as solid as any mid size luxury sedan. Originally I didn't care for it since I expected Tesla to sell them for a lot more here than in the US, but I was proven wrong...
The MSRP is comparable to an 2.0 Audi A4 TFSI, cheaper than the BMW 330e, and the C300. Key difference is that the Audi and the Merc would be stuck paying a very high roadtax and require emissions inspections every six months. The Tesla doesn't pay or need either.


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nedelja, 06. februar 2011
Would you like a cup of milk?
I'm happy to show you my latest felted earings. I needle felted two tiny cups full of milk and added white buttons for plates and also two pink buttons for good luck. They are available in my etsy shop in my felted jewelry section.
Avtor vesna ob nedelja, februar 06, 2011
Oznake: cherrytime, etsy, felted jewelry
7 komentarjev:
Naročite se na: Objavi komentarje (Atom)


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Scrooby Community Cinema
22 March 2020
At 8.00 pm (Doors open 7.30pm), Scrooby Village Hall
Convinced of his irresistible appeal to women, Texas dishwasher Joe Buck (Jon Voight) quits his job and heads for New York City, thinking he'll latch on to some rich dowager. New York, however, is not as hospitable as he imagined, and Joe soon finds himself living in an abandoned building with a Dickensian layabout named Enrico "Ratso" Rizzo (Dustin Hoffman). The two form a rough alliance, and together they kick-start Joe's hustling career just as Ratso's health begins to deteriorate.
- Director: John Schlesinger
- Screenplay: Waldo Salt
- Starring: Dustin Hoffman, Jon Voight, Sylvia Miles
- Winner of 3 Academy Awards and many others.
- Running Time: 113 minutes
- Certificate: X (18)
- Tickets: £4.00 per person on the door
- Licenced Bar
16 February 2020SCROOBY COMMUNITY CINEMA is proud to present on SUNDAY FEBRUARY 16th 2020 OUR DOUBLE BILL to be shown on our new 3.5m screen in Blu-Ray 4K Ultra-HD quality (availability permitting)
At 4.30pm
Hunt for the Wilderpeople(Doors open 4.00pm) Blu-Ray HD
Bella and Hector, two reclusive country folk, become foster parents to Ricky, a problem child from the city. After some adjustment, things go reasonably well. However, the death of Bella means Hector now has to look after Ricky, and they didn't get along too well. Moreover, her death causes Child Services to decide to send Ricky back to the orphanage. Ricky refuses to go back and runs away, ultimately sparking a national manhunt for him and Hector.
- Director: Taika Waititi
- Starring: Sam Neill, Julian Dennison, Rima Te Wiata,
- Running Time: 101 minutes approx.
- Certificate: 12A
At 6.30pm a meal will be served (Must be pre-booked)
At 7.30pm
The Greatest Showman(Doors re-open at 7.15pm) Blu-Ray 4K Ultra-HD
Orphaned, penniless but ambitious and with a mind crammed with imagination and fresh ideas, the American Phineas Taylor Barnum will always be remembered as the man with the gift to effortlessly blur the line between reality and fiction. Thirsty for innovation and hungry for success, the son of a tailor will manage to open a wax museum but will soon shift focus to the unique and peculiar, introducing extraordinary, never-seen-before live acts on the circus stage. Some will call Barnum's wide collection of oddities, a freak show; however, when the obsessed showman gambles everything on the opera singer Jenny Lind to appeal to a high-brow audience, he will somehow lose sight of the most important aspect of his life: his family. Will Barnum risk it all to be accepted?
- Director: Michael Gracey
- Starring: Hugh Jackman, Michelle Williams, Zac Efron
- Certificate: PG
As part of our support of the Renovation/modernisation of the Village Hall we are asking for a voluntary donation of £2.00 per person at this event. This will be added to funds by putting it in the on line "Gofundme" website.
The Licenced Bar will be open throughout
- £4 per person for each film
- £4 per person for the meal
- £10 per person for both films and the meal
- £7 per person for one film and the meal
Please let us know in good time if you would like to join us for the meal so we can ensure an adequate quantity. A vegetarian option will be available, if required.
We look forward to seeing you there.
Stephen Lincoln email@example.com
19 January 2020
2020 at SCROOBY COMMUNITY CINEMA starts on SUNDAY JANUARY 19th with
At 8.00 pm, (Doors open 7.30pm) Scrooby Village Hall
Set in 1962 America and winner of the Academy Award for Best Picture, Green Book is inspired by the heart-warming true story of working class Italian-American bouncer Tony (Tony Lip) Vallelonga (Academy award nominee Viggo Mortensen) who accepts a job as chauffeur for world-class African-American classical pianist Dr Don Shirley (two time Academy award winner Mahershala Ali). The mismatched pair, armed with the Negro Motorist Green Book - a guide for safe travel through America's racial segregation - embark on a two month tour in the racially charged Deep South. At first the snobbishly erudite pianist and the crudely practical bouncer can barely get along with their clashing attitudes to life and ideals. However, as the disparate pair witness and endure America's appalling injustices on the road, they find mutual respect for each other's talents and start to face them together. In doing so, they nurture a friendship and understanding that changes both their lives.
- Director: Peter Farrelly
- Written by: Nick Vallelonga, Nick Currie and Peter Farrelly
- Music: Kris Bowers
- Starring: Viggo Mortensen, Mahershala Ali, Linda Cardellini, Sebastian Maniscalco...
- Winner of 3 Academy Awrds and several others.
- Running Time: 130 minutes
- Certificate: 12
- Tickets: £4.00 per person on the door
- Licenced Bar
For more information:
e-mail: email@example.com or
call: 01302 719506
We look forward to seeing you.
Spring 2020
- January 19 Green Book
- February 16 Double Bill: Hunt for the Wilderpeople & The Greatest Showman
- March 22 Midnight Cowboy
- April 19 Rocketman
- May 17 The Good Liar
Email List
Scrooby Community Cinema Email List
We email further details of each film close to the date of screening. If you would like to be on the email list, please let us know below:
About Scrooby Cinema
Scrooby Community Cinema holds irregular seasons of film showings in Scrooby Village Hall. The screenings take place on Sunday evening at 8pm.
Since starting in March 2011 we have shown over 80 films with an average attendance of 17 people per show.
Scrooby Community Cinema is open to all, subject to film certification, as we are not a film club. Entrance is £4 per person, on the door; we aim to keep this charge as low as possible, hoping to make each event self supporting. The entrance fee goes towards the cost of the public film licence (currently £83.00 + VAT per showing) we are required to purchase. The fees are supplemented by our own licenced bar where a small selection of alcoholic and non-alcoholic drinks are available.
Films tend to be mainstream and English-language. The audience is asked for film suggestions at each screening. If you have a favorite film, or one you think would be popular, you can suggest a film on this page.
The projection and sound equipment was donated by the Parish Council and Village Show. We have a Bluray projector and Dolby 5.1 Surround Sound system.
Scrooby Community Cinema shows films in Scrooby Village Hall. Doors 7:30, start 8:00, £4 on the door, licensed bar. For more details, contact Stephen Lincoln (07341 386 050), Graham Robbins (07720 509 683) or James Arrowsmith (07818 450 741). Email us at email@example.com. Suggest a film and find more information, including audience feedback, at www.scrooby.net/cinema.
The local STAR newspaper is now available at the-star.org.uk.
New site maintained by Scrooby's Bill Arrowsmith.


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Fontainebleau Miami Beach to Showcase Gloria Gaynor, The Spinners
Hotel & Resort September 16, 2013
Fontainebleau Miami Beach unveiled BleauLive Legends Night, which will be held on Dec. 14 with Disco Queen Gloria Gaynor and The Spinners (Could It Be). In addition to the concert, the evening includes a cocktail hour and buffet dinner. Travelers can buy a Legends Night package that includes accommodations, two passes to the show and the open-bar cocktail hour. The BleauLive Legends Night is part of Fontainebleau's BleauLive series, which in the past has tapped such performers as Lady Gaga, Katy Perry, Tiesto, Icona Pop, Cruella, Pittbull, Pharrell and Robin Thicke.
For more information on Miami
For more Hotel & Resort News
You may use your Facebook account to add a comment, subject to Facebook's Terms of Service and Privacy Policy. Your Facebook information, including your name, photo & any other personal data you make public on Facebook will appear with your comment, and may be used on TravelPulse.com. Click here to learn more.LOAD FACEBOOK COMMENTS


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Society though, often doesn't make enough space for promoting the culture of reading. At least not as much as I think they could be.
SEE ALSO: Pregnant Woman Of Age 18 Dies After Being Hit By Car
The onus is often up to readers to spread the word, promote good books, review them on platforms that cover books and enthusiastically spread the book joy by word of mouth
With power, influence and tremendous clout to their name, many celebrities are not only embracing their love of reading, but they're using their platform to encourages readers and non-readers alike to pick up a book and read.
And we probably have Oprah Winfrey to thank for that. I consider her the true pioneer of the television-turned-online book club society.
And many authors could probably thank her for their bestselling status, because if Oprah recommends that people read your novel, then people are going to listen.
Admittedly many of the books she recommends aren't within my genre preference, but that's the joy of the expanding empire that's become celebrity book clubs.
There's something that will appeal to everyone. And even if it doesn't, the one thing I can say is that celebrities bring something to the table that we don't get in our own book club groups – opportunities to see them interview authors.
The amazing thing about Oprah's book club is that she not only recommends books, but she also includes reading guides for her picks, powerful quotes and has a complete and detailed list of book club picks on her backlist.
And as I've said, for me, even though I don't always read a specific genre, I enjoy finding out more information about the book and the reasons for it being on someone's list.
Other celebrities who've all followed the book club trend include Emma Watson, Florence Welch (of Florence and the Machine Fame), Reese Witherspoon, Emma Roberts and Sarah Jessica Parker to mention but a few.
SEE ALSO: Former NSFAS CEO Steven Zwane: Debunk Being Fired
Each of these celebrities offer something very different. I confess that I've joined Emma Watson's book club since her books focus on contemporary, feminist and social issues.
Her book club also hosts regular interviews as well as book giveaways, so if you're a member of Goodreads.com, just search for the group Our Shared Shelf and click join.
Reese Witherspoon's mix of contemporary and popular fiction has also made for increasing popularity with users. Her Instagram is a collection of beautifully curated feeds from both herself and fellow bookstagrammers.
Each celebrity book club really depends on what you're looking for in books. I confess I'd love to see some local celebrities running book clubs that feature South African reads. Nomzamo Mbatha, Khanyi Dhlomo, DJ Zinhle?
We're looking at you.
Have you joined a celebrity book club? What books have you discovered because a celebrity recommended them? We'd love to hear from you.
Author spotlight: Tomi Adeyemi – Children of Blood and Bone
Speaking of book club picks, we were recently granted the fantastic opportunity to interview the author of one of Jimmy Fallon's book club picks, Tomi Adeyemi.
The Nigerian-American author has written a phenomenal fantasy novel that has become a contender for my top five reads of 2018 and it's one that has seen her book being dubbed as the Black Panther of fiction novels.
SEE ALSO: Rival Rallies As Erdogan Opens Mega Mosque In Cologne
In our interview, she talks to us about what inspired the book, why it was intentional to write a book that was a story of pain and empowerment and how never having seen herself represented in books played a huge role in her novel and in creating her cast of characters.


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This recipe goes together in only a few minutes. It does however require almost an hour baking time.
1 lb extra-lean ground beef
1 can (14.5-oz) tomatoes, do not drain
1 pkg (6-oz) stuffing mix for chicken
1 egg
2 green onions, finely chopped
1/2 cup shredded Italian cheese blend
Preheat oven to 375 degrees.
Mix the tomatoes and stuffing mix until combined; reserve half for later.
Add the ground beef and egg to the stuffing mix that remains; mix together well. Press mixture onto the bottom of an 8-inch square baking dish.
Combine the reserved stuffing mixture with the onions and spread over the meat mixture. Cover pan with foil.
Bake at 375 degrees for 45 minutes; sprinkle the cheese over the top, /Continue baking, uncovered, for 10 minutes or until the meatloaf is cooked through.
This is a recipe I got from Kraft Foods last year.


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Information For Online Trainings
National Institutes of Nursing Research
This online course provides general research training for nurse scientists who are in the early stages of their career development.
Behavioral and Social Sciences Research Interactive Textbook
An interactive, online course developed by the New England Research Institute on research methods and tools for researchers engaging in BSS research on health-related topics.
Evidenced Based Behavioral Practice
The EBBP Project website contains links to many resources about evidence-based practice. In addition, the project has launched seven online learning modules


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By: Jalaksana Winangoen
[UNIKNYA.COM]: Joking may be the basic instinct of Pasundan people. Take a look at the figure of Kabayan who is quietly unadorned but humorist. Well, talking about humorist, we have a number of top comedians from our homeland in which some of them are from Bandung. Indeed, Bandung people are popular with their sense of humor. Here are 5 young comedians from BandungCity.
1. Sule
Entis Sutisna or well-known as Sule (born in Bandung, West Java, 15th of November 1976) is a comedian starting his career from a comedy group named SOS, a resulting group member of a comedy audition in a television program. Sule has been getting more popular by the show of Opera Van Java from the channel Trans7. His career has skyrocketed by the show Awas Ada Sule in Global TV starred by an ex-national volley player, Hikmal Abrar. In addition to comedian, this alumnus of a university STSI Bandung is well-known as a singer and a player for some Sunda musical instruments.
2. Joe "Padhyangan Project"
His real name is Juhana Sutisna (born in Bandung, 6th of May 1967). He is an actor, comedian, and television presenter. He every played in a film titled Wakil Rakyat (People Representatives) in 2009. He has been widely known by a comedian group named Project P. He is also well-known as a presenter of television shows.
3. Iszur Muchtar
Iszur Muchtar (born in Bandung, 22nd of March 1966) is a comedian, an actor, and a songwriter. He was initially widely known by P Project whose the recording album was released by Musica Studio in 1993 with hits songs "Nasib anak Kost", "Antrilah di Loket", and "Kop dan Headen". Then, he got more popular with his talent in presenting television shows. Iszur Muchtar and his group Padhyangan Project or P Project also performed in some television shows such as "Project P" in SCTV 1993, "Project Show" in SCTV, "Keluarga Cilaki" in SCTV and "New Project P" in B Channel/TVN. In acting world, Iszur Muchtar played in many cinemas, from comedy cinemas "Lobi-Lobi" in RCTI, "Copet Cepot Kepepet" in Multivision, to drama cinemas like "Hamba hamba Allah" in Sinemart-RCTI and acing as Mr. Usman for the cinema "Yasmin" in Sinemart-RCTI. Lastly, Iszur Muchtar starred at "Putri Yang Ditukar" in Sinemart-RCTI (2010). In addition, Iszur Muchtar played roles in many FTV or Film TV such as "Mama untuk Lola" (ANTV-Rapi Film), "Sekolah Lagi Nih Ye", "Cinta Hokkie" in Multivision, etc.
He played in a big movie "Kejar Jakarta" in 2005 with his colleagues of P Project and costarred Wulan Guritno. Besides, he also appeared in a semi-animated film "Rizky Anak Ajaib" in 2008 and this year (2010) he played in a film whose script is adapted from a novel and directed by the author of the book Habbiburrahman el Shirazy entitled "Di dalam Mihrab Cinta" and starred by Dude Herlino and Asmirandah.
4. Sogi Indra Dhuaja
Sogi Indra Dhuaja (born in Bandung, West Java, 7th of September 1978) is a well-known comedian from the show Extravaganza in TransTV. Before taking a part in Extravaganza, it was Sogi's voice that had been well-recognized. Informed, he had been a broadcaster of Radio OZ for 7 years. Moving from the radio, Sogi tried to look for office work experience. In some occasions, he was a program assistant in MTV. Once he felt bored with his work, he was called by Ronal (another member of Extravaganza) and he was invited to follow an audition. Acting is not a new thing for him, since he ever joined in a cabaret when he was a high school student in State School 5 (SMAN 5).
Outside the routinely shooting activity or outside entertainment world, this young man with typical birthmark on his nose is active in social activities, including the campaign of Worldwide Anti-Poverty Day held in United Nations' Information Centre (UNIC). This man who was dropped out from Majority Development Economics of Padjadjaran University with some Extravaganze members, i.e. Tike Priatnakusumah, Virnie Ismail, and Ronal Surapradja hilariously helped performance of Art and Culture Performance of the Disabilities held in Jakarta at 26th of May 2007.
5. Fitri Tropica
Fitri Tropica (born in Bandung, 26th of September 1987; 23 tahun years-old of age) is an actress, model, broadcaster, and television presenter. She started her career as a model and broadcaster, then comedian in situational comedy shows, Extravaganza ABG and Prime Time.
Sources: many sources, old.uniknya.com, August 2011


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In a recent post, I wrote about the importance of using mobile devices for capturing and transferring knowledge. Employees are more successful when they have easy-to-use apps at their fingertips—apps that make it simple to find facts, capture data, and share information. When employees are successful, their employers are successful, which explains why there's an upsurge in the investment that companies are making in mobile technology.
In the asset management industry, external wholesalers are one of the largest groups using mobile technology. For everyone, but perhaps especially for those who spend time out of the office, time is money and knowledge is power. The conversations that externals have with advisors can be very detailed. Being able to recall those details is crucial, not only to the external, but also to their internal wholesaler and their firm. Externals are constantly on the go, and utilizing mobile devices and apps to capture those details and make the most of their time is essential to success.
At SalesPage, we like to ask questions, learn from the answers, and craft outstanding solutions. Mobile accessibility is necessary in today's business world—but what exactly are the current mobile trends in the asset management industry? In your firm, which user groups (in addition to or apart from external wholesalers) currently benefit from mobility? What's your firm's mobile strategy?
We thought the best way to find out would be to ask you—financial services professionals—directly; after all, you and your peers are the experts!
We put together a mobile survey to discover how external wholesalers and other user groups (internal wholesalers, sales, operations, and marketing) use mobile devices and mobile apps. If you work in—or with—any of these user groups, we'd appreciate 5 minutes of your time. (Yes, I did mention that 'time is money and knowledge is power' – and yes, here I am, asking for some of your time. Here's the payoff: you give us 5 minutes of your time, and we'll share what we learn with you, AND we'll enter you in a drawing to win an iPad mini 3! With your input, our mobile apps will be stronger and more useful than ever before; having the best apps at your fingertips can have a direct impact on your bottom line.)
So, please take just 5 minutes now—or before September 18, 2015—to complete our short survey.
We'll share what we learn with you. You'll be able to see how your mobile strategy stacks up against that of your peers; the results may provide you with new ideas to weave into your mobile strategy.
While you're waiting to see the survey results, I'd be happy to show you how SalesPage clients are able to access important information when they use our mobile tools. Give me a shout!


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Laser Facial Hair Removal Cost, Prices and Facts | Happel Laser
Are You Bewitched, Bothered and Bewildered on How to Deal with Your Facial Hair?
Laser hair removal for unwanted hair on the face for both women and men could not be easier.
The best part is that your hair is permanently reduced.
Plucking, waxing or shaving is annoying.
It never ends.
Laser facial hair removal cost is very affordable when you compare it to all of the alternatives.
This article will break down and compare those costs for you.
Aren't you ready something that is more permanent?
Laser is the quickest long-term way to get rid of facial hair. It requires a series of treatments.
Usually the session only lasts a few minutes. You are in and out.
That is a big advantage when you compare laser to electrolysis. However, if your hair is blond or light, electrolysis is pretty much the only way to go for long-term hair removal.
What is Our Laser Facial Hair Removal Cost?
At our laser center, the laser cost to remove hair on the lip is $150 per treatment.
For ladies, the laser cost of removing hair on the full face is $175.
For men, hair removal of the full face is $200.
A series of treatments is necessary for long-term lasting laser hair removal. At our medical facility, you pay only for what you need.
It is expensive and unnecessary to buy an expensive package.
Packages are strongly pushed by the chains and at med spas.
Packages make them more money.
You pay lots more.
The truth is that only buying treatments when you need them is more economical.
Buying a series of nine treatments with a legally binding contract is much more expensive.
Compare your cost per treatment.
You will come out ahead financially if you pay for exactly what you need.
No wasted treatments.
We strongly recommend that you only have your laser facial hair removed at a medical facility.
As the popularity of laser treatments has grown, some places have pushed the safety boundaries.
Having your facial hair removed at our truly medical facility as opposed to a med spa, is not only safer and more effective, but it will result in you saving money.
That just follows like mushrooms after a rain.
Do not Make Rookie Mistakes When Choosing a Laser Hair Facility
Cost is the number one question and concern that people have when considering laser hair removal.
Often the experience of an office is never even considered.
However, a laser operator's experience should be one of the most important considerations in deciding where to have your facial hair removed permanently.
Have you ever considered that the worst time to get sick in the hospital is in July?
That's when all of the new inexperienced interns and residents start their medical rotations.
Because these inexperienced interns make more mistakes, you suffer. It is true!
Experience counts a lot in the medical field.
The laser is a medical device that should be operated in a hospital or a doctor's office. Otherwise, you are playing Russian roulette.
Our laser hair removal experience is the longest in the city.
Facts About Laser Hair Removal on Your Face
Time for some cool facts about laser hair removal for facial hair.
Fact #1 Everyone wants to know what it feels like. It feels like tiny zaps.
Our laser shoots a cool jet spray of Cryogen with each laser pulse.
Although some centers recommend taking an over the counter pain reliever, it is not necessary for 98% of our patients. Some places also give a numbing cream.
With the Cryogen cooling jet spray, that is almost never necessary either.
Fact#2 People want to know if it's permanent.
Laser hair removal will permanently reduce the amount of hair on your face.
Since hair grows in cycles, you need to repeat the treatments until the hair is permanently reduced.
As the treatments progress, the remaining hair will become finer. That is villus hair like the hair on newborn babies.
Fact #3 We tell people on their initial free consultation how well we think it will work for your face.
The laser light works best on dark hair and light skin.
Since the laser doesn't have a brain, engineers program the laser like they program a computer to target certain things.
It targets dark colors the best. That's why you cannot tan before you come for laser hair removal.
Fact #4 For laser hair removal on the face, it usually takes 4-6 treatments to get best results. Maintenance is required for most people but some never have to return.
Everyone is different in that regard.
We are all like snowflakes – unique and created specially.
Laser Hair Removal Cost and Prices Compared to Other Hair Removal Methods
Waxing runs about $50 for a full face.
However, the hair grows right back.
For the cost of four waxing treatments, you can have the same full-face laser treatment.
That cost permanently reduces the hair on your face by 10-20%. In the end, you will save money by having laser hair removal. If you just have hair on your lip, it costs even less.
How does the cost of facial laser hair removal compare to electrolysis?
Lip hair electrolysis usually runs about $150 to $300 but can go as high as $1000 if the hair is coarse. It takes 10 to 30 minutes.
If you have blond, gray or light red hair, electrolysis is definitely the best option for you.
Plucking and tweezing is free!
Unless you have just a couple of hairs, that's not practical for most people.
A big negative of plucking or tweezing, besides the pain, is the fact that it never ends.
Most people want a more permanent solution that lasts.
Laser hair removal is trending because it is fast and it works.
Laser facial hair removal cost is very affordable for most people.
As a physician, I think it is irresponsible to offer cookie cutter packages for laser hair removal.
If you are unhappy with the results or the service, you are stuck. If they go out of business, you are stuck paying for treatments that you never receive.
Not everyone needs the same number of treatments.
That will affect your total cost.
Since everyone's needs are different, it behooves you to get an estimate of price and what results you can expect. Go to an experienced physician's office and pay less.
Besides the safety of having it done in a doctor's office, it will cost less than a chain or med spa where your laser facial hair cost will be more. That's because those kinds of places push expensive packages.
You will end up paying a higher price for your laser hair removal at places where there is expensive advertising, marketing people and closers hard selling laser hair removal.
Tired of the unending waxing, plucking or tweezing of your face?
Ready to give it a try?
A hair free face at a fair price that you can afford will be your reward if you call us at 724-969-0600 or contact us here.


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Summer 2020
In academic research, it's important to be able to distinguish between different types of sources. These differences often are contextual, meaning that a single source might fit in different categories depending on how you are using it and in what academic discipline you are writing.
Primary sources are the raw materials of scholarship.
Secondary sources report on or interpret primary sources.
Tertiary sources synthesize and present overviews of primary and secondary sources.
Scholarly sources present sophisticated, researched arguments using both primary and secondary sources and are written by experts.
Popular sources aim to inform or entertain and are intended for a general, non-specialized audience. In academic writing, popular sources most often are analyzed as primary sources.
Need a quick review? Take the online tutorial, which includes a self-assessment quiz at the end.


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We have identified our first spotted wing drosophila (SWD) of 2014 in western Kentucky. It was present in a trap maintained by Patty Lucas in the Purchase Area of the state. The timing of this capture is very close to the date of our first report last year. A trap had one female on June 12, and those same traps had 5 females the following week (Figure 1). Based on our experience in 2013, SWD captures are likely to spread across the Commonwealth over the next 2 to 4 weeks and intensify as the season progresses.
Producers of susceptible crops (raspberries, blackberries, blueberries, and grapes) that still have crops in the field should put out spotted wing drosophila traps, if they haven't already done so.
Traps and Bait
We use 1-quart deli containers with a pair of 1 ½ -inch by 3-inch windows cut in the sides. We hot-glue ¼-inch plastic screen over these windows to keep out larger flies (Figure 2). The bait is a mixture of baker's yeast, sugar, water, and dishwashing soap. To make enough bait for two traps, mix ½ tablespoon yeast with 1 tablespoon sugar, 1 cup water, and one drop of dishwashing soap. Check the traps weekly, pour the contents into another container for identification, and refill the traps with fresh bait. To clean the samples, pour the contents through a reusable coffee filter and rinsing with water to clear out the yeast.
Interpreting Trap Findings
If you don't find SWD, you do not need to spray insecticides during the harvest period. If you do find SWD, then you need to begin a concerted SWD management program. It may mean spraying during the harvest period, so producers need to carefully observe all pesticide label instructions including Pre-Harvest Intervals. Sprays for SWD need to provide excellent coverage, so pressure and spray volume need to be sufficient for coverage throughout the canopy. Reapply sprays on a weekly basis, as well as after a significant rain. Check Entfact 230 (listed in the resources, below) for a list of SWD recommended insecticides and their respective pre-harvest intervals.
Other Management Tactics
It is important to use other SWD management tactics besides only relying on sprays.
Producers not wanting to use insecticides may use fine mesh netting. The netting needs to have a mesh size fine enough to prevent SWD females from passing through, so pore sizes of less than 0.98 mm are needed. The netting needs to be sealed around the base and in place before fruit begin to ripen.
Clean Harvest
Clean harvest is also a key management tool. For clean harvest, pickers use two containers when picking, one for marketable fruit and the other for all other ripe fruit. Removing the unmarketable fruit from the field reduces the buildup of SWD. Unmarketable fruit should be placed in clear bags, sealed, and left in the sun. Burying SWD-infested fruit is ineffective as this insect has been shown to emerge from the soil.
Post-Harvest Care
Post-harvest care of berries is another important management tool. As soon as berries have been harvested, they need to be refrigerated. This suspends the development of SWD by delaying egg hatch, growth, and feeding by larvae (Figure 3). Temperatures as close to but above freezing are best. Freezing berries will kill all immature stages.
More Information
See our factsheets for a description of biology, identification, and SWD management:
- Spotted Wing Drosophila, Biology, Identification and Monitoring http://www2.ca.uky.edu/entomology/entfacts/entfactpdf/ef229.pdf
- Spotted Wing Drosophila Management (discusses trapping, identification, and management) http://www2.ca.uky.edu/entomology/entfacts/ef230.asp
- Spotted Wing Drosophila and Backyard Small Fruit Production http://www2.ca.uky.edu/entomology/entfacts/entfactpdf/ef231.pdf
By Ric Bessin, Extension Entomologist


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With all of the head-shaking talk about nationalizing some of the largest financial banks -- like turning Bank of America into a literal bank of America -- is it outlandish to suggest that Sirius XM Radio
Of course it is. When did your inner capitalist shrivel up and die, kid?
However, there are a few compelling reasons for the government to keep Sirius XM alive at all costs, even if it means going the nationalization route. In the ultimate irony of all, the very reasons for nationalization are core capitalistic competencies.
Just don't tell Howard Stern that he may be taking orders from Uncle Sam, OK?
Billions at stake
There are two huge advantages to nationalizing Sirius XM: the company's tax-loss carryforwards and the significance of satellite radio to the ailing automotive industry. Billions rest in the balance of either reason.
I discussed the satellite radio operator's massive tax-loss carryforwards last month, though only to the extent that billions in accumulated losses will result in billions of tax-free profits in a cheerily optimistic view of the company's future.
The Wall Street Journal over the weekend posed a more near-term solution, suggesting that Liberty Media
More than $2 billion in extra pocket change would sound great to companies like Liberty Media and EchoStar -- and an even better deal to the truly profitable media giants like Comcast
Conspiracy theorists, start your engines.
The other hefty reason that the government should wager on a healthy Sirius XM is that it has already dished out billions to salvage the automotive industry. General Motors
What does Sirius XM have to do with Detroit? Everything. At a time of waning demand and margin contraction, satellite radio represents an add-on accessory that delivers a predictable revenue stream to the carmakers. Both Sirius and XM have brokered deals with the automobile manufacturers, rewarding them financially for delivering subscribers. Most of the nearly 19 million activated receivers are factory-installed systems.
Sirius XM can't save the automakers on its own, but it's clearly part of the solution at a time when everything else appears to be part of the problem.
In other words, a $3 billion to $4 billion bet on nationalizing Sirius XM -- and that is with its creditors made whole but its common shareholders wiped out -- would result in avoiding a better than $2 billion hit in tax revenue if Sirius XM is tactfully acquired, and it would protect the $17 billion investment -- going on $39 billion bet -- keeping domestic automakers alive.
Sounds feasible? Fuhgeddaboudit. It's never going to happen.
The nationalization reality
Sirius XM's model may have its flaws. The programming costs are high. The satellite upkeep is steep. However, it's preposterous to believe that Sirius XM will be nationalized just because it's having a challenging time in turning the free cash flow corner.
Why suggest nationalization then? Well, somebody is going to bring it up given the troubled banking chatter. I may as well do it first so I can soberly shoot it down.
Sirius XM isn't going away. Even if Liberty didn't emerge with its last-minute capital infusion last week, Chapter 11 bankruptcy reorganization would only destroy the common stock investors. Sirius and XM services will live on, though likely under new leadership.
There are way too many media companies -- from satellite television operators to terrestrial radio networks -- that would bid on Sirius XM's assets before letting the licenses be squandered.
So breathe easy, capitalism. Take a load off, Stern. Sirius XM isn't going away. It may eventually wind up as an appendage to Liberty Media, but never on the arm of Lady Liberty.
Some other Sirius stories:


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ST. PAUL, Minn. (AP) — A federal appeals court Friday upheld the 2009 conviction and 50-year prison sentence of Minnesota businessman Tom Petters, who was found guilty of orchestrating a $3.7 billion Ponzi scheme.
The Eighth U.S. Circuit Court of Appeals ruled that Petters got a fair trial.
A three-judge panel rejected defense claims that the U.S. District Judge Richard Kyle prevented his attorneys from presenting a complete defense by restricting their ability to question a key prosecution witness, Larry Reynolds, a convicted felon and disbarred lawyer who was in the witness protection program, about his links to organized crime.
The panel also said the judge acted properly when he rejected proposed jury instructions that would have highlighted Petters' claims that he was an unwitting participant in a fraud conceived by others, and that he acted in good faith on advice from his attorney.
It ruled that the judge did not err by denying a change in venue due to the extensive media coverage the case generated. The panel also rejected defense claims of procedural errors in Petters' sentencing.
A jury found Petters guilty of 20 counts of wire fraud, mail fraud, money laundering and conspiracy.
According to testimony and documents presented at trial, Petters Co. Inc. used fake purchase orders and phony bank records to dupe investors into financing what they were told would be purchases of electronics such as big-screen televisions that PCI would resell to discount retailers such as Sam's Club and Costco. In reality, the prosecution contended, the merchandise never existed and the sales never took place.
Petters testified that he thought PCI, an arm of his now defunct Petters Group Worldwide, was conducting real deals involving real merchandise.
Now 54, Petters is serving his sentence in the federal prison in Leavenworth, Kan.
(© Copyright 2011 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)
Money isn't everything. Too bad for Petters that he learned that lesson too late.
Poor Petters, all because of some dumb woman blowing the whistle on him, now he has to do 50 years.
Yeah, it wasn't Petters fault at all….what a dumb thing to say…By the way, what are you? ten years old….what kind of man goes by Billy????
What kind of person calls themself 'deep thinker and never thinks deep?
always blow the junk and never the whistle
just sayin'
He can rot in hell, next year he will pull another trick to get out early, it's all a game for these thoughtless people…scam-scam-scam……all for me and F for you…….
Yeah, good behavior, prison crowding and influence will get him out of parole way before 50 years. I bet he's out in ten or less.
He best watch his back too – rumors abound they cut a deal with Amy Senser to patrol the prison courtyard with a suv …. think they figure she'll save us taxpayers a buck or two.
Then again – the booze she's a drinkin' may make up for any potential savings….
I vote we instead toss her in with Petters and let 'em have at at it
I like your thinking. Where can you get tickets?
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Revell, James (Jim) T
Jim is the Chief Executive Officer of the Insurance Company of Prince Edward Island (ICPEI). In 1993 he joined the board of directors of ICPEI and in 1996 joined the company where he assumed increasing responsibilities as vice president and general counsel to the firm and subsequently added the role of vice president of operations in 2002. Jim also oversees the operations of Echelon Insurance in the Maritimes.
A graduate of the University of P.E.I. (1982) and Dalhousie University Law School (1985), prior to joining ICPEI Jim practiced law and was a partner in a Charlottetown law firm. In addition Jim has a number of private company interests outside of P.E.I. in real estate and transportation.
He has served in local organizations such as Four Neighborhoods Community Medical Centre, and Parkdale Sherwood HeadStart as well as a number of sports and charitable organizations.
Jim was a director on the Health PEI Board for 8 years until March 2018 where he served on the Audit, Nomination and Executive committees of the Board. He was appointed as Health PEI Board Trustee in June 2018 and subsequently appointed as Health PEI Board Chair in October 2018. Jim's family has a long association with health care as his grandmother, Mary, was a long time Head Nurse at Hillsborough Hospital and his father, Joe Revell, was Chair of the Charlottetown Hospital Board of Directors and Vice Chair of the Queen Elizabeth Hospital Board of Directors.
A member of the P.E.I. Law Society and Canadian Bar Association, he resides in West Covehead with his wife Margaret.


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For one of the commission pieces I was asked to design a Harry Potter cover image for a podcast which fortunately I do have some experience in already.
Though I have to say I struggled stepping into the Harry Potter universe and capturing them (mainly him) the way I felt I wanted to.
Commission pieces are still available though there is a bit of a wait right now (if you are keen on getting one I would still lock it in now so you secure your spot in the line LOL).
Remember if you dig my stuff and wouldn't mind seeing semi-daily journal entries which include sneak peeks, behind the scenes and first looks then head over to Patreon and subscribe for as little as $1 (US) a month.


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- You are here:
- Home
- ››
- Too late to turn a blind eye
Too late to turn a blind eye
Too late to turn a blind eye
Stillness sweeps through the forest,
A silence from all inhabitants,
All life quietens to a whisper,
A quiet crackle grows,
Turn a blind eye.
The unchaining of a free spirit,
An entity with no limits,
Never knowing the boundaries of destruction,
The massacre of the green giants,
Turn a blind eye.
The anniversary of loss,
Magnificent beings defeated,
No remains besides the thick blanket of ash,
A barren stretch of land,
Too late to turn a blind eye.
Raesharwn Anyidoho
Raesharwn Anyidoho
About this poem
Every year, Poetry on Loan runs a poetry competition, free to enter, for people who live, work or study in the West Midlands. This year our theme was Anniversary.
Raesharwn Anyidoho has never entered the competition before. He says:
Thank you so much for choosing my poem for it means a lot.
I was born in Madeley (a small town in Telford) which has a rich heritage and history. To me, this lends itself to creative writing which has allowed me to find a fascination with writing about the natural world. I have always been fascinated with poetry and creative writing, due to the fact that a few words can transport you to another 'dimension'. My aspirations for the future are to become a forensic pathologist or a linguist because of how much of a passion I have for French, Arabic and science, yet I will still carry on writing. I thoroughly enjoy learning and I believe that everyone should be entitled to an education, for "the pen is mightier than the sword". I like to write poetry because it can send a message to everyone. One of my favourite poets is Benjamin Zephaniah. In my spare time, I thoroughly enjoy baking and cooking because, similar to poetry, it allows me to create something for others.


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More than a garden centre and less than one hours drive away from Loch Lomond, Dobbies Garden Centres plc are the second largest garden centre chain in the UK, and the Glasgow branch in Milngavie has everything under one roof for that perfect gardener's day out.
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Consider patient perception of pain when planning cataract procedures
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Cataract surgery is thought to be painless for most patients, but for the few who report discomfort during surgery, ophthalmologists can take precautions to limit pain.
Most surgeons believe only 10% of patients report pain during cataract surgery; however, studies have shown that the rate is significantly higher, with the majority of patients, if asked, experiencing some level of pain during the procedure, according to a recent 30-patient study performed by OSN Cataract Surgery Section Editor John A. Hovanesian, MD, FACS.
In a 2015 study published in Journal of Ophthalmology, researchers found that 35% of patients in a 106-patient cohort undergoing first-eye cataract surgery reported intraoperative pain. In a 2014 study published in Pain Research and Treatment, Apil and colleagues wrote that the type of cataract can affect a patient's perception of pain. Even with topical anesthetic eye drops, cataract surgery is not a completely painless procedure. The study reported most patients with dense cataracts are more likely to experience severe or unbearable levels of pain during surgery.
"Pain is a perceptive thing and very individual," Hovanesian said. "We will probably never completely eliminate it, but we should take all steps to minimize it. In a patient's mind, and I'll attribute this to Eric Donnenfeld, MD, pain is considered by the patient to be a complication of surgery. We surgeons don't view it that way; we view it as a sometimes necessary by-product of doing an operation. In a 2015 survey study done by MDbackline, we asked patients what they fear most before surgery, and they reported that they fear pain more than they fear going blind."
Preoperative precautions
Patients have an outsized fear when it comes to their eyes, so it is important for surgeons to limit pain as much as possible during all facets of cataract surgery. Surgeons need to be conscious of every step of the procedure and what is being done to the patient, including the first application of dilating drops, Hovanesian said.
Dilating drops may hurt, so the use of proparacaine first can lessen pain and help the drops penetrate better and more quickly, he said.
"In the beginning of a surgery, if you cause pain in a patient who is wide awake, that patient will be on high alert for further pain," Hovanesian said. "That's what you want to avoid. I learned that tip from Lisa Arbisser, MD."
The use of Omidria (phenylephrine 1% and ketorolac 0.3% injection, Omeros) during cataract surgery can also help reduce pain.
"Putting Omidria into the fusion bottle probably lessens the need for intracameral lidocaine or eliminates the need, and it reduces pain not only during surgery but also after surgery. That is proven in the FDA study because it contains ketorolac, which is a nonsteroidal. Omidria is a good one," he said.
Uday Devgan, MD, Healio.com/OSN Section Editor, said he loads patients with preoperative NSAIDs for several days before surgery and then continues to give NSAIDs on the day of surgery and into the postoperative period.
"During surgery, we give a combination of topical tetracaine and intraocular preservative-free lidocaine. The IV sedation is an important part of the process, and the importance of an excellent anesthesiologist cannot be underestimated. The choice of agents as well as their dosing and timing all play into achieving a comfortable experience," Devgan said.
Patient expectations
Setting expectations for patients with regard to pain is an important part of the surgical process that is often overlooked, Steve H. Chang, MD, of Nevada Eye Consultants, said.
"Nine out of 10 of your patients may say they have no pain whatsoever during a surgery, but the one patient that does experience pain is often neglected," he said.
Earlier in his career, Chang said that he typically would tell patients that cataract surgery was a painless procedure.
"But as you do more, you realize that some people actually have pain," he said. Now he tells patients that cataract surgery is "generally painless" and advises them that medication will help prevent pain, setting that expectation at the beginning of the cataract surgery conversation.
Chang's protocol begins with patients starting with an NSAID, typically BromSite (bromfenac ophthalmic solution 0.075%, Sun Ophthalmics), on the morning of surgery followed by additional preoperative drops when patients arrive at the surgery center.
"During the surgery we utilize topical proparacaine or tetracaine along with intracameral lidocaine. Also, there is an anesthesiologist or a nurse anesthetist who is giving medication through an IV, usually some sedating and pain control medication, nothing to fully put them out but to try to relax them," Chang said.
Postoperatively, Chang prescribes BromSite for 2 to 4 weeks, depending on whether retinal pathology is present.
Intraoperative tips
In addition to using pain-relieving NSAIDs and anesthetics, Hovanesian said surgeons can use different techniques intraoperatively to reduce patient pain.
A commonly overlooked problem in young patients, those with high myopia or those who have undergone previous vitrectomy is the issue of fluid pressure in the eye, he said. When the phacoemulsification probe is put into the eye for the first time, the fluid in the eye can cause pressure and pain. The anterior chamber overdeepens, resulting in reverse pupillary block. The pupil is pushed back into the lens capsule, and it falls backward quickly and firmly, Hovanesian said.
"That's a significant pain to experience," he said. "It's like stretching the iris and the front structures of the eye."
To lessen the effects, Hovanesian recommended tenting up the iris in those patients before infusing fluid.
"We can slip an instrument under the iris while there is viscoelastic in the eye, tent up the edge of the iris so that it won't fall so far backward, and then turn on the infusion fluid. What that does is it allows fluid to go through that opening and it will equilibrate in front of and behind the iris, and then the patient won't have that pain," he said.
The drapes used during the procedure can also cause pain when removed. To reduce the pain, Hovanesian suggested placing a thin film of povidone-iodine or K-Y jelly on the cheeks and forehead to lessen the stickiness of the drapes and make them easier to remove.
Finally, when developing a limbal relaxing incision, lubricating the cornea so that the diamond blade does not cause epithelial defects is another way to reduce pain in the postoperative period, he said.
Factor in anxiety
OSN Cornea/External Disease Board Member Preeya K. Gupta, MD, said that patients with high anxiety or those who take anxiety-reducing medications need special attention to help manage pain during cataract surgery.
In general, patients with pre-existing anxiety are often on an oral medication that can change their receptors, Gupta said. These patients may need higher doses of fentanyl or midazolam to treat pain and decrease anxiety.
"Those are patients who may need higher doses to achieve the same therapeutic effect as those with no anxiety," she said.
Oral sedation with MKO Melt (Imprimis Pharmaceuticals) is another way to alleviate anxiety before cataract surgery, either alone or in conjunction with IV sedation, William F. Wiley, MD, of Cleveland Eye Clinic, said. The compounded midazolam, ketamine and ondansetron troche is administered sublingually.
"We use an MKO Melt and/or, depending on the patient, we'll use IV sedation with Versed (midazolam, Roche) and ketamine," Wiley said. "In general, our preference is the sublingual because the patients tend to like that."
For patients who also need IV access, the troche can be "a nice way to start the process" because they are more comfortable when brought to the operating room, have less anxiety and do not experience the pain point of an IV needle stick, he said.
Second eye surgery
Pain management strategies need to change when a patient is undergoing surgery in the second eye. In a 2016 study published in International Ophthalmology, Akkaya and colleagues reported patients undergoing phacoemulsification for cataracts in the second eye experienced more pain and showed worse cooperation during the surgery compared with the first eye procedure.
"It's a fascinating phenomenon," Chang said. "I get this a lot when I'm doing a second eye. Patients say, 'Oh, I don't remember this part. That was a little more uncomfortable this time.'"
Chang partially attributed the phenomenon to the amnesic effects of the sedatives.
"A lot of it is psychological as well. They don't know what to expect when it comes to their first surgery," Chang said. "The second time around, the body is prepared for eye surgery and expects certain things."
Despite the two procedures being the same, patients report different experiences between them.
"When they don't happen exactly the same or not as they recall, the patient thinks something is weird or different, even though everything is exactly the same," Chang said. "My strategy is not perfect, but when I talk to the patients preoperatively, when I'm prepping them, I tell them this may seem different from the first eye. You forget things from the first eye. My anesthesiologist knows the drill. If they need to give a little bit more medication the second time around, they will."
Devgan also noted the amnesic effects of sedatives and said it is important to carefully measure and calculate the necessary amount for a second cataract procedure.
"Many of the systemic agents such as benzodiazepines will induce amnesia around the time of administration. This can alter patient perception of the surgery, and if a lesser dose is given for the second eye surgery, the patient can perceive more. Looking at the notes from the first surgery helps us deliver a consistent level of anesthesia and a great patient experience for both eyes," he said.
More pain vs. more awareness
Patients can also become more "tolerant" to some of the common sedatives used in cataract surgery, Hovanesian said, which can result in more pain in the second surgery despite receiving the same amount of sedative.
"In the second surgery ... patients are not naïve to the sedation drug. We hear it so incredibly often. Patients say, 'I was much more asleep in the first procedure,' when in fact they had the same dose or even a higher dose of the sedative with the second procedure. Somehow, particularly with Versed (midazolam), one of the most common sedatives, patients develop a 'tolerance' to it. They're more conscious the second time they receive it about a month later or a few weeks later. I believe that drives the perception of more pain largely in the second procedure. There may be other factors as well," he said.
Patients experiencing or perceiving more pain in the second eye surgery is a "universal phenomenon," Gupta said. It is debated as to whether patients feel more pain during the second procedure or if they are more aware and anxious about what is going on the second time around.
"I believe if you ask most cataract surgeons, it's not that patients experience more pain in the second eye; it's just that they're more aware despite getting the same dosage of medication. It makes it harder for them to relax, harder to feel like everything is OK because it's so different from their initial experience. I've always told patients that they're probably not as nervous the second time because they've been through it and know what it's like, but they're going to be more aware and being more aware might make them more nervous while they're in there," she said.
Surgeons should tell patients that their second surgery may be a different experience from their first, she noted.
"It's very important for a patient to hear from their doctor that it's OK if they're more awake the second time and it's OK if they're more aware. It acknowledges the fact that we know that will happen and it's not abnormal. If we know it's going to happen and that it's not abnormal, if a patient knows it's not abnormal, they'll be more apt to be comfortable and not alarmed," Gupta said.
Pain needs to be taken seriously by surgeons. Surgeons should be cognizant of when they consistently cause pain during a cataract procedure and discuss strategies with colleagues to reduce the painful experience for their patients, Hovanesian said.
"Pain is real. The world has enough pain by itself, and we as surgeons should be committed, just as we are to our craft, to minimizing pain for our patients," he said. – by Robert Linnehan
- References:
- Akkaya S, et al. Int Ophthalmol. 2017;doi:10.1007/s10792-016-0295-3.
- Apil A, et al. Pain Res Treat. 2014;doi:10.1155/2014/827659.
- Jiang L, et al. J Ophthalmol. 2015;doi:10.1155/2015/383456.
- Wiley WF. Hustead Memorial Lecture: Use of MKO Melt in ophthalmic surgery. Presented at: Ophthalmic Anesthesia Society annual meeting; Sept. 22-24, 2017; Chicago.
- Yu, JG, et al. J Ophthalmol. 2016;doi:10.1155/2016/6521567.
- For more information:
- Steve H. Chang, MD, can be reached at Nevada Eye Consultants, 5420 Kietzke Lane, Suite 103, Reno, NV 89511; email: firstname.lastname@example.com.
- Uday Devgan, MD, can be reached at Devgan Eye, 11600 Wilshire Blvd., Suite 200, Los Angeles, CA 90025; email: email@example.com.
- Preeya K. Gupta, MD, can be reached at Duke University Eye Center, Department of Ophthalmology, Box 3802, Durham, NC 27710; email: firstname.lastname@example.com.
- John A. Hovanesian, MD, FACS, can be reached at Harvard Eye Associates, 24401 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653; email: firstname.lastname@example.com.
- William F. Wiley, MD, can be reached at Cleveland Eye Clinic, 2740 Carnegie Ave., Suite MW, Cleveland, OH 44115; email: firstname.lastname@example.com.
Disclosures: Chang reports he is a speaker for Sun Pharmaceuticals. Devgan and Gupta report no relevant financial disclosures. Hovanesian reports he is a consultant for Omeros and the founder of MDbackline. Wiley reports he is a consultant for Imprimis Pharmaceuticals.
Click here to read the , "What are the differences between pain management protocols for first and second eye cataract surgeries?"


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PIQ Sport intelligence brings home the 2017 ISPO BrandNew Award for the Wearables category
Paris, February 6th 2017 - PIQ Sport intelligence will also receive the ISPO BrandNew Award during the Awards ceremony on February 5th 2017.
The ISPO BrandNew organization will recognize PIQ Sport Intelligence by granting it the 2017 Award in the Wearables category. With its 2,600 exhibitors, 80,000 visitors from 110 countries, ISPO is the leading industry event since 1969 for sports in Europe. Through this award, PIQ technological platform is recognized. As such, this award also goes to Mobitee, Babolat, North Kiteboarding, Everlast and Rossignol which are PIQ Sports partners. PIQ Sport Intelligence will present its products and innovations in the ISPO BRANDNEW Village in hall B5 – booth BN54.


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YT-K1 Walkie-Talkie Poker Cheating Tools for Poker Analyzer
If you use poker scanner analyzer, there must have poker predictor walkie-talkie. YT-K1 is one of these poker spy walkie-talkie.
This analyzer interphone is charging with cable. Once it is fully charged, it can use for 10 hours, just as like as the marked cards earpiece.
The working distance between the interphone and signal receiver is about 50 meters, while receiver and spy earpiece is 10 meters. To make sure you can hear the information clearly, do not over the working distance. Moreover, if you think there is other signal disturb, you can change the channel of this marked cards analyzer walkie-talkie.


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North Carolina's first state constitution in 1776 mandated "That a school or schools shall be established by the Legislature, for the convenient instruction of youth, . . . and all useful learning shall be duly encouraged, and promoted, in one or more universities." In 1789, the University of North Carolina was established at Chapel Hill, and the first class of students arrived six years later. Today, the UNC System has 16 universities and the N.C. School of Science and Mathematics. In 2017, over 185,000 undergraduates and nearly 47,000 graduate students are enrolled. Kari Travis, Associate Editor of Carolina Journal, joins Terry and Kory to discuss the future of the UNC System under the leadership of system president Margaret Spellings and Board of Governors chairman Harry Smith.
Head Locke Episode 020: The Future of the UNC System?
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Shoes that originate from Scotland and Ireland and later named after Oxford University, are classic, charming, and eternal. Shoes that can be worn in really every occasion, from weddings to everyday commute to work. Shoes that make every outfit more sophisticated. Todays article we dedicate to them – Oxford shoes. Sometimes a perfect outfit can be completely destroyed with one, some would say, banal trinket – shoes. They can say so much about men. And for that reason, oxford shoes are an excellent choice, because alongside with being comfortable and eye catching, they fit perfectly with every combination. So guys, be bold and sometimes leave your favourite sneakers aside and replace them with oxford shoes.
How to style them? Very simple! For daily and leasurely outfit an ideal combination is a interestingly patterned pullover, jeans, bag and belt with color that matches the one of shoes. Which oxford shoes to choose? For this look the perfect are plain oxfords that basically consists of the quarter and the vamp. This style is simple but elegant.
Shoes: arrowsmithshoes ; Bag, belt, sweater: Mango
For a more business outfit a splendid choice would make these wingtips or brouges which you may also combine with tweed or with other more casual outfits, but they look perfect on a suit.
Shoes: arrowsmithshoes ; Suit:Heart & Dagger Check Suit (Asos)
For our combinations we have chosen a pefect pair of shoes from Chicago based Arrowsmithshoes, established in 1974. which ,besides quality and great design, has a very broad selection so we are certain that the stronger sex will find at least one perfect pair for them.
Photo: Asos (suit), Mango (sweater, belt, bag), Shoes: Arrowsmithshoes