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Offering general practices more money according to the number of people with long-term health conditions like diabetes, cancer or dementia they treat does not lead to improved care, according to a study by the University of Kent.
The study, led by Dr Lindsay Forbes from the University's Centre for Health Services Studies (CHSS) and commissioned by NHS England, assessed the Quality and Outcomes Framework (QOF), the world's largest pay-for-performance scheme in primary care.
Around 99% of GPs in England are part of the QOF, which was introduced in 2004 to try and create a more uniform standard of care across surgeries, and on average around 10-15% of income for general practices is derived from the scheme. However, this has led to criticism that many GPs over-prioritise QOF related activities because they are so reliant on the additional income it provides.
Furthermore, there is an increased focus within the NHS to better manage and treat people with long-term conditions, who take up some 70% of health service resources. As such there is a concern the QOF is no longer suitable as it does not encourage GPs to manage people holistically in a way that encourages them to be involved in decisions and coordinates care across different services.
To assess this, the study by CHSS looked at a range of prior peer-reviewed, quantitative research that examined the effect the QOF has on a broad range of patient outcomes such as personalised care, self-care, patient experience, coordination of care and mortality rates, among others.
Based on the evidence the study found the QOF may be associated with some very modest positive effects in limited areas, such as slowing the increase in emergency admissions, an increase in consultations in severe mental illness and improving diabetes care.
However, the study found no evidence that the QOF leads to better coordinated care, more holistic care, better encouragement to self-care, or improved patient experience or involvement in decisions. It also had no effect on mortality rates.
As a result the paper says the NHS must consider more broadly what constitutes long-term high quality care and find other ways of motivating GPs and primary care teams beyond monetary rewards.
The full paper, entitled The role of the Quality and Outcomes Framework in the care of long-term conditions: a systematic review, has been published in the British Journal of General Practice.
Source: University of Kent

subset: commoncrawl


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You can use the coax for extending the cable from the outdoor aerial for your Mobile Repeater kit or for use with a signal splitter to attach multiple indoor coverage antennas.
Our low loss cable lengths come pre-fabricated with connectors at both ends and is an ideal way to customize your repeater kit to suit your needs. This product is ideal if the standard cable length that comes with your repeater is too short or you would like to upgrade your repeater by using more than one coverage antenna.


text: As winter arrives, more and more people especially those living in cold countries making them to seek for different ways to keep them warm and having a warm dip in a hot tub will do the trick. To keep the warm temperature of your hot tub, you need to have your tub covered. When not in use, a hot tub cover will also save you time from cleaning out those leaves, debris, and dust that your hot tub can possibly collect if not properly covered. You can purchase your hot tub cover in stores near you. However, if you want, you can also make your own to save some amount of money. Simply measure your tub's size, purchase your materials, transfer your outline into a plywood board, cut, glue them up, install the vinyl using your glue and fix your handles using a screwdriver.


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Over at The B Bar's blog The Well, we ask our readers a question each month and anyone can answer it, this month we asked what their summer essentials were because our theme for the month is essential. When I think about "summer essentials" my mind immediately goes to what do I use/wear constantly throughout the summer, and five things immediately came to mind.
Continue reading for my 5 summer essentials!
I love hanging out by the pool, so I'm constantly wearing COOLA Sunscreen.
If you're going to be in the sun a lot during the summer, a hat and sunglasses are as much an important part of your "beauty routine" as sunscreen is! If you want to avoid having a wrinkly leathery face when you get older, wearing a hat is the way to go — but layer some sunscreen under that too! I wear my Panama Hat to the pool.
They say blue/green eyes are more sensitive to light than brown. Whether or not they are right, my eyes are very sensitive to light, and it's a bad day if I leave without sunglasses. Currently these flat top sunglasses are what I'm putting on each day.
One Love Organics Skin Savior to keep my face moisturized and One Love Organics Vitamin C body oil to keep the rest of my body moisturized and it helps me keep my tan longer! I put this on my arms, legs, and décolleté before I go to bed.
Check out what 50+ other bloggers said were their summer essentials for this month's linkup for The B Bar!
26 and Not Counting
Alyssa J Freitas
soak and simmer
The Not Quite Adult
Carrie Loves
The Yuppie Files
Knowing Kelly
Something Good
Feathers and Stripes
Cassandra Monroe
Sunny Side Up
Life Modifier
Leigh Clair
Rae Loves
Rose Colored Water
Fashion to a T
Emilie Lima Burke
Ember & March
Business Betties
with love from ellie
Mint Julep Girl
Love Peace and shimmer
Rae Everyday
Little Wild Heart
star-crossed smile
Luv in the Bubble
Perfect Enough For Us
Sorcha Eleanor
Dreams and Colour Schemes
Elana Lyn
Sequins & Strawberries
Pattern Me Pretty
Beauty and the Pitch
White Oak Creative
The Toppy Top
White Cabana
In The Grey
Taryn Williford
Cooper + Thames
Mrs. on the Move
Magnificent Temptations
Victoria McGinley
Photos by Meg Biram


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Continuation of earlier … Had I thought of it I would have included this video for her birthday celebration. A li'l more sexually explicit than is appropriate for my dear friend and colleague, but "whatevs." Happy Birthday, Lady of … Continue reading
Category Archives: music
OK, so … Happy Birthday to a dear friend. She wants to be a "fag hag," but she doesn't know what vogueing is. *sigh* LOL.
GOP = Nobody Be Liking You Right Now Cuz You Turned Off Our GOV
Says Gallup:
OK, somebody be liking you but they be smokin' the Bill Clinton and inhaling or they be snortin' the George W. and … yeah, sortin' the George W. Continue reading
Goin' in for the Kill – whose tantrum is it? I'll tell you.
Republican Tantrum continues?
Yes, U.S. Government 101, friends. This is the Republican Party that has shut us down. President Obama on Congress' [Republican] Unprofessional & Unacceptable Government Shutdown: Continue reading
Nostalgia's for Geeks
I guess, sir; if you say so …
I wanna' be with you.
I won't be right without you
And I might break without you
I'd rather be poor and happy than rich and alone
I'll write hit songs about you
No matter how we'll get through
I'll keep on singing for a living, but I wanna be in love
And I wanna be with you


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A, Aβ42 slope (95% CI), −0.3 (−1.2 to 0.6); r2 = 0.001; P = .54. B, Tau slope, 0.2 (0.1 to 0.3); R2 = 0.06; P < .001. C, F2-IsoPs slope, 0.1 (0.04 to 0.15); R2 = 0.04; P < .001. Solid line indicates the fitted least-squares line unadjusted for any covariates; dashed lines, 95% CIs. AD indicates Alzheimer disease; MCI, mild cognitive impairment.
The solid line indicates the fitted least-squares line for the log10 score unadjusted for any covariates; dashed lines are 95% CIs for the line. Slope, 0.005; 95% CI, 0.003-0.007; R2 = 0.06; P < .001. AD indicates Alzheimer disease; MCI, mild cognitive impairment.
eTable 1. Demographics and baseline biomarkers and cognitive test scores by last clinical follow-up diagnosis
eTable 2. Cross-sectional analyses, including sensitivity analyses
eTable 3. Longitudinal analyses based on linear mixed effects models, including sensitivity analyses
eTable 4. Cross-sectional analyses, including dose model for APOE e4
eFigure 1. Baseline test score versus age for 315 cognitively normal subjects
eFigure 2. Longitudinal scores on neuropsychological tests for 158 subjects who were cognitively normal at baseline and had at least one follow-up test visit
eFigure 3. Longitudinal Immediate Recall and Delayed Recall scores for 158 subjects who were cognitively normal at baseline and had at least one follow-up test visit
Customize your JAMA Network experience by selecting one or more topics from the list below.
Li G, Millard SP, Peskind ER, et al. Cross-Sectional and Longitudinal Relationships Between Cerebrospinal Fluid Biomarkers and Cognitive Function in People Without Cognitive Impairment From Across the Adult Life Span. JAMA Neurol. 2014;71(6):742–751. doi:https://doi.org/10.1001/jamaneurol.2014.445
© 2019
Age-related cognitive decline among older individuals with normal cognition is a complex trait that potentially derives from processes of aging, inherited vulnerabilities, environmental factors, and common latent diseases that can progress to cause dementia, such as Alzheimer disease and vascular brain injury.
To use cerebrospinal fluid (CSF) biomarkers to gain insight into this complex trait.
Design, Setting, and Participants
Secondary analyses of an academic multicenter cross-sectional (n = 315) and longitudinal (n = 158) study of 5 neuropsychological tests (Immediate Recall, Delayed Recall, Trail Making Test Parts A and B, and Category Fluency) in cognitively normal individuals aged 21 to 100 years.
Main Outcomes and Measures
To investigate the association of these cognitive function test results with age, sex, educational level, inheritance of the ε4 allele of the apolipoprotein E gene, and CSF concentrations of β-amyloid 42 (Aβ42) and tau (biomarkers of Alzheimer disease) as well as F2-isoprostanes (measures of free radical injury).
Age and educational level were broadly predictive of cross-sectional cognitive performance; of the genetic and CSF measures, only greater CSF F2-isoprostane concentration was significantly associated with poorer executive function (adjusted R2 ≤0.31). Longitudinal measures of cognitive abilities, except Category Fluency, also were associated broadly with age; of the genetic and CSF measures, only lower baseline CSF Aβ42 concentration was associated with longitudinal measures of immediate and delayed recall (marginal R2 ≤0.31).
Conclusions and Relevance
Our results suggest that age and educational level accounted for a substantial minority of variance in cross-sectional or longitudinal cognitive test performance in this large group of cognitively normal adults. Latent Alzheimer disease and other diseases that produce free radical injury, such as vascular brain injury, accounted for a small amount of variation in cognitive test performance across the adult human life span. Additional genetic and environmental factors likely contribute substantially to age-related cognitive decline.
Cognitive function, especially declarative memory and executive function, decreases with age in nonhuman primates1 and in humans, even in individuals who have not crossed the clinical thresholds for mild cognitive impairment (MCI) or dementia.2 Age-related cognitive decline appears to be associated with several factors, such as events that occurred earlier in life, which include the genetic complement inherited from parents, environment, processes of aging, and latent disease. However, the extent to which these different factors drive age-related cognitive decline remains unclear.
Observational studies3-5 using neuropathologic examination of adults who were cognitively normal proximate to death suggest that latent Alzheimer disease (AD) and vascular brain injury (VBI) are prevalent in those aged 65 years or older. Accumulation of cerebral amyloid, determined by molecular neuroimaging, and changes in cerebrospinal fluid (CSF) concentrations of β-amyloid 42 (Aβ42) and tau that are characteristic of individuals with amnestic MCI or AD dementia also occur in a proportion of cognitively normal adults, raising the possibility that some amount of age-related cognitive decline may be the result of the earliest expression of AD.6-8 Similarly, if one assumes that white matter hyperintensities as revealed by T2-weighted magnetic resonance imaging are at least in part a consequence of microvascular VBI,9 then structural neuroimaging further supports a possible role for microvascular VBI in age-related cognitive decline.10 Finally, studies of CSF F2-isoprostanes (IsoPs), biomarkers of oxidative injury to the brain, have shown11-14 that levels of IsoPs are characteristically elevated in MCI, AD dementia, and/or VBI; these associations have been validated mechanistically in animal models.11 In combination, the findings of these laboratory-based studies raise the possibility that some, or perhaps even most, age-related cognitive decline is the earliest expression of latent diseases of the brain. If this hypothesis is true, it would suggest that existing therapies to control risk factors for microvascular VBI and disease-modifying therapies for AD that may be developed soon could greatly affect age-related cognitive decline.
A focus of our AD centers is developing CSF biomarker approaches to aid in the diagnosis and management of MCI and dementia. As part of these efforts, we have obtained CSF samples from many research participants across the adult life span who were carefully evaluated to establish that they are cognitively healthy control individuals. In the present study we used this valuable resource to examine the association between CSF biomarkers of AD or oxidative injury and cognitive function in relation to aging using cross-sectional and longitudinal data.
Participants in the present study were recruited between October 26, 2001, and September 24, 2009, from the University of Washington Alzheimer's Disease Research Center and collaborating AD centers, including the University of California, San Diego; Oregon Health and Science University; Indiana University; the University of Pennsylvania; and the University of California, Davis. All procedures were approved by the institutional review boards of each study site. All participants provided written informed consent and received financial compensation. Participants underwent detailed neuropsychological testing and clinical and laboratory evaluations and then were classified as having no cognitive impairment, MCI, or dementia based on standard research criteria as previously described.15 Clinical diagnosis was made at a consensus conference based on history provided by informants, neurologic examination, detailed neuropsychological test results, and laboratory studies (including neuroimaging with magnetic resonance imaging in the case of MCI or AD). Exclusion criteria were major neurologic diagnoses that may affect cognitive function, such as stroke, Parkinson disease, multiple sclerosis, and history of moderate to severe head injury; major psychiatric disorders, such as schizophrenia, major affective disorder, and posttraumatic stress disorder; unstable major medical conditions, such as insulin-dependent diabetes mellitus; and use of illegal drugs. Individuals aged 45 years or older were asked to participate in a longitudinal study with annual follow-up visits. Additionally, 5 younger individuals (aged 35, 38, 40, 41, and 43 years) had follow-up visits and were included in the longitudinal analyses.
Cerebrospinal fluid was obtained by lumbar puncture as previously described,16 using 24-gauge atraumatic spinal needles (Sprotte). All CSF samples were analyzed in a single laboratory17 using 0.5-mL aliquots that had been stored in polypropylene cryotubes, frozen, and maintained at −80°C and never previously thawed. The CSF was analyzed for Aβ42 and total tau using multiplexed reagents (Luminex; InnoGenetics) according to the manufacturer's instructions and as previously described.18 Levels of CSF F2-IsoP were quantified using a stable isotope dilution assay with gas chromatography/mass spectrometry and selective ion monitoring as described previously.19 Apolipoprotein E (APOE; GenBank, M12529) genotype was determined by a restriction digest method.20 Assays were performed with personnel blinded to clinical diagnosis.
We selected 5 neuropsychological tests to examine multiple domains of cognition. The Wechsler Memory Scale–Revised Logical Memory Immediate Recall and Delayed Recall paragraph tasks measure verbal episodic memory21; we used total scores for the immediate and delayed recall functions (each with a possible range of 0-25). Category Fluency is a test of semantic memory22; we used a total number of unique animals generated in 1 minute. Trail Making Test Parts A and B (Trails A and B) are timed tests of a person's ability to adapt to shifting task demands. Time taken to complete Part A (upper boundary of 150 seconds) is a measure of processing speed, and time taken to complete Part B (upper boundary of 300 seconds) is a measure of executive function.23
Inclusion criteria for the cross-sectional investigation were (1) all participants classified as having no cognitive impairment at baseline evaluation, (2) CSF at baseline that had assay results for all 3 CSF biomarkers, and (3) a full set of neuropsychological test scores at baseline. The longitudinal investigation included individuals from the cross-sectional study who had at least 1 follow-up visit at approximately 12 months with results for at least 1 of the cognitive tests. The number of follow-up visits and time span they encompassed varied depending on the time of recruitment to the study and the person's age. The longitudinal study sample was a subset of the cross-sectional study participants; characteristics of each study sample are reported in Table 1. At each follow-up visit, history obtained from the informants, clinical examination, and neuropsychological test data were reviewed to determine whether the cognitive status of the participant remained the same or changed to MCI or dementia.
Linear regression models were used to assess cross-sectional relationships between CSF biomarker concentrations and coincident cognitive test performance. Raw scores were used for each test except log10-transformed times for Trails A and B to remove skewness. In addition, we created a composite test score constructed by computing z scores for each of the 5 cognitive tests based on the baseline mean (SD) (z scores for log10-transformed Trails A and B were multiplied by −1) and then determining the mean. Regression models consisted of cognitive test performance as the dependent variable and baseline CSF biomarker concentrations as predictors, along with the covariates baseline age, sex, educational level, and APOE ε4 status (no ε4 alleles vs at least 1 ε4 allele).
To assess the association of baseline CSF biomarker concentrations with subsequent longitudinal changes of cognitive test performance, we used linear mixed-effects models,24 with cognitive test performance as the dependent variable and time since baseline and baseline CSF biomarker concentrations as predictors, along with the covariates baseline age, sex, educational level, and APOE ε4 status. The associations of baseline age and CSF biomarker concentrations with change in cognitive performance were tested by including time × baseline age and time × biomarker concentration interaction terms in the models. Marginal R2 values for the linear mixed-effects models were computed according to the method of Nakagawa and Schielzeth.25
We performed several kinds of sensitivity analyses. For both the cross-sectional and longitudinal analyses, we included the ratio of tau to Aβ42 as a predictor (per Kronmal,26 both tau and Aβ42 were kept in the models as main effects as well). We also looked at models in which Aβ42 was dichotomized as 192 pg/mL or less vs greater than 192 pg/mL based on the cutoff suggested by Shaw et al.27 Because the relationship between CSF biomarkers and cognitive function may differ between older and younger people, we restricted all analyses to those 60 years or older. To understand the relationship between cognition and CSF biomarkers that is related to normal aging, we looked at models in which we excluded participants whose clinical diagnosis converted to MCI, AD, or other dementias. For the longitudinal analyses, we also used 2-stage regression (least-squares slope for each test in each individual over time, followed by a weighted regression model with slope as a response variable and baseline test score included as a predictor variable),28 with weights based on participants having different numbers of follow-up visits at different times after baseline. Finally, to understand the role of APOE genotype in cognitive decline, we examined APOE ε4 gene dose-effect relationship in the cross-sectional analyses by coding APOE ε4 genotype as follows: ε2/ε2 = −2, ε2/ε3 = −1, ε2/ε4 = 0, ε3/ε3 = 0, ε3/ε4 = 1, and ε4/ε4 = 2. In the longitudinal analysis, we expanded the linear mixed-effects model to allow for interaction effects between APOE ε4 status and biomarkers.
Correction for multiple comparisons, taking into account 6 separate cognitive outcomes (the 5 test scores plus the composite score) was based on the method of Holm.29 Statistical analyses were performed using R, version 3.0.130; linear mixed-effects models were fit using the R packages nlme31 or lme4.32
Table 1 presents demographic characteristics, baseline CSF biomarker levels, and cognitive test scores for the 315 eligible cognitively normal participants in our cross-sectional analysis. Of these, 157 did not have a follow-up visit and 158 had follow-up visits and were included in our longitudinal analysis. Individuals in the longitudinal analysis had a mean length of follow-up of 4.4 years and were approximately 10 years older than those in the cross-sectional analysis. Four participants completed only 1 test session but had 1 or more clinical follow-up visits. Of the 162 participants with clinical follow-up, cognitive function in 14 persons (8.6%) had converted to MCI, 7 (4.3%) to AD, 2 (1.2%) to dementia with Lewy bodies or Parkinson disease dementia, and 4 (2.5%) to another type of cognitive impairment. The Supplement (eTable 1) presents baseline information stratified by final clinical diagnosis and baseline test score vs age stratified by final clinical diagnosis (Supplement [eFigure 1]). Participants whose clinical diagnosis converted to MCI, AD, or other cognitive impairments were older at baseline and had slightly longer durations of follow-up than did those who remained cognitively normal. As expected, people whose clinical diagnosis converted to MCI or AD were more likely to be APOE ε4 carriers.
Figure 1 presents results for the 3 CSF biomarkers from our 315 cognitively normal participants compared with age at baseline evaluation and stratified by final clinical diagnosis. We initially focused on associations between these baseline CSF biomarker concentrations and baseline cognitive abilities, including memory, in cognitively normal participants. Table 2 reports the regression coefficients and P values associated with demographic characteristics and baseline CSF biomarker levels for each cognitive test in multivariable regression models. Model 1 included age, sex, educational level, and presence of the APOE ε4 allele, and model 2 included the previous variables as well as concentrations of CSF Aβ42, tau, and F2-IsoPs. Age was significantly (P < .05) associated with lower cognitive function for all cognitive tests and models, and educational level was associated with higher cognitive function except for Trails A. For Trails A and B, lower scores reflect better cognitive function. The CSF F2-IsoP concentration was associated with lower cognitive function for Trails A (P = .04), Trails B (P = .007), and the composite score (P = .02), and low Aβ42 concentrations were associated with lower cognitive function for Trails B (P = .05); however, after adjusting for multiple comparisons based on 6 different cognitive measures, only the association between CSF F2-IsoP concentration and Trails B remained significant (Holm-corrected P = .04). Figure 2 shows unadjusted Trails B scores vs F2-IsoP concentration, along with a fitted line and 95% CIs for the line. Adding biomarkers to model 1 did not noticeably improve the adjusted R2 for any of the cognitive tests. Phosphorylated tau was highly correlated with total tau but did not provide additional predictability in any model.
Our next analysis focused on the association between baseline CSF biomarker concentrations and longitudinal change in cognitive performance. Table 3 presents the regression coefficients and P values associated with baseline age and CSF biomarker levels for a 10-year change (ie, slope coefficients multiplied by 10) in each cognitive test based on linear mixed-effects regression models. Model 1 included baseline age, sex, educational level, presence of the APOE ε4 allele, time (decades since baseline), and a time × baseline age interaction term; model 2 included the previous variables as well as concentrations of CSF Aβ42, tau, and F2-IsoP at baseline, as well as time × biomarker interaction terms. Baseline age was associated with declining cognitive function for all tests except model 2 of Trails A, model 2 of Trails B, and both models of Category Fluency. Low baseline CSF Aβ42 concentration was associated with declining cognitive function for Immediate Recall (P = .004), Delayed Recall (P = .001), and the composite score (P = .007), and all of these associations remained significant after adjustment for multiple comparisons (Holm-corrected P = .02, P = .006, and P = .04, respectively). Also, baseline CSF tau concentration was associated with declining cognitive function for Immediate Recall and Delayed Recall (P = .03 and P = .04, respectively), but these associations did not remain significant after adjustment for multiple comparisons. The Supplement (eFigure 2) shows spaghetti plots of test score vs time stratified by final clinical diagnosis for all 5 tests and spaghetti plots of test score vs time stratified by baseline Aβ42 quartiles for Immediate Recall and Delayed Recall (Supplement [eFigure 3]).
Results were similar when the tau to Aβ42 ratio was added to the cross-sectional analysis models (ie, the ratio was not significant and did not affect the other associations) except that the Trails B association with low Aβ42 became nominally nonsignificant (P = .34). When the tau to Aβ42 ratio was added to the longitudinal analysis models, it was not significant for any of the cognitive tests. When we modeled CSF Aβ42 level as a dichotomous variable (low vs high) instead of as a continuous variable (model 2 compared with model 3 in the Supplement [eTable 2 and eTable 3]), we observed a significant cross-sectional association of low Aβ42 with low composite score and with poor performance in Trails A (Supplement [eTable 2]). For the longitudinal analyses, the association between low baseline CSF Aβ42 concentration and declining cognitive function for Immediate Recall became nonsignificant (Supplement [eTable 3]). When we restricted analyses to individuals aged 60 years or older, the cross-sectional associations of CSF F2-IsoP concentration with Trails A, Trails B, and the composite score were all attenuated to nonsignificance (Supplement [eTable 2]). The relationship between baseline biomarkers and cognitive trajectories essentially remained unchanged in this restricted group of older participants (Supplement [eTable 3]). When we omitted individuals whose clinical diagnosis converted to MCI, AD, or other dementias or cognitive impairments, our findings did not change significantly in either the cross-sectional or longitudinal analysis (Supplement [eTables 2 and 3], models 2 and 4, respectively). Results were similar for the longitudinal analysis based on using 2-stage regression with weights that account for different numbers of follow-up visits at different times after baseline compared with the results based on linear mixed-effect models; however, the associations between CSF tau concentration and Immediate Recall and Delayed Recall scores were no longer nominally significant.
Finally, coding APOE genotype as a dose instead of APOE ε4 status did not change the results for the cross-sectional analyses (Supplement [eTable 4]). For the longitudinal analyses, when we expanded model 2 to allow for interaction effects between APOE ε4 status and biomarkers, the only significant result was for Trails A, for which there was a significant interaction between APOE ε4 status and Aβ42 concentration. Low Aβ42 concentration was associated with worse 10-year change in Trails A for APOE ε4+ individuals compared with APOE ε4− individuals (difference in slopes for 10-year change in log10-transformed time [seconds] for every 100-ng/mL decrease in Aβ42 = 0.1, SD of difference in slopes, 0.05; P = .01). However, this interaction effect did not remain significant after controlling for multiple comparisons.
Cognitive decline occurs in older adults, even in those whose cognitive function does not cross clinical thresholds to MCI or dementia or the Clinical Dementia Rating score does not change.33 Several processes may contribute to age-related cognitive decline, including genetics, environment, and latent disease. Using the resources of the large research CSF repository built among our collaborating AD centers, in the present study we tested the hypothesis that age-related cognitive decline could be accounted for in part by latent AD or oxidative injury to the brain as detected by CSF biomarkers. We tested our hypothesis in a cross-sectional analysis of 315 adults who underwent baseline lumbar puncture and neuropsychological testing and in a longitudinal analysis of 158 persons from that cohort who had follow-up neuropsychological testing.
Our study focused on decline in cognitive abilities among cognitively normal adults, not on progression to cognitive impairment or dementia, which has been investigated in previous studies15,34-36 using biomarkers for AD. Our cross-sectional analysis of 315 carefully characterized individuals from across the human adult life span showed that age, sex, educational level, and APOE ε4 status accounted for a small percentage of the variability in cognitive performance on tests of immediate and delayed recall, executive function, and verbal fluency. Indeed, these 4 variables were strongest in accounting for variability in our measure of executive function (adjusted R2 = 0.31) and weakest for our measure of immediate recall (adjusted R2 = 0.08). The associations that existed were driven largely by age and educational level, without a significant contribution by sex or APOE. Subsequent addition of the 3 CSF biomarkers to the model did not alter the adjusted R2 for any of the neuropsychological test results; however, after controlling for multiple end points, we observed a novel finding that CSF F2-IsoP concentration was significantly associated with tests of executive function in middle-aged and elderly adults.
We speculate that this association may derive from CSF F2-IsoP concentration being a more-sensitive but less-specific marker of age-related brain injury and baseline executive function similarly being a more-sensitive but less-specific index of age-related cognitive decline. This association was diminished when analysis was restricted to participants aged 60 years or older, perhaps indicating the importance of mid-life free radical injury to the brain similar, and perhaps even mechanistically related, to the contribution of mid-life hypertension. The influence of age may also explain in part why no significant association was observed between CSF F2-IsoPs and longitudinal executive function because the mean age of the longitudinal group was greater than that of the cross-sectional group.
We did not observe an association between CSF F2-IsoP concentration and APOE ε4 in cognitively normal adults as suggested by others.37 Neither baseline CSF Aβ42 nor tau concentration was significantly associated with any of the 5 cognitive test results in cognitively normal adults, similar to other smaller cross-sectional studies38,39 of cognitive function in older individuals.
Our analysis of longitudinal change in neuropsychological test performance in a subset of 158 individuals using linear mixed-effects models showed that little change in cognitive test performance was explained by models that used age, sex, educational level, APOE ε4 status, and a time × baseline age interaction term (marginal R2 ranged from 0.21 to 0.31). The addition of CSF biomarkers to these models increased the marginal R2 very little; however, after controlling for multiple end points, low CSF Aβ42 concentration was significantly associated with cognitive decline in measures of immediate and delayed recall (R2 ≤ 0.31). These findings are similar to the results of another study40 of 165 older adults with normal cognition with or without subjective cognitive impairment.
Overall, these results indicate that age, sex, educational level, and inheritance of APOE ε4 accounted for little variability in the 5 neuropsychological tests used. These results highlight the need for deeper understanding of the genetic factors that influence age-related cognitive decline and the likely important contributions of systemic disease and environmental factors, such as nutrition, drug and alcohol abuse, and traumatic brain injury, which were not captured in our study. Cognitive performance in aging may also be influenced by lifestyle factors such as cognitive stimulation, physical exercise, and socialization, which may contribute to cognitive reserve. To the extent that the variables included in our study were significantly related to cognitive performance, age and educational level were the dominant variables in cross section, and baseline test performance and age were the dominant variables longitudinally. One interpretation of these results is that they reinforce the cognitive reserve hypothesis, similar to findings of recent neuroimaging studies.41
The CSF biomarkers contributed little to the R2 measures of goodness-of-fit when included with age, sex, educational level, and APOE ε4 status. Nevertheless, 3 significant associations withstood correction for multiple comparisons. These were an association between CSF F2-IsoP concentration and poorer performance on executive function in cross-sectional analysis and an association between low CSF Aβ42 concentration and longitudinal decline in immediate and delayed recall. The direction of these associations deserves some comment. Our measure of executive function, Trails B, is measured in seconds (maximum, 300 seconds) needed to complete the task; thus, a higher value indicates poorer performance. In our cross-sectional analysis, higher levels of oxidative injury to the brain, as measured by CSF F2-IsoP concentration, were associated with poorer executive function, as measured by longer time needed for Trails B (Figure 2). Interpretation of the association between low CSF Aβ42 concentration and decline of immediate and delayed recall is more complicated. Outside of autosomal dominant forms of AD,42 recent findings8 indicate that CSF Aβ42 concentration does not change much with aging until parenchymal Aβ42 deposition begins and ultimately progresses to clinical expression as MCI and dementia. Our results showed a negative correlation between decline in immediate and delayed recall and CSF Aβ42 level, suggesting that this association reflects the phase of declining CSF Aβ42 concentration and parenchymal deposition with increased risk for near-term conversion to MCI or AD dementia.15,43
Age-related cognitive decline is a complex trait that potentially derives from the confluence of multiple processes, including aging, environmental factors, inherited vulnerabilities, and latent disease. The strengths of our work are that it is relatively large for a CSF biomarker–based study, it used standardized data collection and central laboratory analysis, and participants were relatively healthy and selected to exclude factors that obviously may have a major effect on cognition. Shortcomings of our work are that our neuropsychological test battery was relatively limited and that we may have limited variance in cognitive function because of the general healthiness of our group. Lack of statistically significant associations between CSF biomarkers and baseline test scores and decline in test scores for most of the cognitive tests could be the result of issues related to statistical power, such as limited sample size (especially in the longitudinal samples), relatively short duration of follow-up, and relatively large within-participant variability in the neuropsychological tests used. Future studies should consider addressing these limitations. Regardless of these concerns, the fact that the CSF biomarkers contributed little to the R2 measures of goodness-of-fit even when they showed statistical significance suggests the importance of other underlying factors for cognitive health not captured by these CSF biomarkers.
With these strengths and weaknesses in mind, our analysis showed that CSF biomarkers of free radical injury and early changes of AD accounted for little variability in specific cognitive domains and that age, educational level, and previous cognitive performance were the predominant predictors of cognitive function in cross section or over time. Our results also suggest that factors not accounted for in the present study contribute to most of the variance in cognitive function in older, cognitively normal individuals. These factors may include other genetic factors, systemic disease, environmental factors, or white matter dysfunction as suggested by some neuroimaging studies.44-46
Accepted for Publication: February 19, 2014.
Corresponding Author: Thomas J. Montine, MD, PhD, Department of Pathology, School of Medicine, University of Washington, PO Box 357470, Seattle, WA 98195 (email@example.com).
Published Online: April 21, 2014. doi:10.1001/jamaneurol.2014.445.
Author Contributions: Dr Montine had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Li, Millard, Peskind, Raskind, Galasko, Montine.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Li, Millard, Zhang, Montine.
Critical revision of the manuscript for important intellectual content: Li, Millard, Peskind, Yu, Leverenz, Mayer, Shofer, Raskind, Quinn, Galasko, Montine.
Statistical analysis: Millard, Shofer, Montine.
Obtained funding: Peskind, Leverenz, Raskind, Galasko, Montine.
Administrative, technical, or material support: Peskind, Zhang, Yu, Mayer, Raskind, Galasko, Montine.
Study supervision: Li, Peskind, Raskind, Montine.
Conflict of Interest Disclosures: Dr Leverenz serves as a consultant for Boehringer Ingelheim, Navidea Biopharmaceuticals, and Piramal Health Care. Dr Galasko serves as editor of Alzheimer's Disease Research and Treatment; serves on data safety monitoring boards for Elan, Janssen, and Balance Pharmaceuticals; and is a consultant for Elan Pharmaceuticals, Inc, and Genentech, Inc. He receives research support from the National Institutes of Health, the Michael J. Fox Foundation, and the Alzheimer's Drug Discovery Foundation. Dr Montine receives grants from the National Institutes of Health and personal compensation in the form of honoraria from invited scientific presentations to universities and professional societies not exceeding $5000 per year. No other disclosures were reported.
Funding/Support: This work was supported by National Institutes of Health grants AG023185, AG031892, AG05131, AG05136, AG08017, AG033693, and U01-NS082137; the Department of Veterans Affairs; the Oregon Clinical and Translational Research Institute grant UL1TR000128; the Jane and Lee Seidman Fund; and the Nancy and Buster Alvord Endowment.
Role of the Sponsor: The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Additional Contributions: Kathleen Montine, PhD, Department of Pathology, School of Medicine, University of Washington, provided editorial assistance. No financial compensation was provided.
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Minnesota Vikings Chat previews the final preseason game of the 2011 season between the Minnesota Vikings and the Houston Texans.
Preseason Review: Vikings Defense vs. Cowboys
Minnesota Vikings Chat reviews the Vikings' defensive performance during their 2011 preseason loss to the Dallas Cowboys.
Preseason Preview: Vikings vs. Cowboys
Minnesota Vikings Chat previews the third 2011 preseason game between the Minnesota Vikings and the Dallas Cowboys.
Preseason Preview: Minnesota Vikings vs. Seattle Seahawks
A preview of the Minnesota Vikings second 2011 pre-season game against the Seattle Seahawks.
Daily Chat: The Deep Threat
With Sidney Rice gone, the Vikings turned their attention to Green Bay Packers wide receiver James Jones and possibly Braylon Edwards.
Daily Chat: The Recent Unpleasantness Ends
With The Recent Unpleasantness behind us, we can resume discussing our favorite subject: Football generally, and Minnesota Vikings football, specifically.
Daily Chat: CBA Extended
The NFL owners and the NFLPA agreed to extend the current collective bargaining agreement five days to March 11 in hopes of getting a new deal done, so there's hope for a somewhat uninterrupted (off)season.
Daily Chat: The Problem At Safety
Should the Minnesota Vikings shore up the safety position or leave well enough alone?
Daily Chat: Vikings vs. Giants, Take Two
Minnesota Vikings Chat reviews the Vikings 2010 regular season loss to the New York Giants at Detroit's Ford Field.
Daily Chat: Lobbying Lito Sheppard
Why is Lito Sheppard lobbying for playing time via the Pioneer Press?


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As a whole, the Off Beat series has been a bit of a departure for me. It was the first series I developed with an editor's input, and it was a nerve-wracking foray into something I'm not terribly familiar: rock stars. But once we'd brainstormed the concept, Body Rocks came alive in my mind very quickly. Dominic and Trey's romance was a lot of fun to write, and yes, it comes with my trademark #evilauthor angst.
The other departure was in the cover art. The bare-chested, abs-for-days cover models aren't what my readers are used to seeing on my book covers, but it seemed to fit for what we were doing. Or did it?
The cover for Steady Stroke came out a few months ago, with a similar feel to it, and after listening to feedback from myself, and from readers, Swerve decided to go with another approach. To soften the covers and make them better a part of my author brand. So the old Steady Stroke cover has been replaced with something I love a whole lot more. The models really portray Lincoln and Emmett as I see them in my head.
And finally, the cover for Hot Licks, my promised menage romance. The model is abs-for-days, but there is a confidence there that very much reminds me of Van Holt, one of the heroes of this novel. I just need to make sure I write that leather jacket into the story....
What do you think?
The homepage for m/m romance author A.M. Arthur, where grand love stories often unfold in small, unassuming towns...
Monday, August 22, 2016
Tuesday, August 9, 2016
First Chapter: Steady Stroke (Off Beat #2)
Chapter One
"Damn, Linc, you're worse than my mom when she's expecting guests." Roxy Bounds leaned against the now-sparkling kitchen counter and crossed her arms. "It's not the president, dude, chill."
Lincoln West kept scrubbing the sink with Comet, determined to get the thing to shine before he gave up. "Unless you want to grab a rag and help, go away."
"I told you when we moved in that I dust and vacuum. I don't do kitchens or bathrooms."
"Like I could forget." He worked another small spot of rust out of the metal basin. "You also don't kill spiders."
"That thing wasn't a spider. It was an evil minion from hell come to haunt the bathtub."
Lincoln chuckled at the high pitch Roxy's voice took on at the memory of finding a camel cricket in the bathtub last night. The thing was ugly as fuck and as big as a poker chip, and having spent half her life in a nice house in the Philadelphia suburbs, Roxy was no longer used to finding big bugs in the bathroom.
After spending the last six years living in cheap-ass apartments in inner-city Philly, Lincoln was used to finding all kinds of creepy-crawlies around him.
They were spending the summer at the shore, using the apartment that his best friend's boyfriend kept as a home base for when they weren't traveling the country performing. Lincoln and Roxy had the run of a three-bedroom apartment that took up the bottom floor of a three-story, renovated house only a few blocks from the ocean. They'd been there for a week, and while Roxy had been successful at finding a job as a waitress in a local seafood restaurant, Lincoln kept striking out.
No one wants to hire someone with your issues.
He cleaned so he didn't have to think about it. Besides, having Dominic home for a while would make him feel less like a complete and utter failure.
Roxy's big brother Dominic Bounds and his boyfriend Trey Cooper had been hot shit for almost a year now, after performing together at a national music competition in New York City. Their act, called Off Beat after the quirky bar where they first met, was a big hit, because they combined Dominic's stunning talent on the violin with Trey's singing voice and keyboard skills to create some pretty fucking awesome music.
They were also disgustingly in love, which played well to more liberal audiences. Twice Dominic reported that they'd had to cancel in the South for safety concerns.
Lincoln adored the fact that Dominic was happy and doing what he loved, even if it made Lincoln feel like a car on cinder blocks—stuck, unable to move forward, thanks to some asswipe who ran his car off the road and sent him headfirst into a telephone pole last summer.
"Don't you have to work?" he asked.
"Not for, like, another hour, so I'm free to torment you a while longer."
"Yay me."
The last bit of stain came off the steel basin. Lincoln rinsed it with warm water, then surveyed his work. Perfect.
"Seriously, Dom isn't going to care if the sink is spit-polished," Roxy said.
"No, but I do."
Despite the shit-tacular way his relationship with his parents had ended, Lincoln had grown up in a very well kept house. Not a speck of dust or spot of grime on anything, ever. Partly to do with his sister Mercedes's severe mold and dust mite allergies, and partly because his parents were all about appearances, some habits died hard. Lincoln had taken care of every bad apartment he'd ever lived in with the same tenacity he was showing Trey's kitchen.
Plus it wasn't his place, and he didn't want the actual tenants to think he was taking advantage of their very generous offer to live here for the summer rent- and utility-free. The only things Lincoln had to pay for were food and fun; hence the need for a job. He wasn't going to freeload off of Dominic's parents forever.
He was twenty-five years old, damn it. He'd been taking care of himself since he was seventeen.
A slim brown hand covered his too-pale forearm and squeezed. "Just don't clean yourself into a migraine, okay?" Roxy said. "Then Dom will get mad at me for letting you work too hard."
He winked, then tucked the Comet container back under the sink. "Heard and understood."
"Dom loves you, Linc. That's not going to go away because he's out there performing with Trey ten months out of the year."
"I know." In his head, he knew it. His heart was having trouble getting on board with the idea. He and Dominic had been best friends for eight years, and they knew all of each other's worst secrets. Almost all of them, anyway. What went unsaid sometimes left Lincoln feeling so isolated he ached from it.
Roxy pinched his biceps. "Maybe one day you'll say it and I'll actually believe you."
He swatted at her, but she darted out of range.
Sink done, he turned his attention to the stove top, keeping his thoughts firmly on the task at hand. A while later Roxy shouted good-bye and the front door slammed shut. He was running a Swiffer mop over the kitchen floor when the first tiny pricks of a headache flashed behind his eyes. He put the mop away, then washed a pill down with water, hoping to stop the migraine before it started.
Fucking pain in my ass.
Around four his cell blared out with Dom's ring tone, Off Beat's violin cover of "My Immortal" because the song was fucking beautiful. "Hey, man, you guys still waiting to board your flight?"
"Hey, babe." Dominic's voice wasn't right, even without the background noise of what had to be a crazy, crowded airport. A lot of people traveled on Memorial Day weekend, and he and Trey were supposed to be boarding a connecting flight to BWI at ATL any moment.
Supposed to be.
Lincoln's heart plummeted. "Don't say it."
"I'm so sorry, Linc, but they changed our plans."
"Just now. They got us a last-minute gig in Memphis, three shows over the weekend starting tomorrow, plus a daytime show on Memorial Day."
Tomorrow being Friday. Lincoln swallowed back a bunch of curses, because making Dominic feel bad about the schedule change wasn't going to help. He didn't want Dominic to know how much he'd been looking forward to this. How much he'd needed a weekend with his brother.
"And then you start that stint in Austin all next week," Lincoln said, proud of his even tone of voice when he was shaking inside.
"Yeah. I'm not sure when we'll be able to get back to visit."
"It's fine."
"Are you sure?"
Not even a little bit. "Of course. You gotta do what you love, man."
"I promise we'll be down to the shore sometime this summer."
"I know."
"Shit, they called our section to board. Love you, man."
"Me too."
Lincoln hung up, then gently put his phone on the couch so he didn't fling it across the room in a fit of rage. He stared at the far wall, hands clenched, arms shaking, while he tried to keep it together. The intensity of how much he missed Dom and needed to see him, to talk to him in person instead of over Skype, hit him so hard he almost fell over.
Once the small fit passed, he texted Roxy about the change of plans, then shut off his phone. He didn't need to see her reply text asking if he was okay. She mothered him just enough that it wasn't smothering, but he didn't want it. Not tonight.
With no more need to clean, he ordered a pizza, grabbed a beer from the fresh six-pack he'd forbidden Roxy from touching, and hunkered down with Netflix and his own shredded emotions.
After an entire day spent filling out applications and doing on-the-spot interviews, Lincoln was done. He was hot, sweaty, and pretty sure he'd never work again. It wasn't even his medical issues, it seemed, as much as the fact that finding a job at the beach at the end of May was next to impossible unless you were a pretty girl or a decent line cook. Everyone started hiring help early in the spring.
Shit out of luck, as usual.
He was also riled up and kind of horny, so he took a shower, and then did something he hadn't done all week—he went out. Specifically, he found himself staring at the fake barbershop exterior of Off Beat, a hidden gem of a club known mostly to locals because it didn't look like a club at all. Even once you entered the strip-mall doors, the top floor was all funky couches, piped-in music, and a giant chalkboard for folks to write on with buckets of sidewalk chalk.
It always reminded Lincoln of a dormitory common room on an acid trip.
The Atlantic Bell telephone booth in the rear housed another door. This one led down a set of cement stairs to the actual club. Lincoln didn't care that he looked like a diva wearing wraparound sunglasses in a dark bar; he needed the protection from the flashing lights or he'd be in pain within five minutes.
The small room had a U-shaped bar to the right and a sea of tables and chairs—some pub height, some shorter, all mismatched and different. The bar itself had a cheesy surfboard theme that worked for the quirky place.
The crew was setting up the stage for the eight o'clock performance, whoever that was. He hadn't bothered to check on his way in. The owner, Beatrice Westmore, played three gigs a night at eight, ten, and midnight. Thursday was always an open-mike night, something Lincoln kind of wanted to come out for.
Maybe next week.
He'd played here once, just about a year ago, with his former band XYZ. It was the first time that he met Trey Cooper and the rest of Fading Daze—another band still out there, making music with Lincoln's former lead singer Benji Moore. XYZ's drummer, Tyson Reed, had kind of faded off the radar, occasionally poking his head onto social media to say hi, but that was it.
The place wasn't too crowded yet, so Lincoln snagged a spot at the bar. He vaguely recognized both the male and female bartenders from last year. It didn't take long before the guy, a hot number with spiky black hair and very sharp cheekbones, asked what he was drinking.
"What local on tap would you recommend?" Lincoln replied.
The bartender winked, then grabbed an empty glass. He returned a moment later with a pale ale with a light head. "Tab?"
He didn't plan on getting wasted, but it was easier than sliding his debit card over and over. Not that he had an endless amount of money in there, either. He hated knowing every penny in his account was a gift from Dominic's parents and tried to use as little as possible. Tonight he needed to fucking unwind.
"You look familiar, man," the bartender said while he mixed another drink order. Just Lincoln's luck he sat near the man's workstation. "Been here before?"
"About a year ago."
"Welcome back."
"Thanks." Lincoln sipped his beer. Perfectly chilled, malty with a nice, crisp finish. Not bad. "What is this?"
"Dogfish Head," the guy replied without looking up from his garnishes. "Firefly Ale."
"Weird name." But a good beer.
Hot Bartender handed off his two drinks, then took cash to the register. On his way back, he said, "Named it after a local music festival."
Ah-ha, that made sense. Lincoln had been to the Firefly Music Festival two years ago as part of the general audience, and it had been amazing. It had also been a dream of his to see XYZ perform there, and that wasn't happening ever.
He hummed a few verses of "Don't Dream It's Over" while he sipped his beer and crowd-watched. Groups of women at the tables, a scattering of guys. Eight was pretty early for the typical bar crowd, and he had no idea if the place attracted a lot of queer patrons. Lincoln was just as interested in the music as in a physical talent search.
His phone buzzed with a text alert. Photo from Dominic. Cute selfie of him and Trey outside of some Memphis bar advertising Bar-B-Q in bright neon.
Hope you guys have a redneck set for that crowd.
He sent a thumbs-up emoji as reply.
Movement right in front of him made Lincoln jump and nearly elbow his drink. The male bartender was grinning at him while wiping a glass with a towel. "Thought I recognized you, man."
Lincoln raised an eyebrow.
"You were in that band XYZ," the bartender went on. His smile faded away. "Shit. You were in that accident, right?"
"Yeah, I was in that accident." Lincoln held his temper, waiting for the pity or the sad looks, questions about his general health.
The guy surprised him by offering his hand. "Van Holt."
Lincoln shook. "Lincoln West."
"Look, next one's on me, okay?" Van pointed at his half-empty glass.
"I appreciate it, thanks."
Van went about his work, smoothly dancing around the back of the bar with a short female. He had a seriousness about him that gave his angular face an almost angry look, but he smiled and flirted with his customers, lining his pockets with tip money. Lincoln no longer trusted his gaydar after getting it blown to pieces by Trey coming out last summer, so he shelved Van under Undetermined.
The eight o'clock act ended up being a girl with a guitar doing folksy renditions of pop hits. She wasn't awful, but Lincoln wasn't sure that anything other than local stages were in her future. He spent most of her set picking apart her arrangements and redoing them in his head on a guitar he could no longer play.
Not that he'd forgotten how or had lost control over his hands from the concussion. Traumatic brain injuries were crazy tricky, and for some reason that his neurologist could not explain, the vibrations of the guitar strings made him dizzy. It sucked ass, because he loved guitar. It had been his focus instrument since he was ten years old, and now his sat in its case in a closet at the Bounds house. Doing nothing.
Should've pawned the damned thing.
A slinky female number in a tight blue dress eased onto the empty stool next to his, angled toward him. "What are you doing out all alone on a Friday night?" she asked.
Lincoln leaned his elbow against the bar, too bored to shut her down right away. "Nothing much. Listening to some music. Enjoying a local brew. You?"
"Same. Except I don't seem to have a drink to enjoy."
Oh yeah, she was hustling him for a drink. But Lincoln didn't swing that way, and he wasn't wasting good money on something he had no hopes of banging later tonight. "You might want to get on that, then."
She pulled out her very best pout. "Someone's not feeling generous tonight."
"Someone's not fishing for your brand of talent tonight."
"And what brand is that?"
"Seriously?" She dropped the pout and just looked . . . tired. "You're gay?"
"Why can I never flirt with the right people? Why?"
Lincoln laughed. "I don't know you well enough to make a guess about that one, sorry."
"Don't be." His companion flagged down Van and ordered a vodka sour. "Melody."
"Excuse me?"
"My name. Melody Thompson."
"Lincoln West." His second introduction in less than an hour. Maybe he wasn't so bad at this socializing thing.
Van returned with Melody's drink. She immediately ate the cherry garnish. "So, how come someone as hot as you doesn't have a boyfriend?"
Lincoln blinked. Despite Roxy's blunt nature, he wasn't used to hanging around chicks who said whatever was on their mind. It was kind of refreshing, given the way most people in his life treated him—like they wanted to wrap him in bubble wrap so he didn't fall over and break. "You're not so bad-looking yourself," he replied. "How come someone as hot as you doesn't have a boyfriend?"
"I'm too picky, I guess. Plus, you know, this tendency I have of sniffing the wrong tree."
He wasn't sure that was the right metaphor, but whatever. "Ever try online dating?"
"I'm not that desperate yet."
She sipped her drink, and Lincoln took the pause in conversation to study her. Melody had a pleasantly round face, no sharp angles, and plump lips perfectly shaped with lipstick. Just enough makeup to accent her eyes and cheekbones without being over-the-top. Curly dark hair that barely brushed her shoulders. Slim body with not a lot of curves, small tits she made the most of with that tight dress. Someone tonight would definitely want to hit that.
Just not him.
"Want to man-watch together?" Melody asked.
"Sure, why not?" Dominic would be so proud of him for making a friend. Even if only for a few hours of bar conversation. "You have a type?"
She winked. "Blond."
He ran a hand through his unkempt blond hair that was probably a month past needing a decent trim. "Shocking."
The words "tall, dark, and biracial" lingered on the tip of Lincoln's tongue, but he kept them to himself. Despite the fact that Dominic was madly in love with Trey, and that Lincoln hadn't had a sexual relationship with Dominic since they were teenagers, a part of Lincoln had remained in love with Dominic since he was seventeen. Every guy he dated got compared to Dominic, every prospect falling short of expectations until Lincoln gave up on dating and focused on his music. Casual fucks became the norm, and he kept his long-distance crush to himself.
He and Dominic would always be friends and brothers, but that was it, and Lincoln needed to move on. "I'm not too picky," Lincoln replied.
They both spun their stools around and spent the next half hour critiquing every guy in the place. Some talent existed, but they were either on the arm of another girl or in a clinch with another dude. As the time wore closer to the ten o'clock act, the bar filled with more people and Lincoln was halfway into his fourth beer. Probably not a great idea, considering he'd taken his depression meds later in the day than usual, but whatever. He was out having fun for a change.
His lips also felt a little numb from all the alcohol, so he tapped a finger against them.
Both still there.
He also found himself stupidly curious about his drinking companion. "So are you local or on vacation?" Lincoln asked.
"New transplant." Melody had only just ordered her second vodka sour, and she stirred it with the tiny straw. At least Dom would have been matching him beer for beer. "I moved to the area about a month ago."
"Onley, Virginia. Tiny town on the lower shore. You?"
"Here for the summer."
"Where do you live when it's not summer?"
"I've never been."
"What?" Lincoln stared at her in genuine horror. Philly was the best city within a three-hour driving radius. "Now that's a damned shame. I'll have to show you around sometime."
"I guess you will now that you've offered." She tapped at her phone, then turned it around. "Give me your digits." He did, and she immediately shot him a text. "There, now I can bug you until you do take me."
He laughed, then finished off his beer. The alcohol gave the world a nice, fuzzy edge. All of his problems were far away, no longer haunting his every step. He liked the fuzzy.
He liked the fuzzy so much he almost missed the appearance of a new face behind the bar. Younger than Van, with a slim, almost twinkish frame and thick, dark hair. Adorable face with a serious expression. He dumped a container of lime wedges into the bin at Van's station, head ducked in a way that said "Don't notice me."
Lincoln couldn't stop noticing him. He stared so hard the guy must have felt it, because he looked up. Pale eyes met his, and something inside of Lincoln sat up and took notice. Except the object of his attention looked away fast and practically bolted from behind the bar.
Fucking sunglasses. Probably couldn't tell I was totally cruising him.
His issue all night, he was sure of it. He couldn't hold eye contact when guys couldn't fucking see his eyes.
He sensed the warm body near his before the hand gently brushed his hip. Lincoln swiveled away from Melody, toward tall, blond, and stacked. The new guy leaned against the bar on his elbow, his free hand drifting to Lincoln's knee. The bar back's pale eyes lingered in his memory, but this guy wasn't running like a startled deer.
"Hey," Lincoln said.
"Hey, yourself." That hand inched a bit higher. "Don't think I've seen you here before."
"First time in a while." His dick started paying attention to the pressure on his leg. "Didn't feel like staying in tonight."
"Same here."
Lincoln leaned in, angling his head, hoping to make his intentions clear. "I'm not opposed to calling it an early night if I have someone to take home with me."
"You taking them home for anything in particular?"
His lips were inches from the guy's ear when Lincoln said, "So we can fuck."
Tonight's talent shivered, then said, "Sounds good to me. Let's get out of here."
"Yes. Let's."
(c) A.M. Arthur 2016
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text:
Sweet corn is sautéed spicy with red pepper and jalapeño then tempered with cumin tomato scented beans. A tortilla makes the perfect plate for this summer corn spin on a classic Mexican breakfast. This recipe comes to us from Emily of Well Fed, Flat Broke.
Serves 4
- 2 tablespoons canola or olive oil
- ½ medium onion, chopped
- 3 cloves garlic, minced
- 1 cup fresh corn, cut from the cob
- or
- 1 cup frozen corn, thawed
- 1 cup red bell pepper, diced
- 1 jalapeño pepper, minced
- 3-4 large tomatoes, puréed to make 2 cups tomato purée
- 1 14 ounce can black or red beans, drained
- 1 teaspoon salt
- 1 teaspoon chipotle chili powder
- 1 teaspoon ground cumin
- ½ teaspoon dried oregano
- 4 eggs
- ¼ cup queso fresco*, crumbled
- 4 flour tortillas
- 1 lime, cut into wedges for garnish
- ¼ cup fresh cilantro, chopped
*a soft, mild chees. Queso fresco can be found in Mexican markets or the Mexican or dairy section of most grocery stores. Substitutions include feta, ricotta or any other soft cheese.
Preheat the oven to 375 degrees.
Place the oil in a large pan over medium-high heat for 3-5 minutes, or until the onion becomes translucent. Add the garlic, corn, bell pepper and jalapeño to the pan. Stir to combine and cook for another 3 minutes, or the veggies until are glistening.
Stir the puréed tomatoes, beans, salt, chili powder, cumin and oregano into the pan. Turn heat down to low and simmer for five minutes more, or until the mixture has reduced and thickened slightly.
Remove the pan from heat and crack the eggs on top. Sprinkle with the queso fresco and place the pan into the heated oven on the middle rack. Bake for 12-15 minutes, or until the whites of the eggs are fully solid and the yolks are cooked to preference.
Serve the egg bean corn mixture in equal portions atop 4 tortillas. Squeeze a lime wedge over each portion, sprinkle with cilantro and enjoy.
This Recipe's Ingredients:Beans, Corn, Garlic, Red Onion, Red Pepper, Tomato, White Onion
Nutrition Information
Chipotle Corn Huevos Rancheros
Servings per Recipe: 4Amount per Serving
Calories: 383.5
Calories from Fat: 111
Total Fat: 12.3g
Saturated Fat: 2.6g
Cholesterol: 211.5mg
Sodium: 865.5mg
Potassium: 905.7mg
Carbohydrates: 53.1g
Dietary Fiber: 11.2g
Protein: 18.4g
The U.S. Food and Drug Administration (FDA) recommends 2000 calories a day as a reasonable average guideline for most American adults. Click here to learn how you can use the Monday 2000 to reset the calorie budget you have to spend each day. For specific calorie recommendations based on your age, metabolism and medical history, consult your doctor or nutritionist.


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ideas, innovations and apps for social work in the age of smartphones and social media
As you may have mentioned I didn't post very much the last weeks. There are some reasons for this that I would like to share with you. Since summer I've been focusing on three projects that asked for most of my time so I had to let go of Mobile Social Work. These three projects are…
The most important thing … family. Jule May was born in March and is still trying to find the best ways to keep us from sleeping, working, relaxing and spending time on things that we once thought are important. Changing diapers, looking for the right milk, securing sockets and finding that life is a miracle is now one of my main tasks.
Great project! I recommend it to everyone. 🙂
Some days ago I got message that my application for a doctorate is accepted. That means the next 4 to 5 years I will spend on research. This fits great into my academic career but will ask for a lot of time. The topic of the doctorate is on the intersection of social work and technology: Evaluation of usability, adherence, effectiveness and costs of a blended face-to-face and web-based smoking cessation treatment versus treatment as usual.
Looking forward to do this.
Last year I started a project within the European Lifelong Learning Programme that develops a a competence framework for youth work in the age of smartphones and social media. It's called YOWOMO2.0 – Youth Work Mobile 2.0. This is now running and also asking for attention. I think that this project can be seen as a little sister of Mobile Social Work focussing on a special part of the topic. In the long term the project can lead to offering training and assessments to social workers. A great challenge.
As you can see these topics may ask for a lot of attentions besides being a husband, a father, a son, a brother, a friend, a lecturer, a runner, a musician, …
So where does this lead to: After nearly two years, more than 600 posts and more than 26,000 views I stop with Mobile Social Work. It was a great time aggregating ideas and news on social work in the age of smartphones and social media. I learned a lot and made contact with wonderful people like you. Thank you for your attention and support!
I hope to meet you in another context.
Take care,
Good luck with your pursuits. Let us know at http://supportnetworkonline.com if we can be of any service to your various endeavours.


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The expertly curated combination of glass and aluminum makes this high quality tip a must-have for any vaper.
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Have you seen the movie Girl With the Dragon Tattoo? The movie is based on the book of the same title by Swedish author Stieg Larsson. The main character is a girl who lives with asperger's syndrome and has an amazing ability to hack information. She uses her skills to help a journalist solve a mystery. This representation of a computer hacker is realistic in some ways, but misses the mark in others.
Reality: The young hacker, Lisbeth Salander, goes by the alias "Wasp" when she's involved in computer hacking. Some hackers, especially notorious ones that have been caught and publicized or those who use their skills to point out flaws in security systems (known as "white hat" hackers), are known by their legal names. However, many hackers have an internet "handle" or code name that they're known by.
Reality+Myth: Lisbeth has a "lone wolf" sort of hacking persona but does communicate with other hackers in what seems to be a vey loosely organized context. They know each other by their handles and communicate mostly via the internet, sharing tips and helping one another occasionally. According to "The social organization of a criminal hacker network: a case study" by Yong Lu, this sort of hacker community does exist in some cases. However, there are also networks that are far more akin to a professional crime ring, where a hierarchy exists and and the work load is very specifically shared among members.
Lu characterizes this sort of network as being a fairly recent phenomena. While hackers of old tended to use their skills for Continue reading Hacker Myths and Realities in Girl With The Dragon Tattoo


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The idea of this activity is to understand what does deep learning means and what are the kind activities and assessment that the teacher needs to create so that deep learning can happen.
In order to study this aspect of the learning experience there are some resources to read:
- The Higher Education Academy guide
- This blog post
- The National Education Association blog
- Conceptions of learning and knowledge in HE: relationships with study behavior and influences of learning environments (Noel J. Entwistle and Elizabeth Peterson, 2005)
- Some files I have been reading are available this link to my box
- Steven Johnson's Ted Talk: Where does good ideas come from?
Normally I adopt a deep and strategic approach to learning. Meaning with deep that I seek for meaning by relating ideas, using evidence and monitoring my learning so I can improve if needed and, with strategic I use Entwistles' ideas meaning that it is an integral personal understanding. Achieving through organised and self-regulated effort guided by self-determination.
My experience with deep and surface learning
I usually want to go the bottom of things and understand the origins of ideas, from where they come and to what they relate in the bigger picture. I try to construct meaning all the time looking for connections among prior knowledge and the new one. The more connections I found the deeper and stronger the knowledge and the broader the range to where I can apply this knowledge. I think I have a big connected network of knowledge units that feed each other. I try, through my learning, to connect the majority of nodes in my knowledge network that I can, making it a strong and relevant network for my job and life in general.
I am not after grades. I do even read many things and take many online courses for the sake of learning and I am not interested in any certificate or accomplishment. Although I think this is not entirely right as in our society other people will ask me for evidence of my knowledge and I need to have those grades or certificate at hand to show them when necessary.
When the topic is not of my interest I try to think how relevant it is to what I am interested in and so I decide if I will go deep in that particular topic. If it is not so relevant I do the readings but more than reading I scan and see how that can answer the questions and then I move on.
In this course I adopt the two approaches in different moments. For example if my time is very limited and I do know the content I do not go very deep in the answers because time is gold at the moment but when I confront myself with new content that is relevant and totally new for me, i.e. unit 3, I will stop and go deeper in order to be able to connect this unit to my overall work in the university and my own research.
There must be a relevance to my practical work which is normally close connected to my intellectual interest. Therefore I have to say that most of the times I adopt a deep approach to learning.
Deep vs deeper learning
As you know I am a math teacher so I studied math education as my undergraduate degree. There I had a math teacher that taught us integrals. He gave us the algorithm to calculate the integrals and voilá he gave us 234 exercises for homework. I did them all but I just followed the rules he gave us. It was quite easy and at that time I was so busy (I had already my 3 children, house, husband, dog and all the rest of a very active family life) that I did not care about not understanding the essence of it. I did wonder why we didn't see any theorems but again no time to go deeper. 15 years later (2014) I became interested in the history of math, so I started to research in the origins of calculus. I had to give a workshop in a summer university in Denmark, so I new the only way to do a good workshop is having a deep understanding of the subject. So I went deeper!! I struggled so much, I read and read and looked at many different sources of knowledge. I saw videos, I heard podcast, I read original sources, secondary sources. I did a lot of exercises, I did a time line with the important stepping stones of the development of the calculus, I assisted to talks. I did not leave my house for a week just studying. I wrote an email to my supervisor one day really desperate and he send me from the Netherlands via post a chapter of a book but also an attachment with an exercised I did not understand, already resolved and explained and suddenly, the light came to me I got it!!! I understood the whole threat of reasoning I was after (Descartes and his discovery of analytic geometry as one of the stepping stones for Calculus to move forward and develop). It was really intense for me. I did not any thing different for almost a week. I know one should change, go out, forget, etc but I couldn't, I was so into my learning desperate finding connections, links to my prior knowledge that I couldn't leave nothing aside. When all the bits and pieces of discrete knowledge strarted to become part of a continuum I felt inside my head how all suddenly was making sense and many of the problems became clear to me.
After my workshop, I felt the ontological transformation I went through!! I really changed inside, it was such a nice feeling. This moment of AJA, UNDERSTANDING, THE PENNY FALLING, its for me one of my favorites. So I guess that is why I avoid surface learning


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Rudolf Nureyev ought to need no introduction - he is widely regarded as the greatest male dancer who ever lived. We will no doubt be doing a feature on him in the future but for the moment you can read about him here. This is a fine example of his dancing, taken from Le Corsaire, filmed in 1963.
We set up this site to support and encourage young men who do ballet
and demystify the world of ballet for those who don't.
Essential clips: Nureyev in Le Corsaire
4 comments:
- Rita Damper1 December 2010 at 18:53
this link doesn't work any more :(ReplyDelete
Thanks for the notification, Rita.ReplyDelete
I'll see if I can find another version of it as soon as possible.
Right, post updated, I think this is the same excerpt. Quality slightly lower, I'm afraid...ReplyDelete
- Anonymous8 April 2011 at 01:31
Well, I had no problems with the video, and the young man was a very good dancer. Ha! There are those with very wrong opinions regarding male dancer, especially ballet, but I let that not to bother me, as there is much grace in ballet. Shalom, and have a nice day.ReplyDelete
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You Can't Step into the Same River Twice
It is a funny name, I know. But, it seems to me to be a metaphor for life.
It is the first in this series. I find it quite joyful to work in this small size, trying out ideas for larger works to come.
Thanks for viewing and leave a comment if you are inclined. I would love your feedback.
Best to all.
Linking to Off the Wall Friday


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NLP {Neuro Linguistic Programming} is a very powerful process
Neuro Linguistic Programming works by tapping in to the resources of the brain and confusing them. Yes, that sounds simplistic but that is, in my opinion, the crux of NLP.
For instance, I have worked a lot with fear issues. One bike rider had experienced a fall on the road where he was unconscious for thirty minutes and then rushed to hostpital. A cyclist of some forty years, Julian had always been a confident bike rider. But, now he was scared to get on his bike. After only one session with me, using a method called SWISH, he admitted that he felt different right away. The next time he went out on his bike he could literally feel no fear. That was several years ago and he has been riding his bike happily every day since then.
I have worked with horse riders, bike riders, businessmen and women, sports people and many more and for a wide variety of issues.
In my capacity as a Positive Mentoring Coach, I will often use NLP to help people make the mental shift to inaugaurate changes. Please visit the coaching page by clicking on the link in the menu bar above for more details.


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Do you like puzzles? How about perception based puzzles? Now I have your attention. Closure is a puzzle game that was originally developed for the website Newgrounds. Recently, the indie developer, Eyebrow Interactive, has created a version for release on the PSN with a bunch more levels. Is Closure just some cheap, internet time waster, or will it shine bright on the PSN? Find out after the jump.
The gameplay in Closure is much like the puzzle game, Echochrome, where if you don't see something then it doesn't exist. Most of the levels are shrouded in dark, and if the player steps into the darkness, then they will fall and have to restart the puzzle. This goes for keys and other objects, as well. The player will have to manipulate light sources in order to navigate levels and solve the puzzles. There are some really cool implications of this gameplay style. First of all, everything has an air of mystery about it. Everything is in dark and you don't really know what is in a level. Even with spotlights, handheld lights, and hanging lanterns, there will still be areas of a level that never get lit up, and so you never know what is over there. There are also static images in the background that can only be partially be seen by the player. Some provide atmosphere, while others give subtle clues about what to do next. This game is as much about learning your environment as it is solving the puzzles contained within in it. Now, it may seem like not being able to see a puzzle you are trying to solve would be a bad thing, but the game never gets frustrating. Sometimes, you might need to take a leap of faith or activate a platform just to see what it does, but I never found myself wandering around a level with no clue what I was supposed to be doing. The layout of the levels light sources, platforms, and other objects always give strong hints about where you should be and what you should be trying to do.
The difficulty and complexity of the game keep it interesting and engaging. Initially, it starts out very simple in order to give the player a feel for the game. Then it starts playing around with new types of light sources. Then it starts introducing levels that are harder to navigate, and then it will start introducing even more light sources. The game goes back and forth between introducing harder environments and introducing new light sources that the player will have to figure out how they work. Water also plays an important role with some objects that float and some objects that sink. The mechanics are all very simple, so getting accustomed to some new gameplay or light source doesn't take much time. Eventually, you will need to get to the point where you will need to think about the puzzle as a whole and try to make connections between different parts of the puzzle. This is where the game really shines, and figuring out the relationship between two things that at first seem unrelated is very satisfying.
The game runs into some issues with collision detection and some of the jumping puzzles. Oftentimes, the player will be required to drop a key in a precarious position. Not only is it hard to tell exactly where the item will fall, but sometimes the key will fall off the edge when it seems it shouldn't. It is also hard to tell how dropping items onto each other will affect them. Sometimes they push each other out of the way and sometimes they don't. This could lead to some frustrating parts where the player keeps causing keys to fall off ledges. Jumping and getting close to edges also has its glitches. Much like the keys, sometimes the player will fall off an edge when it seems they shouldn't. The game doesn't require a lot of long distance jumping, so the issue doesn't come up that much, but it is very frustrating when it does happen. Luckily, there is a quick reset button for when you screw up a puzzle.
The style and aesthetics of the game are simply amazing. Everything is in black and white and has a feel of being very dark and grimy. Lines shake and move around to make the entire level seem as if it is alive. The drawing style itself give the impression of some dystopian future created by Tim Burton. The music also fits really well, which mostly consists of drum beats and ambient noises.
Closure is one of those puzzle games that challenges a player and looks good while doing it. Like all great puzzle games, it follows the philosophy of "easy to learn, difficult to master." Learning about the mechanics of the game is simple, and woven into the gameplay well enough that it is actually fun to learn about the game. Anyone who picks up this game will find hours of challenging gameplay, but ultimately a great sense of accomplishment that comes with any good puzzle game.
PlayStation LifeStyle's Final Score
+ Aesthetics Are Amazing
– Some Mechanics Are Clunky


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Brown Wing Overdrive (11 Albums, 22 Tracks)
TAGGED AS:brooklyn, chuck bettis, dave miller, brown wing overdrive, mikey iq jones, See More...
- Living Myth
- Tzadik
- Chuck Bettis (electronics + throat) & Derek Morton (electronics + banjo) .
- Mikey IQ Jones (electronics + jaw harps + percussion + objects + vocals)
- Mikroknytes
the last BWO performance: http://youtu.be/fyLFY12Z6ag
Brown Wing Overdrive is Chuck Bettis (electronics + throat), Mikey IQ Jones (electronics, objects, percussion, vocals) and Derek Morton (electronics, banjo). They started as a duo of Bettis & Morton, then with the addition of Mikey IQ Jones, became a trio for a couple of years until IQ went rogue shortly after BWO's Tzadik record was released. For a few years BWO explored rituals as an amorphous group that constantly included Bettis & Morton plus many great musicians; influenced by pollution, angry shamans, burning circuitry, lonely poltergeists, sandpaper, dental work, alarm clocks, hallucinogenic banjo claw hammer, trash trucks, beat box'in, synthy modular meltdown and chaotic analog. Now IQ has returned from his walkabout and BWO has resurrected as the original trio to bring forth the insanity once again.
also, BWO's "ESP Organism can be ordered directly through Tzadik
Brown Wing Overdrive + (((10))) "Zombie Allergy" Living Myth
Brown Wing Overdrive "L Phantasm" Kavekavity
Brown Wing Overdrive "Esp Organism" Tzadik
Brown Wing Overdrive "We've Got Issues: live at Issue Project Room" Living Myth
*"We've Got Issues" was tour only recording, now out of print but the live show is on FMA


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The 10 Best Gaming Mouse Pads
This wiki has been updated 22 times since it was first published in July of 2015. If video games are more than a casual hobby for you and you want to step things up a notch, try out one of these dedicated mouse pads. They are designed specifically to provide greater responsiveness and control than regular models, allowing for improved enjoyment and performance. And when you want to share your latest triumph with a screenshot, they'll even make working in Photoshop feel cool. When users buy our independently chosen editorial recommendations, we may earn commissions to help fund the Wiki. Skip to the best gaming mouse pad on Amazon.
A Brief History Of The Computer Mouse
But the mouse alone cost more than $400, making it too expensive for most consumers.
But the mouse alone cost more than $400, making it too expensive for most consumers.
A device approximating the form and function of the now ubiquitous computer mouse was first developed in the early 1940s. As is so often the case with innovative technology, the unit was developed to assist with the waging of war. The earliest trackball controlled "pointing device" was designed to help a radar system that could track incoming enemy aircraft. It was part of the "Comprehensive Display System" that was run by a series of analog computers.
In the 1960s, as computing technology developed ever more quickly, so too did the computer mouse begin to take a more practical form. Several companies in several countries developed mice using trackballs that could interface with computer hardware and software, but none would prove practical prior to the release of the Xerox Alto in the 1970s. That computer, one of the first personal computers that saw broad appeal and use, could be controlled using a mouse, which freed its operators from the laborious task of memorizing (or referencing) long text commands.
The Xerox Alto was a successful computer, and its moue was a fully functional piece of hardware. But the mouse alone cost more than $400, making it too expensive for most consumers. Then in 1980, under the leadership of it visionary founder Steve Jobs, Apple Computer partnered with a group of researchers and product developers from Stanford University to develop a functional, affordable mouse. The unit they came up with and soon offered to the general marketplace was the Apple Lisa, the first widely successful personal computer that used the now common graphical user interface, or GUI.
Soon the mouse and the GUI interface had been adopted by Microsoft, and by the mid 1980s, the mouse was being used by people at home, at work, serving the government, and beyond. It followed logically that the mouse would also become one of the most popular ways to control the action of a computer game. Today one can find mice in all shapes and forms, from the ergonomic mouse to the upright mouse to the Bluetooth mouse and beyond. For the best experience using a mouse for gaming, one should treat himself or herself to an excellent gaming mouse pad as well.
Why Gaming Mouse Pads Make Sense
The quality of your game play experience is dictated by the level of control you exert over the action. When every split second matters, you need to make sure your hardware is as responsive and precise as possible. You can do much to fine tune your game play by adjusting the sensitivity settings of your mouse (and indeed by choosing the right mouse for your specific needs in the first place), but you give your mouse a great deal of added support by getting a good gaming mouse pad.
By ensuring an optical mouse provides clean, consistent control, a gaming mouse pad removes the issues your mouse can experience on reflective surfaces like glass or a glossy tabletop, or that can occur with uneven or textured surfaces such as wood. Your gaming mouse pad is to your top quality mouse as race track is to a super charged vehicle: if you've made the considerable investment in a great mouse, it only makes sense to make the minor investment in a great gaming mouse pad.
A gaming mouse pad also offers the added benefit of protecting the desk (or tabletop) you use during long gaming sessions. There will be no wear and tear endured by your desk even if you are moving your mouse around vigorously thanks to the protection afforded by a large, durable mouse pad.
Choosing The Right Gaming Mouse Pad
Gaming mouse pads are not expensive items. The priciest model you will find will cost only around fifty dollars, and many decent options cost well under twenty. Thus the gamer who also uses his or her computer for work or other purposes can afford to use one mouse pad for their gaming, and another for different applications, if need be.
Many gaming mouse pads are wide enough to span much of your desk, accommodating your keyboard and providing a sizable area for mouse operation as well.
When choosing a gaming mouse pad, size matters. Many gaming mouse pads are wide enough to span much of your desk, accommodating your keyboard and providing a sizable area for mouse operation as well. If you use a desktop computer and are fine with always having the same setup at your desk, these are fine options.
If you use multiple monitors that require plenty of lateral motion for proper control, these wide mouse pads are likely necessary. If, however, you use a laptop that might need to sit closer to the edge of your desk, or that you often use in varied locations, these large pads are illogical. They are also a poor choice for use at smaller desks or tables, of course.
And remember that it's perfectly acceptable to select a gaming mouse pad based on aesthetics alone, aka the "cool factor." Many gaming mouse pads have unique designs and color patterns that make them stand out, while others are even illuminated, which not only looks great, but can also make it easier to use your computer in lower light settings. So if you want your gaming setup to look as great as it functions, treat yourself to a vibrant, eye catching mouse pad your friends and colleagues will appreciate.
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Hosting a
? Planning a
? Chairing a
regional meeting
or planning a
? Watrous and Manitou Beach offers a broad range of facilities and catering services to suit your needs!
Centrally located, Watrous and Manitou Beach is the perfect destination for guests, staff and clients. Travel time will decrease as fun and productivity will increase. No need to weigh your wallets down with coins as each venue has plenty of free parking. Economical rental rates, clean, bright facilities with a myriad of extra amenities and skilled caterers
are the perfect combination to hosting everything from a small intimate wedding or anniversary to a large provincial conference.
With many venues from which to choose, economical rental rates, facility amenities of which there are too many to list and food services with impeccable reputations it is time for you to take advantage of the Watrous and Manitou Beach hospitality and plan your next event in the heart of Saskatchewan! You will wonder why you didn't do it sooner!
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Published by Image and "Joe's comics", this dark and tragic tale from the possibly slightly-disturbed mind of J.Micheal Straczynski is beautifully portrayed from both a heavenly perspective, right down to it's revolting demonic depths! The lead man Joe Fitzgerald IS the new John Constantine, an ex hit-man turned paranormal detective, who is out for revenge after the tragic death of his girlfriend Laura. Joe has no other choice but to join forces with the angels to help combat the demons that roam our world; but this is more than just a job for Joe, it's a personal journey, a tale of love, hate and revenge…
I love the sketchy, and at times "fear and loathing in Las Vegas" style of the art and characters that make this comic truly special, thanks to Ben Templesmith. The colouring is equally as elegant and gothic, the colour-washed style sets the scene effectively, and draws out all of it's 'personal feelings' while imprinting them onto our influential brains! The tones change along with Joe's personal sighting's, invoking Joe's feelings within us… all very thoughtful, from the moody blues to the fearful greens, heavenly white and hellfire red it is this artistry that really determines the timing and flow of the whole comic.
Obviously we can't forget about the abstract lettering which works very well with the one of a kind scripting and artwork. In a nut shell this issue sees the debut of TEN GRAND, a comic that deserves all of the recognition it can get regardless of personal preference. Author Straczynski gives us an interesting insight, along with further incentives to follow "Joe's comics", and the ten grand series in a two page 'letter' at the end of this first instalment, which has without a doubt left it's mark on my mind…
By Dylan Butcher. 😀
Here are some related links, well worth checkin' out!:
J.Micheal Straczynski Ben Templesmith
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