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Objectives The aim of this study was to determine mortality among pulp and paper mill workers according to the main mill pulping process, department, and gender, particular reference being given to diseases of the circulatory and respiratory systems. Methods The cohort of 18 163 men and 2291 women employed between 1939 and 1999 and with >1 year of employment was followed for mortality from 1952 to 2001 (acute myocardial infarction from 1969). Standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were estimated by comparing the observed number of deaths with the expected number for the entire Swedish population. Exposure was assessed from personnel files in the mills. Data from an exposure measurement database are also presented. Results There were 5898 deaths in the cohort. Total mortality had an SMR of 1.02 (95% CI 0.98-1.06) for the men in the sulfate mills and an SMR of 0.93 (95% CI 0.90-0.97) for the men in the sulfite mills. Mortality from acute myocardial infarction was increased among the men in both the sulfate and sulfite mills [SMR 1.22 (95% CI 1.12-1.32) and SMR 1.11 (95% CI 1.02-1.21), respectively] and by department in sulfate pulping (SMR 1.29, 95% CI 1.07-1.54), paper production (SMR 1.26, 95% CI 1.06-1.49), and maintenance (SMR 1.16, 95% CI 1.02-1.30). Mortality from cerebrovascular disease, diabetes mellitus, and nonmalignant respiratory diseases was not increased. Conclusions Death from acute myocardial infarction, but not cerebrovascular diseases, was increased in this cohort and was probably related to a combination of different occupational exposures (eg, dust, sulfur compounds, shift work, and noise).
Introduction: There is little information available on the effects of problem-based undergraduate curricula on doctors and their performances after graduation. Therefore, we conducted a questionnaire study of all graduates of the new medical programme at the Faculty of Health Sciences, Link÷ping University. Methods: All 446 medical students who had graduated from the new programme were asked to fill in a questionnaire about selected activities during their studies and their careers after graduation. They were also asked to evaluate the quality of their undergraduate education retrospectively. Statistical analysis was performed using descriptive, multivariate and bivariate approaches. Results: A total of 77% of the graduates responded. They showed a high degree of overall contentment with their undergraduate education and felt well prepared for professional life during their preregistration period and specialist education (mean = 4.0 on a 6-point Likert scale ranging from 0 to 5). They felt especially well prepared in terms of skills for communication with patients, collaboration with other health professionals and development of critical thinking/scientific attitudes. The students' age at the beginning of their studies correlated positively with their contentment as graduates, especially in terms of preparation for patient communication and collaboration with other health professionals. No differences between students originally admitted via a local admission procedure and those admitted via a national procedure were detected concerning retrospective evaluation of undergraduate medical education. Conclusion: Graduates of the new curriculum showed a high degree of satisfaction with their undergraduate education and its preparation of them for medical practice. Specifically, they were very content with the particular emphases of the new curriculum.
Aim: To verify the occurrence of cognitive impairment in patients with chronic whiplash-associated disorder (WAD) and to provide a more detailed description of the impairment's character and context. Methods: Thirty (30) patients with chronic WAD and 30 matched healthy controls completed a cognitive test battery. Four computerised tests were used: a) two different types of cognitive tasks (reaction time vs. working memory) and b) two types of information processing (verbal vs. spatial). Before testing and after every randomised subtest, subjects rated their pain level on a visual analogue scale. Results: A worse overall performance among patients with WAD and, specifically, worse results concerning working memory tasks were found. Post-hoc testing revealed a statistically significant difference concerning the single variable "verbal reaction time". Pain intensity among patients increased significantly during testing. Pain intensity after the subtest for verbal mental reaction time (independent of test sequence) was significantly correlated with results in this subtest, the more pain, the more time was needed. Conclusion: Compared to healthy controls, patients performed worse overall. Concerning verbal reaction time, the impairment was correlated with pain intensity. The findings support the hypothesis that pain might be one important factor leading to cognitive impairment in patients with chronic WAD.
Chronic musculoskeletal pain has biological, psychological and social components. This review deals with the biological factors, with emphasis on the fibromyalgia syndrome (FMS). Studies on central sensitization of pain-transmitting neurons, changes in endogenous pain modulation that give rise to pain disinhibition, referred pain, pain-related decrease in muscle strength and endurance, and pain generators in deep tissues are reviewed. In FMS there is strong scientific support for the statement that the biological part of the syndrome is a longstanding or permanent change in the function of the nociceptive nervous system that can be equated with a disease. Further research is necessary in order to determine which methods are best for diagnosis of the pain hypersensitivity in clinical practice. FMS may be the far end of a continuum that starts with chronic localized/regional musculoskeletal pain and ends with widespread chronic disabling pain. © 2007 Elsevier Ltd. All rights reserved.
Objective. To compare in a pilot study the effect of two physical therapies, the Mensendieck system (MS) and body awareness therapy (BAT) according to Roxendal, in fibromyalgia patients and to investigate differences in effect between the two interventions. Methods. Twenty female patients were randomized to either MS or BAT in a program lasting 20 weeks. Evaluations were tender point examination and questionnaires, including visual analog scales (pain intensity at worst site, muscular stiffness, evening fatigue, and global health), Fibromyalgia Impact Questionnaire (FIQ), Coping Strategies Questionnaire, Quality of Life Scales, Arthritis Self-Efficacy Scale (ASES), and disability before, immediately after, and at 6 and 18 months followup. Results. The BAT group had improved global health at 18 months followup, but lower results than the MS group. The MS group had improved FIQ, ASES other symptoms, and pain at worst site at 18 months followup. Conclusion. In the present pilot study, MS was associated with more positive changes than BAT.
The aim of this investigation was to study in healthy women the effect of a moderately intensive physical exercise session on the pressure pain thresholds of tendon, bone and muscle. Twenty-four healthy women in the 7-14th day of the menstruation cycle took part in a 60-min exercise class. Pressure pain thresholds were measured by electronic algometer at four points before and after the class. Habitual exercise habits and perceived class exercise intensity were recorded. There was no change in pressure pain sensitivity at any site. Increased pressure pain thresholds tended to be linked to older age and later day in the follicular phase of the menstrual cycle. In conclusion, a single session of moderate exercise in an exercise setting outside the healthcare system or the laboratory did not increase pressure pain thresholds at group level in healthy women.
Objectives: To evaluate the effect of the Feldenkrais intervention, in fibromyalgia patients. Methods: Twenty fibromyalgia patients started Feldenkrais intervention done as one individual and two group sessions weekly for 15 weeks. Nineteen started a group-based pain education program followed by a pool program. Test and self-report questionnaires were administered at the start, at six month follow up, and at the end of intervention. Results: After the Feldenkrais intervention improvement in balance and trends to better lower extremity muscle function were shown, but the improvements were not maintained. Conclusions: No sustained benefit of the Feldenkrais intervention compared to a pool program was seen. Methodological problems are discussed. ⌐ 2001 by The Haworth Press, Inc. All rights reserved.
The study was performed to investigate the relationship between perceived muscle tension and electromyographic hyperactivity and to what extent electromyographic (EMG) hyperactivity relates to personality traits in fibromyalgics. Thirty-six females with fibromyalgia performed isokinetic maximal forward flexions of the shoulder combined with surface EMG recordings of the trapezius and infraspinatus muscles. Signal amplitude ratio and peak torque were calculated in the initial and endurance test phases. Pain intensity, perceived general and local shoulder muscle tension, and personality traits using the Karolinska Scales of Personality were assessed pre-test. Neither perceived muscle tension nor muscular tension personality trait correlated with EMG muscle hyperactivity. Perceived general muscle tension correlated with aspects of anxiety proneness (including muscle tension) of the Karolinska Scales of Personality. Pain intensity interacted with many of the variables. We propose that when patients with fibromyalgia report muscle tension that they may be expressing something other than physiological muscle tension.
Objectives: To compare detection and pain thresholds in the skin of female fibromyalgia patients who were either ketamine responders or ketamine nonresponders.
Methods: Detection thresholds to innocuous warmth, of cold, heat or cold pain, and touch and dynamic touch sensation were determined in the skin. Pressure pain thresholds, local and widespread pain intensity, and pain duration were also registered.
Results: Ketamine nonresponse was associated with more pronounced hypersensitivity for thermal pain [especially cold pain] than ketamine response.
Conclusions: Blockade of N-metyl-D-aspartic acid receptors by ketamine and the recording of pain thresholds in the skin, especially for cold pain, might reveal different mechanisms of allodynia.
[Abstract not available]
Kapitel om rehabiliteringsmedicinens utveckling och nuvarande plats i sjukvården samt begrepp och metodik inleder boken. I två delar ges därefter rehabiliteringsmedicinska aspekter på de dominerande sjukdomsgrupperna - komplexa smärttillstånd respektive skador och sjukdomar i nervsystemet. Som avslutning beskrivs bland annat stressrelaterade tillstånd. Läroboken är avsedd för grundutbildning av läkare, arbetsterapeuter och sjukgymnaster, logopeder samt för läkare under AT-tjänstgöring. Den är också lämplig som introduktion i specialistutbildningen i rehabiliteringsmedicin, geriatrik, neurologi och smärtlindring. Vidareutbildningar av olika vårdyrkesgrupper kan ha nytta av boken och den kan också användas som referenslitteratur av yrkesverksamma med intresse för rehabiliteringsmedicin.
Kapitel om rehabiliteringsmedicinens utveckling och nuvarande plats i sjukvården samt begrepp och metodik inleder boken. I två delar ges därefter rehabiliteringsmedicinska aspekter på de dominerande sjukdomsgrupperna - komplexa smärttillstånd respektive skador och sjukdomar i nervsystemet. Som avslutning beskrivs bland annat stressrelaterade tillstånd. Läroboken är avsedd för grundutbildning av läkare, arbetsterapeuter och sjukgymnaster, logopeder samt för läkare under AT-tjänstgöring. Den är också lämplig som introduktion i specialistutbildningen i rehabiliteringsmedicin, geriatrik, neurologi och smärtlindring. Vidareutbildningar av olika vårdyrkesgrupper kan ha nytta av boken och den kan också användas som referenslitteratur av yrkesverksamma med intresse för rehabiliteringsmedicin.
Kapitel om rehabiliteringsmedicinens utveckling och nuvarande plats i sjukvården samt begrepp och metodik inleder boken. I två delar ges därefter rehabiliteringsmedicinska aspekter på de dominerande sjukdomsgrupperna - komplexa smärttillstånd respektive skador och sjukdomar i nervsystemet. Som avslutning beskrivs bland annat stressrelaterade tillstånd. Läroboken är avsedd för grundutbildning av läkare, arbetsterapeuter och sjukgymnaster, logopeder samt för läkare under AT-tjänstgöring. Den är också lämplig som introduktion i specialistutbildningen i rehabiliteringsmedicin, geriatrik, neurologi och smärtlindring. Vidareutbildningar av olika vårdyrkesgrupper kan ha nytta av boken och den kan också användas som referenslitteratur av yrkesverksamma med intresse för rehabiliteringsmedicin.
Purpose: To identify subgroups of chronic pain patients based on the occurrence of depression, anxiety, and catastrophizing and the duration of pain and pain intensity. In addition to this, to investigate the relationship between the subgroups with respect to background variables, diagnosis, pain-related disability, and perceived quality of life.
Methods: This study used 433 chronic pain patients including 47 patients with spinal cord injury related pain, 150 with chronic whiplash associated disorders, and 236 with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological and health related items.
Results: Based on depression, anxiety, catastrophizing, pain intensity and duration, we identified subgroups of chronic pain patients that differed with respect to perceived quality of life, disability and diagnosis. The psychological factors, especially depression, significantly influenced perceived quality of life and disability. Pain intensity and duration play a minor role with respect to quality of life although pain intensity is associated contributes more to perceived disability.
Conclusions: The results of this study highlight the importance of not looking at chronic pain patients as a homogenous entity. A detailed assessment, including psychological factors with emphasis on depressive symptoms, might be essential for planning and carrying through treatment and rehabilitation.
Objective: To develop evidence-based recommendations for the management of fibromyalgia syndrome. Methods: A multidisciplinary task force was formed representing 11 European countries. The design of the study, including search strategy, participants, interventions, outcome measures, data collection and analytical method, was defined at the outset. A systematic review was undertaken with the keywords "fibromyalgia", "treatment or management" and "trial". Studies were excluded if they did not utilise the American College of Rheumatology classification criteria, were not clinical trials, or included patients with chronic fatigue syndrome or myalgic encephalomyelitis. Primary outcome measures were change in pain assessed by visual analogue scale and fibromyalgia impact questionnaire. The quality of the studies was categorised based on randomisation, blinding and allocation concealment. Only the highest quality studies were used to base recommendations on. When there was insufficient evidence from the literature, a Delphi process was used to provide basis for recommendation. Results: 146 studies were eligible for the review. 39 pharmacological intervention studies and 59 non-pharmacological were included in the final recommendation summary tables once those of a lower quality or with insufficient data were separated. The categories of treatment identified were antidepressants, analgesics, and "other pharmacological" and exercise, cognitive behavioural therapy, education, dietary interventions and "other non-pharmacological". In many studies sample size was small and the quality of the study was insufficient for strong recommendations to be made. Conclusions: Nine recommendations for the management of fibromyalgia syndrome were developed using a systematic review and expert consensus.
Fibromyalgia is currently classified as chronic widespread pain with widespread allodynia to pressure pain. There are few data describing pain characteristics, quality of life, consequences for daily living, and psychosocial status in patients who meet the classification criteria for fibromyalgia proposed by the American College of Rheumatology compared with patients with chronic widespread pain but not widespread allodynia. This study used a randomly selected sample from the general population. A postal questionnaire and a pain mannequin were sent to 9952 people. The response rate was 76.7%. The pain drawings showed that 345 people had widespread pain, that is, they noted pain in all four extremities and axially. Clinical examination, which included a manual tender point examination, was performed in 125 subjects. These people answered commonly used questionnaires on pain, quality of life, coping strategies, depression, and anxiety. Compared with chronic widespread pain without widespread allodynia, fibromyalgia was associated with more severe symptoms/consequences for daily life and higher pain severity. Similar coping strategies were found. Chronic widespread pain without widespread allodynia to pressure pain was found in 4.5% in the population and fibromyalgia in 2.5%. © 2007 European Federation of Chapters of the International Association for the Study of Pain.
Introduction: There is a need for tools that are easy to use in clinical practice supporting decision making upon treatment in early rheumatoid arthritis (RA). Aim: The aim was to identify components of prognosticators in early RA and to identify individual patients with a poor prognosis as early as possible.
Methods: Two cohorts from the Swedish TIRA project including 320+408 patients with recent onset RA were included in the study. Disease activity was measured by C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and the 28-joint count disease activity score (DAS-28), and by the physicians' global assessment of disease activity (PGA). Disability was assessed as activity limitation by the Swedish version of the Health Assessment Questionnaire (HAQ) and impairment was reported by pain on a visual analogue scale of 0–100 mm. Serological markers were rheumatoid factor (RF) and anti-CCP. RF was measured at the time for diagnosis, and anti-CCP at the time of diagnosis or at one or some of the follow-ups. If at least one anti-CCP test was positive, the patient was judged to be anti-CCP-positive. Assuming different clinical practice in the different cohorts, two different treatment strategies were assumed based on clinical practice in real-world settings. Principal Component Analysis and Multiple Linear Regression Analysis were used to identify prognosticators. Prediction rules were identified by data-driven approach, controlling for different treatment strategies.
Results: Progression of disease and disability measures and inflammation measures the first three months after inclusion predicted a considerable part of DAS-28 at the 1-year follow-up. Serological markers had a larger explanatory power for men than for women. Anti-CCP was a significant predictor for men, but not for women. Two versions of rules, one for women and one for men, predicting good or poor prognosis at one year after inclusion were produced by using measures of disability (Health Assessment Questionnaire), DAS-28, relative change in DAS-28 during first three months, sex, and test of anti-CCP. The rules demanded high prognostic specificity but the prognostic sensitivity was moderate.
Conclusion: A considerable part of DAS-28 at one year after inclusion could be explained by the first 3 months' progression of disease, disability and inflammation. Anti-CCP was predictive for men but not for women, and needs further investigation. A decision tree predicting poor prognosis among individual early RA-patients showed high specificity and moderate sensitivity on a validationcohort. The medical informatics approach used, controlling for different treatment strategies, yields promising results and further studies will control for more specific differences in treatment strategies, e.g. different DMARDs initiated.
We studied the effects of individualised growth hormone (GH) substitution, aiming at normal insulin-like growth factor I (IGF-I) levels, on biomechanical output and surface electromyogram (EMG) of isokinetic muscle strength and endurance performance in 18 hypopituitary adults and compared with 17 matched healthy controls. The muscle function tests consisted of isokinetic contractions of the right knee extensors, from which torque and EMG were recorded. Three patients were excluded from the final analysis of the muscle function tests due to technical errors and one control subject moved from the area during the study. We found that GH-deficient adults without GH substitution were weaker and had less endurance than healthy control subjects. At the group level, plasma levels of IGF-I were normalised but generally no significant effects upon biomechanical output and EMG were found after dose titration and 6 months of a constant GH dose. However, subjects with the largest changes in IGF-I had significantly better biomechanical output and EMG compared to those with small changes in IGF-I. This finding may indicate that the net increase in IGF-I levels is critical for improvements in biomechanical output, EMG and perception of fatigue to occur.
Objective. To investigate if muscle tension according to the surface electromyogram (EMG) of the shoulder flexors is increased in consecutive patients with fibromyalgia (FM) or chronic whiplash associated disorders (WAD). Methods. A total of 59 consecutive patients with FM (n = 36) or chronic WAD (n = 23) performed 100 maximal isokinetic contractions combined with surface electromyography of the trapezius and infraspinatus. A randomized group of pain-free female (n = 27) subjects served as control group. Peak torque initially (Pti) and absolute and relative peak torque at endurance level (PTe, PTer) were registered as output variables, together with the EMG level of unnecessary muscle tension, i.e., the signal amplitude ratio (SAR). Results. The patient groups had a higher level of unnecessary tension initially and at the endurance level. The patients had lower absolute output (PTi and PTe), but the relative levels (PTer) did not differ comparing all 3 groups. Subjects with FM had significantly higher body mass index (BMI) than the other groups. BMI did not influence the SAR but correlated positively with PTi. Conclusion. The results confirmed earlier findings that groups of patients with chronic pain have increased muscle tension and decreased output during dynamic activity compared to pain-free controls. However, the results indicated there is heterogeneity within groups of patients with the same chronic pain disorder and that not all patients with chronic pain have increased muscle tension.
The aim of the present study was to analyse the effects of gender and age in a population-based sample of clinically healthy subjects on: (1) strength, endurance and perception of fatigue, (2) mean frequency (MNF) of the electromyogram (EMG), and (3) the ability to relax between active contractions (signal amplitude ratio, SAR) of the surface EMG of an isokinetic shoulder forward flexion test. With this aim we have analysed aspects of the validity of MNF as an indicator of fatigue, using peak torque as a criterion variable. The subjects were 27 men and 28 women (age range: 20-60 years), who were obtained by random sample from the official census lists (participation rate: 66%). The peak torque and surface EMG of two portions of the trapezius, deltoid and infraspinatus muscles were recorded throughout 100 repetitive maximal isokinetic shoulder forward flexions. No significant differences in the perception of fatigue and relative endurance levels of peak torque and work were found between males and females. Males were significantly stronger than females and, on average, females produced approximately 60% of the output of the males, 76% after normalisation for body mass. The men had significantly lower MNF endurance levels for three of the investigated muscles. When controlled for age and body mass, the men had a significantly higher MNF of the deltoid muscle than did the females. These differences were only found for the deltoid muscle. Significant correlations existed between the MNF of the four muscles and biomechanical output, indicating criterion validity for the MNF variable with respect to fatigue. There were no significant effects of gender or age on the ability to relax between repetitive contractions (SAR). The higher prevalence of musculoskeletal complaints of the neck-shoulder region in females cannot be explained by a higher intrinsic muscle tension. Age, gender, body mass index and biomechanical output can have significant effects upon MNF. These effects are important considerations in the interpretation of MNF, for instance in ergonomic situations.
Background: Volatile anaesthetics are chemically related to organic solvents used in industry. Exposure to industrial solvents may increase the incidence of multiple sclerosis (MS). Aim: To examine the risk among nurse anaesthetists of contracting MS. Methods: Nurses with MS were identified by an appeal in the monthly magazine of the Swedish Nurse Union and a magazine of the Neurological Patients Association in Sweden. Ninety nurses with MS responded and contacted our clinic. They were given a questionnaire, which was filled in by 85 subjects, 13 of these were nurse anaesthetists. The questionnaire requested information about work tasks, exposure, diagnosis, symptoms, and year. The number of active nurse anaesthetists was estimated based on information from the National Board of Health and Welfare and The Nurse Union. Incidence data for women in the region of Gothenburg and Denmark were used as the reference to estimate the risk by calculation of the standardised incidence ratio (SIR). Results: Eleven of the 13 nurse anaesthetists were exposed to anaesthetic gases before onset of MS. Mean duration of exposure before diagnosis was 14.4 years (range 4-27 years). Ten cases were diagnosed in the study period 1980-99, resulting in significantly increased SIRS of 2.9 and 2.8 with the Gothenburg and the Danish reference data, respectively. Conclusion: Although based on crude data and a somewhat approximate analysis, this study provides preliminary evidence for an excess risk of MS in nurse anaesthetists. The risk may be even greater than observed, as the case ascertainment might have been incomplete because of the crude method applied. Further studies in this respect are clearly required to more definitely assess the risk.
Kapitel om rehabiliteringsmedicinens utveckling och nuvarande plats i sjukvården samt begrepp och metodik inleder boken. I två delar ges därefter rehabiliteringsmedicinska aspekter på de dominerande sjukdomsgrupperna - komplexa smärttillstånd respektive skador och sjukdomar i nervsystemet. Som avslutning beskrivs bland annat stressrelaterade tillstånd. Läroboken är avsedd för grundutbildning av läkare, arbetsterapeuter och sjukgymnaster, logopeder samt för läkare under AT-tjänstgöring. Den är också lämplig som introduktion i specialistutbildningen i rehabiliteringsmedicin, geriatrik, neurologi och smärtlindring. Vidareutbildningar av olika vårdyrkesgrupper kan ha nytta av boken och den kan också användas som referenslitteratur av yrkesverksamma med intresse för rehabiliteringsmedicin.
Background. This population study based on a representative sample from a Swedish county investigates the prevalence, duration, and determinants of widespread pain (WSP) in the population using two constructs and estimates how WSP affects work status. In addition, this study investigates the prevalence of widespread pain and its relationship to pain intensity, gender, age, income, work status, citizenship, civil status, urban residence, and health care seeking. Methods. A cross-sectional survey using a postal questionnaire was sent to a representative sample (n = 9952) of the target population (284,073 people, 18-74 years) in a county (Östergötland) in the southern Sweden. The questionnaire was mailed and followed by two postal reminders when necessary. Results. The participation rate was 76.7% (n = 7637), the non-participants were on the average younger, earned less money, and male. Women had higher prevalences of pain in 10 different predetermined anatomical regions. WSP was generally chronic (90-94%) and depending on definition of WSP the prevalence varied between 4.8-7.4% in the population. Women had significantly higher prevalence of WSP than men and the age effect appeared to be stronger in women than in men. WSP was a significant negative factor - together with age 50-64 years, low annual income, and non-Nordic citizen - for work status in the community and in the group with chronic pain. Chronic pain but not the spreading of pain was related to health care seeking in the population. Conclusion. This study confirms earlier studies that report high prevalences of widespread pain in the population and especially among females and with increasing age. Widespread pain is associated with prominent effects on work status. © 2008 Gerdle et al, licensee BioMed Central Ltd.
Objective. To investigate the prevalence of current and chronic pain and their relationship to pain intensity, sex, age, income, employment status, citizenship, marital status, urban residence, occupational activity, and healthcare-seeking based on a representative sample from a Swedish county. Methods. A cross-sectional survey using a postal questionnaire was sent to a representative sample (n = 9952) of the target population (284,073 people, age 18-74 yrs) in a county (Östergötland) in southern Sweden. A questionnaire was mailed and followed by 2 postal reminders if necessary. Results. The participation rate was 76.7% (n = 7637), nonparticipants were on average younger, male, and earned less money. The overall point prevalence of pain was 48.9%. The corresponding one-month period prevalence was 63.0%, and pain on several occasions during the previous 3 months was reported by 61.3% of participants. The prevalence of chronic pain (pain > 3 months) was 53.7%. Female sex, age, and sick leave/early retirement were generally of significant importance in the regressions of pain. No sex factor was found in the regressions of pain frequency and pain intensity. Chronic pain - especially frequent and intensive pain - showed clear associations with healthcare-seeking and occupational activity. Conclusion. High prevalence of current pain (48.9%) and chronic pain (53.7%) were found in this community-based study. Being female, older, and on sick leave or early retirement were generally of significant importance in the regressions of pain. Chronic pain showed clear associations with healthcare-seeking and occupational activity, indicating considerable socioeconomic costs.
Syftet med rapporten är att sammanfatta det vetenskapliga underlaget rörande effekter, biverkningar samt kostnadseffektivitet för metoder som används för att behandla långvarig, icke-cancerrelaterad smärta. Behandling som innebär öppen kirurgi har exkluderats från genomgången.
Background: fibromyalgia is a relatively common condition with widespread pain and pressure allodynia, but unknown aetiology. For decades, the association between motor control strategies and chronic pain has been a topic for debate. One long held functional neuromuscular control mechanism is differential activation between regions within a single muscle. The aim of this study was to investigate differences in neuromuscular control, i.e. differential activation, between myalgic trapezius in fibromyalgia patients and healthy controls. Methods: 27 fibromyalgia patients and 30 healthy controls performed 3 minutes bilateral shoulder elevations with different loads (0-4 Kg) with a high-density surface electromyographical (EMG) grid placed above the upper trapezius. Differential activation was quantified by the power spectral median frequency of the difference in EMG amplitude between the cranial and caudal parts of the upper trapezius. The average duration of the differential activation was described by the inverse of the median frequency of the differential activations. Results: the median frequency of the differential activations was significantly lower, and the average duration of the differential activations significantly longer in fibromyalgia compared with controls at the two lowest load levels (0-1 Kg) (p andlt; 0.04), but not at the two highest load levels (2 and 4 Kg). Conclusion: these findings illustrate a different neuromuscular control between fibromyalgia patients and healthy controls during a low load functional task, either sustaining or resulting from the chronic painful condition. The findings may have clinical relevance for rehabilitation strategies for fibromyalgia.
The origins of chronic Muscle pain development and maintenance are debated regarding the relative contributions of peripheral nociception and central pain processing. Bradykinin (BKN) and kallidin (KAL) have been suggested to be algesic kinins involved in muscle pain. This in vivo study investigates whether there were significant differences in interstitial muscle concentrations of BKN and KAL between chronic work-related trapezius myalgia (TM), chronic whiplash associated disorders (WAD), and healthy controls (CON). These subjects were studied Lit rest, during a 20-min repetitive low-force exercise and recovery. The interstitial concentrations of BKN and KAL of trapezius were determined using the microdialysis technique. The interstitial concentration of KAL was overall significantly higher in TM than in CON. [KAL] and [BKN] increased significantly during the brief exercise in all groups. The increase in [BKN] during exercise was significantly higher in TM than in the other two groups,whereas the increase in [KAL] during exercise was highest in WAD. In chronic pain, positive correlations existed between the two kinins and the difference in pain intensity between recovery and baseline. In this in vivo study of two groups of patients with chronic pain clinically involving the trapezius muscle, we found alterations - most prominent in TM in the interstitial concentrations of BKN and KAL. The results indicated that the two kinins were involved in aspects of hyperalgesia.
This study is an investigation of the relationship between muscle morphology and surface electromyographic (EMG) parameters [mean frequency of the power spectrum (MNF), signal amplitude (root mean square, RMS) and the signal amplitude ratio (SAR, i.e. the ratio between the RMS level during the passive part of the contraction cycle and the RMS level during the active part of the contraction cycle)] during 100 maximal dynamic knee extensions at 90░.s-1. Each contraction cycle comprised of 1 s of active knee extension and 1 s of passive knee flexion. The surface EMG was recorded from the vastus lateralis muscle. Twenty clinically healthy subjects participated in the study, and muscle biopsy samples of the vastus lateralis were obtained from 19 of those subjects. The relationships between muscle morphology and EMG were investigated at three stages of the test: initially, during the fatigue phase (initial 40 contractions), and at the endurance level (the final 50 contractions). Major findings on correlations are that SAR and MNF tended to correlate positively with the proportion of type 1 fibres, and RMS correlated positively with the proportion of type 2 muscle fibres. The muscle fibre areas showed little correlation with the EMG variables under investigation. The results of the present study showed that the three EMG variables of a dynamic endurance test that were investigated (RMS, MNF and SAR were clearly correlated with the proportions of the different fibre types, but only to a small extent with fibre areas. These findings contradict some of the theoretical models of the EMG, especially for parameters in the frequency domain.
The mechanisms behind the development of chronic trapezius myalgia in patients with whiplash associated disorders (WAD) appear to involve both peripheral and central components, but the specific contribution of alterations in muscle is not clear. Female patients with WAD and involvement of trapezius (N = 22) and female controls (N = 20; CON) were studied during an experiment compromised of rest (baseline), 20 min repetitive low-force exercise and 120 min recovery. Their interstitial concentrations of serotonin (5-HT), glutamate, lactate, pyruvate, potassium, interleukin-6 (IL-6), and blood flow were determined in the trapezius muscle using a microdialysis technique. Pressure pain thresholds (PPT) over trapezius and tibialis anterior muscles were also assessed. In WAD, we found signs of generalized hypersensitivity according to PPT. The WAD group had significantly higher interstitial [IL-6] and [5-HT] in the trapezius than the CON. [Pyruvate] was overall significantly lower in WAD, and with lactate it showed another time-pattern throughout the test. In the multivariate regression analysis of pain intensity [5-HT] was the strongest regressor and positively correlated with pain intensity in WAD. In addition, blood flow, [pyruvate], and [potassium] influenced the pain intensity in a complex time dependent way. These findings may indicate that peripheral nociceptive processes are activated in WAD with generalized hypersensitivity for pressure and they are not identical with those reported in chronic work-related trapezius myalgia, which could indicate different pain mechanisms.
Kapitel om rehabiliteringsmedicinens utveckling och nuvarande plats i sjukvården samt begrepp och metodik inleder boken. I två delar ges därefter rehabiliteringsmedicinska aspekter på de dominerande sjukdomsgrupperna - komplexa smärttillstånd respektive skador och sjukdomar i nervsystemet. Som avslutning beskrivs bland annat stressrelaterade tillstånd. Läroboken är avsedd för grundutbildning av läkare, arbetsterapeuter och sjukgymnaster, logopeder samt för läkare under AT-tjänstgöring. Den är också lämplig som introduktion i specialistutbildningen i rehabiliteringsmedicin, geriatrik, neurologi och smärtlindring. Vidareutbildningar av olika vårdyrkesgrupper kan ha nytta av boken och den kan också användas som referenslitteratur av yrkesverksamma med intresse för rehabiliteringsmedicin
Objective: The aim of this study was to compare the interstitial concentrations of pyruvate, lactate and glutamate in the trapezius muscle between patients with fibromyalgia syndrome and healthy controls. Design: Comparative cross-sectional study. Subjects: Patients with fibromyalgia (n=19) and healthy controls (n=19); all women. Methods: Subjects answered a questionnaire about different aspects of pain. Pressure pain thresholds over the trapezius and tibialis anterior muscles were determined. The interstitial concentrations of pyruvate, lactate and glutamate were determined in the resting trapezius muscle by the microdialysis technique, with samples collected every hour for 5 consecutive hours. Pain intensity was also rated. Results: Significantly higher interstitial concentrations of pyruvate and lactate were found in patients with fibromyalgia syndrome. The multivariate regression analyses of group membership and pressure pain thresholds of the trapezius confirmed the importance of pyruvate and lactate. Conclusion: Different mechanisms that may increase pyruvate and lactate in patients with fibromyalgia syndrome are discussed. Improved understanding of peripheral muscle alterations in patients with fibromyalgia syndrome could lead to mechanism-based rehabilitation.
I denna rapport sammanfattas det vetenskapliga underlaget för behandling av långvariga smärttillstånd. Smärta vid cancer innefattas inte. Smärtlindrande effekter, liksom biverkningar och andra negativa konsekvenser av behandling berörs samt hälsoekonomiska aspekter.
Fibromyalgia is a common chronic pain condition in the population (2-4%), which often is associated with prominent negative consequences with respect to participation in daily activities. There are several reports in the literature concerning the effects of acute experimental pain on motor control. However, a more heterogeneous picture exists in the literature with respect to whether chronic pain conditions affect motor control. This study compares firing rate and conduction velocity (CV) of single motor units (MUs) in the trapezius muscle of fibromyalgia patients (FM) and healthy controls (CON). Multi-channel surface electromyography was used to estimate both MU firing rate and CV because this technique allows simultaneous estimation of both these variables and the measurements are easy and non-invasive. In this study, 29 FM and 30 CON subjects participated and performed isometric shoulder elevations using weights up to 4 kg. No significant differences in the firing rate of MUs in the trapezius muscle were found between the FM and CON groups (95% confidence interval was -1.9 and 1.3 pulses per second). There were no significant differences in CV between the groups at 1 and 2 kg load. However, the FM group had significantly higher CV in contractions without external load (p = 0.004). We were unable to confirm the pain-adaptation model since no differences in firing rate between the two groups were found. CV was significantly higher in FM than in healthy controls, this might be due to alterations in histopathology and microcirculation. © 2007 Elsevier Ltd. All rights reserved.
Central mechanisms related to referred muscle pain and temporal summation of muscular nociceptive activity are facilitated in fibromyalgia syndrome (FMS) patients. The present study assessed the effects of an NMDA-antagonist (ketamine) on these central mechanisms. FMS patients received either i.v. placebo or ketamine (0.3 mg/kg, Ketalar(«)) given over 30 min on two separate occasions. Habitual pain intensity was assessed on a visual analogue scale (VAS). Initially, 29 FMS patients received ketamine or isotonic saline to determine which patients were ketamine responders (>50% decrease in pain intensity at rest by active drug on two consecutive VAS assessments). Fifteen out of 17 ketamine-responders were included in the second part of the study. Before and after ketamine or placebo, experimental local and referred pain was induced by intramuscular (i.m.) infusion of hypertonic saline (0.7 ml, 5%) into the tibialis anterior (TA) muscle. The saline-induced pain intensity was assessed on an electronic VAS, and the distribution of pain drawn by the subject. In addition, the pain threshold (PT) to i.m. electrical stimulation was determined for single stimulus and five repeated (2 Hz, temporal summation) stimuli. The pressure PT of the TA muscle was determined, and the pressure PT and pressure pain tolerance threshold were determined at three bilaterally located tenderpoints (knee, epicondyle, and mid upper trapezius). VAS scores of pain at rest were progressively reduced during ketamine infusion compared with placebo infusion. Pain intensity (area under the VAS curve) to the post-drug infusion of hypertonic saline was reduced by ketamine (-18.4▒0.3% of pre-drug VAS area) compared with placebo (29.9▒18.8%, P<0.02). Local and referred pain areas were reduced by ketamine (-12.0▒14.6% of pre-drug pain areas) compared with placebo (126.3▒83.2%, P<0.03). Ketamine had no significant effect on the PT to single i.m. electrical stimulation. However, the span between the PT to single and repeated i.m. stimuli was significantly decreased by the ketamine (-42.3▒15.0% of pre-drug PT) compared with placebo (50.5▒49.2%, P<0.03) indicating a predominant effect on temporal summation. Mean pressure pain tolerance from the three paired tenderpoints was increased by ketamine (16.6▒6.2% of pre-drug thresholds) compared with placebo (-2.3▒4.9%, P<0.009). The pressure PT at the TA muscle was increased after ketamine (42.4▒9.2% of pre-drug PT) compared with placebo (7.0▒6.6%, P<0.011). The present study showed that mechanisms involved in referred pain, temporal summation, muscular hyperalgesia, and muscle pain at rest were attenuated by the NMDA-antagonist in FMS patients. It suggested a link between central hyperexcitability and the mechanisms for facilitated referred pain and temporal summation in a sub-group of the fibromyalgia syndrome patients. Whether this is specific for FMS patients or a general phenomena in painful musculoskeletal disorders is not known. Copyright (C) 2000 International Association for the Study of Pain. Published by Elsevier Science B.V.
Background: The ability to reproduce head position can be affected in patients after a neck injury. The repositioning error is commonly used as a measure of proprioception, but variations in the movement might provide additional information.
Methods: The axis of motion and target performance were analyzed during a head repositioning task (flexion, extension and side rotations) for 24 control subjects, 22 subjects with whiplash-associated disorders and 21 with non-specific neck pain. Questionnaires regarding pain intensity and fear avoidance were collected. Head position and axis of motion parameters were calculated using a helical axis model with a moving window of 4°.
Findings: During flexion the whiplash group had a larger constant repositioning error than the control group (-1.8(2.9)° vs. 0.1(2.4)°, P = 0.04). The axis was more inferior in both neck pain groups (12.0(1.6) cm vs. 14.5(2.0) cm, P < 0.05) indicating movement at a lower level in the spine. Including pain intensity from shoulder and neck region as covariates showed an effect on the axis position (P = 0.03 and 0.04). During axial rotation to the left there was more variation in axis direction for neckpain groups as compared with controls (4.0(1.7)° and 3.7(2.4)° vs. 2.3(1.9)°, P = 0.01 and 0.05). No significant difference in fear avoidance was found between the two neck pain groups.
Interpretation: Measuring variation in the axis of motion together with target performance gives objective measures on proprioceptive ability that are difficult to quantify by visual inspection. Repositioning errors were in general small, suggesting it is not sufficient as a single measurement variable in a clinical situation, but should be measured in combination with other tests, such as range of motion.
The helical axis model can be used to describe translation and rotation of spine segments. The aim of this study was to investigate the cervical helical axis and its center of rotation during fast head movements (side rotation and flexion/extension) and ball catching in patients with non-specific neck pain or pain due to whiplash injury as compared with matched controls. The aim was also to investigate correlations with neck pain intensity. A finite helical axis model with a time-varying window was used. The intersection point of the axis during different movement conditions was calculated. A repeated-measures ANOVA model was used to investigate the cervical helical axis and its rotation center for consecutive levels of 15° during head movement. Irregularities in axis movement were derived using a zero-crossing approach. In addition, head, arm and upper body range of motion and velocity were observed. A general increase of axis irregularity that correlated to pain intensity was observed in the whiplash group. The rotation center was superiorly displaced in the non-specific neck pain group during side rotation, with the same tendency for the whiplash group. During ball catching, an anterior displacement (and a tendency to an inferior displacement) of the center of rotation and slower and more restricted upper body movements implied a changed movement strategy in neck pain patients, possibly as an attempt to stabilize the cervical spine during head movement. © 2008 Elsevier Ltd. All rights reserved.
This paper presents a new method for classification of neck movement patterns related to Whiplash-associated disorders (WAD) using a resilient backpropagation neural network (BPNN). WAD are a common diagnosis after neck trauma, typically caused by rear-end car accidents. Since physical injuries seldom are found with present imaging techniques, the diagnosis can be difficult to make. The active range of the neck is often visually inspected in patients with neck pain, but this is a subjective measure, and a more objective decision support system, that gives a reliable and more detailed analysis of neck movement pattern, is needed. The objective of this study was to evaluate the predictive ability of a BPNN, using neck movement variables as input. Three-dimensional (3-D) neck movement data from 59 subjects with WAD and 56 control subjects were collected with a ProReflex system. Rotation angle and angle velocity were calculated using the instantaneous helical axis method and motion variables were extracted. A principal component analysis was performed in order to reduce data and improve the BPNN performance. BPNNs with six hidden nodes had a predictivity of 0.89, a sensitivity of 0.90 and a specificity of 0.88, which are very promising results. This shows that neck movement analysis combined with a neural network could build the basis of a decision support system for classifying suspected WAD, even though further evaluation of the method is needed.
A gas chromatography method, coupled with diode array photometric spectral detection in the ultraviolet region (167-330 nm), was developed for the analysis of the gas phase of cigarette smoke. The method enabled us to identify more than 20 volatiles present in the vapor phase of cigarette smoke. In that way, all major volatile organic compounds ( including aldehydes, conjugated dienes, ketones, sulfides, furans, and single-ring aromatics), as well as nitric oxide ( NO) and hydrogen sulfide (H2S), can be analyzed in a straightforward manner through a single chromatographic run of < 50-min duration. The method can easily be applied by the introduction of a small volume of the gas-phase stream into the GC injection loop directly through the smoking apparatus exhaust circuit, thus providing an excellent alternative to available methods, which usually require extraction or concentration steps prior to any chromatographic analysis. Furthermore, all problems concerning aging of the gas phase are eliminated. Twelve compounds ( including NO) were chosen for quantification through the use of appropriate calibration standards. Comparison of the vapor phase yields of these compounds for the reference cigarette Kentucky 1R4F with already reported data indicates that this method is very reliable as far as accuracy and reproducibility of the results are concerned. Finally, the proposed methodology was used to compare the concentration of these cigarette smoke gas-phase constituents among individual puffs.
Purpose. To explore disability in women with fibromyalgia with a focus on their work situation.
Method. Review of literature on work status of women with fibromyalgia.
Results. Major differences exist between studies in reported disability and in the percentages of women working. Limitations caused by pain, fatigue, decreased muscle strength, and endurance influence work capacity. However, 34-77% of the women work. Individual adjustments in the work situation are reported. When the women find a level that matches their ability, they continue to work and find satisfaction in their work role. Many factors besides degree of impairment or disability influence whether clients with longstanding pain can remain in their work role or return to work after sickness leave.
Conclusion. The total life situation, other commitments, type of work tasks, the ability to influence the work situation, and the physical and psychosocial work environment are important factors in determining whether a person can remain in a work role. More knowledge is needed about how to adjust work conditions for people with partial work ability to the benefit of society and the individual.
According to the classification criteria proposed by the American College of Rheumatology, fibromyalgia is a long-standing multifocal pain condition combined with generalised allodynia/hyperalgesia. It is the generalised allodynia/hyperalgesia that distinguishes fibromyalgia from other conditions with chronic musculoskeletal pain. Central sensitisation of nociceptive neurons in the dorsal horn due to activation of N-methyl-D-aspartic acid receptors and disinhibition of pain due to deficient function of the descending inhibitory system are probable pathogenic factors for allodynia/hyperalgesia. Furthermore, chronic pain is a chronic emotional and physical stressor. Chronic stress and chronic sleep disturbance are not specific for fibromyalgia but could be the causes of symptoms like fatigue, cognitive difficulties and other stress-related symptoms. They may also cause neuroendocrinological and immunological aberrations.
Objective: To review the literature concerning pain mechanisms in fibromyalgia [FMS]. Findings and Conclusions: Thirteen investigations using different methods, comprising 250 patients with FMS, confirm a biological dysfunction of the nociceptive system, especially in the central nervous system in the majority of patients with FMS. The hyperexcitability in the nociceptive nervous system may have different causes in the individual patient. Localized long-standing muscle pain, chronic stress, genetic factors, and hormonal changes may all play a role. Pain generators in the muscle may not be specific for FMS but may be of importance for initiating and maintaining pain and allodynia/hyperalgesia. © 2002 by The Haworth Press, Inc. All rights reserved.
Objectives: The first objective is to present the arguments in favor of considering the biological component of the fibromyalgia syndrome [FMS], a disease of the nociceptive nervous system. The second aim is to present reliable methods for diagnosing such a disease. Findings: Studies confirm that there is long-standing or permanent pain hypersensitivity in FMS. The main causes of the pain amplification are central and peripheral sensitization of pain transmission neurons and/or pain disinhibition due to a disturbed endogenous pain modulation. The manual palpation method for determining the number of tender points is a measure of pressure-pain thresholds and degree of pain perception. Pain perception is influenced by psychological factors. More objective measures of pain thresholds are available and are presented in the article. Conclusions: The biological part of FMS reflects a long-standing or permanent change in the function of the nociceptive nervous system, that can be equated with a disease. It is hoped that upgrading FMS from illness to disease will increase the awareness of FMS among health personnel. This will in turn help patients with FMS to get correct diagnosis and treatment.


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Five Ways To Make Any Phuket Apartment Profitable
Five Ways To Make Any Phuket Apartment Profitable
The rich tourism influx has raised the real estate market in Phuket Thailand. Due to Phuket's year-round perfect weather, it is now a destination of choice for many of today's jet setters. So Phuket apartment investing can be profitable on the island.
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The naturally wealthy surroundings of Phuket keep attracting tourists year after year so you can plan to get great returns on short term and long term rentals and leases. This class of tourist will not mind spending lavishly to use your property as their accommodation. Your Phuket apartment must be in top condition to attract this group of travelers.
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Ensure Great Furnishing
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subset: commoncrawl


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You heard it here first folks.
I posted at least a year ago that the developers would win out and have BC Place torn down to build condos. Everyone in the 'in' crowd would get rich. I suspected and speculated then that Gordon Campbell would find a way to accommodate his friends and perhaps take his cut somewhere. Which I often do because I cannot personally imagine that anyone could sell off the assets of British Columbians as he has done without some personal graft in there somewhere. No one could be that disloyal.
My own opinion of course.
So now we hear that the new expanding roof is not going on the stadium after all. They are merely readying it for those games. (VANOC says we are not allowed to mention what games)
I predict that after these games, they will discover something so bad about our BC Place Stadium, and tell us that it will not be able to be used anymore and why not sell the land for condos? The greed will take hold and it'll be a done deal - if it isn't already.
Watch for the spin preparation to begin right after the games when those costs start becoming public. Once you get the character and agenda of some people, you can figure out the succeeding actions yourself. And Gordon has shown his disdain for BCers over and over again.
You heard it here first.
They are probably writing the copy right now.
addenda: The very next day Gordon Campbell confirmed no new expanding roof. He was very careful to say 'expanding' and wimpy Bill Good didn't ask the obvious follow up question: Will there be ANY new roof?
caterwauls are my screams in the night from the back fence, aimed at the inequitable situations in our present society and the ridiculousness of life's paths........ With a little silliness too . . . for sanity.
Tuesday, August 25, 2009
No BC Place stadium roof?
Posted by Caterwauler at 8:46 pm
1 comment:
- Anonymous8:59 am
I am sure you are right again about Campbell. How he ever got elected again is beyond believe.What the N.D.P. needs to do is get a new leader and throw the Liberals out for good.If Campbell stays in till the end of his term it will be too late for us in B.C. He and all his cronies will be rich and it will take years for us to buy British Columbia back.ReplyDelete
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text:
St. Patrick's Day Tarts
44 comments
- Sylvia said...
So thankful you're feeling better and those tarts sure look good.
- March 13, 2019 at 6:45 AM
- Elizabethd said...
So good to hear that you are feeling better.
- March 13, 2019 at 7:33 AM
- Vee said...
Oh mercy! The bug this year has been horrid. Glad that you're on the other side. Hope that you feel better and stronger every single day.
These little tarts look so minty! "Fake" minty as my grandson would say. They sound perfectly delicious to me!
The kitties are darling and they do look very cozy and maybe it is time for a nap...
- March 13, 2019 at 7:59 AM
- Roosterhead Designs said...
Glad your feeling well enough to post dear Stephanie! And hopefully it's all behind you~ The tarts look scrumptious! Phyllo is nice to work with~ Hope your week ahead is full of blessings : ) Hugs, karen o
- March 13, 2019 at 8:29 AM
- Chris Lally said...
Welcome back, Stephanie. So glad you're feeling better!
Thank you for the delicious sounding tart recipe. A keeper, I am sure!
Hope you have a wonderful day, too!!
- March 13, 2019 at 8:32 AM
- Debbie Harris said...
Oh Stephanie, what a DELIGHTFUL posting!
Those sweet babies made me laugh and put a huge smile upon my face this morning.
I laugh because I'm sitting near the fire, you know, "in the hot seat" and its beginning to feel like a nap. 😉 Ha!
Boy do those tarts look delicious and gorgeous sitting next to those amazing ruffled looking roses, WOW!
Had I not been in Denver yesterday, I may have enjoyed one of those over a cup of tea with you. ☹ I missed out on that one.
Grandma Maxie would have been proud to see you remembering her national day, St Patrick's Day and she would have loved that Irish blessing.
My visit here sure was a blessing and I just know that I will be singing with joy in my heart throughout this beautiful,snowy day, for the Lord is good, and He is good ALL the time!
Love you 💚
- March 13, 2019 at 9:01 AM
- Julie's Creative Lifestyle said...
I'm so glad that you are feeling better Stephanie. The tarts looks so good and just perfect. You could open your own little tea shop with how pretty you make your desserts look and so yummy tasting I'm sure. Hope you have a good week and a happy St. Patrick's Day.
- March 13, 2019 at 9:09 AM
- Brenda said...
Thank you for your lovely blessing Stephanie, and your ability to cook and decorate are amazing. Are you of Irish decent, I am Welsh but living in Northern Ireland. Whenever I mention where we are living the song 'I've been everywhere man' comes into my mind :-) I came to know a person in Inverness who's motto was 'Just do it.' I think that is my husband's and my motto too.
- March 13, 2019 at 9:30 AM
- Brenda said...
I just read your mother's comment and realized it was Grandma Maxie who was Irish.
- March 13, 2019 at 9:33 AM
- Debbie said...
i really love those phyllo tarts, there are so many amazing things you cane do with them. i make a ton of different appetizers with them and fill them right before serving!!
i don't think i have ever made a desert with them, but now i have a wonderful idea!!!
i am glad you are feeling better, it sounds like you had just about everything!! it's almost time to open the windows and let all the fresh air in!!
- March 13, 2019 at 9:54 AM
- Tamago said...
Hi Stephanie, I'm glad you got better! And what pretty tarts you made! They look so yummy. Green whipped cream and sprinkles look so cheerful and perfect for St. Patrick's Day!
I sure would join the kitties and have a nice long nap :-)
- March 13, 2019 at 10:14 AM
- kitty@ Kitty's Kozy Kitchen said...
Good morning, sweet Stephanie! I'm so glad that you're feeling better and that you're feeling like yourself again. Yes, prayers were said for you. Your tarts are just darling and oh so easy! I would love one with a cuppa tea, and the whipped green cream looks perfect! Love 💚 and Irish 🍀 hugs are sent to you.
- March 13, 2019 at 10:33 AM
- Sherida Stewart said...
So delightful to have tea with you. So glad you are feeling better. Blessings!
- March 13, 2019 at 10:42 AM
- Kate said...
Your tarts are mouthwatering. ^^
Happy to read that you're feeling so much better.
- March 13, 2019 at 11:59 AM
- Mari said...
So glad you are feeling better. Your little tarts are so cute!
- March 13, 2019 at 4:00 PM
Those look so delicious, Stephanie! Thank you for sharing your recipe with us.
- March 13, 2019 at 5:03 PM
- Chas' Crazy Creations said...
Looks absolutely wonderful my friend. Happy St. Patrick's Day to you and your family! Sending hugs
- March 13, 2019 at 5:04 PM
- Zaa said...
Dear Stephanie... What a lovely post ...Your sweet tarts look so charming amongst the roses... Who wouldn't want a cup of tea in such a beautiful setting? I'm sorry that you were not well... It has been one of those years
for flu and sinus infections ... I too was on antibiotics for a similar malady just before my vacation ... St. Patricks day is my hubby's B'Day so he thinks that he is Irish ( Ha ha) ... My Granny was Irish, so we do enjoy the wearing o'the green. Your phyllo tarts will be the perfect treat. Wishing a lovely week-end....Big Hugs
- March 13, 2019 at 5:40 PM
- Paige said...
I'm glad that you're feeling better! ^_^ These tarts look yummy. Have a lovely St. Patty's day!
- March 13, 2019 at 7:18 PM
- Carla from The River said...
Hello Friend,
Those look yummy!
Good News you are feeling better!! Yippee. :-) Just in time for the count down to opening day. Go Crew Go!! :-) I think this will be a fun year for our Division and I think we will be seeing each other again in the playoffs.
Love, Carla
- March 13, 2019 at 7:50 PM
- Elizabeth said...
Happy Wednesday, to you, lovely Stephanie! Oh, I am so glad to hear that you are feeling better...thank the Lord! I know you must be relieved to be feeling like yourself again {{smiles}}
These tartlets look quite delectable, I must say. I am preparing a St. Paddy's tea party for this weekend, and am pulling out all my Irish cookbooks and having such fun perusing them for special recipes. It's such a fun day to celebrate a beautiful land and a man who sought to bring Christianity to its people.
Your kitties are looking as adorable as ever...don't cats have the life? Hee!
Wishing you a most lovely rest of the week, dear friend! Love and hugs to you!
- March 13, 2019 at 8:32 PM
- Regina said...
I'm glad you are feeling better. I hate being sick. The tarts look so yummy! Sleeping cats so adorable!
- March 13, 2019 at 9:28 PM
- Kelly-Anne said...
Oh Stephanie. It was oh, SO good to visit with you today! How I have missed stopping how...
I am sorry to hear you have been unwell...I trust that you'll continue to grow stronger with each day and that soon you'll be back to your old self! These are such gorgeous little tartlets...I love the colour! Thank you for sharing such lovely inspiration...
Love and blessings to you!
And thank you for your sweet visit - always delightful to hear from you!
- March 14, 2019 at 12:42 AM
- mamasmercantile said...
I am thrilled you are feeling better and what a joy to spend a few moments with you, sharing a pot of tea and those delightful tarts.
- March 14, 2019 at 2:15 AM
- hobbyloes said...
Glad you feel better again!
These mini tarts look tasty and delicious.
- March 14, 2019 at 2:57 AM
- Anna said...
So good to read that you are better now !
Your mini-St-Patrick-tarts look delicious !!!!
Have a shinny and yummy day ;)
- March 14, 2019 at 3:53 AM
- Anne Payne said...
I was going to comment but I couldn't past the Verify images for some reason so I sent an email. It turned into a long one! :-)
And I am determined to get past that spam filter. haha
- March 14, 2019 at 5:48 AM
- Jean | DelightfulRepast.com said...
Stephanie, I'm so glad you're feeling better. Love the catnap photo! Your little tarts are gorgeous, too. I never think to buy the phyllo tart shells, but one of my friends uses them quite a bit so I know they're good.
- March 14, 2019 at 8:54 AM
- Ida said...
Oh my those tarts look so yummy. I want some! My mouth is watering just looking at them. So happy to hear you are feeling better.
- March 14, 2019 at 12:44 PM
- Mrs.T said...
What delicious looking tarts, Stephanie! They would be lovely with plain whipped cream and a few appropriate sprinkles for any occasion. Those tart shells are a wonderful convenience and they taste good, too.
So happy that you are feeling better! What a siege you have been through with illness!
- March 14, 2019 at 2:26 PM
- Margie said...
These tarts look great, Stephanie. My brother used to make a similar dessert with phyllo tarts, but he used nutella instead of fruit filling.
- March 14, 2019 at 6:36 PM
- krishna said...
Very delicious! Hope you are feeling good now.
- March 14, 2019 at 7:55 PM
- Linda S. said...
Glad you're feeling better! Love your post! XO Linda
- March 14, 2019 at 9:43 PM
- Sheryl said...
Delightful post Stephanie- Your tarts look delicious and sound so easy to make. Sorry to hear that you have been poorly and hope that you are feeling better now, Spring is nearly here so you can´t be unwell now.
- March 15, 2019 at 11:39 AM
- Lorrie said...
What pretty tarts you made. I'm glad you are feeling better. Happy St. Patrick's Day!
- March 15, 2019 at 9:09 PM
- handmade by amalia said...
The tarts look both pretty and delicious, Stephanie, and I love your china. Happy St. Patrick's Day!
- March 15, 2019 at 10:48 PM
- Kerin said...
This post is a 'smiling' post, to be sure!
From the sweet kitties on the bed napping... such sweeties, to the delicious tarts, and best of all because you are feeling better...Yay!!
Have a lovely week ahead, and keep smiling your beautiful smile, sweet friend!
- March 17, 2019 at 7:13 AM
- Buttercup said...
Hi sweet friend! Hope you had a bright and blessed day. The tarts look so yummy!
- March 17, 2019 at 3:45 PM
- Conniecrafter said...
those look good, I have never made a tart before. I also didn't know about using confectioners sugar in whipping cream, I have learned a few things today :)
I am so glad you are feeling much better, these change of seasons seem to always get all kinds of infections and allergies going.
- March 17, 2019 at 5:32 PM
- Marilyn @ MountainTopSpice said...
What a super sweet recipe that could be adapted to just about any occasion! I love making my own homemade whipped cream too, and the sprinkles added the perfect touch! I must put phyllo dough on my grocery list now :) Did you make your own raspberry and lemon filling?
I am thankful you are feeling better, sounds like quite a miserable dose you had!
We are enjoying gorgeous springtime weather here this week, lots of abundant sunshine, what a treat after the long winter!
Have a blessed and lovely week :)
- March 18, 2019 at 1:20 PM
- Dianna said...
I am so glad to know that you are feeling human again, Sweet Friend. Your symptoms all sound like what my Beloved and I had and we, too, are now feeling human again! Thank you for sharing these beautiful tarts that you made! They are lovely!
- March 19, 2019 at 8:07 AM
- Magpie's Mumblings said...
So glad to hear that you're feeling much better! It's a nasty bug that seems to be going around. And those tarts - look so yummy! I'll have a lemon one, please, to go along with my tea.
- March 19, 2019 at 3:35 PM
- Lowcarb team member said...
So pleased that you are feeling better.
Those tarts look tasty :)
All the best Jan
- March 21, 2019 at 3:52 PM
- kotanopan.com said...
cats with good colors,
i love cats,
- May 16, 2019 at 9:02 AM


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Penne al Quattro Formaggio
December 11, 2010
If you cannot decide which cheese you would like for your pasta tonight this is the dish for you. It is also wonderful when you just have a bit of a few different cheeses left for the week. Use the cheeses I used or make up your own combination of your favorites. A simple but satisfying meal you will be craving once you make it.
Penne al Quattro Formaggio
- 1 lb. Penne
- 4 oz. Unsalted Butter
- 1/2 C. Heavy Cream
- 1/2 C. Parmesan Cheese (grated)
- 1/2 C. Pecorino Cheese (grated)
- 1/2 C. Fontina (shredded)
- 1/2 C. Gorgonzola Cheese (crumbled)
- Salt
- Freshly Ground Pepper
- Fresh Parsley (chopped for garnish
- Boil water for preparation of penne; cook al dente
- Simultaneously in a large pan melt butter and combine with heavy cream
- Add the four cheeses and stir to mix thoroughly
- Drain the pasta when ready and add to the cheese mixture, stir together
- Salt and pepper to taste
- Serve immediately in warmed pasta bowls and top with fresh parsley
(Serves 4)
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This Event is in the past and is no longer available for sale.
The 5th Annual Java Jazz is your opportunity to hear some great jazz by the MNU Jazz Ensemble, relax in a comfy chair, and enjoy a warm beverage and dessert.
Sponsored by REW Music.
Tickets include a drink and dessert.


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The amount of content that has been played for the media item.
- iOS 7.1+
- macOS 10.12.1+
- Mac Catalyst 13.0+
- tvOS 9.2+
- Media Player
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1 indicates that the media item has been completely played. This property's default,
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These were painted in large groups, not really that detailed or accurate and I also played around with some flowers\shrubs I was given.
Below, are some of Kellerman's cavalry
A brigade of Chasseurs (Italeri). Is this the only Chasseur set on the market ?
So yet another side project !. The last few months have been taken up with sorting out Romanians for Operation Uranus, however now they are complete I am working on the following at my leisure :
- 1/72 Napoleonic Armies (above)
- 15mm Sci Fi (For solo skirmish)
- 28mm Sci Fi (For solo skirmish)
- 1/72 Fantasy armies. (Orcs, Rats, undead, humans, dwarves, Elves and Conan the Barbarian.
- A 1/72 medieval fortress and town.
- Siege Equipment.
- 1/72 Modern.


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A novel phase-analysis method is proposed. To get the fringe order of a fringe image, the amplitude-modulation fringe pattern is carried out, which is combined with the phase-shift method. The primary phase value is obtained by a phase-shift algorithm, and the fringe-order information is encoded in the amplitude-modulation fringe pattern. Different from other methods, the amplitude-modulation fringe identifies the fringe order by the amplitude of the fringe pattern. In an amplitude-modulation fringe pattern, each fringe has its own amplitude; thus, the order information is integrated in one fringe pattern, and the absolute fringe phase can be calculated correctly and quickly with the amplitude-modulation fringe image. The detailed algorithm is given, and the error analysis of this method is also discussed. Experimental results are presented by a full-field shape measurement system where the data has been processed using the proposed algorithm.
©2010 Optical Society of AmericaFull Article | PDF Article
OSA Recommended Articles
Yong Li, Cuifang Zhao, Yixian Qian, Hui Wang, and Hongzhen Jin
Opt. Express 18(21) 21628-21635 (2010)
Shuo Xing and Hongwei Guo
Appl. Opt. 56(6) 1591-1602 (2017)
Wei-Hung Su
Opt. Express 15(20) 13167-13181 (2007)


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500 Levi Place, Carrollton, GA 30117
500 Levi Place is a traditional stepless ranch plan in Mt Zion School District! This home features 3 bedrooms and 2 full baths(plus a bonus room) on .78 acres of the Armstrong Crest Subdivision. A split bedroom layout and an open living/dining/kitchen area creates an inviting space for your entertainment events. Outdoor space is important too- so here's a covered front and back porch!
Listed for $169,500.
Give Dale Johnson a call for more info or to schedule your showing today!


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This first feedback session was a small group of people very familiar with The Griot. We selected these participants because they know the museum well and we thought a first round workshop would be a productive way to ensure that our new twists on the Griot story is true to A.) what people love about The Griot and B.) accurate. We had two attendees join us, and though video chat, and though our group was small, the conversation was incredibly rich and we could have even used more time. The intimate nature of the workshop allowed us to review each section of the proposed crowdfunding campaign page in detail.
Our agenda took us through each section of the early draft campaign page where we inquired from our experts to share elements they would add, take away, or definitely keep. We also gathered their immediate reactions to language and photo as well as minute details such as specific tweaks in language. The group setting allowed for our participants to react to each other and build off of one another. Through our screen share video chat, we were all able to view the same elements at the same time, which allowed for a very focused conversation.
This session was incredibly helpful. Key takeaways included:
Because our point person for the project is the sole employee of the museum, her inner circle (including those at the workshop and others) truly are the experts of the museum. They have been key to gaining insight into The Griot and it's context, as well as refining our campaign
A request for language to not appear imploring or to highlight deficiency, but rather to orient our fundraising campaign around 'opportunity' and positive language
The inner circle is eager to connect us to other resources and supporters
The message of the campaign can be further focused
There is a need to balance the story as its always been told with a new way of telling the story to a new audience
There is a need to balance meticulous accuracy and audience-specific linguistic appeals in the campaign. This is always the fine dance of marketing, and an important balance for us to strike in this project
We should embrace the justice platform of the institution through the crowdfunding campaign
We will ensure that in our next workshop we are testing these changes with a group who is unfamiliar with The Griot, to ensure that this story resonates with folks outside of The Griot's inner circle. We are also considering testing two different messages to see what is resonating more with people unfamiliar with the museum. We are also adjusting out language to be more opportunity-oriented, as well as language that centers around the justice-based ethos of the museum and its inner circle.


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I shall be living
In one of them
I shall be laughing
And so it will be
as if all the stars
were laughing
when you look
at the sky at night
- The Little Prince
It goes without saying that the tragedy in Newtown, CT pains me beyond comprehension. I really can't talk much about it because there are no words, but I felt I had to acknowledge it since I was away when it happened and very disconnected to the world and all that was going on. In my head, I try to imagine Ty among those children in heaven -- dancing, playing and laughing so loud. Still, it doesn't bring much comfort, nor does it help me understand the tragedy of any senseless loss.
I've seen a lot of similar posts on Facebook today, and wanted to share this one in particular.
What has occurred cannot be changed, but I can promise myself that these beautiful children will not be forgotten. They have made a lasting impact on my life. In the last few days I have hugged more, shown much gratitude and felt so much pain and love. Patience with my children has been abundant and my to-do list has been trivial. I know I am not alone in this.
Thank you beautiful angels for inspiring us to do better.
Many people believe change is needed by amending gun laws or improving health accessibility. I feel the need to do something immediate and within my own control.
I invite you to join me if you wish. Love more, give more and be grateful every day. ~Gina
This is the good that comes out of tragedy. Just as I have seen when Ty got sick, and again when Ty died. People are inherently good and kind.
Speaking of which, you would not believe the amazing gift I came back to on Monday. MY OFFICE! The Ty Louis Campbell Foundation is almost ready to roll! An incredible crew of volunteers arrived on Saturday and worked their butts off to spackle, prime, paint, clean, rip up carpet and decorate!! The space looks absolutely incredible. I had NO IDEA that they had such plans and I was simply blown away. To this day I still can't figure out how they did it all in one day! One of the greatest gifts was the photo album they left me that documented the entire process. I swear, it was like my own Extreme Home (office) Makeover. They thought of everything. All I need now is some carpet -- the guy came today to measure -- and a few more furniture items -- but nothing that will hold us back from getting to work. After the New Year, that office will be buzzing :) Thanks to all of you who have contacted me to help. I promise, I will be in touch!
Every item in that office, along with the labor that went into it, has all been donated. The carpets will also be donated by a local provider, as well. I am overwhelmed with gratitude for the generosity and love that we have been flooded with.
The office has three rooms. A blue room for Ty, a green for Gavin, and a large yellow room with a kitchenette where we will often work in teams. There were tons of people there to help, including a bunch of kids, and I am simply blown away. They didn't miss a single detail. Ty was everywhere. So were ladybugs and messages of hope. The space is beautiful.


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Being a dad, I know there is nothing that brings father and sons together like shared interests, motorcycles being one. Well Gonzalo Carranza of El Pasillo Custom Classics seems to get this and has started his son early. Seeing how much his son loves the bikes around the shop, he decided to get the crew together and build this awesome little Pagani 50cc 2 Stroke Scrambler for. How cool is that?
The Pagani 50cc started life as a 2 Stroke Dirt Bike. Wanting to make something custom for his son, Gonzalo wanted to create a cool little 2 Stroke Scrambler. The stock plastic tank was ditched for a cool new 2 gallon metal one. The frame was modified with a new rear sub-frame for the custom seat. To finish off the Scrambler look, he added a little headlight to help his son light up the trails.
This little bike has be thinking about building a custom scrambler or tracker out of my sons Honda CRF50 now. We love seeing these little builds for the kids. It's so important to get the kids today to explore working with their hands and get into the outdoors for some fun. I'm sure Gonzalo's son will be doing just that. Go head over to there social media pages and check out some of their other builds.
EL Pasillo Custom Classics | Facebook | Instagram
Pagani 50cc 2 Stroke Scrambler Photos (by Gonzalo Carranza)


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Hello everyone
The aforementioned potions don't stack with they tier 5 "bolster" equivalents. This seems kind of pointless, as the elixirs have shorter durations and are much harder to make than their lower tier equivalents. Could they be made to stack? Or maybe increase the duration and the stat buffs in order to make them worth using.
Thank you for reading.


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Humans of BSL
At BSL, we are all bound by our common passion for conducting our business (and indeed our life) in a way that does good in the world. We discover through these stories the infinite number of different ways that diversity can make this common goal manifest itself. Humans of BSL celebrates this diversity and commonality, and slowly reveals through its wonderfully unique Humans, the Soul of BSL.
Discover a new Human of BSL every week by joining us on Facebook or Instagram
All Humans of BSL photographs by Jonathan Viey
Arshia Soltani & Eric Illick, Students
Bachelor of Business Administration
In order to achieve a goal, one must always prepare, but no matter how much preparation is done, there is always an element of uncertainty that drives and excites each of us. It is the zeal to push boundaries and the desire to experience how it feels outside of one's comfort zone that motivates you at first. Along the journey, you continually visualize yourself conquering the summit. In tandem with visualization, true preparation must begin. A plan for your adventure must be devised so that benchmarks can be set. But what is it that drives you despite setbacks and difficulties along the journey? Achieving smaller goals allows one to be more confident with the image visualized upon beginning of the journey. As you develop trust in your team and yourself, you gain a momentum towards the ultimate goal. Outside of one's comfort zone, one begins to understand the true fragility of life and this removes many of the distractions and allows you to focus only on what is most important to you. It is there where we search for a deeper understanding of self and explore our dreams.
Patricia Carolina Lopez Miranda, Student
MBA in Sustainable Business
I was born and raised in El Salvador to a wonderful family that has always inspired me to live a… Read more >
David Kibbe, Staff
"Treat others how you'd like to be treated." This statement was the life mantra of my recently deceased father. As… Read more >
Alexandra Gritsenko, Student
Bachelor of Business Administration
From an early age, it became evident to everyone who knew me that I have a powerful strive to help… Read more >
Suchi Dubey, Student
Master in International & Sustainable Finance
"If you want to do something, just go for it", I am a true believer of this statement. I grew… Read more >
Yelshaday Gebreselassie, Student
Master in International Business
I'm Yelshaday and I'm from Ethiopia. I was born and grew up in Addis. When I don't study, I play… Read more >
Claire Faessel, Student
EMBA in Sustainable Business
When I started working, I was told it was necessary to conform to the norm of doing business. I was… Read more >
Dr. Sascha Berger, Student
My whole family, my brother, mom, and dad work in our family business called digades. Our company is a German… Read more >
Dr. Bettina Palazzo, Professor
Business Ethics and CSR
When I started to dance salsa a few years ago, I realized that you can only dance well if you… Read more >
Napat Suttapong (Phil), Student
Bachelor of Business Administration
I was intrigued by the world of entrepreneurship since I was young. In a way, it reflects the way humans… Read more >
Dr. Elodie Baerlocher, Professor
Business Psychology
Since I was a little girl, music, travelling and discovering cultures have always been a very important part of my… Read more >
Joshua Spainhower, Student
I grew up in the eastern part of the San Francisco bay area, in a town where my family had… Read more >
Thao Thi Thu Ho & Michal Koltonik, Students
We were born in two different countries: Poland and Vietnam, and met each other 13 years ago in a language… Read more >
Diego Horcajada, Student
Diploma in Sustainable Business
I am on a personal journey of seeking balance between personal and professional values. I joined BSL after 15 years… Read more >
The Legacy Band,
BSL Faculty & Staff
As the idea came up that our faculty and staff could form a band and anyone with goodwill would be… Read more >
Mazen Lahreche, Student
Bachelor of Business Administration
Always stay curious, always explore. Learn new things and the opportunities will come from unseen corners.I am the fruit of… Read more >
Larisa Kryachkova, Candidate
My life has always been full of colors. Born and raised in the Russian Urals until the age of 20,… Read more >
Dr. Jan Erik Meidell, Professor
Master of International & Sustainable Finance
I grew up on the stormy west-coast of Norway. When I was 5 years old, I received my first boat…. Read more >
Cecilia Giacchetti, Student
Master in International Business
The first time I took a flight by myself, I was 16 and I went to the other side of… Read more >
Denitsa Marinova & Yasmina Volet, Staff
Yasmina: "Working with people I love and respect is so important to me, just as important as what I do…. Read more >
Maximilien Abrezol, Student
Diploma in Sustainable Business
Not being able to stay calm even just for a week in my home country of Switzerland, I've always known… Read more >
Hicham Zaime, Student
Master in International & Sustainable Finance
I am grateful for all that life has given me, the bad and the good. Because the good made me… Read more >
Axel Ungurian, Student
Two years ago, I moved from being a realist to an optimist. I learned that if you fail, you should… Read more >
Nikita Safronov, Student
Bachelor of Business Administration
When I was still living in New York City, I received an unintentionally profound piece of advice. It was my… Read more >
Claudia Kranefuss, Professor
I have always been driven to try new things. I like learning how the mind works, how to get people… Read more >
Alexandre Rappaz, Staff Member
I fell in love with Futsal 13 years ago when I started playing as a goalkeeper for the University of… Read more >
Madina Kukenova, Professor
Master in International & Sustainable Finance
My name is Madina, which means "culture" in my native language, Kazakh. I was born and grew up during Soviet… Read more >
Adriaan Trampe, Student
Master of International Business
I've always had a passion for watchmaking. To me, watchmaking is a wonderful profession where craftsmanship still comes first. The… Read more >
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Bachelor of Business Administration
I started running seriously when I was 13 years old, after realising how fast I would get back home from… Read more >
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Bachelor of Business Administration
I was born in Siberia, Russia, the land of bears and snow. With family in Australia, Switzerland and Russia, I… Read more >


text:
Windows 10 Moves Ahead As PC Sales Decline
PCs and operating systems are bosom friends. Whenever a new PC is purchased, usually the latest Mac OS or Windows are pre-installed in it. If you happen to be a PC developer looking for superior quality cost-effective components to craft your own much advanced PC, an OS installation is required, to make you capable of utilizing your new computer rig or extreme gaming. Any personal computer would have operating systems, and previously, PC manufacturers had enough reason to rejoice when a new Windows OS was released.
Considering that the marketing department carried out its task, everyone would be eager to have a taste of the latest Microsoft and the most convenient means for the standard consumer to attain this end has been the purchasing of a new PC with the most recent Windows pre-installed. Thus PC manufacturers may possibly relax while watching their sales soar high with the release of a new Windows.
However, so far as Windows 10 is concerned, the story has taken a somewhat different turn with respect to the expectations of PC manufacturers. Following Windows 10 release, PC sales have in fact declined, and the reason is not the breach of duty on the part of the marketing department of Microsoft. This is supported by the attractive figures for Windows 10 upgrading, with more than 75 million installations being completed within the first 30 days of release. The actual reason behind this plight of PC manufacturers is Microsoft's new policy wherein current Windows operating systems can be freely upgraded to Windows 10. This is completely opposite to the past policy of Microsoft wherein new versions of Windows were sold to consumers looking forward to installing the software in the form of an in-place upgrade over the current system. Considerable investment has also been made by Microsoft for making the upgrade procedure as hassle-free and painless as possible.
At present, rather than paying for a troublesome Windows operating system upgrade, users can opt for a completely free upgrade to Windows 10 through a comparatively effortless procedure. Naturally there has been a decline in PC sales; what's the benefit of purchasing a brand new PC? Again, with increasingly reliable hardware components, it is more probable that the durability of the PC would extend to 5 to 6 years. Enhancements in hardware performance (particularly with respect to CPU processing capability) have also declined in recent years. The 2011 release of the Intel Sandy Bridge technology marked the last noteworthy augmentation in Intel CPU performance. The massive leaps in CPU power visible to consumers through the processor cores are now a thing of the past. During the 2000's, enhancements in CPU power were obvious and could be effortlessly understood; the journey from single through dual to quad core is a clear progression for clients to visualize more and more powerful CPUs.


text:
Share your business case studies and connect with your customers by creating stories that connect and drive action.
Whether it's Facebook, LinkedIn or an easy DIY social strategy you need, reach out to Alex for the right advice.
Corporate collateral that highlights your product and services will communicate the true value of your business.
Effective and fun sessions to make sure content strategy is embedded in your business for cost-effective content marketing.
Bring your words to life with a video. Alex can write scripts and produce video that meets your business needs.
Transform your tired old webstore with wondrous words that make people click. Empower your eCommerce strategy with content.
Alex has a creative network to bring words to life. She works with brilliant photoographers, great graphic designers and videomakers.
Use insights to bring your business story to life. Carve out an affordable insights plan to drive a persuasive content strategy.
I can work with you to teach you all the tricks & tips you need to run your own content strategy, social media and email copy.
Engage, convince and convert your customers with emails they actually open and read. Alex can set up an email strategy that ties in with your site and social.
Make your website work hard with words that establish your credibility and trust while also pleasing those search engines.
Simple and easy how-tos so your business can save costs while building a powerful content strategy.
Start with a summary of your idea, your target market, the tone and voice you want to convey and who the audience is.
I respond with clear strategies and tactics to answer the brief and detail the cost and time involved for you.
We agree full scope of the project and costs in writing within a 'Scope of Project' document so we can work transparently.
You sign to confirm you agree on deposit, invoice terms and timelines of delivery of the project.
You have up to 14 working days to request revisions once the project is delivered to you. Easy, right?


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Regular price
Introducing Butter Beer Crisps from our partner the Spent Goods Company!
Spent Goods loaves help to reduce climate change by using high fibre grains that have already been used to make beer. By diverting these grains, you are directly helping to reduce greenhouse gases had it been disposed. Learn more about why we partner with Spent Goods.
Made in Toronto by the Drake Commissary with leftover barley grains from Henderson Brewing Co.
Ingredients: Brewery barley grains, Khorasan (Kamut), All Purpose Flour, Butter, Sugar, Salt, Yeast, Water, Sesame Seeds.
For more information on this product click here.


text: Barbie is fond of reading books and so she goes to her room to find her favorite book but discovers that the room is in a mess. Help Barbie find her favorite book. Then let her choose her favorite reading spot. Finally, you must carry out a decoration task to make the reading spot very attractive.


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When looking to give something uniquely different, consider this gourmet BBQ sauce duo. Two large bottles of BBQ sauce, handcrafted in Utah. We've taken two of the best-selling flavors — Bourbon Blues and Honey Chipotle — to make sure there is a sauce for everyone's taste buds. Encased in a rustic wooden box and includes a silicone basting brush. **Include your company logo for a lasting impression for an additional $3 to $6. Call for details.**
See list of contents by clicking DESCRIPTION tab below.
Gift includes:
Bourbon Blues gourmet barbecue sauce
Honey Chipotle gourmet barbecue sauce
Silicone basting brush
Container: natural pine lidded crate
Gift is presented with ribbon and gift tag.
|4 lbs
|10 × 8 × 4 in