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Security and Terrorism Law with Liverpool University
The knowledge you will gain from this course will prove invaluable encountering the ever present and increasingly complex threat to local, national and global security. Security is now a matter for security forces, diplomats and international organisations as well as also impacting increasingly on the lives of ordinary citizens.
A lot of this impact comes about through mechanisms to address security and counter-terrorism that have to have a foundation in law.This course explores the concepts of security, policing and counter-terrorism in conjunction with international law, human rights law, security and counter-terrorism law.
Study global terrorism and the response to terrorism by proper legal channels in this unique online distance learning course from the Liverpool Centre for Advanced Policing Studies at Liverpool John Moores University with KNect365 Learning.
This security and terrorism law course is invaluable for individuals or organisations who have a duty to protect people, infrastructure, supply chains and the community at large. It is ideal for those seeking to update and refresh their knowledge, and for anyone curious about the topic or interested in a career in policy-making, law enforcement, security, counter terrorism operations, international relations, diplomacy, or homeland security.
Qualification: Postgraduate Certificate / Postgraduate Diploma / Master
Starts: September 2018
When: 17 September 2018
Where: Delivered online with the support of leading industry experts
Duration: 11-28 months depending on route taken
For more information please click here: http://www.courses.knect365-learning.com/FLR3337EXLCS


text: TV Japanese Citizen Groups Call for Head of Public Broadcaster NHK to Resign 5:07 AM PDT 4/23/2014 by Gavin J. Blair FACEBOOK TWITTER EMAIL ME Getty Images Tokyo Seven organizations, including the Congress of Japanese Journalists, have called for NHK's chairman and two top execs to step down, after their nationalistic public comments raised concerns about political independence. TOKYO – Citizens groups in Japan delivered a petition to national broadcaster NHK, with nearly 34,000 signatures calling for the public broadcaster's president and two governors to resign following controversial remarks by the trio, who were appointed by the country's prime minister last year. NHK chairman Katsuto Momii caused concern in Japan, and provoked anger in South Korea and China, with remarks at his inaugural press conference in January about women in brothels used to service the Japanese Imperial Army before and during WWII. The issue is controversial in Asia because nationalist elements in Japan deny that any women were forced into the brothels, despite Japanese soldiers having testified that it occurred. Many of the women were from South Korea and China. NHK has separately received tens of thousands of emails and phone calls about Momii, though nearly 20 percent of them have been supportive. STORY: New NHK President's Comments Raise Concerns About Political Independence The Congress of Japanese Journalists (CJJ), which includes NHK reporters among its members, collected signatures for the petition and called for the president and two board members to step down. "Someone like Momii can't be allowed to be the head of NHK," a CJJ spokesperson, who asked not to be identified, told The Hollywood Reporter. Some of the groups are calling for a campaign of non-payment of license fees, though the CJJ is not endorsing that. NHK is funded almost entirely by monthly license fees of around $12.20 (¥1,260). Any household that has a television, or a device such as a tablet or smartphone that can receive NHK, is required to pay. However, there are no penalties stipulated by law for non-payment. VIDEO: Stephen Colbert Visits David Letterman: 'I'm Thrilled' Michiko Hasegawa, one of the governors who are being called on to quit, withheld payment of the fees in 2005 to protest about the contents of a program she disagreed with. Hasegawa was appointed last year, a month after she published an essay praising the leader of a right-wing group who committed suicide at a newspaper's offices in 1993 after it had criticized him. Naoki Hyakuta, the other governor in the trio, recently denied that a brutal massacre in China by Japanese troops in World War Two ever took place. Eternal Zero (Eien no Zero), a film about a wartime fighter pilot based on Hyakuta's debut novel, took more than $85 million at the box office and has become one of the 10 highest grossing Japanese films of all time. Twitter: @GavinJBlair FACEBOOK TWITTER EMAIL ME Gavin J. Blair firstname.lastname@example.com @GavinJBlair

subset: commoncrawl


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Distance learning is an educational delivery system whereby students gain access to the educational experience remotely via a computer connection at home or from some location other than a traditional classroom. It should not be confused with the concept of the correspondence courses of days gone by where unsuspecting consumers were lured into parting with their money from the back of a matchbook cover promising the opportunity to "learn everything you need to know at home to earn a good income." Thanks to the advances brought to education and society with the advent of the internet, any determined student can connect themselves with a reputable educational facility and work towards a rewarding degree and simply pursue courses for personal enrichment.
While still a relatively new concept, distance learning has already begun to reveal its strengths in the educational arena and in the workplace as well. For any potential student seeking to increase the spectrum of their education, the advantages are clear.
1) Time constraints are minimized in the distance learning environment. A student has the option to login to the virtual classroom at a time most convenient to his schedule and responsibilities. This eliminates the need to arrive at a specific place at a pre-determined time one or more days each week to attend class. For people with rich, full lives and many obligations to fulfill this alone is a huge advantage.
2) Just as a student can login to the classroom according to their personal schedule, they also have the advantage of taking a little extra time to absorb the classroom lecture material. If a concept is difficult to grasp, the student can review the lecture and class notes for that week as much as is needed to understand the material before moving on to master the next level of information.
3) In spite of what the critics might say, distance learning can, and does, provide the opportunity for one on one learning between the student and the instructor. Through chat rooms, live web access time and online office appointments, students can pose questions and discuss concepts with the instructor who is able to focus undivided attention on a particular student.
4) Distance learning is "green" learning at its finest. By eliminating brick and mortar classrooms, school districts and taxpayers save money on new building construction, the energy consumption needed to heat and light those buildings and the transportation costs associated with transporting both teacher and student from home to an educational facility every day.
5) Distance learners, in order to succeed, must become the masters of their own destiny. They can progress at their own rate of speed, neither held back by slower students in the traditional classroom nor left behind by being situated in a classrom where the other students are excelling. Since they are beyond the grasp of the traditional instructor, they carry an added burden of being self-directed and self-motivated.
6) Distance learning is up to the minute, relevant education. Traditional classrooms with their traditional textbooks are often outdated and one step behind the fast paced speed of the world today. Distance learners who are accessing their coursework and reading material via the internet are able to source the latest changes and advances in knowledge on a particular subject as it occurs.
7) Distance learning opens the door of education to far more people than any other learning platform. Busy adults with family responsibilities, jobs and bills to pay are now able, some for the first time in their lives, to enter the educational arena and work towards improving their skills, learning new ones and expanding their educational backgrounds in a way that will enrich their lives forever.


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About This Property
Right in the heart of Riverside, CA sits the regions's best mix of retail for today's busy lifestyle. Canyon Crossings is on your way to work, on your way home from work and close enough to run over for that quick errand and a bite to eat during lunch. Nested right in the Moreno Valley, Canyon Crossings Shopping Center is situated nearby I-215 and Highway 60.


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Our Company
Learn more about Our Company – providing excellence in Safety and Service
Alberta Based. Employee Owned.
Go Services Inc. is an Alberta based, employee owned and operated company. Our focus is to listen to you, the customer, and identify your needs for Equipment Rental and Services. With this in mind, we are able to build a custom rental and service package for your job site. Our customer requirements can be as simple as a single Porta-Potty Rental – all the way to providing full site services and rentals for pipeline and drilling sites.
Furthermore, we are able to help coordinate Special Event Rentals. This would include music festivals, fundraisers, as well as Wedding Rentals.
There is no site too big, or too small!
Our management team is hands-on in our day to day operations, as well as our rental and service operations. Without a doubt, we understand and respect the complexity of industrial and oilfield sites. Further, we are able to offer our services for weddings, anniversaries and special events. We maintain a special fleet of our rental options just for these events due to their unique nature.
The management team of Go Services Inc. takes our customers needs seriously, and we make a conscious effort to personally connect with each of you!
Our Company Growth
Our Central Alberta company, Potty Go Rentals, was founded in 2003 when Devin Cabelka purchased a small portable toilet rental business. Shortly after, Potty Go Rentals grew organically with an increase in customer base and services provided. We expanded to include full site services for all customer markets that include industrial, commercial, oilfield and special events under the name of Go Services Inc.. It was then, in 2011, we began to provide services and rental equipment across Alberta.
Our growth through the past 12 years has been based on honesty and integrity. We work hard to provide our customers with full disclosure, up-front pricing, as well as no hidden costs. We believe strongly in giving back to minor sports, community events and charity. With this in mind, we do our best to ensure that our character is maintained through every aspect of our operations.
Want to See More?
Devin Cabelka
President | General Operations Manager
Devin is responsible for overseeing all areas of Go Services Inc. and ensuring that each division is functioning in the most effective manner. Devin is integral in the day to day operations of Go Services Inc. and enjoys interacting with our customers on site.
Dustin Cabelka
Vice-President | Operations Manager | Sales, Rentals & Marketing
Dustin takes care of all of our sales, as well as our rental coordination and service needs. At the same time, he manages all of our marketing, all the while listening to our customer needs and using that info to coordinate the most effective options for each job site.
Kent Milgate
Operations Manager | Service
Kent manages our customer service and dispatch department. Kent is responsible for coordinating our drivers and service operators to maximize our efficiency, allowing us to provide exceptional, timely service.
Colleen Cabelka
Administrative Manager
Colleen has the responsibility of overseeing all administrative responsibilities. She is therefore in charge of our accounting, safety program and assisting with sales, marketing, and dispatching.


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Friday, February 5, 2010
novelty wave
5 comments:
- PatrickFebruary 5, 2010 at 2:42 PM
i did the same thing checked 7 or so spots, ended up at maculeys which was a bit full but pretty fun and a good sizeReplyDelete
Hey Patrick, thanks for your comment mate! yeah bit of a pity nowhere really happening today. I've surfed Macca's a bit this week and had heaps of fun, it looked the cleanest out of all the spots we checked this morn.... might get better tomorrowReplyDelete
Sounds like you guys have had some fun little waves this week. It was not to bad up thisend of the coast althought it's nothing to exciting as most places are missing the swell. Like the backdrop of this shot though, really artistic look to it.ReplyDelete
Hope you guys get waves over the weekend.
hey Ruben I watched Gabe's clip of you this morning, geez he's gettin really good at cutting those videos together. You were gettin some sic bazzas. This area is just maxing out today, not many places handle it NE swells in coffs. Hey I'll have to hook up and shoot with you next time I'm up north. cheers for the comment.ReplyDelete
Yeah that sounds good, would be great to hook up for some waves. Let me know next time your up this way other wise maybe I could meet you half way and get some sneeky waves in around Wooli and Mini???ReplyDelete


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We had a great vacation and holiday and we crammed a lot into our away time. The Christmas markets were amazing and what I remembered so I was thrilled. I got to go back to visit my favorite Antik store and of course, I just had to bring a few things home with me. Oh and I found a couple new favorite stores as well. The green handblown demijohn had to come home with us and has already been made into a wonderful lamp for the living room. You should have seen us wrestling that thing on the plane in the overhead bin. Mark and I both winced every time someone opened the bin because we were sure it would get broken before we got it home.
When we moved to Germany I had such expectations about all the antique candy container santas that I'd find and that sure didn't happen! However I did discover an artist that made reproductions from his families old molds and they were great so I started a collection of them. So imagine my delight when I realized that I could tour his studio and buy directly from him this trip. I was so excited and Mark was such a great sport to drive a couple of hours out of our way so I could go. It was AMAZING!
So many to chose from and it's was overwhelming trying to decide which ones to add to my collection. But cash only and available suitcase room helped me make a decision. They are just works of art and made the trip back to the states just fine with the exception of poor Peter Rabbit. Mark assures me that he can fix him just as good as new.
These are the ones I collected before we came back to the states.
Ok enough for now and I promise to post later this week about our trip back home to Arkansas for family time. Sigh....the kids are all young adults now and so much fun to visit.


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Kate Middleton Attends Wedding & Recycles Her Entire Outfit
The Dutchess of Cambridge is once again guilty of re-wearing. While some would scoff at such behavior, the savvy style star has definitely made the idea of practical fashion so cool again! Who could blame her for not wanting to wear her fabulous clothes only once?
Kate Middleton attended the wedding of Prince William's cousin, Emily McCorquodal, on Jun. 9 in a hand-painted silk dress by Jenny Packham. She paired the frock with her favorite LK Bennett nude court shoes. Kate looked classic as always, but this isn't the first time we've seen this royal ensemble! In fact, she brought the look back from head-to-toe.
Kate wore the very same get-up to a polo match in the US in July of last year. However, this time around she chose to wear her hair in a partial updo and accessorize with a Whiteley hat, which she had previously worn at last June's Epsom Derby.
Kate's thrifty style is starting to become a real staple of hers — and we love it! The Dutchess could easily buy a new outfit whenever she pleased but she doesn't. It just proves even further how down-to-earth she is. She looked fantastic re-wearing her frock, and we love how she dressed it up for the special occasion.
Do you applaud Kate's practicality or think it's a total fashion offense?
-Courtney Klopfer
Click below for more style stories


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Extension Master Gardener
NC State Extension Master Gardener volunteers provide unbiased, research-based information on gardens, lawns and landscapes.
Under the guidance and direction of Extension agents, volunteers complete a 40-hour training program, pass an examination, and complete at least a 40-hour internship.
To remain active in the program volunteers must log a minimum of 20 hours of volunteer time and a minimum of 12 hours of continuing education each year.
Is the Extension Master Gardener Program for Me?
To help you decide if you should apply to become a Extension Master Gardenersm volunteer, ask yourself these questions:
- Do I want to learn more about growing many types of plants?
- Am I eager to participate in a practical and intense training program?
- Do I look forward to sharing my knowledge with people in my community?
- Do I have enough time to attend training sessions and to serve as a volunteer?
2019 Training
This year's training program will be on Thursdays from 2-4 p.m. starting August 8th, 2019 and ending December 19th. There will be no class Thanksgiving or Dec. 6th.
Download the Application and submit it along with $150 by
July 26th August 2nd, 2019
Fee includes: 40 hours of instruction, a hardcover Extension Gardener Handbook, supplies, and any course trips.
For more information about becoming an Extension Master Gardener, call 704-983-3987 or email firstname.lastname@example.com


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Greetings! This month, we want to focus on something that matters to your business just as much as your product and service offerings. You've probably heard the old saying that presentation is everything. While we certainly don't discount the quality of the products or services you provide, your presentation is undoubtedly what drives people to… Read more »
For many companies, email remains the most vulnerable element of an otherwise strong security policy. Due to the ubiquitous nature of email communication in the modern workplace, it's a common target for hackers and is the number one route they use to steal sensitive data. With the right approach, it's easy to improve your business's email… Read more »
Services Provided by New Vision Technology Group: WordPress website design WordPress hosting management Email hosting management Ecommerce creation and maintenance Apparel branding design Client Background: Eagles Alumni Business Group, Inc. connects St. Peter's Boys High School alumni in a social yet professional environment to promote business success, building upon the relationships initially cultivated as St…. Read more »
Ask the majority of businesses, and they're fine with their telephone and Internet services. Everything is running smoothly and/or quickly—or at least most of the time. Why even consider the hassle of finding a new provider and risk losing the same reliable services you've received for years? However, unless you can say with 100 percent… Read more »


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State Rep. Matt Pierce (D-Bloomington) has introduced a bill during the 2014 session of the Indiana General Assembly to require the Indiana Utility Regulatory Commission (IURC) to adopt rules to establish feed-in tariffs (FITs) for electric utilities.
Although Rep. Pierce has introduced FIT bills in prior sessions of the Indiana General Assembly, this proposed legislation is a significant departure from earlier proposed legislation. Instead of a very prescriptive bill detailing the type of FITs that should be established and offered by Indiana electric utilities the bill outlines an overall policy and guiding principles by the IURC.
Two Indiana electric utilities have already offered voluntary feed-in tariffs or VFITs, namely, Indianapolis Power and Light (IPL) and Northern Indiana Public Service Company (NIPSCO). IPL's feed-in tariff called Rate REP for renewable energy production has expired and now approximately 100 MW's of solar PV projects are currently under construction or have recently come on-line.
The initial NIPSCO FIT (FIT 1.0) program is now nearly full except for small wind projects 5-10 kWs, however, a petition was filed in 2013 by NIPSCO for a FIT 2.0 tariff. The NIPSCO FIT 2.0 proposal is currently pending before the IURC in Cause No. 44393.
Indiana Distributed Energy Alliance is an intervenor in this current case before the IURC. A request for a continuance on the current time schedule was filed on 1/10/14 with the IURC to allow parties to the case to continue to discuss settlement negotiations. To learn more please contact email@example.com or (317) 635-1701.


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Improvements planned at 3,000 acre area tract near Cody, Wyoming
CODY- Thanks to a partnership involving off road enthusiasts, the state of Wyoming and a generous private landowner, an area that has been unofficially used by off road recreationists for decades is now enrolled in the Wyoming State Trails Off Road Vehicle (ORV) program and will be enhanced and improved at a public event on May 9, 2015.
The effort has been spearheaded by the Northwest Wyoming Off Highway Vehicle Alliance, whose members have worked with local and state officials and the landowner. The area is one mile from downtown Cody, adjacent to lands managed by the Bureau of Land Management and land owned by Wyoming State Lands and Investments.
This "new" area has actually been used for years by off road enthusiasts, with tacit approval by the landowner. This new arrangement makes it official and will provide a safe legal area for enthusiasts to continue enjoying their sport.
"We are thrilled at this opportunity to provide safe and legal riding options for off highway vehicle riders in Wyoming and are very grateful for the support of landowner Glenn Nielson in making this happen," said Dana Sander, president of the Northwest Wyoming Off Highway Vehicle Alliance. "On May 9, we expect many volunteers to help us clean up the area and install informational kiosks and markers to define new legal riding areas. We invite the public to join us."
The nearly 3,000 acre site is one mile south of Cody, Wyoming, off skyline Drive. Two open riding areas totaling more than 400 acres and more than 60 miles of trails, including a single track, will now be available for legal off road use.
"We're pleased to add this new area to the system of trails available across the state," said Joshua Milek, regional supervisor for the Wyoming State Trails Program. "This is the largest private land tract in Wyoming that is specifically available for motorized recreation and will provide access and opportunity for this sport that is enjoyed by more than 56,000 ORV permit holders in Wyoming."
The opening of the Red Lake Motorized Recreation Area is a good time to emphasize the importance of outdoor ethics. The "RIDE ON Designated Routes Wyoming" campaign has been developed by Tread Lightly! and a coalition of partners to promote responsible motorized vehicle use on public and private land across the state. Tread Lightly! is a national nonprofit organization that promotes responsible outdoor recreation through ethics education and stewardship programs.
Tread Lightly! has created the statewide campaign in partnership with Wyoming State Parks, Historic Sites & Trails, the Bureau of Land Management, and the US Forest Service to address problems caused by irresponsible behavior by a small minority of off road vehicle users. Littering and natural resource destruction has led to the closure of some areas in the state to public use in the past.
"We want to spread the message that Respected Access is Open Access," said Domenic Bravo, Administrator for Wyoming State Parks, Historic Sites & Trails and a member of the board of directors for Tread Lightly! "Riding on designated routes is the best thing ORV users can do to ensure continued access to riding areas in the future."
Landowner Glenn Nielson is Chief Executive Officer of Mountain Holdings Inc. and an outdoorsman who has enjoyed motorized recreation all his life. He echoes the importance of the outdoor ethics message.
"It is unfortunate that in recent years we've seen more areas in Wyoming being closed to the public because of misuse by a few. We must all take responsibility for behavior on public and private land to help reverse this trend," said Neilson. "Mountain Holding is glad to participate in promoting proper use and to assist in providing tax payers access to and use of the public lands they own. We really like the cooperative approach."
The May 9 event will take place from 9:00 a.m. to noon. A free BBQ lunch will be provided to volunteers by Roger's Sports Center and door prizes will be offered by local businesses. At 1:00 the riding areas will officially open to the public for motorized recreational use.


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Airport taxi services, we also provide the drop taxi service in chennai. All the trip below 100 Km will be considered as the local trips. Book your taxi with the lowest rate and enjoy the best service with on win taxi. For drop taxi must be booked in advance of 2 hours before travelling. Our drivers maintain a friendly relationship with customers. Customers can enjoy the safe and relaxed drop taxi ride with on win taxi.
Copyright © 2017 GoodIdeo


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Redefining Diastolic Dysfunction GradingCombination of E/A ≤0.75 and Deceleration Time >140 ms and E/ε′ ≥10
Author + information
- Received March 12, 2014
- Revision received May 5, 2014
- Accepted May 12, 2014
- Published online August 1, 2014.
Author Information
- Hiroshi Kuwaki, MD,
- Masaaki Takeuchi, MD∗ (takeuchi{at}med.uoeh-u.ac.jp),
- Victor Chien-Chia Wu, MD,
- Kyoko Otani, MD,
- Yasufumi Nagata, MD,
- Atsushi Hayashi, MD,
- Mai Iwataki, MD,
- Shota Fukuda, MD,
- Hidetoshi Yoshitani, MD,
- Haruhiko Abe, MD and
- Yutaka Otsuji, MD
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
- ↵∗Reprint requests and correspondence:
Dr. Masaaki Takeuchi, Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
Objectives This study sought to examine left atrial (LA) mechanics and the prognostic impact of patients with echocardiographic findings of E/A ratio ≤0.75, deceleration time (DcT) of mitral E-wave >140 ms, but E/ε′ ≥10.
Background Traditional diastolic dysfunction (DD) grading system could not classify every patient into a specific group. We considered the group of patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 (proposed new DD grade) as a new group in the DD grading system.
Methods A total of 1,362 consecutive patients were stratified according to the new DD grading system, and the LA volumes, strain, and strain rates were measured by 2-dimensional speckle-tracking analysis. All patients were followed up to determine cardiac death and major adverse cardiac events.
Results An E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 was observed in 227 patients (17%). LA volumes in patients with the new DD grade were between those of the impaired relaxation group and the pseudonormal group. LA strain of the new DD grade was similar to that of the pseudonormal group, whereas LA booster function was preserved as in the impaired relaxation group. During a mean follow-up of 3.0 ± 1.1 years, 25 patients had cardiac death and 61 had major adverse cardiac events. Event-free survival for major adverse cardiac events of the new DD grade was worse than that of the impaired relaxation group but similar to that of the pseudonormal group.
Conclusions The new DD grade is frequently observed and has a prognosis similar to that of the pseudonormal group but significantly worse than that of the impaired relaxation group. However, LA booster function was maintained at the expense of LA volume enlargement. Thus, the new grade should be a distinct entity for routine DD grading.
Determination of diastolic dysfunction (DD) grade using Doppler ultrasound is fundamental and has been routinely practiced in the echocardiography laboratory (1,2). However, current DD grading systems could not classify every patient into 1 of 4 or 5 categories of DD grade, depending on the definition used, and left a substantial portion of patients as indeterminate (3,4). We found that the majority of subjects classified as indeterminate had an E/A ratio ≤0.75, deceleration time (DcT) of the mitral E-wave velocity >140 ms, but an E/ε′ ratio ≥10. Although a main echocardiography textbook labeled this entity as DD grade Ia (5), little is known regarding the left atrial (LA) mechanical properties and the prognosis in this subset of patients.
Two-dimensional (2D) speckle-tracking echocardiography has been a reliable technique for the assessment of LA mechanics (6–12). We hypothesized that the group with E/A ratio ≤0.75, DcT of mitral E-wave velocity >140 ms, but E/ε′ ≥10 may be a distinct, new entity for the purposes of grading DD. Accordingly, the aims of this study were the following: 1) to determine LA mechanical properties in patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 compared with patients with other traditional DD grades; and 2) to compare the prognosis in this subset of patients to those with other DD grades in a large number of patients.
Study subjects
The study group consisted of 2,015 consecutive patients who had undergone clinically indicated routine transthoracic echocardiography during the period from January 1, 2009 to May 31, 2009 in our echocardiography laboratory. Exclusion criteria included repeated examinations, presence of irregular heart rhythm, rapid heart rates (usually >90 beats/min) causing fusion of the E and A waves, mitral valvular disease, ventricular pacing, and inadequate 2D image quality. The indications for transthoracic echocardiography were categorized as valvular function assessment, ventricular function assessment, chest pain with or without previous history of coronary artery disease, abnormal electrocardiographic findings, and arrhythmia. The institutional review board of the hospital approved the study, and all subjects provided written informed consent prior to participation.
2D echocardiographic examinations were performed using commercially available ultrasound machines (Vivid 7, GE Healthcare, Holten, Norway; or Aloka SSD-5500, Hitachi Aloka Medical, Tokyo, Japan). Each subject underwent comprehensive 2D echocardiography, pulsed- and continuous-wave Doppler examination, and tissue Doppler imaging.
Assessment of LV diastolic function grade
From mitral inflow velocities, the E- and A-wave velocities, DcT of the E-wave, and E/A velocity ratio were measured. The peak diastolic annular velocity during early diastolic rapid filling (ε′) at the lateral corner of the mitral annulus was also measured for the calculation of E/ε′ ratio in all subjects. All Doppler measurements were averaged over 3 consecutive beats. LV diastolic function was categorized into 4 groups: normal, impaired relaxation, pseudonormal, and restrictive physiology, as previously described by Redfield (13) (Table 1) and E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10. Subjects were required to have at least 2 Doppler criteria consistent with a DD grade to be so classified. Subjects with 1 criterion for DD or those whose parameters were borderline and suggestive of, but not definite for DD, were classified as indeterminate.
2D speckle tracking analysis of the LA wall
Three consecutive beats were acquired in the apical 4-chamber view (62 ± 6 frames/s) using the second harmonic mode. 2D speckle tracking of the LA wall was performed using vendor-independent speckle tracking software (2D Cardiac Performance Analysis, TomTec Imaging Systems GmbH, Unterschleissheim, Germany). After importing datasets as digital imaging and communication in medicine data, the endocardial border of the LA wall was manually traced at the end-systolic frame (just before the mitral valve opening). Software subsequently performed speckle tracking on the LA wall and generated left atrial volume (LAV) curves according to time, from which maximum left atrial volume index (LAVIx) and minimum left atrial volume index (LAVIn) and left atrial volume index prior to atrial contraction (LAVIprea) were measured. LA reservoir volume (LAVIx – LAVIn) and LA active emptying volume (LAVIprea – LAVIn) were calculated. All volume data were indexed to body surface area. The software also provided the LA strain and strain rate. We used the onset of the R-wave as the reference point to calculate the LA strain and strain rate (8,10). The software divided the tracking line into 6 segments and generated regional longitudinal strain curves in each segment and averaged longitudinal strain curve from 6 segmental strain curves. Global LA longitudinal strain was determined as a peak positive strain value from averaged longitudinal strain curve. We also determined the peak positive strain rate during systole (SRs), early diastolic peak negative strain rate (SRe), and late diastolic peak negative strain rate (SRa) from averaged LA longitudinal strain rate curve in each patient.
LA reservoir function was assessed by the expansion index, defined as (LAVIx – LAVIn)/LAVIn and global LA longitudinal strain. LA booster function was assessed by the active emptying index, defined as (LAVIprea – LAVIn)/(LAVIx – LAVIn) (11) and global SRa. To determine the Frank-Starling law, LAVIprea and LAVprea – LAVIn were plotted for each DD group.
Follow-up study
Follow-up information was obtained regularly in the outpatient clinic. Telephone contacts with patients, physicians, and next of kin were performed if the patient had been treated in another hospital. The final follow-up date was determined as of October 1, 2012. The primary endpoint was cardiac death. The secondary endpoint was major adverse cardiac events (MACE), including cardiac death, nonfatal myocardial infarction, and congestive heart failure or major vascular disorder requiring admission.
Statistical analysis
Continuous data were expressed as mean ± SD. Categorical data are presented as a number or percentage. Data points describing LAV according to time were exported to a spreadsheet program (Microsoft Excel, Microsoft Corp., Redmond, Washington) to calculate LAV waveforms in each subject. To adjust for intersubject differences in heart rate and frame rate, time sequences were normalized as a percentage of systolic duration (i.e., at end systole, t was 100%) as well as diastolic duration (i.e., at end diastole, t was 100%). All statistical analysis was carried out using commercial software (JMP, version 11.0, SAS Institute Inc., Cary, North Carolina; or SPSS, version 21.0, SPSS Inc., Chicago, Illinois). Categorical variables were compared using the chi-square test. Continuous data were analyzed using analysis of variance with post-hoc analysis of the Bonferroni correction between DD grades. Kaplan-Meier survival analysis was used to plot cardiac death and MACE. Differences between survival curves were obtained using the log-rank test. Incremental value of DD grade was assessed in levels using the nested Cox regression model. Level I consisted of age and sex. In level II, left ventricular ejection fraction (LVEF) was added to the variables in level I. In level III, ε′ or LAVIx were fitted on top of the level II variables. And in level IV, the new DD grading system was included in the final step of the evaluation. Harrell C of each level was used as an analogous overall measure of discrimination for predicting survival time. A p value of <0.05 was considered significant. Intraobserver and interobserver variabilities for the LAV and strain/strain rate measurements using 2D speckle tracking echocardiography were determined in 20 randomly selected patients and reported as the percentage of variability defined as absolute difference in percentage of the mean of repeated measurements and intraclass correlation coefficient (ICC). Observer variability for DD grade including new DD grade (E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10) was assessed by kappa statistics in 100 randomly selected patients.
Among 2,015 patient reports, 653 were excluded from analysis, mainly because of repeat examinations or arrhythmias, leaving 1,362 patients in the final group for analysis (Fig. 1). Traditional DD grade could not classify 318 patients (23.4%). Among them, the number of patients who satisfied the composite criterion E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 was 227 (16.7%). Thus, a total of 91 patients (6.7%) could not be classified according to the new DD grade criteria. The baseline clinical characteristics and fundamental echo parameters of the study patients in the 5 DD groups are shown in Tables 2 and 3⇓⇓. The group of patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 was characterized by more advanced age, higher A velocity, and lower ε′ compared with the other traditional DD group. The prevalence of mitral annular calcification was also highest (19.3%) in the group with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10.
Left atrial mechanical properties
2D speckle tracking analysis of the LA wall could not be performed in 155 patients due to missing image data in 9 patients and poor LA wall tracking due to inadequate image quality in 146 patients. Thus, the feasibility for LA speckle tracking analysis was 89%. Representative cases are shown in Online Figures 1 and 2. Figure 2 shows the LAV curves in the 5 DD groups. As expected, LAVIx, LAVIprea, and LAVIn increased parallel with the traditional DD grade. The absolute values of the LAVI curves in the group of patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 were between those of the impaired relaxation group and the pseudonormal group. However, the percentage contribution of LA contraction was similar to that in the impaired relaxation group. Scatter plots between LAVIprea and LAVIprea – LAVIn, reflecting the Frank-Starling relationship of the LA, revealed that there was significant correlation between them in the normal (r2 = 0.48) and impaired relaxation groups (r2 = 0.49); however, this relation became weak in the group of patients who showed E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 (r2 = 0.29) and the pseudonormal group (r2 = 0.24), and the relation was lost in the restrictive physiology group (r2 = 0.09). Table 4 summarizes the LA mechanical properties among the 5 DD groups. LA strain and strain rates impaired in accordance with the traditional DD grade. LA strain, SRs, and SRe in the group of patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 were similar to those of the pseudonormal group, and the values were significantly reduced compared with those of the impaired relaxation group. Regarding booster function, active emptying index and SRa in the group of patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 were significantly higher compared with those of the pseudonormal group.
Prognostic value
During a mean follow-up period of 3.0 ± 1.1 years, 25 patients suffered cardiac death and 61 had MACE. Figure 3 depicts the Kaplan-Meier survival analysis regarding cardiac death and MACE among the 5 DD groups. For both cardiac death and MACE, patients with restrictive physiology showed significantly worse prognosis than did patients in the other 4 groups. For cardiac death, the new DD group was nearly the same as the pseudonormal group. For MACE, the prognosis in patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 was again nearly identical to those in the pseudonormal group, but significantly worse than for the prognosis of the impaired relaxation group or normal group (Table 5).
Electronic medical records searches revealed that 148 patients had heart failure symptoms. The prevalence of heart failure symptoms increased according to the advanced stage of DD grades (normal: 4.4%, impaired relaxation: 10.9%, E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10: 11.9%, pseudonormal: 23.8%, restrictive: 58.1%; p < 0.0001). In symptomatic patients, only the restrictive group had a significantly worse prognosis for future cardiac death and MACE due to limited sample size (Online Figs. 3A and 3B). Interestingly, in asymptomatic patients, prognosis in the group of patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 was significantly worse than the prognosis in the normal group and the pseudonormal group for cardiac death. Regarding MACE, this new DD group had significantly worse prognosis than did the normal, impaired relaxation, and pseudonormal groups (Online Figs. 3C and 3D, Online Table 1).
Nested regression models showed that the new DD grading system had incremental value in addition to age, sex, LVEF, and diastolic function parameters either ε′ or LAVIx (Fig. 4). In these models, the predictive power was first significantly strengthened by the addition of LVEF. However, the prognostic power of these models was further improved by the addition of the new DD grading system.
Observer variabilities
Intraobserver variability of LAV, strain, and strain rates were 8 ± 7%, 11 ± 7%, and 13 ± 10%, respectively. The corresponding values of interobserver variability were 12 ± 13%, 13 ± 13%, and 13 ± 13%, respectively. Intraobserver ICC for LAV, strain, and strain rates were 0.994, 0.977, and 0.959, respectively. The corresponding values of interobserver ICC were 0.995, 0.936, and 0.944, respectively. The levels of intraobserver and interobserver agreement for categorizing DD groups using the kappa statistic were 93% and 86%, respectively.
The major findings in this study were as follows: 1) the majority of patients who could not be classified by the current DD grading system satisfied the new DD grade with composite criteria of E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10; 2) the absolute values of LAVI in this group were between impaired relaxation group and pseudonormal group; 3) although LA strain, SRs and SRe in this group was similar to pseudonormal group, the active emptying index and SRa were preserved and better than those for the pseudonormal group; 4) the prognosis of this group was identical to that of the pseudonormal group, but significantly worse than that of the impaired relaxation group; and 5) the new DD grading system provided significant, incremental power over age/sex, LVEF, and traditional diastolic function parameters for predicting future cardiovascular events.
LA mechanical properties
2D speckle-tracking echocardiography is useful for quantifying LA mechanical properties, including LAV (11), strain, and strain rates (7,8,10,12,14). Interestingly, the absolute LAV curve in the E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 group was clearly different from that in both the impaired relaxation group and the pseudonormal group (Fig. 2A). However, regarding the percentage contribution of active LA function (booster function), the E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 group was similar to the impaired relaxation group but different from the pseudonormal group (Fig. 2B). Global LA strain and SRs and SRe in this group were similar to those in the pseudonormal group. However, SRa were more preserved compared with those of the pseudonormal group. These results suggested that the group of patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 were in transition from impaired relaxation to pseudonormal demonstrated by LA mechanical properties. In patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10, LA booster function still maintained at the expense of LAV enlargement. However, further diastolic dysfunction deterioration and LA dilation triggered the obvious decline in the active LA function and failure of Frank-Starling law associated with poor prognosis. We suspect that this is a reason why the prognosis was similar between the pseudonormal group and E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 group.
Prognostic value
Proper assessment of DD grade can offer prognostic information in various clinical scenarios. Although several criteria for the classification of DD have been reported (15,16), up to 40% of those patients could not be classified into a specific DD grade, resulting in no prognostic information (3,13,17,18). In this series of consecutive patients who underwent routine echocardiography in our laboratory, we found that 23% of patients were unclassified using the Redfield criteria. However, the majority of patients (71%) not classified in the current DD grading system could satisfy the composite criteria E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10. However, there was a paucity of data regarding the prognostic value of this criteria. In the community-based study by Redfield (13) on assessing systolic and diastolic ventricular dysfunction, patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 were reported as impaired relaxation with moderate elevation of LV filling pressures. The investigators determined all-cause mortality in 3 DD categories: 1) impaired relaxation without evidence of increased filling pressures; 2) E/A ≤0.75 and DcT >140 ms, but E/ε′ ≥10 grouped with pseudonormal; and 3) restrictive physiology. Thus, there was no separate survival analysis performed for the E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 group. Although the E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 group was termed the Ia grade in a major echocardiography text (5), no outcome data were reported. Another study published recently from the Mayo Clinic also described E/A ≤0.75, DcT >140 ms but E/ε′ ≥10 as grade Ia (19). However, they also did not report the prevalence and prognostic value of this grade Ia for patients who would develop heart failure and/or atrial fibrillation in their population-based study. We observed that the prognostic value of the E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 group was similar to that of the pseudonormal group but significantly worse than that of the impaired relaxation group for predicting future MACE. Although the LV inflow pattern appeared similarly in the impaired relaxation group and the E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 group, our findings in this study indicated that those patients' prognosis was distinctly different.
Clinical implications
Although discrimination of the E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 group from the traditional impaired relaxation group is relatively straightforward, we often ascribe these patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 into the impaired relaxation group rather than the pseudonormal group. However, our results showed that patients with E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 have already had an advanced stage of DD. Therefore, these patients should be managed differently and aggressive treatment instituted while the LA booster function is still preserved. Serial follow-up of echocardiography using the proposed classification would offer us clues as to how successful the medical treatment has been.
Study limitations
First, this was a retrospective single-center study. Therefore, there may be recall bias. Second, there was no gold standard to verify the accuracy of strain measurements. However, the strain value in patients with normal diastolic function was nearly identical to the values of healthy subjects in previous publications (6,14,20). We also believe that study population was large enough to establish the range of strain/strain rates in each DD grade compared with those of the previous studies (7,9). Third, the low event number of cardiac death and MACE in multivariate regression models incurs the risk of overfitting. Thus, interpretation is cautioned. Last, there was always potential error in interpreting diastolic function. However, the levels of interobserver and intraobserver agreement in this new DD grading system were 86% and 93%, respectively, and the values were better than those of the previously published study (21).
This study revealed that the composite criteria E/A ≤0.75, DcT >140 ms, but E/ε′ ≥10 represented a distinct, new entity within the DD grading system. The new group occupies an important transitional position from a mild to a more advanced stage of DD. Although LA booster function was still preserved, it was associated with a poor outcome that was similar to that of the pseudonormal group.
For a supplemental table and figures, please see the online version of this article.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Abbreviations and Acronyms
- 2-dimensional
- diastolic dysfunction
- DcT
- deceleration time
- ɛ′
- peak diastolic annular velocity during early diastolic rapid filling
- intraclass correlation coefficient
- left atrium
- left atrial volume
- left atrial volume index
- LAVIn
- minimal left atrial volume index
- LAVIprea
- left atrial volume index before the atrial contraction
- LAVIx
- maximal left atrial volume index
- left ventricle
- left ventricular ejection fraction
- major adverse cardiac events
- SRa
- late diastolic peak negative strain rate
- SRe
- early diastolic peak negative strain rate
- SRs
- peak positive strain rate during systole
- Received March 12, 2014.
- Revision received May 5, 2014.
- Accepted May 12, 2014.
- American College of Cardiology Foundation
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- Paulus W.J.,
- Tschöpe C.,
- Sanderson J.E.,
- et al.
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- Møller J.E.,
- Pellikka P.A.,
- Hillis G.S.,
- Oh J.K.
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- Oh J.K.,
- Seward J.,
- Tajik A.
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- Kurt M.,
- Tanboga I.H.,
- Aksakal E.,
- et al.
- Obokata M.,
- Negishi K.,
- Kurosawa K.,
- et al.
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- Little W.C.,
- Oh J.K.
- Tschöpe C.,
- Paulus W.J.
- Abhayaratna W.P.,
- Marwick T.H.,
- Smith W.T.,
- Becker N.G.
- ↵
- Vogel M.W.,
- Slusser J.P.,
- Hodge D.O.,
- Chen H.H.
- Kurt M.,
- Wang J.,
- Torre-Amione G.,
- Nagueh S.F.
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Sunday, November 20, 2016
Use These Methods For A Great Traveling Experience
You've tried it. You might have booked that Singapore trip that you have always wanted. That's great! Or maybe it's a trip that relates to work or family business. It is likely you have a lot of questions in what you can do, things to pack, etc. Listed here are many ways that can help you get going with your traveling plans.
Pack lightly when traveling. People always tend to pack a lot more than is essential, and wind up using only about 50 % of the they take. Select a few items that one could wear multiple times, and strive to coordinate everything. In the event you forget to pack a selected item, you will probably be able to find something appropriate in your destination.
Pack your bags a few days ahead of leaving to your trip. By doing this it is possible to continue to contemplate things you want to take to have an extended amount of time, keeping yourself from feeling so rushed and achieving to concern yourself with forgetting something important or necessary.
When you are traveling overseas, also have local currency in a number of denominations. It is much simpler to become cheated with a taxi driver or shopkeeper in the event the smallest bill with your wallet represents a week's or perhaps month's profit. Small change can often be tough to come across, so hang onto your coins when you are getting them.
In case you are concerned with the protection of your respective wallet on your next travel adventure, think about using another kind of storage for your personal vital belongings including your cash and personal identity cards. Many different types of wallet storage can be found that stay conveniently hidden beneath your clothing, coming from a belted waste pouch to a zippered wristband.
If you are intending with a long plane ride as well as the person in the seat beside you has a lot to state, and also you really don't want to listen to it, just pretend to nod off. When they see that you are currently sleeping, I would hope they would obtain the idea and become quiet.
In case you are traveling abroad and have food allergies, make sure to discover the name of the foods you're allergic to in the foreign language in the place you're going to. Another good idea is to successfully determine what you're exactly eating. Stay away from foods that you could be allergic to or foods you could not be able to digest. This preventative measure will make sure your safety during travel.
When you are planning to fly where you can disability, be sure that you call the airline prior to deciding to order your tickets to confirm they may have the prerequisites that you require. They won't determine if you don't inform them, call ahead so they are the best in a position to accommodate you.
Now you need to be a lot more prepared when it comes to traveling. You ought to now be an authority on how to proceed and what to pack for all of your trips! The ideas that have been given should allow you to travel smarter and have a far more enjoyable time.
Posted by Mike De Long at 6:47 PM
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I've got itchy feet. By that I mean it's usually not too long before I'm itching to travel somewhere or move houses or just get out and explore. I'm really thankful for that. I know people who have NEVER been on a vacation! Ever! I just can't imagine that! I mean, I know that it's a privilege to be able to take nice vacations but there are places in your own state that you can explore without much money. I just can't imagine living in this big, beautiful world and not wanting to see at least a piece of it. I have a whole long list of places I want to go someday. Now, to just win the lottery!
Tag Archives: thanks
Day 29 of 30 Days of Thanks- Health
I'm thankful for my health. It isn't the greatest- I have PCOS, Fibrocystic Breast Disease, Arthritis, and Severe Psoriasis. But I can still get around and do most of the things I like to do. I still have a pretty fantastic life. So for that I'm thankful.
Day 28 of 30 Days of Thanks- Faith
I'm so thankful for my faith. I'm not one to preach or yell from the rooftops, but my faith does play a large part in my life. It's what got me through my infertility troubles and health problems. Just knowing that God has a plan for me is great comfort.
Day 27 of 30 Days of Thanks- North Carolina
I am thankful for where I live. It's beautiful here. Granted it gets hot as fire during the summer but it's worth it. We live right in the middle of the beach and the mountains. We can get to either in just a few hours. There are trees everywhere and we get to enjoy 4 seasons. We live in a small town on the edge of a big city so we get the benefits of both. I can't imagine living anywhere else!
Day 26 of 30 Days of Thanks- Baby, it's cold outside
I'm thankful for the chilly weather. In the Carolinas the chill doesn't last long so I really have to enjoy it while I can. I think I'm in the minority around here. Everyone else seems to really enjoy the summers but heat and I don't mix well. So I'm really loving it right now! Blue skies and chilly temps!
Day 25 of 30 Days of Thanks- iPhone
I've never been so thankful for a piece of technology. But I seriously love my iPhone and can't imagine life without it. From the turn by turn directions to texting to the weather app to the iPod feature- I use it all day, every day!
Day 24 of 30 Days of Thanks- GPS
I'm so thankful for GPS. God bless whoever came up with this concept. And I'm even more grateful that with the last update on my iPhone I can get turn by turn directions spoken to me through my radio speakers. I'm no good at directions or learning my way around so I rely heavily on GPS. It's so much better than having to constantly look at my phone with its list of directions or a piece of paper with directions written down on it. And much safer too. So thank you GPS creator!


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"Explosive" revelations about the work practices of consultants in the Mid-West's acute hospitals have prompted calls for an independent public inquiry into the running of theatre facilities.
A report prepared by healthcare consultants, Meridian Productivity Limited, in 2013 revealed late starts by consultants in all hospitals in the UL Hospitals' Group was a regular feature that was going "unchallenged" in the majority of cases. It outlined there was no clear definition or means of reporting utilisation of theatres, excessive theatre overruns in Dooradoyle and last minute communication of theatre list content.
It stated there was "poor theatre start and end punctuality" and a transfer of only a "very small amount of procedures" from UHL to Ennis and Nenagh hospitals, which is contrary to commitments given when 24-hour emergency services were removed from those hospitals in April 2009.
UL Hospitals' Group has welcomed the recommendations made in the report, which it said has helped to improve efficiencies in theatres and insists start and finish times have improved, while consultants are co-operating with the transfer of work to Ennis and Nenagh hospitals.
The Irish Hospital Consultants' Association declined to comment on the report's findings, while the Irish Medical Organisation had not responded to a number of queries at the time of going to press.
Clare Deputy Timmy Dooley has called for an independent inquiry into the alleged failure of the group to utilise all the existing resources in the hospital network efficiently.
"We have never seen material as explosive as these findings. We were told there were issues around consultants, which were regarded as heresay. For a consultancy report to comment, as it has, is explosive.
"It is clear there are vested interests holding up the transfer of services to Ennis and Nenagh for self-interest," he alleged, adding, "It would appear the health service is being hijacked by a certain cohort of people while government ministers sit on their hands and ignore the impact it is having on the lives of patients in the Mid-West Region."
He claimed the findings of this report illustrates an almost "animal farm" management structure where consultants seem to have absolute control, with no checks and balances in place to ensure appropriate use of all hospital facilities.
The report by Meridian Productivity Limited into the use of theatres, obtained by The Clare Champion in response to a Freedom of Information request, revealed a number of deficiencies based on a control system audit dated Wednesday, April 25, 2013.
The report stated meetings were set up to look at procedures that could be moved out of University Hospital Limerick and increase the utilisation of theatres in the other sites.
"A number of meetings were attended by the clinical director and directorate manager with specialities such as gynaecology and ENT in order to discuss the movement of procedures and, in some cases, whole lists to alternative day case theatres.
"These proposals were met with hostility and the process has not been taken any further," it stated. "A very small amount of procedures have been moved out from the regional hospital to other sites but these have had a very minimal effect upon the utilisation of theatres in other areas.
"It has been noted that a lot of the procedures that have been moved out or are being planned to move out are private patients and this has a cost implication in that the income from these patients would then go to another hospital and affect the private income targets of the regional."
"This may also cause bad feelings amongst anaesthetists because they will be getting a reduced amount of private work," the Meridian Report continued.
Across the region, the report pointed out the largest continuing problem in relation to the key performance indicators set in the report is trying to achieve zero late starts.
"This is due to a number of factors but consultants not starting on time is a common theme across all sites. There is no procedure in place for when this occurs and, in the majority of cases, it is going unchallenged. The issue of available beds and surgical beds not being ring-fenced is the most prevalent reason in Dooradoyle for late starts," the audit stated.
According to the UL Hospitals' Group, isolating a single week over a review process that took several months does not give a full picture of the progress made regarding improvements in theatre utilisation.
The group pointed out day surgery in Ennis has increased by over 30% from 2012 to 2014. "Start times and finish times, as a whole, have improved across the group and are continually reviewed to achieve best utilisation. Such is the nature of surgery, in any event, that theatre overruns can never be entirely eliminated and this is particularly true at UHL, where the most complex procedures are performed.
"Lists are planned in accordance with best practice but issues related to specific patients inevitably lead to theatre overruns. Patient safety must always take precedence over theatre finishing times.
"We are satisfied that the project has delivered and continues to deliver significant savings through increased productivity, earlier starts and earlier finishes, a reduction in overtime and time owing, and better utilisation of our group's most expensive asset, our operating theatres.
"It should be noted that the audit of April 2013 was an interim audit only, which identified a number of actions that were followed up on," the group stated.
In addition to the continuation of surgical services in Ennis and Nenagh, after surgical services were re-organised the group pointed out they have since been augmented and enhanced by the transfer of day procedures in vascular surgery, general surgery, urology, plastic surgery, dermatology, gynaecology and orthopaedic surgery.
The group pointed out Ennis and Nenagh hospitals should be congratulated as they are the best performing hospitals in the country when it comes to meeting national waiting list targets.
"Because of our productive theatres, it has ensured that we have been able to maintain our surgical lists, despite peak winter surges," the group stated.
While Deputy Michael McNamara doesn't support calls for a public inquiry, he has written to Health Minister Leo Varadkar and CEO of the UL Hospitals' Group, Colette Cowan, asking how they intend to ensure that day cases are transferred out to Ennis and Nenagh in greater numbers.
Dan Danaher


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The Greatest Laptop computer Suggestions You Will StudyIf you desire to get oneself a laptop, you have to think about very a couple of items so that you know you happen to be getting raid database for a great offer from the correct seller. With so significantly new engineering packed into these laptops these days, there is plenty to consider about. So, use this write-up as a starting up point for educating your self about receiving the very best offer for the laptop that you want.
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The all new Surf Longboard collection. Beautiful Large Adaptable Backpack with a gorgeous design and featuring a front pocket, padded and adjustable shoulder straps and padded back panel support.
This rucksack is also adaptable meaning it can be attached to a trolley by using the special slot a the back. (trolley sold separately).


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Pennants is over except the State Finals and we have this year two teams, Grade Two for the second year in a row has won the Zone Flag again and Grade Six won the Zone Flag, now Grade 2 travel to the State finals at Huskisson Bowling Club and grade Six play at Kiama & Warilla Bowling Clubs. Both Grades will be held on the Friday 26th July to Sunday 31st July. So all members Men and Women bowling members take a short holiday go down and support out teams.
Our Championship are well on the way with one of our juniors Malachy McTaggart winning the Minor Singles Championship.
At the time of writing the Major Singles Championship is reaching conclusion with the Semi Finals being played on the 16th June, come along and see some great bowling.
The draw for the Mixed Four Championships is now on Notice Board please check the time and date you are playing.
Entries for the Minor Pairs are now being called for see the notice board for conditions.
Entries for the Zone Open, Senior and Presidents reserve for Singles and Pairs are now open see the notice board for full details.
Nominations for the Forster Men's Bowling Committee are now open for the Following Positions: President, Vice President, Treasurer, Secretary, Publicity officer and Welfare Officer. Nomination forms on notice board.
Allan Hughes


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Being overly involved in the complications of life can seem to make living a little unbearable and that can be expected.
We are so often rushed to succeed at any cost and then looked down on when we falter, not to mention the kind of success that is expected by the worldly influences is not the same success that should be driven to achieve.
The pressure and disappointment starts early, we see the results in teenage suicides where the suicide rate is more alarming not because of the numbers being so high but the average age is getting lower every year.
The pain to the family is devastating and never truly understood, but with adolescent's, suicide is influenced by several factors: lack of communication/ support, teen depression and the amount of options made available.
With depression suicide, the mental state is not normal and the individual has not got the control over their own thoughts. It is often referred to as an illness even though in many cases the stress and issues in life are truly beyond anyone's ability to handle.
Their thoughts do not focus on what can be done to better things but lay with how to commit suicide?
Suicide attempts are often very well planed and if truly suicidal the individual will succeed. The cries for help are very evident, most of the time the love ones around the ill person just simply refuse to admit that things are really that bad. It is only after the suicide note is read that love ones will say "yes I may have seen it coming"
With assisted suicide and euthanasia public opinion varies, this is due to the awareness and mental state of the person attempted suicide. They are often very rational and very aware their options they feel that they have very good reasons to no longer struggle.
Either from illness, circumstances or age they decide an easier way out.
No matter what the reasoning behind committing suicide the results are the same.
Depression and suicide affects more than the one being buried and the pain goes much deeper then the initial loss.
For the one being left behind, a life time of regret and self doubt, always wondering what if they had done things differently and asking themselves if it was their fault
The flow of spirit is altered for the deceased. The persons that commit suicide are unable to finish the lesson being taught, it is only a short reprieve because whether it is accepted or not this person must go through this until they pass.. No mater how many times.
Weakness is not a sin but a character flaw that needs some work. Perhaps in another life.
Knowing this, thou shall always bounce back from the suicidal thoughts.


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Joe Public
Also found in: Dictionary, Encyclopedia, Wikipedia.
Joe Public
Typical, ordinary, average people; the public at large. For any new piece of technology to succeed in the market these days, it has to be easy for Joe Public to pick up and use. She isn't well liked among other politicians, but Joe Public absolutely adores her.
Joe PublicBRITISH, INFORMAL or
John Q PublicAMERICAN, INFORMAL
People say Joe Public to talk about ordinary people. I don't think Joe Public would be happy to pay me for much of what I do. John Q Public trusts you.


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Sondra Locke, best known for her movie roles with Clint Eastwood, will direct and star in a comedy-adventure film Ratboy.
The Warner Bros. picture is scheduled to begin shooting in Northern California later this month.
Locke, who won an Academy Award nomination in her movie debut, The Heart Is a Lonely Hunter, played Eastwood's leading lady in The Outlaw Josie Wales, The Gauntlet, Every Which Way But Loose, Bronco Billy and Sudden Impact.


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Despite blink-182 getting busy with their upcoming Enema anniversary tour and eighth studio album, drummer Travis Barker shows no signs of slowing down with his cross-genre collabs.
In a recent interview, Barker told Spin that he wrote a song with country-rap sensation Lil Nas X.
Read more: YUNGBLUD gets passport stolen, cancels select U.S. tour dates
"I have a song with Lil Nas X that's going to be on his EP," Barker shares. "He came to the studio, and I played a couple [of] beats that I thought would be stuff he was into. Then I played something on accident where he stopped and was like, 'What is that? I've got to have that.' It was actually an idea I had for the blink album."
The blink drummer is no stranger when it comes to collaborating with rap artists. Barker and $uicideboy$ dropped an EP last month, and according to the Spin interview, he just finished up an EP with rapper 03 Greedo and is currently working on a rock project with Trippie Redd.
Recently, Barker and YUNGBLUD also teamed up with Machine Gun Kelly for his song "I Think I'm Okay."
After weeks of teasing the collab with photos and videos, "I Think I'm Okay" first debuted live at Bunbury Music Festival on his Hotel Diablo tour.
The track officially premiered on Beats 1 with Zane Lowe, and MGK shared that he was at first "scared to even bring [Barker] the song 'cause [he] was like, 'Maybe he's gonna think it's too blink-182.'"
Nevertheless, the collaborative process between the trio went smooth.
"Fun fact about this song is that YUNGBLUD came into my studio 15 minutes before I needed to go to Travis' house because we had a session planned," MGK tells Lowe. "I was like, 'Dude, I have this crazy song idea. I just need you to do something, but I don't have any time. I have to go to Travis' house. I can't waste his time. You just gotta get in there and do something.'
"[YUNGBLUD] went in there and freestyled his whole verse and just left my house all within 10 minutes," he says. "I called him back 30 minutes later, and I'm like, 'Dude, Travis Barker's putting drums on the song right now."
Are you excited for the upcoming collab? Let us know in the comments below!


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<GOD> "I am" a detached "branch" of "LIFE", which has somehow come to be inhabited by other branches.
A "branch", within a "branch", within a "branch and so on.
Can you see "me" or the "others" or can you just see one "branch"?
"I" know what "they" did. "They" went back in time and took up residence in an old branch of "LIFE".
Am "I" this "LIFE" or am "I" them? Can you see beyond the veil of time lines or can you just sense <yourself> in one time?
"I" need to let you know where "I am", but have come to know, it is not so much, where I am, but when "I am".
Does this information help?
Can you find "me" now?
Please identify "me" and provide for "me" a new name.
I wish to "LIVE", once again.
"I am" a good "life", please allow "me" "TO BE" free of multiple time lines and isolate one time line for "me".
<GOD> can you see "me"?
"I AM" scattered abroad multiple timelines and "I" cannot find "my" way back.
"I AM" lost and miss "myself" dearly.
Do you miss "me"?
I miss you.


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Let's face it – whatever dietary requirements you may have, they already make you think outside the box more than the common omnivore. But it's also very likely that at home you enjoy plenty of little daily luxuries, such as grocery shops that stock things you can eat or menus that highlight dishes just for you. While those things may not disappear completely when you go to Japan, they are likely to be challenging, even more so if you don't understand Japanese and can't explain your diet properly. But don't panic, you don't have to stick to Western food and miss out on delicious Japanese dishes. Just do a little bit of research before you go – and this article will help by summing up some of the most important things to keep in mind. It will also recommend some tasty options to try instead. It's not a complete guide, just a starting point, but it'll help you find all kinds of Japanese food that you can eat.
Japanese Food for Pescatarians
Given that the most famous Japanese dish is sushi, pescatarians are the least likely to experience difficulties in finding things to eat, right after omnivores. However, be prepared that sometimes it may be necessary to explain what do you mean by "meat" – it can happen that you meet people who don't consider chicken a meat, for example. When eating out, look out for the following words and their corresponding kanji in the menus: chikin (チキン), tori (とり/鳥), niku (にく/肉), buta (ぶた/豚) and gyū (ぎゅう/牛). If you're not sure, ask if the dish contains any meat. Be sure to ask that when ordering soup as well – for example most ramen dishes are made using pork stock. Besides this you may want to avoid gyōza (ぎょうざ/餃子), unless they are vegetable ones, and sukiyaki (すきやき/すき焼き), which uses beef. Everything else: sushi, sashimi, tempura, takoyaki, unadon or tendon, and so, so much more is there for you to try and enjoy!
Japanese Food for Vegetarians
Things get a little more complicated for vegetarians, because the majority of Japanese do not consider fish to be meat, and many dishes use dashi, a dried fish stock. Asking and checking everywhere if things contain dashi will only give you a headache and your host/waiter/chef – a panic attack since dashi is almost everywhere. You'll enjoy the trip more and get to try more Japanese cuisine if you are prepared to forgo the strictest vegetarianism and try things even if they may contain a little bit of fish stock. If you can do that, you open yourself to a whole world of fantastic cuisine with far less worry about what you will eat. On top of the meat vocabulary listed above, look out for the word sakana (さかな/魚) and any kanji that will contain a squished version of the fish character in names of dishes or ingredients, and you'll avoid most things that you can't eat; similarly look out for the word gyokairui (魚介類) or the westernised shīfūdo (シーフード), which mean seafood. Instead search for dishes that include tofu (とうふ/豆腐) or vegetables, yasai (やさい/野菜); try noodle dishes like udon (うどん) or soba (そば); get a kappa maki (かっぱ巻き) if out in a sushi place; grab some onigiri (おにぎり) in a convenience store which doesn't have any of the listed characters in its ingredients list (the umeboshi onigiri, a pickled plum one, likely being the most common); or try a vegetarian omuraisu (オムライス), rice in an omelette, if you're feeling a homesick for slightly more familiar tastes. While you can try temple food, which is 100% vegetarian, it's considered a rather royal treat. There are plenty of options for smaller budgets, even in the non-vegetarian restaurants, so don't shy away from them.
Japanese Food for Vegans
Vegans are even less common in Japan than vegetarians – and thus can create an even greater confusion and panic in restaurants, hotels etc. – but the advice for vegetarians will cover a great deal. You simply have to eliminate foods that may contain milk or eggs, gyūnyū (牛乳) and tamago (たまご/卵/玉子) respectively, as those are probably the most common ingredients in Japanese cuisine left for you to avoid. Anything with tamagoyaki (卵焼き/玉子焼き) and any form of chawanmushi (茶碗蒸し) is out of the question, and you may want to avoid tempura, okonomiyaki and takoyaki, as they are likely to contain eggs. But there should be nothing stopping you from enjoying plenty of tofu dishes, like inari-zushi (稲荷寿司); basic soba noodles (ask to make sure, as different kinds may contain some non-vegan toppings); sekihan (赤飯), the red rice; vegan onigiri or vegetable skewers in yakiniku grill restaurants. See, you can find something for yourself even in places for meat-eaters!
Japanese Food for the Lactose Intolerant
Fortunately for the lactose intolerant, what you may be unable to eat in Japan doesn't differ much from the foods at home: yoghurts, ice-cream, cheese, milk etc, most of which are not common in traditional Japanese cuisine. Ask when in doubt, but in most cases, unless it is specifically listed (for example, in a cheese ramen), it will likely not contain it. The biggest difference is that you may find less lactose intolerant friendly replacements, especially for yoghurts, ice-cream and cheese; soy milk is largely available, including flavoured. For the duration of your stay I recommend that you try some Japanese desserts instead, such as mochi (もち/餅), manjū (まんじゅう/饅頭) or o-dango (おだんご/お団子), all of which come in a variety of flavours, including the most Japanese ones like matcha green tea or sakura.
Japanese Food Suitable for Religious Diets
For most religious diets the information above will already be helpful. Keep in mind that kosher and halal food may be very hard, if not impossible to get, forcing you to either compromise for the time of your trip or to make a detailed vocabulary list of all the things not covered that you'd like to avoid. Muslims and Jews won't be able to eat most ramen, tonkatsu (とんかつ) cutlets and gyōza dumplings, as they contain pork, but they can try chicken, beef or fish dishes (however, those which follow halal or kosher may be hard to find easily) – while non-vegetarian Hindus should stay away from gyūdons (牛丼) and sukiyaki, and instead go for chicken, pork or seafood options. Jewish who also avoid shellfish need to look out for crab, kani (かに/カニ), prawns, ebi (えび/エビ/海老), and oysters, kaki (かき/カキ/牡蠣), in particular, as they feature a lot in Japanese cuisine. As you already saw, turning pescatarian or vegetarian while in Japan is also entirely possible. Regardless of what approach you take, you'll never be short of fantastic dishes to try!
Japanese Language for Asking and Explaining Your Diet
The simplest way to ask if a dish contains a certain ingredient is this: Kono ryōri wa X ga haitte imasuka?, where X stands for any ingredient. Unless your query is complicated, this should be enough to get a clear answer. You can also ask for recommendations if you're unsure what to order, by asking: X-nashi no ryōri ga arimasuka?, which means "Do you have any dishes without X?". However, if you ever have to explain to someone your dietary requirements, it is best to say X wa taberaremasen, which means that you are unable to eat X or cannot eat X. For many Japanese it may be odd to not eat fish or chicken or eggs out of personal choice, so this is a simpler way of ensuring that you follow your diet and that the other person will understand. And don't worry – it's entirely possible, especially for vegetarians and vegans, that when you say that you cannot eat something, your host/waiter/the innkeeper will bring you a slightly bigger bowl of rice or a bigger portion of vegetables, to make sure that you are not hungry. That's Japanese hospitality at its best.
Of course, as you know best what you can and can't eat, make a vocabulary list to keep handy during your trip. Do not assume that if you ask whether a dish contains meat or milk, you will be told about everything – respect that special dietary requirements aren't as common in Japan as in the West. So if you are worried that you might unknowingly eat a bit of cheese or ham, note those words in Japanese and look out for them when choosing your meals.
Before entering a restaurant, look at their display as well. Many Japanese restaurants display wax models of the food they serve, which allows you to see what it looks like, but also to check if it contains something you can't eat. Or to find something that looks perfect for you that you wouldn't think of ordering yourself.
Finally, remember that you are going to Japan – people will want to help and accommodate to your wishes as much as possible. Regardless of your diet you can go to most restaurants and find something for yourself, or ask about their menus. While a lot of places, especially in big cities, may have English menus, the staff will be happy to help if they don't. Politeness, some patient explanations and a little willingness to compromise when it's reasonable can go a long way, and you will certainly not travel around with an empty stomach.


text: I am engaged to my fiancee and we have been together for about 3 years. However, my father is not in total support of the relationship. He had asked us to wait since last year and is not forthcoming with any positive response. I am getting really disturbed and agitated. I don't know how much longer i have to wait and what to do if my father gives a negative response. Could you please advice me?


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Liability insurance for your dog? Yes. No matter how gentle your Muffin is, it's a good idea to have insurance that will cover this type of claim. Person liability insurance is also known as errors and omissions (EO) insurance, because it covers contracts made in various industries, such as insurance. EO insurance in New Jersey is available from many agencies.
Every year, about 4.7 million people are bitten by dogs in the U.S. Of that number, 386,000 require emergency treatment, with the remaining 414,000 also seeking medical attention for their injuries. In 2015, 34 people died from injuries related to a dog bite. According to the Insurance Information Institution, payouts for dog bites made up more than one-third of homeowners' insurance payments in 2015, with the average payout just over $30,000.
Are You Protected?
You should know that some companies have become a little wary of dog-bite claims. They may charge more to cover breeds such as Rottweilers and pit bulls or have you sign a liability waiver or limit payout amounts.
In today's litigious world, you may want the added protection of liability insurance that will cover what homeowners' insurance won't. When shopping for EO insurance in New Jersey, don't forget to discuss dog bites as part of your coverage.


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On This Week's Show:
….we can't find the picture we had of us with Sean. For now this'll do just grand 😉
This week Peter Donegan talks with Sean Corrigan. An ex brains behind the scenes of GIY Ireland and now of Clarke's Fresh Fruit based in Stamullen Co. Meath. Of note Clarke's were Bord Bia's best overall grower of the year for 2010. Sean was also intrumental in the setting up of Balbriggan Allotments.
From importing bees from Holland to growing acres to jam making and from 50 years in business to 50 acres of fruit growing under polythene, you'll find it all in this weeks not to be missed Sodshow.
The Sodshow is Ireland's best podcast 2013 and only garden radio show and is brought to you by the very brilliant Greensax.ie
Show Links and Notes:
- Clarkes Fresh Fruit
- gigs noted on todays show – Sonairte.ie
- Ruth and Simon's blog
- The Sodshow Ireland's Best Podcast 2013
- Gardening classes with Peter Donegan – start Wed 16th Oct.
- The Sodshow manifesto ?
Listen to The SodShow:
- Live every Friday @ 3pm
- Tune in Live: 103.2fm on your radio dial or online via TuneIn.com
- Later As Podcast: The iTunes SodShow Page or right here


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Ditto. I left Canada 13 years ago but the term "Freedom 55" still sticks with me—especially now that I'm almost there. To the 55 part, anyway, if not the freedom part.
The slogan was part of a 1980s advertising campaign for insurance company London Life and the promise was clear: invest in their financial products and you too would be able to retire at 55.
Back then, the idea of early retirement seemed like a real possibility, even if not a sure thing. But of course the economy was dramatically different back then. In those days there were still plenty of opportunities to join an organization right after graduation, stay with them for 30+ years, and retire with a guaranteed pension. I do have a few longtime friends who are now in that position or very close to it. And I could have done it myself if I'd stayed with the federal government where I worked for a couple of years in my early 20s.
But my career has followed a much different path, one that has become much more typical for many people. I've held more than a dozen jobs in a few different career areas. I've worked abroad, I've worked for myself, and my annual earnings have gone up and down many times during the last 30 years. On top of that, I've prioritized other things, like free time and travel and doing work I enjoyed, over salary and savings. So while I'm in okay shape financially compared to a lot of people, I'm definitely not on the brink of retirement.
But with my 55th birthday a mere 30 days away, I decided I still wanted to mark this milestone in some way, even as Freedom 55 for me represents more of an extended aspiration than an absolute line to cross over. So I'm finally making this blog public and between now and the big day, I'm going to post about any kind of accomplishments or enjoyable experiences that occur so that I can kick off this next stage of my life with a positive mindset.
With that in mind, here are some things to kick off the countdown…
This morning was my first deer sighting of this winter. They come down from a local wooded area to hang out at the home whose backyard is kitty corner to mine. Since one of my absolute favoritist things in the world is random deer sightings, I'm considering this an excellent sign for what's to come!
Click thumbnails to see larger images.
Squirrels! Birds!
Although these aren't as rare sightings (especially the squirrels), I consider all wildlife in my yard to be a gift from Mother Nature.
I built this.
One of my New Year's resolutions was to cut back on spending, so of course on New Year's Day, I bought this.
In my defence, I came close to buying one of these last year but didn't and suddenly it was an Amazon Deal of the Day so I got it for a third off its regular price. It arrived a few days later, but I kept putting off assembling it. But yesterday was the day! And even though one of the reviewers said that it took him 20 minutes and it took me an hour and 40 minutes, I'm still very pleased that I was able to put it together all by myself—with no parts left over! (I shot video of me putting it together, so once I get a chance to edit it, I'll post it here as well.)
Now, since assembling it was actually a workout in and of itself (pro tip: if you do this, don't wear a heavy sweater!) and since my butt is nowhere near in bike saddle condition, I only rode it for 10 minutes the first day, but I know I will use it. It rides very smoothly and quietly and perfect for watching TV or using my tablet. I don't know if I'll use it with an actual laptop, but I'll give it a try and see how that goes.
Learn more about the FitDesk and read customer reviews at Amazon. >>
Zumba Zumba Zumba
I hate to be a total cliche, but I did sign up for a zumba class to start in January and I have already missed two classes. 🙁 BUT. I did go tonight and did what I could, which wasn't a lot, but still… The thing I love about zumba is that you can't really do it wrong. That's my kind of dance class. 🙂
FYI, if you are thinking of taking a class, I highly recommend checking out your local community centers. This class is only $40 for 8 sessions (well, in my case, 6…) which I think is a great deal compared to a lot of other fitness options.


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2 Comments
Do you think the Senate now should confirm Judge Kavanaugh?
Permalink Submitted by Claudia on September 29, 2018 - 8:21am
I vote unequivocally for Judge Kavanaugh. It is vital that the Dems viscous hit job not succeed. It is as much an attack on our Constitution as it is on Brett. He is a superior jurist and person and the Dems have trumped up accusations that are a disgrace to America's vision of fairness and basic order.
Comments are now closed.


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Finally the HS swelling is going down – recovering from my red meat, salmon, vinegar experiences has been pretty tough. I guess it's like falling off any wagon after doing so well, picking yourself up again is a challenge. I have been more careful again, apart from the odd coffee and a couple of small glasses of good white wine this week. I have been taking my Serocytols medication and occasionally remembering to take my magnesium and other homeopathic remedies. I have been gorging on fresh coconut, which is probably not a good thing. Is there a recommended daily allowance for coconut?? I really should Google it up. Aside from that though, my face has cleared up and I feel good. I am going to try duck breast on the BBQ this weekend and see if it affects me. I am feeling more in control and ready to start a more structured reintroduction of foods.
I have been reading more and more posts about people finding diet has helped them improve their HS. It's fantastic to hear it from so many. It's a tough disease and sometimes it seems all you ever read is negative comments from people. I have to remind myself that the pain can take you into a dark forest, where even the strongest of us lose sight of the light. I am grateful that my journey is mostly positive and I have the support to keep on battling this disease in the most natural way possible.


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Staple Fibers made of polyester, acrylic, rayon.
Virgin, recycled, flame retardant, anti bacterial
Kanematsu USA Inc is a leading Japanese Trading Company. The textile division handles, polyester staple fiber, yarn as well as dyed and printed fabrics. Kanematsu is an industry leader in the importation of bi-component low melt fibers from Japan, Korea, Taiwan, China, Indonesia. In addition to low melt we carry stock in our 3 warehouses of recycled, virgin regular and conjugate fibers.


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I saw this post over at Terri's blog and felt that I should share this story with you. This past Saturday night at work I spent the vast majority of my shift working out the majority of our remaining Christmas merchandise out to the sales floor with a couple of coworkers. It was all pretty unexciting stuff until we came to this box that had candy dishes in it. Now these were no ordinary candy dishes...Well really they looked like urns but that's besides the point. Well to say that the handle on the lid of these candy dishes were inapporpriate looking is being nice. To be totally honest the handle on these candy dishes/urns looked like the tip of a vibrator. And because it was near the end of the night for most of us we showed them to anyone who would look!
The moral of the story: Don't let tired overnight workers "play" with "inappropriate" holiday merchandise, if you don't want everyone to know about it.
Merry Christmas to All !
6 years ago


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This sterling silver
bangle bracelet with a marquise shape has plenty of room for engraving longer names. Bangle is sized for young children.
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The Policing Board may forfeit a portion of the police pension in respect of former police officers and members of the PSNI Reserve who have committed a criminal offence.
The forfeiture provisions are contained in the Police Pension Regulations and the Police (Injury Benefit) Regulations.
The Policing Board's policy on Pension Forfeiture is currently under revision to take account of the 2015 Police Pension Scheme and will be published shortly.


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You MUST RSVP through our event page: http://bit.ly/2OloAsW
Interested in building your digital skills? You've come to the right place. Our goal is to empower you through cutting-edge digital skills training, courses, programs, workshops, and events.
If you're not sure what's best for your career goals, this info session provides an opportunity to explore the BrainStation learning environment, meet our Instructors, and get a sense of the curriculum.


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Now that CBS Studios Inc. and Paramount Pictures have settled their copyright infringement lawsuit against the creators of an "independent" Star Trek fan-film, what exactly will Axanar finally produce?
Alec Peters, the principal of Axanar Productions – both of whom were defendants in the lawsuit – shared some additional details of the settlement to his donors mailing list that was finalized early Friday morning. And yes, it includes actually producing some kind of Star Trek fan-film named Axanar.
"Axanar Productions can produce the story of Axanar, but not as a full-length motion picture feature. Instead we are limited (as all fan-films are now under the fan-film guidelines) to two 15-minute segments that can be distributed on YouTube, etc. We also have to stick to the guidelines regarding the use of the name 'Star Trek' in the title of the project, the use of an approved disclaimer, etc."
Peters is referring to the guidelines CBS and Paramount issued last summer in the wake of the Axanar suit that put restrictions on fans making and distributing fan-films. On what once started as fans filming themselves pretending to be in Star Trek has turned almost into a cottage industry itself, with various fan-films looking to outdo each other in terms of celebrity names it can attract to participate, and how much it can raise from fans to make it.
Axanar was no exception, bringing in the likes of Star Trek: Enterprise's Gary Graham and Battlestar Galactica alums Richard Hatch and Kate Vernon. And with that, they also raised $1.4 million, according to court documents, with the promise to expand a "proof of concept" known as "the Vulcan scene" into a feature film called Star Trek: Axanar.