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Rosemary L Hoffmann, RN, MSN
In the current society, many individuals fear death and the feelings of suffering and loneliness that often accompany death. Two visionaries in the United States, Florence WaId and Dr. Elisabeth Kubler-Ross, recognized these fears and planned the nation's first hospice movement in the 1970s. The hospice philosophy continues to prosper in the new millennium. In this article, the founding American hospice's philosophy, types of facilities, standards, health team composition, patient demographics, organizations, reimbursement, and research are compared and contrasted with those of the current hospice movement. Existing issues with the modern movement are also discussed.
Death, the culminating event in life's trajectory, often is feared. Some of these fears include (Thorson & Powell, 1996):
* Suffocating.
* Feeling alone.
* Losing control.
* Leaving loved ones behind.
* Entering an unknown place.
* Fear of physical pain or suffering.
Even the word death is usually not spoken openly, but referred to as "passing away" or simply "departed." The inability of health care workers and lay people to talk openly about death became one of the underlying principles behind the hospice movement.
Nursing care for the dying was advanced by the pioneering effort of Dr. Cicely Saunders in the second half of the 20th century. The hospice movement flourished under her leadership, beginning with the opening of St. Christopher's Hospice in 1967 in London, England. Dr. Saunders charted new directions in both philosophy and techniques when treating individuals with terminal illnesses. Dr. Saunders stated:
The name hospice, 'resting place for travelers or pilgrims,' was chosen because this will be something between a hospital and a home, with the skills of one and the hospitality, warmth, and time of the other (Neigh, n.d.).
Dr. Saunders emphasized three important components of hospice care (Torrens, 1985):
* Research.
* Education.
* Superb patient care with emphasis on the relief of all types of pain - physical, emotional, spiritual, and social.
The hospice movement spread internationally, coming to the United States in the 1970s. Although many hospice models exist, the basic philosophy of caring, compassion, and comfort remain constant. Nursing is a pivotal component of the interdisciplinary hospice team. Nursing's importance is evident in the mission statement, goals, and objections of the original hospice, St. Christopher's, as well as research and strategic management of present hospice models.
In this article, the early hospice movement in the United States, which began with two visionaries - Dean Florence WaId and Dr. Elisabeth Kubler-Ross - is briefly described. The founding American hospice is then compared and contrasted with the modern hospice movement in terms of philosophy, types of facilities, standards, health team composition, patient demographics, organizations, reimbursement, and research. Issues with the current modern hospice movement are also discussed.
The hospice movement in the United States began to evolve in the mid 1960s. Several students, under the leadership of Dean WaId from Yale University School of Nursing, heard of the remarkable progress Dr. Saunders and her colleagues had made with the care of patients dying in England. In 1965, they invited Dr. Saunders to speak at Yale School of Nursing. During this same time period, Dr. Kubler-Ross (1964) published her classic book, On Death and Dying, which launched new concepts related to care of patients who were dying. Both of these new philosophies contrasted with the American dream of youth, vigor, and science. Kubler-Ross testified on behalf of the hundreds of dying patients she interviewed for her book that treatment at the end of life should remain the patient's preference. Alternatives to institutionalization are paramount, and more important, choices for the care received must be offered. Speaking before a U.S. Senate Special Committee on Aging in 1972, Kubler-Ross stated:
We isolate both the dying and the old, and it serves a purpose. They are reminders of our own mortality. We should not institutionalize people. We can give families more help with home care and visiting nurses, giving the families and the patients the spiritual, emotional, and financial help to facilitate the final care at home (Neigh, n.d.).
Initial funding from the National Cancer Institute (NCI) provided the monetary incentive to open the New Haven Hospice in 1974 (Neigh, n.d.). This hospice, under the direction of Dr. Sylvia Lack from St. Christopher's in England, served patients in the home (Campbell, 1986). The success of this initial hospice prompted the U.S. Department of Health, Education, and Welfare to report that:
the hospice movement as a concept for the care of the terminally ill and their families is a viable concept and one which holds out a means of providing more humane care for Americans dying of terminal illness while possibly reducing costs (Neigh, n.d.).
Demonstration projects through the Health Care Financing Administration and foundation grants further supported the hospice concept (Paradis & Cummings, 1986). As a result, the Connecticut Hospice opened a 44-bed inpatient unit in 1980 (Paradis & Cummings, 1986). Conferences sored by the Connecticut Hospice, The Hospice of Marìn in California, and the Palliative Care Services of the Royal Victoria Hospital began to offer seminars on developing hospice models (Torrens, 1985). As a result of these initiatives, additional hospice facilities began to open in the United States.
As a result of the grassroots movement in Connecticut, the hospice movement continues to exist in the 21st century. Through continued support for alternative end- of - life care, some principles have changed or flourished, but many early concepts remain intact. A timeline outlining important events in America's hospice movement is shown in the Table.
Hospice produced a paradigm change in the delivery of care from a "cure" model to a "comfort" model, by treating the patient and family as a unit. This allowed the terminally ill patient to live life with the fullest of quality until death (Stoddard, 1978). Thus, early pioneers in hospice care emphasized the humanistic and holistic approach to patient care (Paradis & Cummings, 1986).
One of the maj or goals that originated at St. Christopher's and is shared with hospices in America is the objective of keeping the patient pain-free, comfortable, and without diminished sensorium during the final stages of life (Campbell, 1986). This goal is achieved by a combination of art and science researched by Saunders (1978) and practiced throughout the world. Saunders believed pain was physical, psychological, social, spiritual, or any combination of these factors. Therefore, it is important that all members of the health team actively participate in pain management. Optimal dosages of medications and knowledge that the patient's needs may change rapidly necessitates frequent readjustment of medication (Campbell, 1986). Pain relief is a common objective for both European and American hospices, although the types of pain medication used differs. This is evident in the differing administration of opiods, psychotropic agents, sedatives, cortiosteroids, or non-steroidal anti-inflammatory agents (Saunders & Baines, 1989). For example, heroin, available in England and commonly used to treat pain in cancer patients, is not legally available in the United States (Hospice Net, n.d.).
The philosophy of hospice care encompasses far more than pain control. Additional components of hospice care that originated in England and are evident in America include (Dubois, 1980):
* Extensive use of volunteers.
* Bereavement follow-up care.
* Expert, multidïsciplinary management.
* Recognition of the patient and family as a unit.
* 24-hour availability of medical and nursing staff.
* Continuity of care, including homecare and outpatient programs.
The Ten Principles of Hospice Care established by the Connecticut Hospice in 1974 are still followed (Sidebar).
Types of Hospice Facilities
Funds from the NCI for the Connecticut Hospice not only provided the opportunity to test the efficacy of hospice for both terminal and non-terminal care, but also to determine its cost effectiveness (Paradis & Cummings, 1986). Therefore, the Connecticut Hospice opened as a freestanding, non-profit institution that provided services in the home through visiting nurses and volunteers (Paradis & Cummings, 1986). The decision to provide services in the home developed as a response to a federal Request for Proposal (Paradis & Cummings, 1986). As a result of positive effects from this initial NCI grant, two additional Requests for Proposal funded three other hospice projects in Arizona, California, and New Jersey (Paradis & Cummings, 1986).
Various hospice models have flourished since the first hospice opened in 1974. One example includes the community-based model, with primary locations in either freestanding units or offices (Campbell, 1986). Many of these models have contracts through local hospitals to provide beds to dying patients. Hospitalbased models provide multidisciplinary consultation, and staff members visit patients throughout the hospital. Institutional-based hospice models contain a discrete unit within an acute-care facility (Campbell, 1986). In the institutional-based model, home care may be contracted through local professional nursing agencies (Campbell, 1986). According to the National Hospice and Palliative Care Organization (NHPCO) (2004), 67% of hospices were non-profit, 29% were for profit, and 4% were operated by the U.S. government. The NHPCO estimates that hospice programs exist throughout the United States and number more than 3,300 (NHPCO, 2004).
One of the early problems inherit in any new program is the lack of standards and accreditation agencies. This was true of the first hospice models. As a result of continued growth and expansion in the field, it became necessary to explore ways to establish and maintain high standards of care. The development of third-party reimbursement programs further emphasized the need to develop standards of care for all hospice models.
NHPCO has developed recommended standards entitled "Standards of Practice for Hospice Programs" as a means to self and field evaluation (NHPCO, 2004). Hospice organizations are typically accredited by one of the following independent not-for-profit accreditation organizations (Levi, 2003):
* Accreditation Commission of Health Care.
* Community Health Accreditation Program.
* Joint Commission on Accreditation of Health Care Organizations.
Also, hospice programs are certified voluntarily by Medicare. NHPCO (2004) estimated that in 2003, 94% of hospices were Medicare certified and 64% were accredited.
Health Team Composition
The staff composition in many early hospice models comprised community volunteers and health care providers (Paradis & Cummings, 1986). The community leaders shared a strong sense of community involvement and mission (Dubois, 1980). The health care providers included nurses, physicians, and social workers committed to providing quality health care to individuals who were dying.
This staff composition still exists. Staff members realize cure is not possible and the desire to provide alternative methods of comfort to the dying must be granted. Examples of the interdisciplinary health care team include:
* Clergy.
* Physicians.
* Secretaries.
* Pharmacists.
* Social workers.
* Music therapists.
* Physical therapist.
* Certified home aids.
* Nurses.
To receive Medicare reimbursement, hospice models are mandated to maintain a volunteer staff comprising at least 5% of the total patient care hours of all paid employees (Colburn & Hiveley, 1993). Some of volunteers' duties include help with everyday tasks, such as shopping, and personal care services, such as bathing and dressing (U.S. Department of Health and Human Services, 2002).
Nursing is still the primary source of professional services in more than 90% of hospices surveyed (Buckingham & Lupu, 1982). Some requirements for employment in the early Connecticut Hospice included a strong foundation in basic nursing skills, experience in gerontology or oncology, flexibility, and possession of strong psychodynamic and crisis intervention skills (Dubois, 1980). Nurses chosen for early hospices saw their role as threefold (Dubois, 1980):
* Supplying pain and symptom management.
* Providing emotional support to the patient and family.
* Teaching the family basic nursing skills, such as medication administration and rehabilitative exercises.
The goal of nurses was to be available to the patient and family whenever services were most needed (Dubois, 1980).
Many of these qualities are still practiced by hospice nurses in the 21st century including:
* Nurturing.
* Physical care.
* Spiritual concerns.
* Advocacy and teaching.
Hospice nurses work interdependently with other members of the team. However, they function independently when patients' physical symptoms must be assessed and when interventions, including pain management, must be implemented quickly. Nurses must have the knowledge and skills to modify the plan of care when disease progression ensues. Connor (1998) identified several attributes of a hospice nurse including:
* Ability to counsel, manage, instruct, care, and communicate.
* Ability to coordinate the extended and expanded components of hospice services.
* Capacity to manage physical, psychological, social, and spiritual problems of individuals who are dying and their families.
* Ability to balance one's selfcare needs with the complexities and intensities of repeated encounters with death.
Certification in a profession is a mechanism that guarantees the public a higher level of quality care. In 1993, the National Board for Certification of Hospice and Palliative Nurses (NBCHPN) was incorporated to fulfill this goal. This board is affiliated with the Hospice and Palliative Nurses Association. The purpose of this association is to promote delivery of comprehensive palliative nursing care through the certification of qualified hospice and palliative nurses. Certification of qualified hospice and palliative nurses is recognized in individuals who meet the eligibility requirements for certification, practice continued education and personal growth in end-of-life nursing care, and follow national standards of requisite knowledge in the assessment of hospice and palliative nurses (NBCHPN, 2005). According to the NBCHPN, there are currently approximately 6,000 RN certified hospice and palliative care nurses (NBCHPN, 2005).
Patient Demographics
Typically, the average hospice patient was an elderly individual who was terminally ill with a diagnosis of cancer. The definition of "terminally ill" is any individual with a medical prognosis in which life expectancy is 6 months or less (Hoyer, 1998).
Modern hospice models serve a variety of patients. Similar to the first hospice patient cared for by nurses through the Connecticut Hospice, many patients admitted to an American hospice have a diagnosis of cancer. A growing number of patients with chronic life-threatening illness, such as end-stage heart and lung disease, AIDS/HIV, or dementia, also receive hospice services (NHPCO, 2004). Finally, increasing statistics show that a small, but growing, percentage of young children and adolescents need hospice services.
Estimates from NHPCO show that more than 950,000 patients received hospice care in 2003. This represents approximately 25% of all Americans who died that year (NHPCO, 2004). Thirty-seven percent of those served under hospice died less than 1 week after admission. The median length of stay was 22 days (NHPCO, 2004). This represents many short, interrupted hospice admissions, increasing the stress for many caregivers. Similar to past decades, the majority of Americans still spend the last days of their lives in acute care settings deprived of family and familiar surroundings.
The Medicare Act formulated basic admission criteria for tients, although individual hospice programs may elect to modify their criteria. Basically, the criteria are (Sheehan & Forman, 1996):
* The individual is diagnosed as terminally ill.
* The individual wants hospice care.
* The physician is willing to provide medical care and consultation.
Family members, attending physicians, and patients must be in agreement that non-curative medical and support services for a terminal illness is the appropriate choice (U.S. Department of Health & Human Services, 2002). Some hospice programs may require a primary caregiver, do-not-resuscitate orders, and a safe and conducive environment for care (Sheehan & Forman, 1996).
The largest non-profit organization established to represent hospice and palliative care professionals and programs is the NHPCO. Established in 1978 as the National Hospice Organization, the name was changed in 2000 to reflect the range of care and services both hospice and palliative care provide. It has become the premier advocate for terminally ill patients and their families (NHPCO, 2002). Some of the objectives of this organization include developing public and professional educational programs to enhance understanding of hospice and palliative care, establishing conferences on emerging issues, conducting research, and monitoring Congressional and regulatory activities (NHPCO, 2002).
One example of fragmentation within the hospice community is the development of additional hospice organizations. In 1988, the American Academy of Hospice and Palliative Medicine was organized. Additional states, including California, Oregon, and Arkansas, have their own hospice organizations. Furthermore, international hospice organizations are located in the United Kingdom, Australia, and other parts of Europe.
Reimbursement and Revenue Generating
Contrary to England's National Health Service, reimbursement is often difficult in the United States. The first hospice program was a non-profit model. Patients were selected regardless of ability to pay for services. There were no thirdparty reimbursements for hospice services until 1982, when Congress created the Medicare Hospice Benefit clause. Hospice participation in Medicare is reimbursed under Medicare Part A (hospital insurance). To be eligible for this benefit, beneficiaries must be entitled to Medicare Part A and be certified by their medical doctor and the hospice medical director as having a terminal condition with a prognosis of 6 months or less to live if the illness were to run its natural course (U.S. Department of Health and Human Services, 2002). Results from NHPCO showed that 79% of hospice patients were covered by Medicare, 13% had private insurance, 5% had Medicaid, 1% were indigent, and 3% had other payment plans. These payment sources include workers' compensation, home health benefits, or donations (NHPCO, 2002).
Even though the majority of hospice patients have Medicare coverage, many hospices still rely on service organizations, philanthropies, and private contributions to balance expenditures. Some hospices report up to 12% of income from charitable contributions (NHPCO, 2002). Some of the services not fully covered by Medicare include treatment to cure the terminal illness, another provider administering the same care received from hospice, and room and board if hospice care is delivered in the home (U.S. Department of Health and Human Services, 2002). Counseling may be reimbursed through traditional coverage by third-party payers under the provision of mental health, but only by physicians, social workers, clinical psychologists, or psychiatric nurses (Campbell, 1986).
Nursing has been at the forefront of hospice care research. One of the primary goals of this research is to develop a scientifie basis of practice. As Sheehan and Forman (1996) state, nursing research involving hospice care is based on the following four goals:
* Seek improvements in care settings.
* Find means to quantify or describe hospice care.
* Discover new techniques for care of individuals who are dying.
* Problem-solve in philosophical approaches to understand suffering, grief, and transference from life to death.
Beginning in the 1960s, Florence WaId and others produced a study that included diaries of dying patients and their caregivers (WaId, 1999). Since then, additional research has expanded knowledge of working with patients who are terminally ill (Baer & Hanson, 2001; Hollen, Hollen, & Stolte, 2000; Raudonis, 1993).
In the late 1970s, government agencies recognized the need to research end-of-life care issues. In 1978, the U.S. Department of Health, Education, and Welfare established a task force that substantiated hospice care as a viable concept for terminally ill individuals and their families and as one that should receive federal support (Neigh, n.d.). Demonstration projects were funded by the Health Care Financing Administration in 1979 to study the cost effectiveness of hospice care and provisions necessary when caring for individuals with terminal illnesses. Research continued through foundation grants and helped initiate standards for hospice accreditation (Neigh, n.d.).
The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT), an extensive study of seriously ill hospitalized patients, was launched in 1989. The SUPPORT investigators published results related to symptom burden, preference for care, choices for resuscitation, and decision-making in seriously ìli hospitalized adults (Desbiens, Mueller-Rozner, Connors, Wenger, & Lynn, 1999; Desbiens, Mueller-Rozner, Hamel, & Connors, 1998; Knaus et al., 1995; Phillips et al., 1996). One of the most striking findings from this study was that participants requested end-of-life decisions prior to hospitalization and alternatives to aggressive treatment (Oliverio & Fraulo, 1998). Therefore, nurses must become patient advocates for hospitalized patients because these professionals are most actively involved in the day-to-day interactions with terminally ill individuals and their families.
As federal grants and foundation monies became available for hospice research, the Oncology Nursing Society developed guidelines in 1989 for submission of nursing research studies (Ferrell, Nail, Mooney, & Cotanch, 1989). These guidelines included criteria for contributing to the science of hospice, expanding future investigation, and increasing published literature (Sheehan & Forman, 1996). Furthermore, beginning in 2000 the NHPCO awards the Distinguished Research Award yearly to an individual who has made substantial contributions to hospice and palliative care.
Some practitioners argue that hospice care is intensely personal and should not be involved with research (Sheehan & Forman, 1996). However, early research endeavors by nurses and other health care professionals helped expand the hospice movement in the United States. Because the new millennium ushered in the promise of health care reform, it is essential that hospice establish a strong financial and health policy perspective through research. Consequently, research supporting hospice principles will be strengthened as the demands created by chronic disease and advancing age become greater than ever.
Many of the issues the early founders of the hospice movement faced are still evident in the 21st century. Some of these issues include:
* Idealistic vision of youth and vigor.
* Financial concerns related to reimbursement.
* Ongoing high technology of modern medicine.
* Resistance, especially from the health care profession.
Advocates of hospice care stress that the increasing elderly population in America, compounded with increasing longevity, co-morbid health concerns, advancing technology, and access, will only accelerate the need for end-of-lìfe choices (Corless, 1983). According to reports from the National Hospice Foundation, three of four Americans are not aware of the full extent of hospice services. Approximately 75% of Americans do not know that hospice care can be provided in the home, and approximately 90% do not realize that hospice care can be fully covered through Medicare (NHPCO, 2004).
Professionals and paraprofessionals must be innovative and embark on creative programs that increase the chances of hospices surviving and thriving in the future. One of the key elements to this survival is education. Nurses can be at the forefront of this movement through projects such as the Endof-Life Nursing Education Consortium funded by the Robert Wood Johnson Foundation. This 3V£-year project is in partnership with the American Association of Colleges of Nursing (AACN) and the Los Angeles-based City of Hope National Medical Center (AACN, 2004). One of the primary goals of this project is to develop a core of expert nursing educators to coordinate national nursing education efforts in end-of-life care (AACN, 2004). Also, this program will seek to foster collaboration with medical colleagues, schools of nursing, and health care agencies. Therefore, as consumers demand more endof-life choices, this approach may help eliminate uncertainty during a highly stressful time for families and their loved ones.
Education will foster the growth of future employees of a hospice program. Starting with the board of directors, hospice personnel must hire individuals who will help the hospice movement grow and prosper. These individuals need to understand the business of hospice without losing sight of its philosophy of care. Community support is essential, as well as cooperation with health care organizations. End-oflife care need not be overly expensive or impersonal. Although modern medicine has overlooked many of the needs of individuals who are dying, nursing can be proud that many of the founders of hospice were nurses who put patient needs above technology and specialized medicine.
The hospice movement will continue. Although health care reform has introduced new policies into the hospice movement, such as regulations, documentation, and fiscal and political realities, the basic principle of death with dignity endures. This movement has increased physician accountability, patient preferences, and family involvement - important elements of early hospice principles. Furthermore, as stated in the bylaws of the American Nursing Association (2001), one of the responsibilities of nursing is to respect human dignity and alleviate suffering. It is the art of nursing to provide quality care at the end of life. With this philosophy in mind and as founding partners of the nation's hospice concept, nurses must embrace their role in the history of and future goals for the hospice movement.
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Journal: Journal of Pharmacy Research
Title: Formulation and optimization of controlled released floating tablets of clarithromycin
Category: Pharmaceutics
Section: Research Article
- Abstract
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Floating matrix tablets are designed to prolong the gastric residence time after oral administration, at a particular site and controlling the release of drug especially useful for achieving controlled plasma level as well as improving bioavailability. With this objective, controlled release floating tablets of clarithromycin were formulated by using D-optimal mixture design for the treatment of Helicobacter pylori. The amount of HPMC K4M: HPMC K100LV in 1:1 ratio (X1), amount of Na- CMC (X2) and amount of sodium bicarbonate (X3) were selected as independent variables and percentage drug release at 3h (Y1), percentage drug release at 6h(Y2), percentage drug release at 12h (Y3) and total floating lag time (Y4) as dependent variables. Tablets containing HPMC K4M and HPMC K100LV, drug and different additives were prepared by wet granulation. The tablet composition and mechanical strength have great influence on the floating properties and drug release. Optimization of the evaluating parameters with Design expert software was employed to generate optimized formulation and criteria of desirability was employed. The optimized formulation was obtained with HPMC K4M: HPMC K100LV in 1:1 ratio (125.428 mg), Na-CMC (40.256 mg) and sodium bicarbonate (34.316 mg). The in vitro release data showed that the drug release follows zero-order release kinetics.
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Shashikant D. Barhate*1, Dr. Madhabhai M. Patel2, Amol B. Patil, Sandeep R. Pawar and Sumit R. Rathi.
Affiliation(s) Name:
*1Department of Pharmaceutics, Smt. S. S. Patil College of Pharmacy, Chopda- 425107. Maharashtra.
2 Principal, Kalol Institute of Pharmacy, Kalol -382721. Gujarat.
For correspondence:Prof. Shashikant D. Barhate, Department of Pharmaceutics, Smt. S. S. Patil College of Pharmacy, Chopda- 425107. Maharashtra.
Received on:17-10-2008; Accepted on :26-01-2009
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Shashikant D. Barhate*1, Dr. Madhabhai M. Patel2, Amol B. Patil, Sandeep R. Pawar and Sumit R. Rathi.
Title: Formulation and optimization of controlled released floating tablets of clarithromycin Journal: Journal of Pharmacy Research Vol(issue): 9 (March) Year: 2015 Page No: (445-448)
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Methodology: Formulation and optimization Research Materials: clarithromycin
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African awesomeness
Item Type: Evening DressesOccasion: Formal EveningSleeve Style: REGULARBuilt-in Bra: YesFabric Type: LaceNeckline: SweetheartSleeve Length(cm): SleevelessDecoration: Laceis_customized: YesTrain: Sweep TrainActual Images: NoWaistline: NaturalMaterial: PolyesterFashion Element: vintageSilhouette: Trumpet / MermaidDress
Shweshwe Wedding Traditional Dresses For 2019 ShweShwe 1
3,680 Likes, 33 Comments - Fashion & Style | IG Growth (@mzansi_fashions) on Instagram: "Beautiful . . . Double tap and tag her if you know her 🔥🔥👌🏽👌🏽 . . . Follow 👉🏽👉🏽 @mzansi_fashions…"
more dresses like this in a variety of designs. The panels are really becoming more popular and there are so many lovely patterns that I need to restrain myself. Despite it's European origins, this distinctive fabric has become something of an African symbol, with some even referring to it as 'African tartan'. There's some debate as to … Continue reading African sotho Shweshwe dresses for 2020 →
The ideal source for your afro chic life style and fashion site
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972 Likes, 3 Comments - Tswanafied fashion Blog (@tswanafied) on Instagram: "📸 || @phatsy_seabo #tswanafied #leteisi #seshweshwe #ankara #chitenge #jeremane #germanprint…"
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Fat hairy lesbians take a bathWe had been married just two years and had been able to buy a lovely new house. It was the last available house in a very exclusive gated community. This community consisted of fifteen homes and a large club house and all the residents were in the movie business. This was very evident because all the women were breathtakingly beautiful and the men were tall, handsome and looked very virile. Even though a couple of the women were visibly pregnant as yet there were no children.
He waited patiently until I held out my hand. Then we walked up to a long, one-story building next to the taller sanctuary, and he paused, turning to me. "I know it's not exactly what you wanted. but it has to be better than none at all. " He stepped to the side, revealing a sign on the door stating that the normal soup kitchen was serving a free, three-course meal with all the fixings until seven o'clock today.
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Pete 'The Plow. ' I always thought it was because of how well he played football. I didn't find out till later that he got his nickname from clearing snow with his dad every winter.
He took over the physical labor part of his dad's landscaping business when his old man retired.
Until a year ago. It all started to make sense. So I told her about us. " Jolie let go of my hand. "I told him I wouldn't marry him unless he confronted you.
His fingers and then his cock pressing between my legs made the decision. Soon, we were both moaning. Writhing. Panting. Coming together.
But that was only half of the equation. Maybe Chris didn't want to be a dad. We hadn't exactly had this discussion yet, so I didn't know his thoughts on it. Then there was the fact that he was strapped for funds with starting school again in January.


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Why neuromarketing is crucial for your business
There is a new consumer looking for experiences and emotions. Is your company able to adapt its communication and marketing strategies to reach this new consumer?
In the "Why neuromarketing is crucial for your business" learning pill you will find an excellent opportunity to deeply understand how the human brain works from the point of view of marketing and business, but also to understand and predict consumer behavior, for example, or preferences. for a particular brand, the desire to buy or not buy a product.
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Logistic details
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Understanding the deep neurological mechanisms that underlie our decisions, and how you can trigger the right emotions that determine the decision to "buy" a person.


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Asked by Matt from USA | Feb. 02, 2016 15:59
About:72-Hour Visa-Free Transit
Access from Hong Kong to the mainland
If our plane lands in Hong Kong can we access the mainland for 72 hours without a visa? Or are we required to get one if traveling by land from Hong Kong?
Thank you,


text:
Hello lovelies, how are you all?
I cannot speak for the rest of the world but here in Australia maxi dresses are having their moment and I am loving it. The great thing about the maxi dress is that there are no rules on how long, how fitted or floaty it has to be as long as you find your perfect fit and are looking gorgeous in it. Same applies to the colour choice: it could be a solid colour or a lovely print, in soft or bold colours – everything is left to your personal sense of style, colour and shape.
I have a couple of maxi dresses in my closet but they were purchased a few years back and I was on the lookout for a fresh new one. Since the demise of the economy due to the latest pandemic, the shops have been having perpetual sales and while it is a disturbing sign of the havoc that this virus has wrecked our economy, there is nothing wrong in taking advantage to re-fresh our wardrobes and save some money in the process.
Case in point, the wrap-around dress I am wearing today. Soon after the department stores re-opened their doors, I summoned up my courage and ventured into the shopping centre to have a look around. Every store advertised sales and promised massive discounts and attracted by that, I stepped inside the Reiss store. Under normal circumstances, as much as I admire their clothes, I don't shop there simply because I find that the prices are rather high for my liking but now with the prices drastically slashed down, it was worth a look.
Everything in the store was heavily discounted including this dress which I liked the minute I saw it. I have always loved wrap-around dresses and this one in a fresh neutral colour with an unusual geometric print that vaguely reminded me of the birch trees (berezka) of my old country, caught my attention. Since the dresses that I currently wear are very colourful, I figured that a dress in softer calmer tones would bring a breath of fresh air. After all, there comes a time when you want to wear a dress that does not look like your flower bed 😉.
I must admit that the creators of Reiss clothing have every reason to ask a high price for their garments: every dress, blouse or skirt looks extremely elegant yet modern, the fabric is of the best quality and most of all, on closer inspection you cannot help but admire the level of the dressmaker's craftsmanship.
The dress fitted me perfectly, it was very well constructed down to a small, invisible button on the front panel that prevents the dress from gaping around the chest. The applied discount made it very affordable so I couldn't find any reason why I shouldn't buy it and so I did👍.
When I checked it on Reiss official web-site, the model was wearing black high heel tall boots which is quite unusual styling choice for Australians. Anyway, I liked the way it looked so I decided to replicate it.
I am carrying my old Bvlgari bag and wearing earrings that were custom made for me by a very talented friend of mine.


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Hi All,
All of a sudden my galaxy s9 plus gave up on me. While I was browsing, the screen started to fade out and all i could see next was black and white patches. I am very sure that I didn't drop my phone nor my phone had any liquid damage. I don't think it is anything to do with the touch screen since the touch seem to work just fine and also intermittently, I get to see the normal screen without any issues. However, it doesn't stay that way long enough and goes back to the black and white patchy screen. Even the spalsh screen during start up is showing up fine without any issues.
I already did a factory reset hoping it would work, but to my dismay it didn't work. I contacted customer care over chat, but since my phone is in the 2nd year, it is no longer covered by warranty. I have owned numerous galaxy phones until this date, but none of the phones had any damage. I used them to the fullest life and switched them for new phones. This is the first time I am having a bad experince.
Did anyone face similar issues and can suggest any fixes?
thanks in advance,
Is look like your lcd is disconnected or damaged. Wires/connection's can become loose on rare occasions. The digitizer is what records your touch actions and the lcd shows the screen so they are two different components its also possible the lcd just went bad over time.
You will most likey need a professional to take the screen off and test it to see what the exact problem is. Hope this helps.


text:
Stories are posted on the statewide news page. You can subscribe to Alaska Public Media's newsfeeds via email, podcast and RSS. Follow us on Facebook at alaskapublic.org and on Twitter @AKPublicNews
Monday on Alaska News Nightly:
The Army Corps of Engineers prepares to publish an important Pebble Mine study later this week. And Anchorage officials defend the city's plan to expand services for the homeless. Plus, the cruise ships may be absent but tourists are still visiting Juneau.
Reports tonight from:
- Liz Ruskin and Kavitha George in Anchorage
- Krysti Shallenberger in Bethel
- Jeremy Hsieh in Juneau
- Tim Ellis in Delta Junction
- Robert Woolsey in Sitka


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We have professionals that are certified to help you through your claim process. We've got your back. Let the VFW's Nebraska network of accredited service officers help you file your VA claim - free of charge.
Sign up to be a VFW Post 1581 member. We understand the unique bond you share with other veterans of overseas conflicts because we, too, have been there. Since 1899, the VFW has been the nation's leading veterans service organization. Stand strong with the nearly 1.7 million members of the VFW and its Auxiliary as together, we continue to fight for all that's good FOR VETERANS.
Student Veteran Support, Get your GI bill questions answered.
Coming home doesn't mean the battle is over. With over 10 times the amount of veterans lost to suicide than to combat operations in the same time period, there has never been a more important time to TAKE A STAND and DO something to support our veterans!! No matter what you're facing, VFW Nebraska is here to support you and your family before, during and after deployment with a wide range of FREE programs and services. If you or someone you know is suffering from PTSD, we have people that have shared a similar experience and are ready to help.
VFW Post 1581 Monthly Meeting
- Date:September 12, 2020, Saturday
- Time: 7:00 AM to 9:00 AM
- Place: SHERATON OMAHA HOTEL, 655 N 108th Avenue, Omaha, Nebraska 68154
- Full hot breakfast will be provided, the post will pay for it. Go to the breakfast area and tell the cashier that you are with VFW Post 1581 and are eating breakfast. The hotel will charge the post based upon the number of people eating. The meeting room is next to the breakfast area. Breakfast starts at 6:00 AM.
- Enter the main entrance of the hotel, turn right, go down to the breakfast area about 50 feet.
Try to come earlier than the meeting start at 7 AM to have breakfast. We want to start the meeting at 7:00 AM sharp to manage all members time schedules.
Future VFW post 1581 meeting dates CLICK HERE
You were not alone over there. You are not alone now. There are 20
million veterans who would give their lives for you. Please don't take
In the End, we will remember not the words of our enemies, but the silence of our friends.
KANSAS CITY, Mo. - Hal Roesch II, of Hampton, Virginia, was installed as the Veterans of Foreign Wars' 112th national commander to...
KANSAS CITY, Mo. - The Veterans of Foreign Wars is proud to announce its 2020 "Uniting to Combat Hunger" campaign has raised more ...


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Early Years Funding - Information for childcare providers
Early Years Funding has to be claimed by childcare providers on-line If you want to claim funding you can request to be set up via emailing: firstname.lastname@example.com
Within the system you will be able to:
- Check the eligibility of parents or guardians to have funded childcare for their child under the 30 hours funding scheme.
- Make regular claims for payment from the Local Authority for the funded hours of childcare that you deliver under these schemes.
Check children for eligibility for two year old funding.
Useful documentation for childcare providers
- Funding Portal User guide
- Funding update summary (Updated for April 2020)
- Funding FAQs (Updated for Autumn 2020)
- Early Years Funding Monthly Payment Breakdown Summary 2020/21
- Funded weeks calendar April 2020 - March 2021
- Funded weeks calendar Sept 2020 - August 2021
- Early Years Funding Privacy Notice
- DfE Early Years entitlements operational guidance
- North Somerset Model Agreement 2020
- Parent Declaration Form
- Childcare Provider Toolkit
- 0 - 2 funding forms
- Top up Funding Rates
- 2019/20 financial year monthly summary
- 2018/19 financial year monthly summaries
- COVID19 Scenarios
|Make a funding claim>


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LOS ANGELES — For 59-year-old Rosa América Gómez, her vacation in the U.S. has been anything but a walk in the park.
"I'm de-stressing a bit because my situation is very tense," América Gómez said in Spanish.
That's because she has been stranded in the country since March 17 when the president of El Salvador abruptly shut down the airport to international flights due to the pandemic.
"I'm one of the people stuck out here in Los Angeles," she said, adding it was her 99 day in the U.S. "And I feel vulnerable because of my age, because of my illnesses. I feel cornered."
América Gómez came to L.A. on March 4 to visit a goddaughter she hadn't seen in 36 years, she said.
But two weeks after arriving things began shutting down. All of a sudden, she couldn't go back home and her living situation became tense because with a tourist visa she can't work and contribute to the household.
"I don't' feel comfortable enough to get food or to sleep. I have to wait for everyone to go because I sleep in the living room. So it gets really difficult," América Gómez said.
Then at the end of April, her father had a stroke, she petitioned the Salvadorian government to make an exception and allow her to fly back to take care of him.
"It's illogical that they won't let us in," América Gómez said. "We are Salvadorian. We have rights. We were born there and we love our country."
They did not allow her to go back. Her father died on June 2 and was buried on June 7.
"That was very painful. Not being able to say goodbye, seeing the images on my phone, I cried all night," she said.
Now her biggest worry is her health, said América Gómez, who is a diabetic, and suffers from hypertension.
"I brought enough medicine for four months. I'm using the last bit of prescriptions I have, and I'm worried because as soon as July comes, I'm out of medicine," she said.
There are hundreds of other Salvadorians in the area under the same circumstances. They've formed a WhatsApp group to keep updated and help each other out because they say no support has come from the government.
Spectrum News 1 reached out to the Salvadorian government for comment and they said a plan for repatriation is in the works but a date has not been set.
"I'm frustrated because I feel like our government hasn't given us any hope, they have abandoned us," América Gómez said. "I [sometimes] lock myself in the bathroom to cry."
América Gómez said she often sees planes fly by the house where she is staying.
"From the window, I see the planes as they go by. And I get happy and think, 'Oh, maybe tomorrow. Maybe soon we'll get word that we can go home.' But night comes and nothing changes."


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A Space for Healing (1)
Week 1: God provides a place of healing
When we are wounded, we look for ways of protecting ourselves so that our wounds have a chance to heal. God finds us where we hide and provides all that we need so that we can heal from within, even when our search for safety and justice takes us among strangers. The stories of Hagar and Ruth illustrate the way that God cares for those who cry out to him. Though they were vulnerable and powerless, their faith gave them the courage to cross cultural and social boundaries, even though this meant taking the risks involved in trusting the strangers amongst whom they settled.
Psalm 38 The wounded one cries to God.
Genesis 21.8-21 God finds us where we hide
Isaiah 62.1-5 God's commitment to the healing of Jerusalem.
1 Corinthians 12.1-11 One Spirit, given for the good of all
John 2.1-11 An abundance of the best
Ruth 1 Committed to one another
Ruth 2 Making a home amongst strangers
Week 2: God moves us toward healing and peace
The story of Ruth not only illustrates the breadth and richness of God's community, but also the way in which that community is built: through honesty, respect, faithfulness, generosity, persistence, resilience, courage and hope. The wounds of the world are not healed by prayer alone, but also by the effort of understanding, the humility of love, the courage to take risks and the grace of personal sacrifice. We commemorate Holocaust Day to remind ourselves that apathy and complacency - as well as sheer malevolence - produce terrible consequences.
Ruth 3 Trusting to the integrity of others
Ruth 4 Fruition and fulfilment
Psalm 19 The light of the world
Nehemiah 8.1-12 The joy of the Lord is your strength
1 Corinthians 12.12-31 One Body, inter-connected and inter-dependent
1 Corinthians 10.23-11.1 Consideration and respect
Psalm 88 The unhealed wound
Healing the Wounds of the World
We live in a world profoundly scarred by the memories of massacres, pogroms, genocides and other crimes against humanity on a vast scale. The Holocaust - the systematic slaughter of approximately six million European Jews by the Nazis between 1941 and 1945 - is one specific genocide which, in some ways, has come to symbolise all the others. Unfortunately, such crimes are still being committed. Can we, as Christians, lead by example, not only finding and pursuing a way of addressing the conflicts between us, but also modelling it in a manner that will encourage other communities to move "from death to life, from falsehood to truth, from despair to hope, from fear to trust, from hate to love, from war to peace."
Unfortunately, the heart has gone out of the Christian Unity movement in recent years, as we get overwhelmed by survival issues, and bogged down in the minutiae of institutional co-operation. Despite some advances, such as the Anglican-Methodist Covenant, there is little enthusiasm for ecumenical work at the grass-roots. We are all too busy struggling to keep our own causes going, or to deal with vast quantities of institutional change, to seek a renewed vision in other directions. Divided, we are falling down.
Where we are coming together, it is around other tasks, or other issues, where co-operation is taken for granted and denominational differences or differences of theological emphasis are almost irrelevant. Where we are separated, we are, likewise, separated by issues, or by a differing attitude to issues. Not on denominational lines, but on the stance we take to an issue, even to whether it is an issue at all.
So denominational ecumenism fails to ignite the grassroots because it is outmoded. Indeed, it may now be possible because the denominations are, in a sense, already dead. We are living in the carcass of them because, at present, there is nowhere else to go. But over the next few years that will change. The new alignments and movements, already in effect on the ground, will begin to emerge as named, structural, visible organisations. The only question is how violent the process of transition will become, and what their future relationship with each other will be like.
This being the case, what is the process that will enable us to move forward together, rather than apart. It has to be based on the healing process that Gael Lindenfield has summarised:
Honesty. Exploring our feelings. Acknowledging the bruises.
Finding a safe place to express and explore our feelings, and to say, "I am hurting."
Receiving - or giving ourselves - active listening support. Receiving comfort and consolation.
Investing in ourselves and being compensated for our losses.
Stepping outside the box. Re-framing our experience and gaining a fresh perspective.
Working for justice.
Reaching for forgiveness.
How can this be expressed in readings?
Honesty. Exploring our feelings. Acknowledging the bruises.
Psalms 38, 39; John 4.1-9
Finding a safe place to express and explore our feelings, and to say, "I am hurting."
Genesis 16.1-16, 1 Kings 19.1-18; John 4.10-17a
Receiving - or giving ourselves - active listening support. Receiving comfort, consolation and the challenge to change, if we can bear it.
Genesis 21.8-21; Ruth 1; John 4.17b-24
Investing in ourselves and being compensated for our losses.
Ruth 2-3; John 4.25-30.
Stepping outside the box. Re-framing our experience and gaining a fresh perspective.
Ruth 4; John 4.39-42.
Working for justice.
1 Corinthians 6.1-11, 12-20; 8.1-13; 9.15-27; 10.23-11.1
Reaching for forgiveness.
1 Corinthians 13; Matthew 18.21-35;


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Endovision Officers
Endovision provides a non-biased environment to allow innovative endoscopists to take device ideas from concept to proof-of-concept, as well as to support the education of the public and the mentoring of health care providers to disseminate advances in interventional endoscopy.
Kenneth F. Binmoeller, M.D.
Founder and President, Board Member, ENDOVISION
Director of Interventional Endoscopy Services, CPMC, SF, CA.
Medical Training: University of Freiburg, Germany; University of Bern, Switzerland; Baylor College of Medicine, Houston, Texas; Oregon Health Sciences University, Portland, Oregon; University of Washington, Seattle, Washington.


text:
Depending on your point of view, the polling for best power vendor was either really close or not close all. The argument for really close is that Cyber Power Systems Inc. beat Eaton Corp. by just four votes. The argument for not close at all is that CyberPower's votes and Eaton's together add up to precisely half the ballots that APC by Schneider Electric collected all by itself.
ConnectMeVoice is on a mission to level the telecommunications playing field for managed service providers and their small and medium-size


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Discount offers for Ford Aspire in MandiChange City
Ford Figo Aspire August offers in Mandi
Bring Home Ford Aspire and Get EMI of Rs. ...
Bring Home Ford Aspire and Get EMI of Rs. ...
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Are you Confused?
Ask anything & get answer in 48 hours
Questions & Answers
- Latest Questions
As of now, there is no official update from the brand's end.
No, Rear Seat Centre Arm Rest is not available in Ford Aspire.
For this, we would suggest you walk into the nearest authorized service centre a...Read More
As of now, there is no official update from the brand for the launch of CNG vari...Read More
Both BS6-compliant 1.2-litre, 3-cylinder petrol and a BS6-compliant 1.5-litre di...Read More
- A.Ford Aspire has a tyre size of 195/55 R15.
- A.Radio,Speakers Front,Speakers Rear,Integrated 2DIN Audio,USB & Auxiliary input,Bluetooth Connectivity,Touch Screen.
- A.The kerb weight of Ford Aspire is 1063-1091kg.
- A.Ford Aspire has automatic climate control.
- A.Ford Aspire does not have a sunroof.
Must read articles before buying Ford Aspire
Offers available only on three models leaving aside the Figo and the Endeavour
The sub-4m sedan is available in four variants: Ambiente, Trend, Titanium and Titanium
Which of these two updated sedans will be the right choice for you? We find out
A sub-4m sedan or sub-4m SUV - which Ford is a better fit for your needs?
Along with updated aesthetics, the Aspire facelift gets new engines and some additional features
Ford Aspire Videos
- 4:352018 Ford Aspire Facelift: Pros, Cons and Should You Buy One? | CarDekho.comNov 06, 2018
- 11:29Maruti Dzire Vs Honda Amaze Vs Ford Aspire: Comparison Review | CarDekho.comJan 09, 2019
Further Research
Compare Variants of Ford Aspire
- Diesel
- Petrol
- Figo Aspire Trend DieselCurrently ViewingRs.7,79,000*EMI: Rs. 16,21824.4 kmplManual
- Figo Aspire Titanium DieselCurrently ViewingRs.8,29,000*EMI: Rs. 17,22524.4 kmplManual
- Figo Aspire Titanium Plus DieselCurrently ViewingRs.8,64,000*EMI: Rs. 17,91924.4 kmplManual
- Figo Aspire AmbienteCurrently ViewingRs.6,09,000*EMI: Rs. 12,77018.5 kmplManual
- Figo Aspire TrendCurrently ViewingRs.6,69,000*EMI: Rs. 13,97818.5 kmplManual
- Figo Aspire TitaniumCurrently ViewingRs.7,19,000*EMI: Rs. 14,96418.5 kmplManual
- Figo Aspire Titanium PlusCurrently ViewingRs.7,54,000*EMI: Rs. 15,67918.5 kmplManual
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- Ford AspireRs.6.09 - 8.64 Lakh*


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Vintage 1970s Tan Tooled Bag
Sorry, currently out of stock
Rare Vintage 1970s Tan Tooled Bag. In an unusual rectangle shape with floral design. In great condition this bag finishes of any bohemian look.
Condition: Good vintage condition, small stain on the top of one side of the bag
Height – 9in / 23cm
Width – 14.5in / 37cm
Remember this vintage piece is completely unique and has been handpicked by one of our treasure hunters around the world!


text: Detailed Minutes for Weekly AED Meeting Monday, September 10, 2012 Next Meeting Monday, September 17, 2012 at 7PM o APPLICATIONS ARE DUE WITH THE $30 DUES Check (made out to VT Alpha Epsilon Delta) or money order…NO CASH Location: Litton-Reaves 1670 Speakers THIS WEEK o Ms. Emily Wong, Territory Manager, from The Princeton Review Contact: [email protected] NEXT WEEK o Dr. Jack Evans College of Science Director of Undergraduate Advising; PreMed and Pre-Dent Advisor Executive Officer Contact President: Sirisha Iruvanti ([email protected]) Vice President: James Sung ([email protected]) Treasurer: Sarah Bayliff ([email protected]) Secretary: McKenna Creasey ([email protected]) Member Relations: Stephanie Kimbro ([email protected]) Committee Head Contact Service Chairs o Ashley Emery ([email protected]) o Caroline Young ([email protected]) o Christine Luu ([email protected]) Social Chairs o Zach Jenkins ([email protected]) o Kristen Nymberg ([email protected]) o Sarah Kashanian ([email protected]) Speaker/Open House Chairs o Ali Thompson ([email protected]) o Ashley Uvanni ([email protected]) Fundraising Chair: Nikita Parmar ([email protected]) Relay for Life Chair: Tanner Hurley ([email protected]) Webmaster: James Byun ([email protected]) Membership Requirements Must attend 9 out of the 12 meetings per semester Must obtain 5 service points and 3 social points per semester Inactive Membership o Exemption from attending the weekly Monday meetings o Can only be an inactive member for ONE semester during your time in AED at Virginia Tech o Must obtain ALL of the required points for the semester but not required to attend the weekly meetings o If you want to go inactive, you must bring in documented proof of a conflict (from work, class, etc.). Probation Policy If you do not complete all of your required points during the fall semester, then those points will carry over to the spring semester. If you still do not complete all of the extra points in addition to your required points by the end of spring semester, you will be blacklisted from the organization and your name will be given to Dr. Wubah. National AED Membership Not required to join the VT chapter Contact Sirisha Iruvanti for requirements Visit http://www.nationalaed.org/join.cfm for more information AED Website http://www.aed.org.vt.edu/ Upcoming Social Events Frost Parrot o Wednesday, September 12, 2012 at 7PM AED Barbeque with games o Tuesday, September 18, 2012 from 6-8PM D2 Lunch o Friday, September 21, 2012 at 1PM Watch Scrubs or Grey's Anatomy o Monday, September 24, 2012 after meeting Campus Scavenger Hunt o Sunday, September 30, 2012 at 2PM Upcoming Service Events Marine Corp Mud Run o Saturday, September 15, 2012 at 9:15 AM o At Green Hill Park in Roanoke VA o Contact Ashley Emery for more details o Sign up: https://survey.vt.edu/survey/entry.jsp?id=1347326634552 o http://www.mudrun.com/ Ronald McDonald House o Friday, September 21, 2012 Humane Society o Saturday, September 29, 2012 Pre-Med Extravaganza o Sunday, September 23, 2012 o Interview Practice 5-6PM in Pamplin 1045 o "Meet the Deans" 7:30-9PM in Litton Reaves 1670 Ongoing Service Events Blood Drives o Bring in proof that you donated blood and receive 1 service point per semester Micah's Backpack o Thursdays from 6-7PM o Contact Ashley Emery if interested VT Rescue Ride-Alongs Valley Interfaith Childcare Diaper & Wipe Drive o Bring in at least 1 pack of diapers and 1 pack of wipes for 1 service point Outside Organization o You may receive 1 service point per semester from any community service completed outside of AED. o Bring in a statement of proof of your service signed by a supervisor in order to receive the point. Hope everyone has a relaxing and productive week! AED Minutes written by McKenna Creasey ([email protected])


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Where Primroses and understated and gentle in their yellowness, Celandines throw all that aside and are unashamedly bright and brash. I love gentle yellows, but I also love this bright yellow, brightening up the hedgerows and verges with their splashes of sunshine.
Tag Archives: spring
Spring is springing – Primrose
The colour of primroses makes me think of lemon cheesecake. They're such a gentle shade of yellow – not bright and in your face, but fresh and clean, a clear sign of spring.
Spring is springing – Willow
The lovely fluffy catkins are on display now on the willow trees. There are the really furry ones which look like a small animal's paw, and the more frilly yellow ones too. I do love a nice catkin 🙂
Spring is springing – Snake's Head Fritillary
It's reassuring to see that despite everything, spring is still springing all around us. Some things are still normal, still happening in the usual spot, in the usual way. It's all to easy to be consumed by anxiety and fear in these difficult times, so finding something that feels reassuring is especially welcome now. I'mContinue reading "Spring is springing – Snake's Head Fritillary"
More signs of spring
There were more signs of spring on our walk last weekend, and I'm really looking forward to more. There will be Bluebells, Wood Anemones, Buttercups, Cuckooflowers… all the lovely spring flowers to look forward to! But for now here's a few of the more early signs of spring.
Splashes of sunshine
Celandines are growing now and starting to speckle the hedgerows with little splashes of sunshine. Spring is coming! 🙂
The crocuses seem to have taken a bit of a battering in the storms lately, but I found a couple that were still intact. Sadly no purple ones, as they seemed to be in a worse state than these golden yellow ones.
Red Dead-nettle
My usual Red Dead-nettle spot hasn't let me down this year. There are, as usual, lots of pretty little flowers growing there. I like to know that year after year, I can rely on the various different spring flowers to appear in their usual spot, at the usual time. It's quite comforting.
We had a little walk around the village yesterday after the storm had passed (Storm Dennis). It was still pretty breezy, but not as bad as it has been. We went to my usual favourite spot to find Hazel catkins and as usual there were plenty there. It wasn't ideal weather for photography with theContinue reading "Hazel"
My favourite spring flower has popped up in my garden and I am delighted to see it! I didn't even have to walk down to the field, it is right here outside my front door 🙂 Happy April!


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A UN investigation has found evidence that North Korea sent material used in ballistic missile and chemical weapons programmes to Syria, along with missile technicians, in violation of UN sanctions, according to the Associated Press.
The 200-page report found that Pyongyang sent more than 40 unreported shipments to Damascus between 2012 and 2017, which included the transfer of prohibited ballistic missiles, conventional arms and dual use goods. Myanmar has also been an illegal recipient of a range of weaponry, bringing the total value of the exports to nearly $200 million in just nine months last year.
As part of the investigation, an unidentified UN member state testified that North Korean technicians "continue to operate at chemical weapons and missile facilities at Barzeh, Adra and Hama," after a technical delegation arrived in Syria in 2016.
The panel also carried out investigations into Ryu Jin, who is on the UN sanctions' blacklist, and is a senior official in Syria for the Korea Mining Development Trading Corporation, the primary arms dealer for North Korea. He is believed to have shipped ball-bearings and fibre-optic cables to Syria, equipment related to ballistic missiles and conventional weapons.
The report, addressed to the UN Security Council, is expected to made public next month, with the details of "substantial new evidence" about North Korea's dealings with Syria dating back to 2008. The North Korean and Syrian missions at the UN have not yet responded to the new claims.
Read: Germany sold technology to Iran used in Syria chemical attacks
This is the second such report in a year that has found evidence of chemical weapons transfers between North Korea and Syria. In August, a 37-page report found that two shipments sent by North Korea to a Syrian government chemical weapons agency have been intercepted in the previous six months.
In 2013, the International Business Times also reported that North Korea had supplied Syria with the latest technology to convert chemical weapons into warheads.
Despite the Syrian government agreeing to destroy all of its chemical weapons in 2013, there have been dozens of incidents where sarin gas and chlorine have been used on civilians. Earlier this month the Syrian Network for Human Rights found that the Syrian regime of President Bashar Al-Assad has used chemical weapons 211 times since the start of the conflict, killing some 1,421 people.
Of the chemical strikes committed, 33 were before UN Security Council Resolution 2118 was issued in 2013 and 178 took place after.
On 27 October, the United Nations Joint Investigation Mechanism on Syrian Chemical Weapons concluded that the regime was responsible for killing at least 100 people in Khan Sheikhun, in the countryside of Idlib, with chemical weapons. US officials also said earlier this month that the Syrian government may be developing new types of chemical weapons for use against opposition groups.
Staunch Syrian ally, Russia has repeatedly denied that the regime has used such weaponry and, in November, vetoed a US-drafted resolution to renew an international inquiry into the incidents.
Read: Britain may join US strikes against Syria if chemical weapon use proven


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Ryan Hall's Conquer the Wall - Virtual
- Time:
9:00 AM to 12:00 PM
- Contact: Tamara Stiles
August 8, 2020
This year, the 4th Annual Conquer the Wall is going virtual! Instead of climbing the The Wall at Snow Summit - though you're certainly welcome to still do that! - you'll be choosing your own mountain to climb - stairs, steep neighborhoods, etc.
Price: $25 until Aug. 8 at 7 AM. Contact Tamara Stiles for Team Entries.
For those already registered, your entry has already been switched to the virtual platform. If you choose to opt out of the event, please contact Tamara Stiles for a partial refund or defer your race until 2021.
Prizes are on hold until 2021!
T-shirts will be mailed out to registrants about 2 weeks following the race, and be sure to send pictures of yourself conquering your wall! Donations are accepted and the Big Bear High School Cross Country Team thanks you!
Teams: Teams are encouraged and receive 15% off registration. High School teams receive 25% off. You must register as a team!
Event Info: Event begins at 9 AM on Saturday, Aug. 8 at Snow Summit. Parking will be available at Snow Summit and participants will receive a free pass for the chair lift to ride back down the mountain. Spectators who wish to view the finish area at the top of the mountain will need to purchase their chair lift ticket OR hike the Bobsled Hiking Trail for free.
There will be water/gatorade/fruit at the top for participants. The Skyline Taphouse restaurant at the top of the mountain will also be open.
WEAR SUNSCREEN. You are much closer to the sun up here!
More info HERE.
Awards: Awards will be held at 10:15 AM at top of course. $100 prize money to top male and top female finisher. Age categories for Awards include: Male & Female for 13 & Under, 14-18, 19-29, 30-39, 40-49, 50-59, and 60+
Team awards will also be given for top men's team, top women's team, and top mixed team (which must include at least 2 women). Top 5 times will be used to make team score.
About the Event: When Olympian Ryan Hall began his journey as a runner, it all started here. Ryan grew up just 5 minutes away from Snow Summit where his weekly cross country training sessions included a 1-mile timed run up "The Wall" - one of Snow Summit's double black diamond ski runs. Today, the high school cross country team still utilizes this course every summer for their training, hoping to reach the heights Ryan Hall established. Three State Champions later...it seems to be working!


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By Dr. Gary North
Part 1
And the multitude of them that believed were of one heart and of one soul: neither said any [of them] that ought of the things which he possessed was his own; but they had all things common (Acts 4:32).
But Peter said, Ananias, why hath Satan filled thine heart to lie to the Holy Ghost, and to keep back [part] of the price of the land? Whiles it remained, was it not thine own? and after it was sold, was it not in thine own power? why hast thou conceived this thing in thine heart? thou hast not lied unto men, but unto God (Acts 5:3-4).
The first-century church was not opposed to private property, as Peter's words clearly indicate. But great wealth is too great a temptation for most people. Jesus laid down the general rule: "And again I say unto you, It is easier for a camel to go through the eye of a needle, than for a rich man to enter into the kingdom of God" (Matt. 19:24). Nevertheless, this rule is not absolute: "When his disciples heard it, they were exceedingly amazed, saying, Who then can be saved? But Jesus beheld them, and said unto them, With men this is impossible; but with God all things are possible" (Matt. 19:25-26).
The deciding factor is personal self-government under God's law, whether we are speaking of great wealth, great power, great intelligence, great beauty, or any other blessing in abundance. Christians have been suspicious of great personal wealth in the hands of the spiritually average person. They are aware of God's covenantal warning to Israel: beware, lest "thou say in thine heart, My power and the might of mine hand hath gotten me this wealth. But thou shalt remember the LORD thy God: for it is he that giveth thee power to get wealth, that he may establish his covenant which he sware unto thy fathers, as it is this day" (Deut. 8:17-18).
God gives individuals the power to get wealth. Should civil governments deny this principle by passing legislation that deliberately reduces this power for some men — specifically, the successful? On what biblical basis could such legislation be justified? These are rhetorical questions. There is no possibility of legitimately invoking biblical judicial standards to defend either socialism or modern egalitarianism, i.e., hard-core liberation theology or soft-core liberation theology. Peter's words to Ananias are judicially and ethically authoritative. Socialism is therefore a form of ethical rebellion. This is why liberation theologians, not to mention outright Christian socialists, do not begin their analyses or manifestos with a detailed exegesis of this passage.
Until modern times, the leadership of orthodox churches steadfastly opposed socialism. They did not proclaim the ideal of free market capitalism, but they did proclaim ideals that eventually produce free market capitalism: the legitimacy of private property, geographical mobility for the sake of one's service to God (the ideal of missions and one's calling before God), personal responsibility, and voluntary charity to relieve individual cases of poverty.
Within the churches, there have occasionally been defenders of compulsory State socialism — as distinguished from the voluntary socialism of certain vow-taking religious orders — but they have always been regarded as heretical by the churches' leadership. The march into socialist ideology by the leadership of modern mainline churches has been accompanied by their march out of theological orthodoxy.
Heretical Movements
Prior to 1660, there were numerous heretical movements within European Christianity that proclaimed various forms of Christian socialism. The best brief study of the heretical socialist movements of the late medieval and early modern periods is Igor Shafarevich's book, The Socialist Phenomenon. Shafarevich, a mathematician, was a prominent member of the Soviet Union's anti-Communist protest movement of the 1970's. Shafarevich surveys the history of several of these heretical sects: Cathars, Free Spirits, Adamites, Taborites, and Anabaptists. Some were world-denying Manicheans and Gnostics; others were world-affirming pantheists. All were desirous of overcoming the Creator-creature distinction. He concludes: "All these individual theses can be reduced to one aim: overcoming the conjunction of God and the World, God and Man, which had been accomplished through Christ's incarnation (the fundamental principle of Christianity, at least in its traditional interpretation)." But how could the Bible's Creator-creature distinction be overcome theologically? Through either gnosticism or pantheism: escape religion or power religion. He writes:
"There were two ways to achieve this: denial of the world or denial of God. The first path was taken by the Manicheans and the gnostic sects, whose teachings conceded the world to the domain of an evil God and recognized as the sole goal of life the liberation from matter (for those capable of it). The pantheistic sects, on the contrary, not only did not renounce the world, but proclaimed the ideal of the dominion over it (again, for a chosen few, while others, the "rude" folk, were included in the category of the world). In their teachings it is possible to find the prototype of the idea of "subjugating nature" which became so popular in subsequent periods. The dominion over the world was considered possible not through the carrying out of God's will — but by denying God and by transformation of the "Free Spirits" themselves into gods. The social manifestation of this ideology can be seen in the extreme trends of the Taborite movement.
Finally, the Anabaptists apparently tried to find a synthesis of these tendencies. In their "militant" phase, they preached the dominion of the elect over the world; moreover, the ideas of dominion completely overshadowed the Christian features of their world view (for example, Muntzer wrote that his teachings were equally comprehensible to Christians, Jews, Turks and heathens). In their "peaceful" phase, as can be seen in the example of the Moravian Brethren, withdrawal from the world was predominant: a condemnation of the world and a breaking of all ties with it.
The ideas of chiliastic socialism constituted an organic part of this outlook. The demands to abolish private property, family, state and all hierarchies in the society of the time aimed to exclude the participants of the movement from the surrounding life. This had the effect of placing them in a hostile, antagonistic relationship with the "world.""
Socialist ideology is imbued with the notion of a coming fundamental break, of the end and destruction of the old world and the beginning of a new order. This concept is interwoven with the idea of "imprisonment" and "liberation," which, beginning with the Cathars, is understood as imprisonment of the soul in matter and as liberation in the other world. Later, the Amalricians and the Free Spirits saw the idea as spiritual liberation through the achievement of "godliness" in this world. (The Amalricians were a 13th century pantheist, free love movement named after Amalric of Bena). And finally, the Taborites and the Anabaptists conceived of it as material liberation from the power of the "evil ones" and as the establishment of the dominion of the "elect."
The New Hierarchy
Also involved in these heretical movements was the creation of a unique organizational structure: a concentric structure, with "a narrow circle of leaders who are initiated into all aspects of the doctrine and a wide circle of sympathizers who are acquainted only with some of the aspects." system re-established a centralized hierarchy, but in the name of initiation into the inner circle of free men. The older magical humanistic ideal was steadily replaced (in public, anyway) by a secular humanistic ideal. "The leading role in the development of socialism passes to a new type of individual. The hermetic thinker and philosopher is replaced by the fervent and tireless publicist and organizer, an expert in the theory and practice of destruction. This strange and contradictory figure will reappear in subsequent historical epochs. He is a man of seemingly inexhaustible energy when successful, but a pitiful and terrified nonentity the moment his luck turns against him." It is not surprising that the two primary streams of Europe's nineteenth-century socialist revolutionary movements — international socialism and national socialism — had their origins in occultism and journalism.
From Revelation to Reason
The English Civil War and Interregnum of 1642-60 was the last occasion for the socialist heretical sects to gain power in Europe. The openly religious-ecclesiastical phase of socialist agitation ended in Europe with the restoration of Charles II to the throne in 1660. As Shafarevich notes, "The development of socialist ideas did not cease, of course. On the contrary, in the seventeenth and eighteenth centuries, socialist writings literally flooded Europe. But these ideas were produced by different circumstances and by men of a different mentality. The preacher and the wandering Apostle gave way to a publicist and philosopher. Religious exaltation and references to revelation were replaced by appeals to reason. The literature of socialism acquired a purely secular and rationalistic character…" This was equally true of the defenses of economic science. Appeals to Christian morality and biblical revelation were removed from the post-1660 literature of economics. It is this self-conscious removal that marks the origin of scientific economics.
The Advent of Christian Socialism: Nineteenth Century
In the first half of the nineteenth century, there were numerous English and American experiments in voluntary socialist communalism. These communes were sometimes described by their founders as Christian, but their founders were more often Unitarians or openly heretical. A good example is Adin Ballou (1803-90), co-founder in 1841 of the Hopedale Community, a joint-stock Christian venture, who led the group from 1841 until 1852. He was the author of Practical Christian Socialism (1854) and editor of The Practical Christian. He was a universalist, a pacifist, and an abolitionist.
Better candidates were the co-founders of nineteenth-century British Christian socialism, Rev. Frederick Denison Maurice, an anti-Unitarian, anti-Catholic theologian, King's College historian, and a Church of England cleric, and his close friend, Rev. Charles Kingsley. They were a strange pair. Kingsley was a successful novelist (Yeast, Alton Locke, Water Babies), a Darwinian evolutionist, and chaplain to Queen Victoria. He was vehemently opposed to Calvinism. The orthodoxy of his theology can be judged by a letter that he wrote to Maurice in 1863 to describe his new discovery that "souls secrete their bodies, as snails do shells. . . ." Maurice, in contrast, was devout, but his language indicated that he as a universalist. At best, he completely confused common grace with redemptive grace. "Every man is in Christ; the condemnation of every man is that he will not own the truth — he will not act as if it were true that except he were joined to Christ he could not think, breathe, live a single hour." Every man, "as man, is the child of God. He does not need to become a child of God, he needs only to recognize that he already is as such." This confuses the two forms of sonship: disinherited (Adamic) and adoptive (Christian). Mauruce wrote to Kingsley in 1847 to criticize him for having inserted what Maurice regarded as "a sneer against the idea of a Divine Bridegroom…I fully defend your right to be humorous, if by any words in your own mouth or any other you weakened people's faith in this mystery, I should think you were inflicting a deep wound on humanity."
Maurice and Kingsley were socialists in the post-1848 era. The failed socialist revolutions of 1848 were a major turning point in European thought and culture. These simultaneous uprisings were important for the subsequent development of a confrontational Christian socialism. Kingsley wrote to John Stuart Mill in 1869: "In five-and-twenty years my ruling idea has been that which my friend [Thomas H.] Huxley has set forth as common to him and Comte; that `the reconstruction of society on a scientific basis is not only possible, but the only political object much worth striving for.'"
Beginning in the post-Civil War (1861-65) era in the U.S., the rise of the Social Gospel movement within Protestantism led to a fusion of liberal religion and socialism, or at least government intervention into the economy. The general morality of socialism was defended in the name of Christian morality. The Social Gospel movement gathered momentum in the first third of the twentieth century, effectively challenged only by the rise of officially non-political neo-orthodoxy after the First World War and by neo-evangelicalism after the Second World War. But both of these alternative movements have incorporated many of the Social Gospel's ideas regarding "social justice," i.e., State intervention. The leaders of both groups have repeatedly embraced political liberalism. Twentieth-century political liberalism is addicted to humanism's messianic dreams of salvation by civil law. This is the socialists' dream, too.
The Drifting Evangelicals
All socialist economic thought relies on a specific view of civil law, namely, that it is legitimate for the State to use its power to redistribute wealth from richer residents to poorer residents. This view is inescapably a denial of the requirements of Leviticus 19:15: "Ye shall do no unrighteousness in judgment: thou shalt not respect the person of the poor, nor honour the person of the mighty: but in righteousness shalt thou judge thy neighbour."
Socialism comes in many varieties: utopian, Communist, Fabian, and Keynesian interventionist. In some periods of Western history, it has even come in the name of Jesus Christ. Prior to the nineteenth century, however, such claims were regarded by the church as heretical. No longer. There are several reasons for this, but the most important one is that few churches today are willing to define heresy formally, and fewer still are willing to impose the negative institutional sanction of excommunication against those who publicly uphold heresy. It is not merely that socialism is no longer identified as heretical; it is that almost no belief is defined as heretical.
Throughout the twentieth century, the evangelical churches have been progressively unwilling to make up their collective minds about much of anything. They have steadily abandoned the non-negotiable doctrines of the past. When the spokesmen of the church of Jesus Christ no longer believe that God created the earth in six 24-hour days, that God sent a universal flood, or that hell is a real place, we should not expect them to be able to decide in God's name between the biblical legitimacy of competing economic ideologies. J. Gresham Machen identified the theological problem in 1923: modernism, a rival religion. For doing so, and doing it so effectively, he was savagely attacked personally by his liberal critics and was thrown out of the Northern Presbyterian Church in 1936, though of course not for theological reasons, according to the hierarchy. No one is thrown out of the modern Protestant ministry for theological reasons; only for bureaucratic reasons. By the 1970's, modernism was triumphant in the mainline denominations and was nearly triumphant in all but the smallest denominations. One by one, decade by decade, evangelical seminaries drifted into theological liberalism and Barthianism. By the 1970's, the neo-evangelicals had become, in the perceptive phrase of Richard Quebedeaux, the worldly evangelicals. Without an anchor — the ideal of an infallible Bible and its permanent and universal relevance to every society — there has to be drift away from orthodox Christianity. There is no neutrality in life.
Article from http://www.garynorth.com
Part One has been slightly edited by Gospelbbq.


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Thank you for your interest in the University at Buffalo's Undergraduate Research Conference. Our annual conference is an exciting platform for students interested in graduate school to demonstrate their knowledge and talents to an audience drawn from all over the nation.
Due to the COVID-19 pandemic and in accordance with guidance from local and state health authorities regarding travel and group gatherings, the University at Buffalo has canceled the 26th Annual Undergraduate Research Conference and Graduate School Information Program that was set to take place July 20-22, 2020, in downtown Buffalo.
This decision to cancel was difficult and disappointing. Every year, we look forward to connecting with our colleagues and undergraduate student researchers from across the nation. This year's event was particularly exciting, as we transitioned to a new location and developed fresh, new programming. However, the uncertainty surrounding large-scale events is likely to continue, and ensuring the well-being of our entire community is always our first priority.
2021 conference dates will be posted once a new date is confirmed. Thank you for your patience and understanding. Please stay healthy and know that we look forward to welcoming you to our city soon!


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What does a daily routine look like for a microbiology lab assistant at Vanguard Sciences?
What does a daily routine look like for a microbiology lab assistant at Vanguard Sciences?
Former Microbiology Lab Assisstant at Vanguard Sciences
over 1 year ago
As a Microbiology Lab Assisstant at VanGuard Sciences, your tasks consist of handling, weighing, and prepping various food samples for microbiological growth testing. There is a lot of time on your feet to do the tasks at hand and there may not always be a set time that you're off because everything that comes in that day needs to be prepped and processed.
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