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Posted on December 19, 2015
Received on June 21, 2015 New York City
The system has rotated, slightly rotated. Find new alignments between material and spirit.
Now, one of the interstitial membranes that separated material and spirit has disappeared. As membrane-like gloves dissolve, more light is revealed. The intensity and sensitivity to light is greater than before; attune to the light with tiny adjustments in awareness.
The smallest gesture inflects these newborn, hair-thin sensitivities. Move now, with exactness, as you are here, in the new structure. All of the souls in this new dimension are equal, self-directed, and balanced. Blossom by remaining in your place; breathe and continue blossoming. Open and… open and…open into a heightened precision you have never experienced, one that your mind cannot comprehend. The light and the vessel are more similar now, and the membranes between them are thinner, and more transparent.
Angel Michael inhabits the new structure and perceives in surround-awareness, 360 degrees and forty dimensions here. Birth is a pulling down whereas the process of re-birth, within the ongoing life system, is rising up. Rise up to meet it, as the new structure pulls down and is born.
Received June 25, 2015
How is Judaism changing, now?
Judaism, as you know it and practice it, has completed its mission. The recent cycle of Jewish experience through history, logic, and land, have impacted the spirit realms as much as they are able. The new and expanded universal network of co-relational elements exceeds all religious frameworks. Judaism was once the "new" system and it provided access to the last rotation and revelation of universal essence forces.
Justice is Equi-Distance. Everything in the Justice Realm is equidistant from everything else, in energy and composition; the art of distinction, and the distance between distinctions, is set such that everything is equal in relation to everything else, although isolated and on their own, some formulations are more potent that others. Equi-Distance and justice clear a path for you to live now at the speed of light, unimpeded by remnants of old structures. Stream forward, and soar.
The story of god will unfold in three parts. This is the middle part. Become a walking Yud Hay Vav Hay. Humans are composed of these letters, the god letters, in their core.
For example, a single generating Yud flows through the first filter and is then accompanied by a stream of Yuds. An impulse, a Yud, something, someone always has to enter first. Systems are upgraded by their own imagination and the firsts that then establish them.
It is in the nature of the god filter that fresh seeds flutter down in an articulated rhythm over-colored by love and grace. Concepts re-align and re-form; in this rotation, the envelope stretches and you can know more light. Human spiritual potential is circumscribed by the structural concepts from which they emanate.
How is the possible designed?
The template is established by a collaboration amongst the higher selves of people who slip up and down between realities, like liquid in a straw.
Effervescent. When someone is born, if they are connected to the themes of the moment, the high themes, they slide all the way down into the world through the concepts they will embody, gaining skins of the concepts over the gestation period. The first human embodiment had just one skin concept; it was whole. Every concept was condensed into just the one skin.
I am afraid of breaking apart, of shattering, from imbalance and from an overload of light.
A ram stabilizes the moment. Carry the new Torah, again, metaphorically, from the desert to the book. From under the flowing column of letters, receive, absorb and contain. You must receive and contain the new. You have been fortified to hold it. Fear and hesitations are natural, but you are stable enough to contain whatever is downloaded through you. Choose to contain the new.
I ran from my place, and now I will stand in it.
It is your choice to stand in your place. New light and hyper-codes stream in columns. The fulcrum of spiritual activity swings subtly; minuscule gestures generate a large impact at the end of the fulcrum, in the world of action.
Archetypes are containers. Build containers, more containers and inter-related families of containers to process more, to allow more light to pass through.
Is the "you" the collective, or individuals?
Proceed along the incremental path; stay the course. This is not a time to explore different ideas or to experiment. You do not understand the extent to which creation and all of these systems and structures are counting on you. Do this without being a follower, an observer, or conservative in personal practice.
Hold awareness in the core, and again, hold awareness in the core, and again, and breathe and again. And again. And stay here, and stay here, and stay here, and do not waiver or slip into an unconscious level of consciousness. Hold, hold, hold, and the downloading continues, at a different frequency, and hold it, with fortitude. Stand like a glass vessel, and like in childbirth, send the light constructs forth; they will come through you, for forty days and forty nights. Forty days and forty nights — prepare yourself. Every day, starting today, you will receive a different set of structures and codes, each day building on the prior. Receive. Receive the blessings and receive the wisps of this first breath of the new and it will be stabilized.
Is there a practice that can help?
Meditate every morning and evening for forty days. Creation is always iterative. What your vessel will birth will seem both old and new, familiar and different. Take the Torah with you. Remember to take the Torah with you. Do not forget it as you cross the threshold and as the new comes through you, remember to take the Torah with you, as the letters-words-you, together, transition. One cannot pass without the other.
Hold to the idea that there are no others, that everything you experience is a set of mirrors for you to see your self, and you will bring forth a higher frequency of knowledge. In other words, what comes through you and the quality and level of the next iteration will depend on the tenacity of your consciousness.
There is a light beyond any we have communicated about here– it is a consciousness of the mirrors. They are condensed mirrors, compact and tight. The mirrors are closed, facing one another in union, with no space between them.
There is a porthole, a tube interconnecting the fourth dimension of the old world with the new. It will take forty days to build the spiritual elevator, up and down, between realities of different frequencies.
The Aleph comes through. Action sends seeds upward. The Torah is raised back up to its source. Ingest. Ingest Light. The becoming is vibrationally new.
The Kabbalistic structure is not relevant to this role. The Vilna Gaon pre-plunged this fourth dimension channel. It has been hidden but in existence, like a nerve line. Do not be good-bad or right-wrong. Be present, fully present.
Match intention with your awareness and action, and do the work, do the work, do the work, forty days and forty nights, to build the full channel to the new frequency. Eliyahu walked aligned, mind, body, spirit, and brought many phrases into reality. As they passed through him and became magnetized or energized, the phrases could be used, called upon.
The Red Sea holds everything in it, at once.
You will stand in your place and heal. Scan and see where to reflect the wholeness back into a system so it can see itself and choose wholeness. You are an architect of light and of its experiential passages. It is slower to create the passage with the Torah, to carry the laced structures, but that is what is required. Carry the Torah, methodically.
Everything will conspire now to keep you on the path. Everything will support the commitment you make.
Isn't the Torah implied in creation? Why carry the Torah forward?
The Torah is the perfect mirror for every aspect of creation, the perfect mirror collection; it will be enlarged and enhanced by being carried from here to there, and this is how the capacity of capacity grows.
Why do we want everything to expand or evolve?
Find the Torah structure inside you and carry its awareness into the fourth dimension. The beginning will be most thick and challenging. Each day a different twist or angle will be introduced.
This is a human endeavor, and it must be for it to be effective. When centered in your heart, feel the natural desire of the light to evolve and expand. Follow the pleasure of the light.
Forty days and forty nights. Do not complete it early; be a partner in the process, not an independent performer. It will take forty days for this knowledge and the structure to download and do not force it. Be the choosing cursor, point and click where your higher self shows you. The mind, the intellect, will emerge altered from the channel. Make the intellect deferential, small and partial. The fourth dimension holds a nearly equal measure of physical and spirit. It is delicate.
Build a channel of concepts, a channel comprised of concept gates. When one passes through them, one becomes ready for the next gate. The gates build the new characteristics of the soul passing through them. That is the architecture of the spirit.
Image: Wind Dispersed Seeds In Motion Creative Commons
Image: Yud
Image: Red Sea, by author


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Arrival dates and shipping costs above are estimates. Exact shipping costs, arrival dates, and any applicable taxes will be available when you checkout.Return Policy – Returns are accepted within 90 days of order ship date. Learn More
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Every Pet Naturals™ supplement is naturally formulated with the most pure and potent ingredients. L-Theanine is a naturally occurring amino acid that can help support normal chemical balance in the brain, thereby promoting a calming effect without causing drowsiness. Vitamin B1 may aid in calming the central nervous system. Colostrum Calming Complex is derived from proteins that may help support cognitive function and may manage everyday stress.
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For more than 50 years, Puritan's Pride has helped families achieve a lifestyle of wellness. Our vitamins and supplements are made with care from the highest quality ingredients. They are tested or inspected as many as 15 times throughout the manufacturing process. That's why you can shop with confidence. We take pride in our products and helping customers feel their best.
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Starting from 1st January 2021 EGEM acts in the international trading of gas, power, CO2 (as a single interface between Eni and the markets), LNG and Oil derivatives. It is a global, integrated approach designed to make the most of Eni's network of contacts and wide asset portfolio. In turn, EGEM helps to optimise the management of Eni's assets, promoting collaboration within the organisation and devising advanced risk-management solutions. EGEM enhances Eni's unique position as a European leader in the gas sector, acting as a specialized hub for trading and commodity risk management.
Products and Services
Eni for you
Our energy at your service.
For your business
Energy solutions for large and small businesses.
The members of the Board of Directors are:
· Cristian Signoretto, Chairman and Chief Executive Officer
· Elvira Fabrizio, Director
· Donatella Anna Ranco, Director
· Claudia Vignati, Director
· Luciano Pappadà, Director
Integrated operations on commodity market
EGEM has its registered office in Rome and is based on four locations: London, Brussels, Singapore, San Donato Milanese.
Gas, lng, power e CO2
EGEM is mainly engaged in:
· trading operations, on both physical and financial energy commodity markets ( mainly gas, power, LNG and CO2 emissions);
· the use of portfolio flexibility in Asset Backed Hedging activities;
· the provision of services for the management of commodity price risk to the divisions and companies of the Eni Group;
· the trading of CO2 certificates to meet the needs of Eni Group companies.
Below you can find the Brexit-compliant references relevant to our activities related to Eni Global Energy Markets S.p.A. - UK Establishment:
Eni Global Energy Markets S.p.A. - UK Establishment
Eni House - 10 Ebury Bridge Road - SW1W 8PZ – LONDON - UK
UK establishment number: BR022574
Head Office: Piazzale Enrico Mattei n. 1 – 00144 – ROME - ITALY
Registered at Chamber Of Commerce, Industry, Handicrafts And Agriculture Of Roma
Registration number: RM-1609166
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Eni Global Energy Markets S.p.A.
Eni House
10 Ebury Bridge Road - SW1W 8PZ
Email: firstname.lastname@example.com
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Eni Global Energy Markets Spa Bruxelles Branch
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Eni Global Energy Markets S.p.A.
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Email: email@example.com
PEC: firstname.lastname@example.com
Fax: +65 6250 4830


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detapa_by_adm_stacks.zip —
This is a new Cardassian Ship design from Adm. Stacks. The Detapa Class is an excellent addition to your Cardassian Fleet. It is designed to be a heavy battleship and does not disappoint. This package comes with everything you need, including new weapons, Borg textures and the original mesh in ms3d format. – K7A
*****************CARADASSIAN DETAPA CLASS*************** *****************README FILE************************* *****************Version 1************************** When the Federation and Klingons ended their occupation of the Cardassian Union. Central Command ordered 2 new battleship prototypes. The winner of the contest was the mighty Hutet. The Detapa being a capable ship in it's own right was refit into a fleet command battleship. They are armed with several multi-targeting phasers 'borrowed' from the Federation and a more powerful plasma bank, and command and control systems that increase the combat abilities of nearby allied ships. ***YOU HAVE PERMISSION TO USE THIS, OR ANY PART OF THIS MOD, I JUST ASK FOR CREDIT FOR THE MODEL!!!*** the zip file contains: README.txt : this file, with installation instructions SOD file TGA files [only 256 size files this time] techtree / tech1 file Sprite file [gui-global] ODF files [ships, stations, weapons, special weapons, other] AIP files [AI build list, campaign build list] bzn files [maps] ms3d file [not used in Star Trek Armada, I've included it for people that wish to tinker with it] INSTALLATION unzip (and overwrite if computer asks) IF your game is modded, then unzip into a seperate folder and manually install it. KNOWN BUG: no team colors... cause i hate team color :) AND the special weapon texture overwrites a stock texture...make a back up of Wdeathch.tga CREDIT SOD: adm stacks TEXTURE: Mad Doc software [I adjusted the stock textures only] ODF: adm stacks CONTACT for any question: admstacks AT yahoo DOT com ******************************************************** ********************************************************
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Magna Life Settlements is a top-ranked life settlement provider by capital deployed and have been active in the life settlement industry since 2004. In addition to buying life insurance policies older Americans no longer want or need, we also specialize in educating life insurance agents about sharing life settlements with their clients. Learn more below about how to identify if your client's policy qualifies for a life settlement.
Evaluate My Client's Policy Today
As Director of Agent Origination at Magna Life Settlements, Jim Purdy is dedicated to growing and educating a network of agents about the financial opportunities for their clients through life settlements. Prior to joining Magna Life Settlements, Jim managed national accounts at Edison Risk, was a national sales manager at Imperial Financing & Trading and managed broker relations at Peachtree Settlement Funding. Jim has more than 15 years of sales experience that includes all aspects of the insurance industry, specializing in income planning and wealth transfer. He demonstrates a command of solutions-based selling, including products and services to direct markets and within various distribution channels. Jim also served in the United States Marine Corps.
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Today's post is part of our Psalm Saturdays series from guest blogger Robert Chamberlain. You can read his archives at www.roberlain.wordpress.com .
Psalm 137:1–9 (ESV)
1 By the waters of Babylon, there we sat down and wept, when we remembered Zion.
2 On the willows there we hung up our lyres.
3 For there our captors required of us songs, and our tormentors, mirth, saying, "Sing us one of the songs of Zion!"
4 How shall we sing the LORD's song in a foreign land?
5 If I forget you, O Jerusalem, let my right hand forget its skill!
6 Let my tongue stick to the roof of my mouth, if I do not remember you, if I do not set Jerusalem above my highest joy!
7 Remember, O LORD, against the Edomites the day of Jerusalem, how they said, "Lay it bare, lay it bare, down to its foundations!"
8 O daughter of Babylon, doomed to be destroyed, blessed shall he be who repays you with what you have done to us!
9 Blessed shall he be who takes your little ones and dashes them against the rock!
There's a certain symmetry to this Psalm. There's weeping now for God's people whilst their enemies exult. But there's a day of reckoning coming when God's people will rejoice whilst His enemies will despair.
God's people are exiles and strangers in the world. It feels strange to us to sing of our heavenly home in the midst of the world in which we live. Worshipping God isn't something we want to do to the mockery of others.
Israel's singers may have gone on strike in exile in Babylon, but they still wanted to remember the good old days when they sang their old time worship songs. And they still penned laments like this of their lamentable current circumstances. Psalm 137 is from exile in Babylon, and the book of Lamentations is from the devastated homeland.
We want to remember good times in the midst of lament. But we also want God to remember injustices that we have suffered. The final verses of this Psalm seem shocking to our respectable modern sensibilities. But we have an ugly sense of entitlement if we think that God owes us anything other than destruction, because He doesn't.
"Lord, we're strangers and exiles in this world, and we long to come home to You. Please help us in the meantime, and grant us justice against our enemies, in Christ's name, amen."
**If you enjoy reading Shaped by the Word, please consider sharing this post on social media. Doing so helps us reach a larger audience. Thanks for reading!
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Who Was Christopher Walken ?
Christopher Walken (born Ronald Walken; March 31, 1943) is an American actor and comedian who has appeared in more than 100 films and television programs, including Annie Hall (1977), The Deer Hunter (1978), The Dogs of War (1980), The Dead Zone (1983), A View to a Kill (1985), King of New York (1990), Batman Returns (1992), True Romance (1993), Pulp Fiction (1994), Antz (1998), Vendetta (1999), Sleepy Hollow (1999), Joe Dirt (2001), Catch Me If You Can (2002), Click (2006), Hairspray (2007), Seven Psychopaths (2012), the first three Prophecy films, The Jungle Book (2016), and Irreplaceable You (2018).
He has era-fortunate a number of awards and nominations, including the Academy Award for Best Supporting Actor for The Deer Hunter. He was nominated for the thesame response and won BAFTA and Screen Actors Guild Awards for Catch Me If You Can. His films have grossed on peak of $1 billion in the United States alone.
Walken has along with played the gain in the Shakespeare plays Hamlet, Macbeth, Romeo and Juliet, and Coriolanus. He is a popular guest-host of Saturday Night Live, hosting seven times. His most notable roles a propos the perform restructure wedding album producer Bruce Dickinson in the "More Cowbell" sketch; the disgraced Confederate superintendent Colonel Angus; and multiple appearances in the Continental sketch. He has along with appeared in Hallmark Hall of Fame's Sarah, Plain and Tall (1991), which earned him a Primetime Emmy Award nomination.
Walken debuted as a film director and screenwriter once the 2001 rushed film Popcorn Shrimp. He along with wrote and played the gain role in the 1995 take leisure row Him not quite his idol Elvis Presley.
Christopher Early life
Walken was born Ronald Walken taking into account reference to March 31, 1943, in Astoria, Queens, New York, the son of Rosalie Russell (May 16, 1907 March 26, 2010), a Scottish immigrant from Glasgow, and Paul Wlken (October 5, 1903 February 23, 2001), a German immigrant from Gelsenkirchen who owned and operated Walken's Bakery in Astoria.
Read More Biography : Robert Redford
Walken was named after actor Ronald Colman. He and his brothers, Kenneth and Glenn, were child actors upon television in the 1950s, influenced by their mother's dreams of stardom. When he was 15, a girlfriend showed him a magazine photo of Elvis Presley, and Walken higher said, "This boy looked once a Greek god. Then I saying him upon television. I loved all roughly him." He tainted his hairstyle to impinge on Presley and has not changed it previously.
As a youthful, he worked as a lion tamer in a circus. He attended Hofstra University but dropped out after one year, having gotten the role of Clayton Dutch Miller in an off-Broadway revival of Best Foot Forward contiguously Liza Minnelli. Walken initially trained as a dancer at the Washington Dance Studio past moving upon to dramatic stage roles and with film.
Walken Career
As a child, Walken appeared taking into consideration suggestion to screen as an choice in numerous anthology series and variety shows during the Golden Age of Television. After appearing in a sketch behind Martin and Lewis in report to The Colgate Comedy Hour, Walken granted to become an actor. He landed a regular role in the 1953 television perform Wonderful John Acton playing the share of Kevin Acton.
Over the once-door two years, he appeared frequently following mention to television (landing a role in the experimental film Me and My Brother) and had a rich career in theatre. From 1954 to 1956, Walken and his brother Glenn originated the role of Michael Bauer in metaphor to the soap opera The Guiding Light. In 1963, he appeared as a setting named Chris in an episode of Naked City, starring Paul Burke. In 1966, Walken played the role of King Philip of France in the Broadway premiere of The Lion in Winter. In 1968, he played Lysander in A Midsummer Night's Dream and Romeo in Romeo and Juliet at the Stratford Festival in Canada. In 1969, Walken guest-starred in Hawaii Five-O as Navy SP Walt Kramer.
Personal life
In 1963, Walken met Georgianne Thon during a tour of West Side Story. They married in January 1969. The couple have no children, and Christopher Walken has avowed in interviews that swine childless is one of the reasons he has had such a prolific career. The couple have a cat named Bowtie, and their previous cat was named Flapjack.
Source Url : Christopher Walken


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Life is an adventure. I can only wonder what treasure awaits at the top of the path.
Jonathan Locke Huie
The sandiest paths lead to the sweetest places🏖🏖
Following the sandy path in Wildwood, NJ August 23, 2020
Smell the sea and feel the sky, let your soul and spirit fly ~Van Morrison


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LOA Associates are currently recruiting for a Consultant General Psychiatrist for an exciting full time, NHS position based in the stunning coastal region of Tyne and Wear.
This role will enable the Consultant to work across a variety of psychiatric services. The intention is to create a role for a specialist in the field of psychiatry, who will rotate into vacant roles for variable periods of time as agreed depending on the vacancy and the service need.
These posts could be in any area of Adult Psychiatry including Acute In-patient units, Community Mental Health Teams, Assertive Outreach Teams, EIP Services or Crisis Intervention and Home Treatment Teams.
This position offers an excellent salary, NHS benefits and outstanding package.
Please contact me for a detailed job description or forward your updated CV to:


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|THE WESTERN STAR, 25 August 1916
|Marriage of
James D. Strain and Myrtle Anna Daniel were united in marriage at 9:30 p.m. on last Saturday, August 19, 1916, at the home of the bride's mother, Mrs. W. T. Daniel, in the eastern part of this city, Rev. R. W. Wyrick of the M. E. church officiating. The groom has been in this city only a short time and hence is a comparative stranger here. The bride is well known in our city, having lived here for about 3 years. She has won many friends, and now as she and her life partner enter upon the married relations they have the good wishes of all. The Star joins in extending congratulations. It is probable that Mr. and Mrs. Strain will make their home on a farm near Spiro, Okla.
|Transcribed and Contributed by Shirley Brier
Last Updated: Saturday, December 17, 2005 02:29:14
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Sleep problems represent a worldwide health concern among older adults, with an increasing prevalence of multimorbid conditions and a decreased quality of life. However, most elderly patients are not correctly diagnosed due to numerous confounding variables (e.g., medical and psychiatric disorders, polypharmacy, and psychosocial factors) affecting sleep and the confusion regarding the differential diagnosis in older adults between normal changes in sleep pattern as a result of ageing and sleep disorders. There are normal changes to the sleep architecture throughout the lifespan, and sleep disorders are not part of the ageing process; however, there are several sleep disorders that affect older adults. The most prevalent sleep disorder is insomnia, which is found in different forms and affects approximately 30–50% of the older adult population. The treatment strategies for sleep disorders are multivariate, with prescriptions of pharmacological treatments being the most common method among healthcare professionals; however, there is strong evidence that non-pharmacological treatments have better long-term effects. The aim of this review is to explain the difference between sleep disorders and sleep alterations as a result of ageing, to characterise insomnia in older adults, and, finally, to present the different effective non-pharmacological possibilities, accompanied by evidence, for the treatment of insomnia in older adults.
Across all the primary, secondary, and tertiary healthcare levels of both public and private healthcare systems, one of the major complaints that older adults seek medical advice for is changes in sleep behaviour. These subjective complaints are based on changes to the structure, quality, and quantity of sleep. Evidence for sleep alteration is confirmed through measuring objective polysomnographic and electroencephalographic data.
From the age of 60 years, there is a reduction in total sleep duration, with a redistribution of sleep episodes (naps) throughout the day and reduction of nocturnal sleep.1,2 The sleep pattern of older adults is characterised by frequently disrupted sleep, with periods of being awake lasting >30 minutes, and individuals reporting a tendency to spend 15–20% of their time in bed being awake.2,3 A meta-analysis conducted by Ohayon et al.4 sampled 3,577 individuals aged 5–102 years. The study demonstrated that with increasing age, cycles of non-rapid eye movement sleep (NREM) 1 and NREM2 increase in duration, and there is less time spent in NREM3 and a decrease in the percentage of rapid eye movement sleep, impairing sleep efficiency. These data were corroborated by Dijk et al.5 These changes in sleep pattern are explained by a set of anatomical and physiological modifications related to the circadian timing system and homeostatic regulatory mechanisms, as well as the contribution of social factors.3,6
The suprachiasmatic nucleus (SCN), the master pacemaker that adapts behaviour and physiology to recurring changes in environmental conditions, shows deterioration during the ageing process, whereby the ability to respond to information is lost. The decreased expression of SCN genes that serve as the body's clock function indicators also interferes with the circadian rhythm by modifying the capacity of the SCN to generate rhythms or respond to external stimuli.7
In addition to these alterations, the quality of the optical transmission of the external temporal cues (day and night) from the retina to the SCN also undergoes deterioration with age, thus affecting the synchronisation of the rhythms, especially the sleep and wakefulness rhythm.7 These altered sleep patterns are also reinforced by changes in light exposure time (exposure to early morning light, for example) by shifting the phase of sleep to earlier.8
The amplitude of rhythms also decreases with age, resulting in difficulty falling asleep and consequently encouraging naps during the day.9 The amplitude of rhythms contributes to internal desynchronisation; an example is the effect of amplitude on the relationship between increased sleep propensity and melatonin. Melatonin, a hormone secreted at night by the pineal gland, enhances sleep propensity; however, its levels decrease with age, resulting in reduced sleep efficiency,2 marked by the reduction of homeostatic pressure to sleep.8 In addition, cortisol levels increase during the circadian phase of sleep (darkness), leading to increased sleep fragmentation;10 this is because cortisol is associated with increased activity and low sleep propensity. Morgan et al.11 showed that there was an association between sleep disorders and high levels of cortisol among the older population (aged 60–90 years).
In older adults, the changes observed in circadian regulatory mechanisms of sleep promote phase advances that influence homeostasis. An increased sleep requirement, reflected by going to bed earlier, occurs due to reduced sleep efficiency or sleep fragmentation; a decreased sleep requirement results in waking up earlier. Moreover, a lower circadian amplitude results in night-time insomnia and increased susceptibility for day-time napping, while a lower homeostatic sleep drive also results in sleep fragmentation.6
It is important to mention that social synchronisers, such as working hours and social activities, are not as relevant in the elderly population and are replaced by other social and temporal cues. Most of the older adult population are retired and do not have a regular daily routine. Sedentary behaviours and the lack of work and/or social activities can contribute to temporary disorganisation.
Considering that sleep patterns present alterations, as previously mentioned, it is imperative that a differential diagnosis be made between sleep disorders and sleep alterations in order to determine the most appropriate therapy. Sleep alterations are related to personal changes in the ageing process, whereas sleep disorders are disturbances that affect the diurnal functioning of the individual, seriously affecting their biopsychosocial range and quality of life, since sleep is fundamental for the maintenance of several physiological, psychological, cognitive, and social processes.
The sleep complaints of older adults most often lead to sleep disorders. The most prevalent complaint is the difficulty of initiating or maintaining sleep, which is seen in 30–50% of older adults.3,12-15 Precipitating and perpetuating factors for sleep disorders include those that are also related to sleep pattern, such as inadequate behavioural sleep habits, age, and the use of medications. Invariably, insomnia is the most prevalent of all sleep disorders, with studies finding a wide range of insomnia rates. For instance, one study found rates of up to 40%, others found rates of around 20%, and other studies found lower rates.2,12,16,17 Furthermore, insomnia rates have also been found to be on the rise, with Gamaldo et al.12 reporting that insomnia rates among the elderly (≥60 years old) in the USA increased from 0.27% in 2002 to 1.29% in 2012.
Women are reportedly more commonly affected by insomnia than men, despite research data showing that there is a contrast between objective and subjective data.13,18 This difference between subjective and objective sleep quality raises the question of whether standard objective sleep measures are appropriate for measuring women's experiences of poor sleep quality.18 Additionally, it shows there is currently a lower demand from men for specialised healthcare services.
Insomnia is a sleep disorder and can also be a symptom of a medical and/or psychiatric condition. It is defined as a difficulty falling asleep or staying asleep, or waking earlier than expected and not being able to return to sleep, even with adequate opportunity and the circumstances for sleep. There is also a poor quality of sleep and sleep tends to be non-restorative. It results in significant clinical distress and impairment in important areas of day-time functioning.19,20
Insomnia in older adults is more likely to be comorbid with other medical and/or psychiatric disorders, such as:
- Cardiovascular problems,
- Respiratory problems,
- Diabetes,
- Menopause,
- Cancer,
- Fibromyalgia,
- Parkinson's disease,
- Alzheimer's disease,
- Depression,
- Other sleep disorders such as obstructive sleep apnoea.21-23
Literature data have shown that insomnia in older adults is associated with falls and mood disorders and therefore may result in an increased risk of morbidity and mortality.24-26 Alterations associated with cognitive performance are also observed, especially in relation to attention and concentration, memory problems, and executive functioning.27,28 Furthermore, insomnia has been shown to be a predictor of cognitive decline, being considered an early sign and independent risk factor for dementia.29
Insomnia can be classified according to duration:
- Episodic insomnia (symptoms last between 1 and 3 months).
- Recurrent insomnia (when ≥2 episodes occur within 1 year).
- Acute insomnia (duration <3 months).20
Increasing age is not only associated with greater prevalence of insomnia,12 but also with a decline in remission rates and greater persistence of the problem.30 With ageing, there is also an increase in chronic insomnia, with many older people complaining of having had insomnia for years and some presenting with the condition for their entire lives.
In order to understand the chronic insomnia of older adults, Spielman et al.31 explained how there are predisposing factors (a set of individual characteristics that increase the probability of developing insomnia, such as sex, age, neurotransmitter systems associated with sleep and wakefulness, and personality traits); precipitating factors (stressful events that precipitate the onset of the symptom, such as the death of a relative or unemployment); and perpetuating factors (behaviours that perpetuate sleep problems caused by attempts to compensate for poor sleep, even after the precipitating factors have been solved. Factors that maintain the condition include inadequate sleep habits, anxiety, medication, and many more).
Older adults make great use of both prescribed and non-prescribed hypnotic medications to improve their sleep problems and continue to use these medications over extended periods of time. It is well known that many risks associated with the use of medications in this age group exist. Due to altered pharmacokinetics, there is increased central nervous system sensitivity to the effects of these medications, as well as interactions with additional drugs taken for comorbid conditions. Use of benzodiazepines, non-benzodiazepine hypnotics, and diphenhydramine for treating insomnia results in an increased risk of cognitive impairment, acute respiratory insufficiency, vehicle accidents, dependence symptoms, and falls and fractures.32-34 In addition, a review by McCall et al.,35 based on retrospective and prospective cohort studies of suicide victims within the USA and other countries, showed that hypnotic medications are associated with suicidal thoughts. However, none of these studies were adequately controlled for factors such as depression, or other psychiatric disorders that may be linked to insomnia. It is important to mention that the adverse effects depend on the type of medication administered.36-38 Frequent use of sleeping medications has also been found to be associated with a significantly increased mortality risk.39
There has been an effort to analyse appropriate pharmacological approaches. Recently, Edmonds and Swanoski34 and Schroeck et al.40 reviewed the safety and efficacy data associated with new therapeutic pharmacological alternatives approved by the U.S. Food and Drug Administration (FDA) for treating insomnia in the geriatric population (suvorexant, doxepin, ramelteon, and tasimelteon); however, these medications were demonstrated to have limitations and adverse effects.
Organisations such as the American Geriatrics Society (AGS)41 do not recommend using benzodiazepines or non-benzodiazepine hypnotics in older adults. Despite these recommendations, benzodiazepines continue to be widely prescribed to older groups who are at the highest risk of developing serious adverse effects from these medications.42
There are several alternatives for treating insomnia in primary and secondary care settings, including non-pharmacological approaches such as cognitive behavioural therapy (CBT). The main advantages of CBT for insomnia are the lack of adverse effects and its long-lasting efficacy, with the changes in behaviour and beliefs allowing the benefits from this therapy to remain for a longer period of time. This is particularly relevant in the treatment of older adults due to the chronic nature and comorbidity of insomnia at this age; behavioural techniques have therefore been the proposed treatment approach.43,44
Several researchers have concluded that CBT should always be the first-line treatment for older adults.17,44-46 For instance, Schroeck et al.40 commented that "CBTI [chronic behavioural therapy for insomnia] is considered a first-line therapy approach for all forms of insomnia." An example of a case where researchers have argued for discontinuation of a pharmacological approach is Airagnes et al.,33 who stated that, contrary to the belief of most clinicians, benzodiazepine can feasibly be discontinued with the use of psychotherapeutic or pharmacological strategies, and this can lead to long-term abstinence. They also commented that significant risk factors in the use of benzodiazepine include polypharmacy and the presence of comorbidities.
CBT for treating insomnia in older adults involves sleep hygiene (aims to change habits with an impact on sleep quality through psychoeducation); stimulus control (aims to associate sleep with relaxing activities only and avoid those that excite the individual and keep them awake); sleep restriction (limiting time in bed to sleeping time, thus increasing sleep efficiency); relaxation techniques (reduce somatic tension and intrusive thoughts that impair sleep); and cognitive therapy (disrupts dysfunctional beliefs and attitudes about sleep that lead to emotional distress and further sleep problems).45,46
Brasure et al.47 demonstrated through a systematic review of >180 studies that CBT for insomnia improved global outcomes and nearly all sleep parameters in the general adult population, older adults, and adults who experienced chronic pain. These data were corroborated by the meta-analyses performed by van Straten et al.48 and Vitiello,49 who stated: "CBT for insomnia is effective, safe, and highly deployable". Studies show that using CBT is effective, with significant effects on the severity of insomnia, sleep efficiency, sleep quality, and sleep fragmentation.17
Digital forms of CBT for insomnia are also demonstrating promise as a therapeutic option, with some studies showing evidence of validity. For example, Chen et al.50 demonstrated that a patient who successfully discontinued hypnotic treatment experienced restored sleep quality after intervention with a CBT mobile app, despite several limitations. Alessi et al.51 studied community- dwelling veterans aged ≥60 years who met the diagnostic criteria of insomnia for ≥3 months. The researchers used stimulus control, sleep restriction, sleep hygiene, and cognitive therapy (individually or in small groups), in addition to weekly telephone behavioural sleep medicine supervision. The results showed significant improvements in sleep onset, sleep efficiency, and sleep quality in older adults with chronic insomnia.52,53
A complementary therapeutic measure involves social strategies and phototherapy. Diagnostic evaluation protocols should be investigated to indicate a requirement for this therapy. It should be determined whether the individual has decreased physical activity, social isolation, or reduced exposure to light, especially for residents of long-term institutions and those with dementia, including Alzheimer's disease. Therefore, one of the coadjuvant and effective therapeutic possibilities includes decreasing time spent in bed during the day, increasing physical activity and social activation, increasing daily exposure to sunlight (or artificial light), provision of structured sleep routines associated with night-time, decreased exposure to nocturnal light and noise, and, lastly, increased vigilance associated with the times of exposure to sunlight and/or artificial daylight (due to the circadian, homeostatic, and psychosocial changes, as previously explained).46,54 Fiorentino and Martin55 explained the efficacy and benefits of this technique in older adults, although there is no consensus about the results.56-58 Evidence regarding the efficacy of these protocols for dementia patients is still scarce.59,60
In addition to phototherapy, research shows that the introduction of structured social activities improves the parameters of sleep and sleep quality54,61 and increases slow-wave sleep, with an impact on memory.62 Literature data have demonstrated that low-impact aerobic activity, walking, and tai chi improve sleep in sedentary older adults with sleep disorders.63
The progress observed with the use of CBT is clear and has been proven in short, medium, and long-term periods of time. However, there is still a shortage of professionals trained to develop this type of therapy, especially with older adults. This perhaps is part of the explanation for the existing predominance of pharmacological treatments for insomnia in this population. An important issue is that, because many older adults have several contributing factors from different domains in their sleep, these complaints are best managed with a multifaceted treatment approach, that is, with a combination of pharmacological treatment and CBT.


text: August 22 2011 30 Day Photo Challenge: Day 22-Trees Daily Life 0 You know in the suburbs there just is no taking a picture of a tree or trees WITHOUT powerlines in the shot! Except for photos of the tops of them! Will there be a time when new technology will make powerlines obsolete and not ruin good nature shots? LOL! 🙂


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Spoiler-Filled 'The Discovery' Trailer with Jason Segel & Rooney Mara
by Alex Billington
February 22, 2017
Source: YouTube
"Don't you think your discovery was just too dangerous to share with the world?" Netflix has revealed a full trailer for Charlie McDowell's new sci-fi film The Discovery, to follow-up the first teaser launched just before Sundance. This outstanding little indie feature premiered at the Sundance Film Festival, and it comes highly recommended for sci-fi fans. Jason Segel and Rooney Mara star, along with Robert Redford, Jesse Plemons & Riley Keough, in this film about a world where the afterlife is scientifically proven. The two connect and look back over their lives while almost everyone else is considering killing themselves to "get there". I wrote in my review from Sundance that this film is thought-provoking "cinema for intelligent minds." This trailer gives away almost ALL of the movie, which is pretty terrible, so be careful watching this.
Here's the newest trailer (+ poster) for Charlie McDowell's The Discovery, direct from Netflix's YouTube:
One year after the existence of the afterlife is scientifically verified, millions around the world have ended their own lives in order to "get there". A man and woman fall in love while coming to terms with their own tragic pasts and the true nature of the afterlife. The Discovery is directed by American filmmaker Charlie McDowell, of the acclaimed film The One I Love previously. The screenplay is written by Justin Lader and Charlie McDowell. The film premiered at the 2017 Sundance Film Festival in January - read Alex's glowing review from the festival. Netflix is still planning to release McDowell's The Discovery straight to streaming starting March 31st this spring. It's definitely worth seeing if you like sci-fi. Who's planning to watch this?
7 Comments
so should I watch this trailer?
Trey on Feb 22, 2017
m gonna take a stab.....you die...and you become "conscious" in an alternate reality
Trey on Feb 22, 2017
Somebody got lost while making this trailer. And maybe the film itself ...
shiboleth on Feb 22, 2017
Exactly. I pretty much agree with you, Bo, on this. This looks like underachievement, another exploiting of some possible good idea. Rooney Mara has probably chosen what looked like an interesting concept on the paper. However, it remains to be seen, of course. But I share your strong doubts about it. And as for the concept of afterlife and its execution presented in this trailer, it really looks bad. I'd better not start about it. Maybe just waiting for something better, right?
shiboleth on Feb 23, 2017
I definitely understand that Bo. I am just cautious because, and I believe you know that very well and better than me, a lot of films nowadays like to pretend they are real and 'hardcore deal' but are in fact something way too soft. As you, I also know a lot of things been written and read/interpreted on the subject in this film, but I have always some fear that such ideas are picked up for film just to serve as an excuse to draw more people to watch them. To make them think that films are serious (although, there are serious and good films). Anyway, that's some general possibility (but also, as experience tells us, also very probable). Of course, on the other hand, I probably have to cure myself from being over cynical or something when it comes to Hollywood, but a lot of films make me suspect that profit motives are winning over creative ones. So, yeah, my expectations are also somehow moderate about this one and I think that good film needs a lot of true effort to do good about any serious subject matter. Which is something that is not quite visible here. Cheers back, Bo ...
shiboleth on Feb 24, 2017
Interesting concept. A BETTER PLACE would have been a title too.
DAVIDPD on Feb 22, 2017
Way I see it... is that Redford doesn't seem to star in many movies nowadays, so even though the concept of this one sounds a bit like cheap SyFy Channel fare, his involvement makes me interested in how they're gonna handle it. Either way there's definitive potential there.
Terry Craig on Feb 23, 2017
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ASK A COP — What happens when the license plate is upside down?
Published 12:12 am Tuesday, July 28, 2020
Candi from Port Arthur asks: My brother turned his license plates upside down for some reason unknown to any other human being on Earth but him. My brother even claimed he's spoken to not one but two different police officers and they both said it wasn't illegal for him to display his license plate upside down. Are we allowed to be on the Texas roadways with our license plate upside down?
Answer: The whole reason why we have license plates on our vehicle is to be able to properly identify the vehicle. Your brother is in violation of the Texas Transportation Code 504.945 about duty on displaying a legible license plate. Now, which police officers your brother conversed with I'm not sure, but I'd need for them to show me in the code where I'm wrong and they're right. What's the use of putting a license plate on a vehicle if it doesn't have to be legible?
Ray from Winnie asks: I have a question regarding the speed limit in a construction zone. I'm aware that the orange reflective sign with a speed limit is the law while workers are present, but are we regulated by the orange reflective sign if there are NO workers present? Do the normal white signs with black lettering take over if workers are not present?
Answer: When the Texas Department of Transportation is working on a stretch of highway and new orange black/white speed limit signs are erected, when you pass the first sign you are officially in the construction zone. Therefore the orange with the white/black speed limit sign is law. That zone is not designated a construction zone because workers are present in that area. It's a construction zone because the state Department of Transportation has declared it a construction zone. That means that area is a construction zone whether workers are present or not and that orange black/white speed limit sign is enforceable at ALL times. The penalty for speeding in a construction zone DOUBLES in the state of Texas if you are found guilty in a court of law. But the construction zone sign is active 24 hours a day, seven days a week.
Orville from Port Arthur asks: I am now aware we can carry concealed firearms in our vehicles in Texas from the answer you were providing just a couple weeks ago in your article. Can the weapon have a round or a bullet in the chamber of the weapon?
Answer: The state of Texas allows motorists who are not (1) extra felons, (2) have a weapon in plain sight, (3) a member of an organized gang or (4) not committing a crime higher than class C to carry weapons in the car. Yes, the weapon can be loaded with a round or bullet in the chamber ready to go because I don't think I know a criminal who will allow you to have a moment to get your weapon ready to defend yourself. In my opinion, there is no sense in carrying a weapon for your defense unless it's ready to defend you in a moment's notice.
Join Officer Rickey Antoine for Ask A Cop Live on KSAP 96.9 FM every Tuesday from 1 to 2:30 p.m. as he discusses the Ask A Cop article. Tune in at ksapthebreeze.org. Ask your question live at 409-982-0247. Email questions to
email@example.com, call 409-983-8673 or mail them to: Ofc. Rickey Antoine, 645 4th Street, Port Arthur, Texas, 77640. If you happen to see me in public you can Ask A Cop!


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The Rival, book 2 in the Looking to Score Series by Kendall Ryan, is coming June 1st!
Dump my cheating ex? Check.
Land an amazing job with Boston's professional hockey franchise? Check.
Fall stupidly in love with hockey's favorite bad boy? Ugh.
After wasting years of my life with the wrong person, I told myself all I wanted was a little no-strings fun. Enter Alex Braun—the wealthy, handsome, and notorious playboy who is equal parts charming, and dangerous as hell to my wounded heart.
After enduring a very public breakup of his own, the sexy player doesn't want to be anyone's forever. Too bad he barreled his way into my heart, instead of just my bed.
But this professional athlete knows a thing or two about competing, and he won't let go so easily.
Warning: This romance contains one grumpy, emotionally damaged, but gorgeous-as-hell hockey player, and a whip-smart, hardworking heroine who has never quite fit in. It should only be read by those who like their men brawny and their romances red-hot!
Pre-order now!
Amazon US | Amazon Intl. | Apple Books | B&N | Kobo
About the Author
A New York Times, Wall Street Journal, and USA Today bestselling author of more than three dozen titles, Kendall Ryan has sold over 2.5 million books and her books have been translated into several languages in countries around the world.
Her books have also appeared on the New York Times and USA Today bestseller lists more than 70 times. Ryan has been featured in such publications as USA Today, Newsweek, and InTouch Magazine.
She lives in Texas with her husband and two sons.
Visit her at: www.kendallryanbooks.com for the latest book news, and fun extras.
Subscribe to the newsletter: www.kendallryanbooks.com/newsletter/
Facebook | Instagram | Twitter | Pinterest | Goodreads | Amazon | BookBub


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How to ease editing work in MS-Word by automating search/replace operations
- If you frequently have to edit documents according to a large number of editorial rules and regulations
- and if you can partially automate these edit operations (or at least highlight suspicious passages for human review) with Word's search/replace,
- I can recommend an add-in that can automate even the repeated search/replace operations (like the 57 in the video below)
- and even help you manage your search/replace strings and regular expressions in a spreadsheet which it can load from:
- Greg Maxey's VBA Find & Replace Word Add-in. See it in action (click for full size):
TwoThree Caveats: :
- At this point, I cannot get the add-in to work only in Word 2010. Even if I lower Macro security and allow programmatic access to the VBA project, when trying to launch the add-in from the ribbon, Word 2013 complains: "The macro cannot be found or has been disabled due to your macro security settings":.
- The automation is only as good as your underlying search/replace operations. (Hint: "Some people, when confronted with a problem, think 'I know, I'll use regular expressions.' Now they have two problems.")
- I think I will refrain from search/replace during "Tracking changes" – as in the video – , and rather use "Compare documents" after the replace operations – too many quirks otherwise…
Introducing the LangLabEmailer
- The LangLabEmailer helps integrating the digital audio lab (still widely operating based on files and network shares) into the departmental language teaching and learning process by automatically forwarding (audio, text) assessments and assignments collected in the digital audio lab to teachers and students via campus mail (using MS-Exchange automation).
- Easy on the Language Lab Manager who can "set up and forget": 1000s of assessment files will reach their originating students and teachers in near real time without you lifting a finger.
- To earn "extra credit", show your teachers how they can override the default LangLabEmailer behavior by adding "_noemailing" or "_nostudentemailing" to the folder name when saving their digital audio lab collections.
- Status of the language lab and purpose of the software
- Features
- Prerequisites
- Downloading
- Installing
- Configuring (and sharing back)
- Running or scheduling
- End User options
- Troubleshooting
- Requesting features
- Getting Updates
- Uninstalling
- Samples & questions at my IALLT 2013 session.
Protected: How you can automate giving your teachers access to your Sanako language lab in the offices and from home
How to batch download all submissions as a zip file from a Moodle: Gradebook File-upload assignment column.
- I have no file upload assignment with submissions handy in my own Moodle course, so I am patching this together from other universities (thanks, umass.edu, cotc.edu).
- " Another time saver you can use is the Download all assignments as a zip link. This will package all uploaded documents from any submissions in the assignment into
a zipped folder that you can download. Once downloaded, you can unzip the file and access each paper. This can be a real time saver!". Image:
- Extra: This procedure will add the student's name to the file. No more wading through submitted audio files named by students trying to identify submitters.
How to batch watermark your images for free with Irfanview
– just to be a bit more concise than this useful, but long post on yet another great feature of this free program (shout-out to Kai). Not shown here: after making your settings here, click button "Start batch".
Automatically download all documents/files/images linked from a web page
You can easily do this in FireFox with a free extension from Braunschweig (Germany): DownThemAll:
Automating Auralog Tell-Me-More with AutoIt. Presentation at EUROCALL 2008
Auralog Tell-Me-More is a leading language learning software system which provides a vast amount of content in an advanced technical infrastructure that we found lacking in usability within an higher education language learning environment.
AutoIt is a programming language for GUI automation which I used to better integrate the Auralog software into the higher education language learning process, including
- programmatic creation of courses and accounts
- programmatic extraction and digital repository management for over 30.000 learning units.
- programmatic creation of 10,000s of learning paths,
Results were presented (screencast) at EUROCALL 2008: "Automating Auralog (pdf)":
creates 100s of courses , creates and enrols up to 2,000 student accounts every term,
- content extraction produces files for adding search and spreadsheet for sort/filter functionality:
- learning path creation.
More detailed background information here: plagwitz_auralog_accounts_project_pub.pdf, plagwitz_auralog_project_pub.pdf


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Is former Fox News host Bill O'Reilly the most hated man in television? In 1978, Pete Webb of Webb Strategic Communications replaced O'Reilly as 7News's investigative reporter, and he tells Michael Roberts of Westword that O'Reilly was, in fact, a jerk:
According to (Webb,) a former co-worker in Denver, O'Reilly was widely disliked at the station because of behavior that could be rude, egomaniacal and underhanded, and on multiple occasions, he was pranked by colleagues who left aromatic food to rot in his desk.
"He was a hugely disruptive influence in the newsroom, and few people liked or tolerated him," Webb maintains. "He was argumentative, difficult to manage and would literally steal other people's stories. In fact, he'd answer a call for a reporter and say, 'He's out right now, what can you tell me?,' and end up with a story intended for someone else."


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look hrithik roshan and sussanne khan were up to last night! all pics here....
Last night was all about catching up for hrithik roshan and Sussane Khan as they joined a bunch of mutual friends at a hot spot in Mumbai. If we are not mistaken, it was Sonali Bendre's son's birthday yesterday which is why the ex couple was also accompanied by their kids Hrehaan and Hridaan. While usually former couple choose to maintain a distance post divorce. Hrithik and Susssane are one of those exceptions who try hard to not let their failed marriage ever affect their kids.
Whether it's by taking family vacations together or by coming together for their birthday parties, Hrithik and Sussanne always ensure to be the best and the most loving parents when it comes to their children. So it comes as no surprise that even last night, Sussanne and Hrithik looked the happiest in each other's company as they hopped into the same car with their boys and left the venue with much happiness. Here, check out all the pictures below:
Although many hope this loving couple will reconcile one day but Hrithik has time and again maintained how they'll only continue to remain as friends and responsible parents. "Sussanne and I are friends. We still love and care for each other. That's about all.", said Hrithik in a DNA interview; wherein in another interview, he added, "Sussanne and I are not trying to set any example. This is how we are. This is the kind of person I am and I don't think I can have anything that is not peaceful. Relationships should be healthy, mutually beneficial and adding growth to both the parties."
Rumours are rife that Hrithik is also planning to buy an apartment for Sussanne so that she moves closer to his house with their kids. Well, all we can hope is forever peace and love for this not-so-estranged couple!


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UPDATED Wed 11/24/2021
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text: Professional Carpet Cleaning Information 2 October 2020 Categories: , Blog There are a lot of things about carpet cleaning that you should be aware of as a homeowner. The more you understand about professional carpet cleaning, the better you will be about having your carpet professionally cleaned. You will also learn other information that can help you better care for your carpet. Why vacuuming matters It's important for you to understand what vacuuming does and doesn't do for your carpet. Vacuuming will remove the dirt that's on the surface of your carpet and it will remove some of the loose debris, such as dust and pollen, that is under the carpet. Read More


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Are you looking for Honeywell mobile computer service center in Malaysia and Singapore, wait no more, contact ALC now to repair your existing Honeywell, metrologic, Intermec, LXE barcode mobile computer. Send in to Honeywell certify service center in Malaysia and Singapore. We help you to analysis your mobile computer include ScanPal mobile computer, dolphin 6000s, dolphin 60S, dolphin 6500, dolphin 7800, dolphin 99ex, dolphin 6100, dolphin 70E, dolphin 75E, dolphin 7600, dolphin 9700, mx7, SL22, sl62, CN50, CN51, CT50, CK3B, CK3R, CK3X, CK70, CN70, Cn3, CS40, CV40, CV61, IP30 and more.
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Purpose: To evaluate the clinical feasibility and accuracy of 64-section multidetector computed tomography(CT) compared with transesophageal echocardiography (TEE) for diagnosis of a patent foramen ovale (PFO).Materials and Methods: Institutional review board approval was obtained for this retrospective study. The studyincluded 152 consecutive stroke patients (mean age, 61.7 years; 98 men, 54 women) who underwent both cardiacmultidetector CT and TEE. Electrocardiographically gated cardiac CT was performed with a 64-section CT scannerby using a saline-chaser contrast agent injection technique. A contrast agent jet from the contrast agent-filled leftatrium (LA) to the saline-filled right atrium (RA) and channel-like appearance of the interatrial septum (IAS) wereevaluated on axial and oblique sagittal CT images. Two-dimensional and Doppler TEE were performed to detectPFO. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT were obtained with TEE as the reference standard. Results: A PFO was present in 26 patients at TEE. On CT images, aleft-to-right contrast agent jet toward the inferior vena cava was noted in 21 patients (sensitivity, 73.1%; specificity, 98.4%; PPV, 90.5%; NPV, 94.7%). Channel-like appearance of the IAS was detected in 38 patients (sensitivity,76.9%; specificity, 85.7%; PPV, 52.6%; NPV, 94.7%). Channel-like appearance of the IAS was noted in all patientswho had a contrast agent jet. Conclusion: A contrast agent jet from LA to RA toward the inferior vena cava withchannel-like appearance of the IAS on CT images confirms the presence of a PFO.
|Original language
|Pages (from-to)
|Number of pages
|Issue number
|Publication status
|Published - 2009 Jan
All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging


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donate now
Paul Nedzela
Paul Nedzela (Baritone Saxophone) has become one of today's top baritone saxophone players. He has played with many renowned artists and ensembles, including Wess Anderson, George Benson, The Birdland Big Band, Bill Charlap, Chick Corea, Paquito D'Rivera, Michael Feinstein, Benny Golson, Wycliffe Gordon, Roy Haynes, Christian McBride, Eric Reed, Dianne Reeves, Herlin Riley, Maria Schneider, Frank Sinatra Jr., The Temptations, The Vanguard Jazz Orchestra, Reginald Veal, and Max Weinberg. Nedzela has performed in Twyla Tharp's Broadway show, Come Fly Away, and in major festivals around the world. He has studied with some of the foremost baritone saxophonists in the world, including Joe Temperley, Gary Smulyan, and Roger Rosenberg. Nedzela graduated with honors from McGill University in Montreal with a Bachelor of Arts degree in mathematics in 2006. A recipient of the Samuel L. Jackson Scholarship Award, he continued his musical studies at The Juilliard School and graduated with a Master of Music degree in 2008.
About The Artist
Instrument: Baritone Saxophone
Personal Website: paulnedzela.com


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WATCH A VIDEO OF THE "MUSIC, MEMORIES & MOTIVATION" PROGRAM!! (It won't be on the club's YouTube channel due to copyright issues.)
Put your feet up, dim the lights, and log on to the Video Club's General Meeting on Thursday, November 19, at 7 pm for a relaxing walk down memory lane. The program will feature a variety of videos inspired by music from the baby boom generation, selected to spark your imagination and encourage you to preserve your history and memories. At the meeting, Video Club Board Member and instructor, Stephanie Brasher, will be announcing "The Video Club Challenge." To attend, send your name, email, and phone number to firstname.lastname@example.com and request a link. There will be no General Meeting in December.
Click here for flier.


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Marvel's superheroes are about to get a bit bigger on your TV. Disney+ announced today that it's adding an expanded IMAX aspect ratio for 13 Marvel titles, including Shang-Chi and Black Panther, on November 12th (AKA "Disney+ Day"). The 1.90:1 IMAX aspect ratio will look up to 26 percent taller than the typical 2.35:1 widescreen format in Marvel films, so those annoying black bars will almost disappear while you're watching scenes shot in IMAX. (You'll still see some slight bars, though, as the IMAX format doesn't completely fill 16×9 widescreen TVs.)
Before this Disney+ partnership, IMAX and DTS brought the "IMAX Enhanced" home viewing format to a handful of TV streaming apps, like Sony's Bravia Core. IMAX-ified films will have a prominent label on their Disney+ screens, and you'll also be able to launch the standard widescreen version if you prefer. Physical Blu-ray collectors are already used to shifting IMAX aspect ratios in some films, most notably The Dark Knight, Tenet and Mission Impossible: Fallout, but streaming films have typically lost on this perk.
The expanded aspect ratio should give Marvel's action sequences more room to pop on your TV, and it's a feature Disney+ can lord over its streaming competitors. Technically, IMAX Enhanced isn't delivering the large film format's true aspect ratio, which is more square. But, as we saw with Zack Snyder's Justice League, that leads to enormous black bars on the sides of your TV. It's also worth noting that we won't see IMAX versions of The Avengers and Ant-Man, as those are the rare Marvel films that used the TV-filling 1.85:1 aspect ratio (a choice made to convey a better sense of height).
Looking ahead, IMAX Enhanced will also bring immersive DTS sound to Disney+, a competing option to the more ubiquitous Dolby Atmos format. Representatives from all of the companies involved tell us that IMAX Enhanced films will also support Dolby Vision, HDR10, 4K (naturally) and Dolby Atmos sound.
Here are all the IMAX Enhanced films arriving on Disney+ on November 12th:
Ant-Man and the Wasp
Avengers: Infinity War
Avengers: Endgame
Black Panther
Black Widow
Captain America: Civil War
Captain Marvel
Doctor Strange
Guardians of the Galaxy 1 & 2
Iron Man
Thor Ragnarok
Shang-Chi and the Legend of the Ten Rings
All products recommended by Engadget are selected by our editorial team, independent of our parent company. Some of our stories include affiliate links. If you buy something through one of these links, we may earn an affiliate commission.


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Here are the answers to some of the questions users have been asking. Tap on the questions to reveal the answers...
AIS Sharing: How do I get Boat Beacon working with Navionics?
What is an MMSI and do I need one to use Boat Beacon?You do not need an MMSI to see and be seen on Boat Beacon.
Maritime Mobile Service Identity (MMSI) is a series of nine digits which are sent in digital form over a radio frequency channel in order to uniquely identify ships, coast stations and Navigation Aids.
If you have an MMSI or obtain one you will be able to use Boat Beacons' advanced features to share your location and be seen on other Global AIS systems maps like AIS Hub, Marine Traffic and ShipFinder etc.
Having a MMSI assigned in Boat Beacon also allows you to upload klm or klz waypoint overlays to your map - email the klm file as an attachment to your email@example.com. You can also view your current track on google maps by browsing to http://boatbeaconapp.com/go/mmsi where mmsi is your mmsi number.
In the US you can obtain a MMSI for free in minutes by visiting the USCG approved agent and using their online form. We can provide you with a free Boat Beacon MMSI, email us at email@example.com. In the UK visit Ofcom MMSI
You can also use a Marine Traffic pseudo MMSI number after having registered your vessel for a unique vessel's ID at this form on marinetraffic.com. Please note that the Boat Beacon and Marine Traffic MMSI numbers are not official MMSI numbers and are only used for position reporting at MarineTraffic.com and Boat Beacon. This number is NOT to be programmed into any radio equipment such as AIS transponders or DSC radio.
Does Boat Beacon work in the background?Yes, if you are "On your Boat" - have the Sail Boat Symbol, bottom left, selected - Boat Beacon will continue to transmit your position even when you leave the app. Collision Detection, Anchor Alarm and Theft alarms also work in background mode. Collision Detection will sound an alarm once every 5 minutes when a potential collision is detected. The app icon will show 111 on it if a CPA alarm have been fired.
If you want Boat Beacon to stop and not use any power when you close the app or switch to another app make sure the "On my Boat" symbol is off - greyed out.
N.B. When these modes are enabled the iPhone GPS system is active and will use more battery power while the app is running even in background. It will last upto 4 hours on a full battery charge.
How do I stop Boat Beacon running in the Background?Tap the sailboat icon at the bottom left to turn transmit and collision detection on and off. When on - it will also run in background - when off it wont.
How do I enable Collision detection?
Tap the (i) button at bottom left of screen to open Settings, and set Collision Detection on. Boats that are going to be within 200m of your position in the next 10 minutes will start flashing on the screen and sound an alarm. If you tap on one ofthem it will show the Closest Point of Approach (CPA) distance and eta.Collision Detection also works in background mode.
How real time is Boat Beacon?
The AIS standard has different reporting times. Boats at anchor and travelling at less than 3 knots only report their position every 3 minutes. Ships moving at over 23 Knots send updates every 2s.
Boat Beacon receives data from a collection of different sources. All the data is timestamped.
Around 80% of the AIS data is fed directly as it is received by the shore stations and typically there is less than a 1 second delay between the ship sending the transmission and it being available to Boat Beacon via the internet. You can check which areas have realtime feeds on this map Global coverage
The other stations report once a minute, they accumulate the data over a minute and then send it to us. So on average these reports are 30s behind real time. A boat travelling at 30 Knots would have a placement error of +/- 200 meters.
Boat Beacon interpolates the positions between updates.
How do I upload/attach a boat photo to its information page?Please send us a copy of your photo and your Boats MMSI number to email@example.com. and we will add it to our service for you.
How do I use zoom?
Use your fingers to pinch in and out. Tap the compass icon to toggle pan mode which lets you pan around.
Searching for places isn't working?
Please try re-booting your device (battery pull). Apparently the Google Geocode service that we use to search for places requires a re-boot of the device to work correctly after a recent OS upgrade.
"I see no ships"?
Boat Beacon shows all other Boat Beacon boats on its maps. To show boats that are not using Boat Beacon it uses ship data provided by a network of shore based AIS receiving stations. The best coverage (over three fold increase) is enabled if you have AIS sharing on. You can check the coverage for your area on Boat Beacon or via this web site Total coverage
We have coverage for most of the popular coastal areas and coverage is constantly increasing. If your area isn't covered, please let us know by emailing email@example.com , especially if you would like to share your AIS data with us to improve coverage.
One other possibility is the app is not authorised - check the item about "...un-authorised.." below if you see the app not authorised message
How do I get the screen to rotate with the compass?
There is an option in preferences in Boat Beacon - Rotate Map with compass - check this to turn rotate on.
However....The minimum OS version that supports rotation is 2.3. Further there is an Android OS bug with Google MapKit on devices with xhdpi graphics(High Density displays as on the Samsung Galaxy S3) on Ice Cream Sandwich (OS 4).
We currently can't rotate the display on these xhdpi devices and so hide the rotate option - we will enable it as soon as Google fix the bug.
How much data does it use?
The data rate is low - it depends to a certain extent on how many boats are in view and how much you change the map position/scale. On average it receives about 3 kbytes and sends about 1/2 kbyte every minute. Although it's a pretty low data rate (500bps) it can mount up if left on continuously. e.g. if left on continuously for a 6 hour trip that would be just over 1 Mbyte of data.
If you are worried about the cost of mobile data when travelling abroad you can normally get deals at around $3 for 30Mb per day or $5 for 70MB per week using a local PAYG SIM.
Sharing AIS Data
Boat Beacon relies on data from AIS base stations all over the world. Sharing with us is easy. If you have an AIS base station and want to see your data on Boat Beacon please contact us as at firstname.lastname@example.com and we'll send you simple instructions on how to do this.
How do I turn the gps information on and off?GPS info is displayed at the top of the screen when you are in Compass and Transmit mode. It displays your current longitude, latitude, heading, map scale (from the centre to the compass red ring), Course (cog) and Speed (sog)
N.B. When GPS data is showing the Android GPS system is active and will use more battery power while the app is running.
Must I be connected to the internet to use Boat Beacon
Boat Beacon requires a data connection to receive and send boat and location information. Fortunately cellular data coverage extends over 12 miles out to sea in popular coastal areas.
If your compass reading is wrong try re-calibrating it by rotating the phone a few times in each axis and then waving in a figure 8 motion."
The built-in digital compass works just like a magnetic-needle compass. The accuracy of digital compass headings can be affected by magnetic or other environmental interference, including interference caused by proximity to the magnets contained in the Android earbuds. The compass may need to be calibrated from time to time.
Support for VGA/TV out e.g. for MFD's
Some devices like the Samsung Galaxy S range support video out. Check out
Video out from Samsung Galaxy S
for more details
"...this application is unauthorised..."
This is a Google Play store issue and should be able to be corrected by checking the following. There may be something here which should fix the problem: Thanks for your email and sorry to hear you are having problems with the Play Store. This is a general play store error that occasionally affects purchased apps. There are two suggested solutions on the web
- Try clearing data AND cache for Google Play, reboot, and then try again. Settings>Applications>All>Google Play>Clear Data and clear cache.
- Settings > Application Manager > All > Locate Download Manager (will be at the the bottom of the list when it's disabled) and make sure it is enabled.
If these two don't sort things out try the following:-
- Ensure your WiFi connection is stable
- Uninstall Boat Beacon
- Close all applications
- Reboot your device
- Ensure you are logged in using a valid g-mail account. We have had reports from other players that using a "googlemail.com" e-mail account was the problem, which was corrected after switching to "gmail.com"
- Check to see that you have approx. 2 GB of free internal storage space
- Clear your cache
- Re-download/install the app.
- Remain connected to the internet while starting the app and still logged in to your valid g-mail account. (must be @gmail.com not googlemail.com)
Please note that uninstalling the app will erase your current boat data. If you have already set this up before experiencing this issue and do not wish to lose your saved data, please try the rest of the steps without uninstalling/re-installing.If you're still having trouble, please contact with the following information so that we may investigate the problem for your device:
- Confirm the model of device which you are using.
- What version of Android is installed on your device?
- Is your device rooted?
- How are you connected to the internet?
- Where you download Boat Beacon from?
Navigation Safety?
This application should only be used for basic navigation assistance. Never rely solely on the digital compass for determining direction, proximity or distance. The user is responsible for the prudent use of information provided by this application and must not use it for direct navigation. The accuracy of digital compass headings can be affected by magnetic or other environmental interference, including interference caused by proximity to the magnets contained in the Android ear-buds.
Location-based applications depend on data services. These data services are subject to change and may not be available in all geographic areas, resulting in digital compass headings, directions or location-based information that may be unavailable, inaccurate, or incomplete.
You assume all responsibility and risk for the use of this software. The author assumes no liability for damages arising from use of this program.
Can I send you feedback and ideas?
Yes, definitely - we'd love to know what you like (and don't like) about Boat Beacon - the best way is to send an email directly to email@example.com. We'll do our best to get back to you quickly!


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How It Started
"Get it on your thankful list," he yelled as he left the rehab. She had just finished explaining to her counselor something that she really worked hard to complete. Part of the program at this drug recovery center was that every day each person had to make a list of five things they were thankful for. It was an assignment. It felt irritating at first. Actually felt impossible.
Trying to write down anything that she was thankful for felt like walking up a steep hill.
But since she would have to report on what she wrote down at the end of the day, she acquiesced. After a few weeks, the hill didn't seem quite so steep. The practice of writing down what she was thankful for came easier. It had become a habit … a good habit.
Other people coming through the program soon got into the same required habit. She had started recording the required five things just on the paper she had available, but it wasn't long before she ran out of paper.
The thankful lists made their way into inexpensive journals. The required list of five things at the end of the day often grew to eight, ten, or even twelve things. She had a nice collection of those journals now. Encouraging to behold.
In fact, Sarah was getting close to finishing three years at the rehab and her thankful list had a running tally of 20,034 to date.
Counselor's Toolbox
As a counselor I have found that the practice of learning to think thanks and expressing that thanks to God and to others has a place in my "Counselor's Toolbox."
In whatever counseling situation that I find myself in, gratitude is a necessary part of finding solutions and remedies.
In Ephesians 5:1-4 there is a interesting contrast presented:
Therefore be imitators of God, as beloved children. And walk in love, as Christ loved us and gave Himself up for us, a fragrant offering and sacrifice to God. But sexual immorality and all impurity or covetousness must not even be named among you, as is proper among the saints. Let there be no filthiness nor foolish talk nor crude joking, which are out of place, but instead let there be thanksgiving."
Choosing to think and express thanksgiving is the opposite of the sin that Paul is warning the Ephesian believers about in this passage. It is the correct behavior of a person walking worthy of the Lord, walking in love, pleasing the Lord.
How Long Is Your List?
Knowing that practicing gratitude is so helpful, does it alter your own behavior? Do you have a list of things that you are thankful for? I do not have an updated tally for mine. I have so many journals and papers filled up that I am sure it is in the thousands. I do know I kept track of the first 1000.
I encourage you to invest in a th(i)nkful or gratitude journal if you find yourself in a difficult season in your life. It is a well-documented tool of hope and solution. Our Creator God knows our frame and our challenges … and He ordered us to do it.
Virtually every sin that we commit is a result of a lack of thankfulness


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Graphene Themes Forum
Community support for Graphene themes
Home › Forums › Graphene WordPress theme › Support
No matter how big or small my images are the thumbnails are very very pixelated. How can I fix this?
Kenneth John Odle
Include a link to your site so we can take a closer look. Are you using a child theme? Have you added any custom CSS? Are you using any plugins which affect thumbnails?
Try going to Settings >> Media and playing around with the image sizes there. Can't recommend much else without seeing it in person.
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This free Support Forum relies on contributions from our support staffs and fellow Graphene themes users. While we endeavour to provide adequate and timely support, due to its voluntary nature responses are not guaranteed and may be delayed.
If you require urgent assistance, you may like to consider our Priority Support option.
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Global Balance Acupuncture
Dear Patients,
We will be returning to our office this week. And our hours will be by appointment only. Office hours will be adjusted accordingly. Tuesdays and Thursdays: starting at 1:00. Saturdays: 10:00 to 3:00. However, we are scheduling longer intervals between patients, as it takes longer to sanitize the rooms. Thank you all for your patience and understanding. The health and safety of our patients is our number one priority!
When you arrive for your appointment, please wait in your car and we will wave you in when the office is clear. If patients feel comfortable, they can wait in the waiting room, so that option is available to you. Patients are reminded to be advised if they have a fever, cough, or are not feeling well please seek regular medical attention. Also, when you arrive for your appointment please wear a mask.
We apologize for the inconvenience, but appreciate your understanding during this time. We look forward to once again giving you the wonderful balancing treatment and relieving stress, insomnia, and anxiety that is associated with this pandemic. We look forward to seeing you and serving you. Thank you for your past patronage and support. We greatly appreciate you.
In health and best wishes.
Dr. David Chow, L.Ac., M.S.O.M., AP, D.N., LDN
"There are many benefits to acupuncture, one of the most immediate of which is a balancing of energy and emotions. This is typically evident even after just one treatment. Traditional Chinese Medicine allows the element of balance and healing that promotes a great sense of well being and peace. Together we can work to achieve an optimum state of health that does not rely on chemicals, but on natural principles that have been proven over thousands of years."