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Source: International Journal of Medical Science and Public Health
Mehtab Alam, Satish Chandra Sharma, Syed Abrar Hasan.
Background: Cholesteatomatous otitis media is a surgical disease managed either by Intact Canal Wall (ICW) or Canal Wall Down (CWD) mastoidectomy, depending upon the extent of cholesteatoma. The status of the eustachian tube relates to the pathogenesis of cholesteatoma and affects the surgical outcome in terms of recurrence of the disease, postoperative audiological gain, and graft uptake rates. Objective: To compare ICW against CWD mastoidectomies with tympanoplasty, in terms of hearing gain and graft uptake rates, based on the status of eustachian tube ( patent/ blocked ). Materials and Methods: The study comprised of 50 patients , who underwent either ICW or CWD mastoidectomy with tympanoplasty in the department of Otorhinolaryngology, J N Medical College, A.M.U Aligarh from September 2010 to August 2013, with a mean follow-up of 18 months. The Eustachian tube was patent in 30 (60%) cases and blocked in 20 (40%) cases. Chi-square and unpaired t-tests were used to analyze the results. The p-value of 0.05, t=1.73) and graft uptake rate (p=0.711), between patients with patent eustachian tube and those with blocked. Conclusion: The patency of eustachian tube plays a role in the outcome of mastoidectomies in regard to audiological gain.
Τρίτη, 18 Οκτωβρίου 2016
Does Eustachian tube patency affect the outcome of graft uptake rate and average audiological gain in Intact canal wall and Canal wall down Mastoidectomies A study of 50 patients
Evidence Based Approaches For Preventing Urinary Incontinence In Birth and Postpartum Period
Source: TAF Preventive Medicine Bulletin
Dilek Bilgiç, Şükran Başgöl, Nezihe Kızılkaya Beji.
Evidence-based approaches are known to be effective in prevention and management of urinary incontinence. Evaluation of modifiable risk factors associated with urinary incontinence (UI) and taken preventive measures especially in the birth and the postpartum period play major role in reducing the prevalence of UI. Indeed, women's informing, evaluation and monitoring about urinary incontinence in the long term in accordance with evidence-based guidelines by multidisciplinary is extremely important in this process. In this review, changeable risk factors associated with urinary incontinence in birth and postpartum period will be analyzed in accordance with evidence-based and will be discussed with meta-analysis of randomized controlled trials and systematic reviews.
Environmental factors and toxicologic substances' effect on olfactory function
Source: TAF Preventive Medicine Bulletin
Sibel Kıran, Ufuk Emre, Burcu Küçük Biçer, Fikret Çınar.
Evaluation of the negative health effects of smell disfunction gains importance as much as smelling the odor in daily lives. Responses to volatile chemicals and other chemicals are often variable across individuals. This relation is still underobservation. Although variability can derive from differences in individual olfactory sensitivity, the response to a chemical stimulus is also influenced by the complex environment surrounding the exposure. This exposure can include the perceivers cognitive state. Occupational environment is one of the important places that has role on smell disfunction. At the present time, the terms "fragrance-free" or "unscented" gets interest. This paper is a review of smell sense, importance of olfactory functions and dysfunctions, and possible effects of environmental and occupational toxic exposure. We grouped the toxic materials that have negative impact on smell function as inorganic and organic compounds, powders, metals and other industrial agents. Deterioration of smell sense can affect vital functions. Smell disfunction evaluation must be considered with its relation to taste sense. It is of great significance to evaluate smell functions as a routine part of history taking and physical examination in order to detect dysfunctions as an early diagnosis. Smell function is evaluated with a series of chemical tests in clinics. Here you can find some early onset smell disfunctions with some environmental and occupational agents which potentially could affect smell functions.
Under-utilised opportunity: key contribution of public health nurses and school health services for outreach in Delhi, India
Source: International Journal of Community Medicine and Public Health
Neerja Sood.
Background: The post of Public Health Nurses (PHNs) was created and filled for the first time in Delhi Administration, in 1978-79 under School Health Scheme (SHS) to provide services to school children but overtime they were utilised in public health activities without changing their job profile. This paper presents a history of development of SHS in Delhi and the various roles that PHNs played through it and present a case study of SHS in Delhi. Methods: A systems approach was used to study SHS as a part of Directorate of Health Delhi. Purposively selected school health clinics in East and North East Districts managed by Government and NGOs were studied. Review of reports, observation and interview checklist were used. Results: PHNs in SHS provided comprehensive services to school children. Since end of 1988 they were diverted to various public health activities. SHS covered nearly 40-50 percent government schools with no further expansion. Staff was transferred / posted to new hospitals and districts during end of 1990s. In 2002-03 Non-Government Organisations (NGOs) were involved to cover schools but by end of 2010 many NGOs withdrew from scheme. Conclusions: Based on findings, this paper argues that, while PHNs played vital public health roles in the 1970s and 80s, policy changes in governance and service structures have diminished their role since late 1990s. Other options tried by government in 2000s, such as opening SHS to NGOs, have largely failed. The under-utilised potential of PHNs needs to be recognised and better deployed.
Bardet biedl syndrome: a rare occurrence
Source: International Journal of Contemporary Pediatrics
Kavita Tiwari, Suresh Meena, Suresh Goyal.
The bardet-biedl syndrome (BBS) is a rare autosomal recessive genetic disorder that affects many body systems. It is characterized principally by obesity, retinitis pigmentosa, polydactyly, hypogonadism, kidney abnormalities and learning difficulties. We hereby present a 14 year old male patient exhibiting characteristic features of bardet biedl syndrome (BBS) along with a brief review of the literature.
A rare case of neonatal bacterial sinusitis
Source: International Journal of Contemporary Pediatrics
Natashya H. Sima, Poonam K. Saidha, Ophelia DSouza, Sandhya S. Patil.
Acute bacterial maxillary sinusitis is uncommon occurrence in the pediatric age group. Complications from this condition are rarer in the neonatal period with less than 10 cases reported worldwide. The diagnosis and treatment of maxillary sinusitis and its complications poses challenges as there are no clear guidelines on conservative management versus early surgery. We present a rare case of acute maxillary sinusitis with orbital complications in a 13 day old neonate.
Evans syndrome with severe thrombocytopenia: a rare presentation
Source: International Journal of Contemporary Pediatrics
Rugmini Kamalamma, Siddaraju ML, Swathi Badam, Niranjan Mahankali.
Evans syndrome is a rare disease characterized by the sequential or simultaneous presence of autoimmune haemolytic anemia and immune thrombocytopenia with a chronic relapsing and remitting course. Most of them present with severe anemia and moderate thrombocytopenia while neutropenia is associated in some cases. Associated laboratory parameters include unconjugated hyperbilirubinemia, decreased total serum IgG and IgM levels, presence of non-cross reacting auto antibodies against erythrocytes, platelets and in some cases against neutrophils. Management of evans syndrome includes glucocorticosteroids as the first line therapy and IVIG as second line treatment. Resistant cases are treated with cyclosporine, mycophenolate mofetil, vincristine, danazol, rituximab (monoclonal anti-CD20 antibody), alemtuzumab (humanized monoclonal anti-CD52 antibody). Autogenic or allogenic hematopoietic stem cell transplantation (HSCT) is the only curative option available. Here we are presenting an adolescent boy with Evans syndrome who presented with severe thrombocytopenia and moderate degree of haemolytic anemia and responded well to first line oral corticosteroid therapy.
Late onset severe anemia due to rhesus isoimmunization
Source: International Journal of Contemporary Pediatrics
Hareesh Vardhan Jadala, Pooja V., Raghavendra K., Prithvish C. M., Srinivas B..
Rh isoimmunization usually presents with severe neonatal jaundice associated with anemia needing exchange transfusion and phototherapy. Sometimes babies who have mild or no symptoms at birth may present later with severe hemolytic anemia. In this case report we have described a newborn infant who had mild jaundice initially and presented with severe anemia in the fourth week of life. This case signifies the importance of regular follow up and close monitoring of Rh isoimmunized infants for the first two months for delayed onset anemia.
Response to 13 cis retinoic acid in metatstatic neuroblastoma
Source: International Journal of Contemporary Pediatrics
R. Arun Kumar, S. Lakshmi Narasimhan, J. Muthukumaran.
Neuroblastoma is the most common extra cranial solid tumour of childhood, with 5 year survival rate of 40%-50% in high risk group. Surgery, chemotherapy, radiotherapy, high dose chemotherapy with stem cell transplant and retinoid therapy are treatment options for neuroblastoma. Here we present a 5 year female child presenting with abdominal pain for 1 month and abdominal distension for 3 weeks, and underwent biopsy after necessary investigations, and diagnosed to have high risk neuroblastoma and treated with multiple lines of chemotherapy and attained complete response after retinoid therapy. The case is presented because of complete response achieved with retinoid therapy with tolerable side effects.
Varied and atypical presentation of Wilson disease in a family: report of 3 cases in siblings
Source: International Journal of Contemporary Pediatrics
Shilpi Ranjan, Kumar Saurabh.
Study reports a series of three cases of atypical presentation of Wilson disease from a family. First sibling presented with isolated neurological manifestation without hepatic involvement and responded well with low dose penicillamine and zinc. Second sibling had history of recurrent long bone fractures along with hepatitis who also responded well with zinc therapy. Third sibling who was presymptomatic turns up into symptomatic state even after appropriate zinc prophylaxis.
Coffin siris syndrome: a rare clinical entity
Source: International Journal of Contemporary Pediatrics
Rupali Jain, Sandip Gediya, Amzad Khan, Suresh Goyal, Lakhan Poswal.
Coffin-siris syndrome (CSS) is a rare, clinically heterogeneous disorder considered in the setting of prenatal onset of mild to moderate growth deficiency, facial dysmorphism, cognitive/developmental delay, and speech impairment, moderate to severe hypotonia, seizures and 5th finger/nail hypoplasia. The child had distinctive features of CSS like developmental delay, seizures, and coarse facial features, body hypertrichosis, scalp hypotrichosis and SNHL.
Supratentorial atypical teratoid/rhabdoid tumor: a case report
Source: International Journal of Contemporary Pediatrics
Jyoti K. Kudrimoti, Neeta A. Wahane, Shailja C. Puranik.
Atypical teratoid rhabdoid tumor (ATRT) is a rare and highly aggressive malignant tumor of infancy and childhood with fatal outcome. Common site is kidney, but it can also occur in the liver, thymus and the CNS. The supratentorial compartment is less frequently the primary site for this neoplasm, but cases arising from the cerebral hemisphere have also been reported. Study came across a case of 18 months female child who presented with convulsions and MRI showed right frontal space occupying lesion, which after IHC confirmed as ATRT.
Homozygous methylenetetrahydrofolate reductase -a1298c mutation in a case of precursor B acute lymphoblastic leukemia
Source: International Journal of Contemporary Pediatrics
Gaurav Tripathi, Manas Kalra, Amita Mahajan.
Thrombotic events are well recognized during treatment for acute lymphoblastic leukaemia. We report a case of recurrent thrombosis off asparaginase wherein thrombophilia evaluation yielded specific etiology. A 14 year old boy with precursor B cell acute lymphoblastic leukemia (ALL) (high risk) presented with generalized tonic clonic seizures on day +22 of induction. Asparaginase associated thrombotic event was suspected. MRI brain with MRV done showed right frontal lobe infarct and superior sagittal sinus thrombosis with reduced blood flow in left transverse sinus. He was managed conservatively. However, after the first dose of systemic methotrexate therapy he presented with right sided hemiparesis. In view of his recurrent episode thrombosis in the absence of asparaginase, thrombophilia workup was done which showed homozygousity for methylenetetrahydrofolate reductase (MTHFR)-a1298c mutation. MTHFR mutation is a rare cause of thrombophilia which was found in a case of precursor B cell ALL as a cause of recurrent venous thrombosis precipitated by methotrexate therapy.
An infant with trichohepato-enteric syndrome: case report
Source: International Journal of Contemporary Pediatrics
Mayssan Yousef Salman, Sirin Mneimneh, Mariam Rajab.
Trichohepato-enteric syndrome (THE-S) is a disease characterized by severe infantile diarrhea, failure to thrive, facial dysmorphism, woolly hair, and immune or hepatic dysfunction. We report the case of a boy who presented in early infancy with chronic watery diarrhea, dependent on total parenteral nutrition, along with other features of THE-S.
Spontaneous tension pneumomediastinum in young child complicating bronchopneumonia successfully managed with high frequency ventilator
Source: International Journal of Contemporary Pediatrics
Muhammad Asif Ghori, Ibrahim Al Helali, Ibrahim Albenhassan, Ahmad Al Qarni.
Spontaneous pneumomediastinum means air in mediastinum is usually associated with a sudden formation of pressure gradient between the alveolus and surrounding tissue, resulting from either an over inflation of the alveoli or a reduction of interstitial pressure. Spontaneous mediastinum is predisposed to asthma, respiratory tract infections, or situations reproducing the valsalva maneuver, uncommon in young children but potentially life threatening.
Secondary malnutrition: clinico-etiological spectrum
Source: International Journal of Contemporary Pediatrics
Surabhi Chandra, D. K. Singh.
Background: Secondary malnutrition, a less recognized entity results from an underlying disease that compromises growth directly or indirectly. The present study was undertaken to determine the clinico-etiological spectrum of secondary malnutrition in a tertiary care hospital of India. It also aimed at identifying asymptomatic masqueraders of malnutrition. Methods: In this prospective, observational study done in a tertiary care hospital over a year (April 2015 March 2016), all patients admitted were evaluated anthropometrically, as per the World Health Organization (WHO) guidelines, and categorized into having moderate or severe malnutrition. Any underlying secondary cause was worked up and asymptomatic masqueraders were identified on the basis of a pre-devised fixed diagnostic protocol. Results: One seventy seven patients (177/897 = 19.7 %) of a total of 897 malnourished patients had secondary malnutrition. Seventy eight (78/177 = 44.0%) patients had moderate and 99 (99/177 = 55.9%) had severe malnutrition. Asymptomatic masqueraders of secondary malnutrition were seen in 21 patients. Neurological disorders (54/177 = 30.5%) followed by tropical infections (40/177 = 22.5%), were the major underlying cause of secondary malnutrition. Conclusions: Identification of secondary malnutrition and treatment of the underlying disorder is a must to achieve optimal nutritional outcomes and decrease the burden of malnutrition.
Addition of immunotherapy to chemotherapy in pediatric borderline leprosy: a clinical evaluation
Source: International Journal of Contemporary Pediatrics
Raj Kamal, Natrajan M., Dayal R..
Background: Immunotherapy with BCG, BCG + M. leprae, ICRC, MIP has been observed to be effective in improving the treatment in adulthood leprosy. Clinical improvement with accelerated bacterial clearance and histological up grading using MIP vaccine as an immunotherapeutic with standard WHO-MDT has been reported in adult cases with high bacillary load. However, there is lack of information in borderline pediatric leprosy which is characterized by a state of shifting immunity and would therefore be ideally suited to such observations. This pilot study is originated from involvement of our Institute in a trial aimed for improving the therapy of pediatric borderline leprosy by using combined immunotherapy and chemotherapy. The study was aimed to assess the clinical improvement by adding immunotherapy (MIP vaccine) with chemotherapy (WHO -MDT) in pediatric borderline leprosy. Methods: A total of 98 new pediatric borderline leprosy cases were included, after formal written consent, detailed clinical examination. A non-randomized trial was conducted. In this study, patients attending the OPD were serially recruited in two treatment groups. In group-1 (Mw vaccine plus WHO- MDT) 50 pediatric cases and in Group-2 (MDT only), 48 pediatric borderline cases were recruited. The therapeutic regimens containing MIP vaccine was injected intra-dermally at the start of therapy and every six months in addition to chemotherapy (WHO- MDT) in group 1 pediatric patient and chemotherapy only (WHO- MDT) were given in group-2 pediatric cases and effect was observed on clinical parameters (size of lesions, erythema, infiltration, sensory improvement) and bacillary clearance. Results: Addition of immunotherapy resulted in faster clinical recovery from disease, faster bacillary clearance in pediatric borderline leprosy cases. Conclusions: This study shows the usefulness of adding immunotherapy (MIP vaccine) to chemotherapy (WHO- MDT) in pediatric borderline leprosy for faster clinical improvement.
Nutritional and haematological status of human immunodeficiency virus infected children
Source: International Journal of Contemporary Pediatrics
Chandra M. Pandey, Anubha Shrivastava.
Background: Under nutrition and anaemia are among the commonest presenting signs in human immunodeficiency virus (HIV) infected children. Cause could be multi factorial. HIV infection itself may produce this situation. Opportunistic infections, nutritional deficiencies and bone marrow suppression due to various factors could be the other reasons. To study the nutritional and haematological status in HIV infected children this study was undertaken. Methods: 140 children of both sexes, between the age 18 months to 15 years, who were diagnosed HIV positive as per guide lines of national AIDS control organization of India, were included in this study. Their anthropometric, general and systemic examinations were done. Haematological investigations including complete blood count (CBC), general blood picture (GBP), CD4 count was done in all cases. They were classified in clinical and immunological staging according to WHO classification criteria. Bone marrow aspiration was performed in 43 children. They were investigated for suspected opportunistic infections as well. Results: Out of 140 chidren, 91 were male and 49 were female. 47 children were orphan and 111 children were in low socioeconomic status. 101 children were significantly under nourished. No child was nutritionally normal. Clinical signs of vitamin A and D deficiency was seen in 21 and seven children respectively. 85% children were anaemic and most common morphology was normocytic normochromic blood picture. Lymphopenia was seen in 43.57%, granulocytopenia in 48.57% and thrombocytopenia in 30.71% children. There was no significant finding in bone marrow examination. Conclusions: This study concludes that in children, commonest route of infection was vertical transmission. Mean age of presentation was 7.67 years. Varying degree of mal nutrition and anaemia was noted in more than 85% HIV infected children. No child was nutritionally normal.
Reticulocytosis: the unevaluated parameter in neonatal jaundice requiring phototherapy
Source: International Journal of Contemporary Pediatrics
Rose Xavier, Manoj V. C., Sanjeev Kumar T. M., Vinod J. Cherian.
Background: Majority of the jaundiced neonates requiring phototherapy do not have an identifiable cause for the jaundice. Reticulocyte count more than 4% on day 3 of life is called reticulocytosis in neonates. So far no studies have evaluated the prevalence of reticulocytosis among jaundiced neonates requiring phototherapy. Objective of the study was to identify babies with only reticulocytosis as cause for jaundice and identify factors contributing to reticulocytosis. Methods: An observational study was carried out over a period of one year in the neonatal unit of a tertiary care hospital on 200 jaundiced neonates requiring phototherapy for determining the incidence of jaundice with unknown etiology. This data was analysed for prevalence of reticulocytosis and its contributing factors. Results: 67 of 200 babies with jaundice had reticulocytosis. An etiology for the reticulocytosis was found in 37 babies. 12 of the remaining 30 babies had dehydration (weight loss more than 10%) contributing to jaundice. 18 babies had no identifiable cause for the reticulocytosis. Mildly significant correlation was found with sibling history of neonatal jaundice (p = 0.052). No significant correlation was found with any other contributing factors. Conclusions: Reticulocyte count should be done for any baby with jaundice requiring phototherapy. Screening for irregular antibodies and genetic studies need to be promoted along with routine tests, to identify the cause for reticulocytosis after working out the costs involved.
Effect of postnatal magnesium therapy on neonatal seizure in infants with moderate to severe hypoxic ischemic encephalopathy: a post- hoc subgroup analysis
Source: International Journal of Contemporary Pediatrics
Raj Prakash.
Background: Magnesium has got both neuroprotective and anticonvulsant effect on developing human brain. A post hoc subgroup analysis was done to determine the effect of magnesium on neonatal seizures in infants with moderate-severe hypoxic ischemic encephalopathy (HIE) who received postnatal magnesium therapy for perinatal asphyxia. Methods: Term asphyxiated infants were randomly assigned to receive either magnesium sulphate infusion or placebo within 48 hours of life to maintain serum magnesium levels in neuroprotective range. Short term neurological outcome at discharge was evaluated. The post hoc analysis evaluated the effect of magnesium on neonatal seizures in infants with moderate-severe HIE. All statistical analysis was done through SPSS (version 19.0) for windows and p value
Diphtheria pertussis tetanus vaccine induced convulsion: is hypocalcemia a triggering factor?
Source: International Journal of Contemporary Pediatrics
Usha Kiran C. B..
Background: Active pertussis toxin in diphtheria pertussis tetanus (DPT) vaccine has been proposed to cause severe reactions. A convulsion following DPT vaccine is a known adverse reaction but hypocalcemia as a triggering factor is not reported. The aim of the study was to find the association between serum calcium and DPT vaccine induced convulsions and to study the clinical profile. Methods: Retrospective observational and descriptive study was done at emergency ward of a tertiary care teaching hospital. 20 infants of DPT induced convulsions with previous normal neurodevelopment were included in the study. Main outcome measures were association between DPT vaccine induced convulsions and serum calcium levels. Results: Out of 20 infants included in the study, male to female ratio was 1.8:1, all of them were less than 6 months of age, 17 (85% ) were exclusively breast fed, hypocalcemia was seen in 17 cases (85%), 11 (55%) had fever. 16 (80%) had convulsions following third dose of DPT vaccine. Conclusions: There is a significant association between hypocalcemia and DPT vaccine induced convulsion. Hence there is need for Calcium and Vitamin D3 supplementation in pregnant and lactating mothers and early detection and adequate treatment of rickets in infants.
A study of association between vitamin d deficiency in sepsis
Source: International Journal of Contemporary Pediatrics
Nishaat Ahmed, Vikram Yadav, Rajendra Kumar Soni, Niranjan Nagaraj, Pramod Kumar Berwal, Gunshyam Singh Sengar.
Background: Vitamin D is a fat-soluble steroid hormone that contributes to the maintenance of normal calcium homeostasis and skeletal mineralization the aims of this study is to evaluate vitamin D levels in pediatric patients admitted in the intensive care unit with sepsis. Methods: Fifty children between 1 year to 12 years of age with systemic inflammatory response syndrome (SIRS) with suspected or proven sepsis, admitted in PICU were included for the study. Blood was drawn at the time of admission on the first day of hospital stay for measurement of 25-hydroxyvitamin D (25-OHD) levels. Results: Forty two (84%) patients out of 50 patients had vitamin D levels 30 ng/ml. This was statistically significant as the p value was
Clinicoetiological profile of acute kidney injury in paediatric intensive care unit patients
Source: International Journal of Contemporary Pediatrics
Vidya Krishnamurthy, Anil Shetty K., Jaidev M. D..
Background: Acute kidney injury (AKI) is common in patients in the paediatric intensive care unit and is associated with poor outcome. Present study was conducted to determine the occurrence, risk factors and etiology of AKI in the PICU. Methods: Data was collected retrospectively from case records of children admitted to PICU during one year.AKI was defined and classified according to modified pRIFLE (risk injury failure loss end stage renal disease) criteria. Results: 227 children were included in the study, 31(13.6%) developed AKI, of these 16 (51.6%) had risk, 11 (35.4%) had injury and 4 (12.9%) had failure. Overall mortality was 32.3%. 83.9% of AKI was in the age group of
Changing trends in clinicopathological parameters in dengue with evaluation of predictors of poor outcome in children
Source: International Journal of Contemporary Pediatrics
Smita Ramachandran, Akriti Gera, Murtaza Kamal, Rani Gera, Manas Pratim Roy.
Background: A study was planned to evaluate the changing trends in dengue according to the revised WHO guidelines in children and at identifying and evaluating the association between clinical features the child and the outcome. Methods: This was a retrospective observational study conducted in Safdarjung Hospital. Children with signs and symptoms of dengue fever along with serological or antigen NS1 positivity were included. Continuous variables were analysed using percentage, mean, standard deviation. Categorical variables were analysed using chi-square test. P value
Source: International Journal of Current Research and Review
Maqsood Ahmad Dar, Baseerat Ali, Rajasheikar Redid, Rommel Roshan Tickoo, Owais Hamid Dar.
Introduction: Chronic daily headache defined as headache occurring on 15 or more days in a month for at least three months affects around 4% of the general population causes significant distress with substantial impact on the quality of life of an individual and huge economic cost to the society through occupational disability and healthcare consultations. Objectives of the Study: To study the prevalence of chronic daily headaches in people of age group 18-80 years in Max Super Specialty Hospital and to identify risk factors associated with CDH (stressful life events, obesity, and medicine overuse.) Material and Methods: It was a prospective study conducted in Max Super Specialty Hospital, Saket, and New Delhi between Aug 2014 to May 2015. Patients coming with complaints of headache in age group of 18-80 yrs and fulfilling the inclusion criteria and exclusion criteria were enrolled in the study. Sample size was calculated by using n-Master (2.0) software and 176 subjects were enrolled. History of the patient including the precipitating factors and drug history was taken. MIDAS and HIT score was used to know the severity of headache; medical conditions were noted by taking brief interviews. Data was analyzed by using chi square test, Pearsons correlation coefficient. Result: Of the 4500 subjects presented to our hospital with complaints of headache, 176 fulfilled the criteria of chronic daily headache (CDH) with a prevalence of about 4.5%.In our study we observed that 103 (58.5%) had migraine without aura, 30.6(20.5%) migraine with aura, 33(18.8%) tension type headache (TTH), 2 (1.1%) hemicranias continua and 2(1.1%) mixed-migraine and TTH.We observed that out of 176 patients in age group of 18-80 years ,maximum number of patients were in age group of 30-39 yrs- 67 patients(38.1%) and the least common age group was >70yrs where only 1 patient had chronic daily headache(CDH). It was observed that out of 176 patients 123 (69.9%) were females and 53 (30.1%) were males and type of headache was statistically significantly (p=0.00) associated with gender. Conclusion: We conclude that Migraine without aura was the most common type (58.5%) and least common type being mixed chronic migraine and tension type headache and Hemicrania continua 1.1%. We found chronic daily headache was more prevalent in females as compared to males, 123 (69.9%) were females and 53 (30.1%) were males. The most common age group affected was 30-39 years and was more common in married. We observed that most of the patients (61.9%) had BMI between 18.5 and 25.After analyzing risk factors it was observed that history of drug intake was present in 154 subjects, most common being Acetaminophen, Naproxen, Triptans, Ergotamine the rest were using preventive. In our study prevalence of medication overuse headache (MOH) among 176 patients of chronic daily headache is (108/176) 61.36% whereas prevalence of MOH in subjects coming to our hospital with headache is 2.4% (108/4500). Stress was the most common precipitating factor of chronic daily headache (CDH), stress was present in 146 patients (85.9%) others being lack of sleep, hunger, working on computer, noise, menstruation, sunlight, travel. Recommendations: Chronic daily headache is under estimated due to lack of awareness; screening of patients should be done on primary and secondary care centers to estimate the actual burden of disease. Stress, anxiety should be handled as early as possible to prevent transformation of episodic headache to chronic daily headache.
Source: International Journal of Current Research and Review
Shyama Dash, Uday N. Soni, Rahul S. Baldawa, N. G. Toshniwal, Shubhangi A. Mani.
Orthodontic care may seem out of reach for many children with special needs due to physical and developmental disabilities. Orthodontists who lack education and experience to work with such patients with disabilities end up denying treatment of these patients, as a result, patients and parents become frustrated.Orthodontic treatment is an elective procedure for essentially all patients, including those with medical problems. Correction of disfiguring dental and facial problems contributes in an important way to an individuals self-esteem. The positive benefits of orthodontic treatment influence social integration and interaction, and can lead to significant improvement in overall well-being.
Source: International Journal of Current Research and Review
Mohammad Zubair Qureshi, Humaira Bashir, Peer Maroof, Samoon Jeelani, Nazia Bhat, Fehmeeda Akhter.
Objectives: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are important transfusion-transmissible infections. This study was performed to assess the Seropositivity of HBV and HCV Seropositivity among blood donors at a Tertiary Care Hospital based blood bank at SKIMS, Kashmir. Materials and Methods: The blood donation records over 10 years from Jan- 2003 to Dec-2012 were reviewed, retrospectively, for the seropositivity and yearly trends of HBV and HCV. Results: A total of 97427 donations were received. The overall number of HBV seropositive donations was 469 and that for HCV was 194, with the seroprevalence rates of 0.48% for hepatitis B surface antigen (HBsAg) and 0.20% for HCV. The seropositivity rate was higher in the replacement donors compared to the voluntary donors and 0% in repeat voluntary donors. The annual rates showed decreasing trends for both HBsAg and HCV. Conclusion: The seropositivity of viral markers was lower in our study as compared with studies from other parts of the country. It was significantly lower in voluntary donors compared to replacement donors and repeat voluntary donors were found to be much safer.
Source: International Journal of Current Research and Review
S. Rajasekar, V. Ramasubramanian, Sethupathi.
Introduction: Alanine Aminopeptidase (ALAP) and dipeptidylpeptidase (DPP IV) are proteolytic enzymes released in the periodontal tissues from leukocytes, host cells and microorganisms. Both enzymes play an important role in collagen degradation and destruction of periodontal tissues. Therefore, detection of these enzymes might be useful in the diagnosis of periodontal disease. Aim: To assess the salivary levels of ALAP and DPP IV in periodontally healthy and those with chronic Periodontitis and to correlate the enzyme levels with the severity of disease. A prospective comparative case control study was done on 60 systemically healthy patients in the age group of 25-55 and was divided into four groups with 15 patients in each as Periodontally healthy, Mild, Moderate and Severe Periodontitis. Methodology: Parameters like Plaque index, Gingival bleeding index, Probing pocket depth and clinical attachment loss were recorded at baseline and unstimulated whole saliva was collected from each patient and quantified for levels of ALAP and DPP IV using spectroscopic quantification method. Statistical analysis used ANOVA, Students t test and Pearsons correlation coefficient analysis was used. Results: The salivary levels of ALAP and DPP IV were found to be higher in patients with Periodontitis than p healthy controls and were higher in severe (42.34±8.96) (8.41±1.44) and moderate group) (25.46±6.79) (5.17±1.31) than mild Periodontitis group) (15.83±4.54) (3.69±1.00) which was statistically significant. Discussion and Conclusion: ALAP and DPP IV were higher in saliva of patients with chronic Periodontitis and positive correlation existed between the levels of these enzymes with the severity of Periodontitis.
Source: International Journal of Current Research and Review
Nwosu-Obieogu K., Chiemenem L.I., Adekunle K.F..
The utilization of agricultural waste to produce bioethanol proves to be an alternative energy source for the limited non renewable energy and a dependable substitute for food crops. Though the process has several challenges and limitations such as biomass transport and handling, efficient pre-treatment methods, high cost based on current technologies which results in low yield and high cost of the hydrolysis process. This review highlights different classes of agricultural waste, their sources and the processes undergone to produce bioethanol economically.
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July 27, 2012
Look of the day "Peplum Skies"
71 comments:
- Style IsleJuly 27, 2012 at 3:16 PM
I'm in love with your peplum Shirt WANT!!! and your shoes are to die for.ReplyDelete
- Angela DonavaJuly 27, 2012 at 3:39 PM
J'adore le collier! C'est chic:)ReplyDelete
Angela Donava
This is one of the best outfits I have seen lately! Beautiful!ReplyDelete
New post on SEARCH IN FASHION - Top 5 weekly picks: Studded denim jacket
- The Marcy StopJuly 27, 2012 at 6:23 PM
Gorgeous! Love those pantsReplyDelete
- ValentinaJuly 27, 2012 at 7:53 PM
love the peplum!!!ReplyDelete
- AbbysworldclosetJuly 27, 2012 at 9:24 PM
Love the entire outfit!ReplyDelete
- gps_girlsJuly 28, 2012 at 12:18 AM
Great look! Love the peplum!ReplyDelete
- Alessia CassaraJuly 28, 2012 at 8:22 AM
Cute that peplum shirt!ReplyDelete
This is such a beautiful outfit! It looks beautiful! I love the mix of prints ans textures and the luttle destails such as the shoes and necklace really pull it together! Stunning! I can't wait to see future posts !!ReplyDelete
- Sharpen styleJuly 28, 2012 at 12:48 PM
I love your outfit!!! those printed pants with that "new look" shirt plus the powerfull clutch it´s awesome!! great combination of textures.ReplyDelete
I´m starting my own blog so feel free to stop by and leave a comment or whatever you like! would you like to follow each other?? Anyway I´m gonna stick around cause I think you have a great sense of style!
chic and trendy look!ReplyDelete
- Kaitlyn YooJuly 28, 2012 at 7:24 PM
ahhhh love this outfit so much!ReplyDelete
leopoard & peplum <3 all my favorites!
looking fabulous girlie! :)
Pinkbow Icecream
- beauthiJuly 28, 2012 at 11:18 PM
wow. your outfit looks amazing! find your blog very interesting and good :)ReplyDelete
- Sam Frills & ThrillsJuly 29, 2012 at 12:39 AM
Hi doll, I have loved every piece in your fabulous closet and wish that we could someday go shopping together :) Gorgeous pastel top, adore the pairing with the leopard jeans, its completely unpredictable.ReplyDelete
- stylelustpagesJuly 29, 2012 at 6:48 AM
Cute look! I loved that top since I first saw it, but missed out on it :(ReplyDelete
Thank you so much! I like it too!!xoxoReplyDelete
Thank you dear! xoxoReplyDelete
Thank you marina! I will stop by your blog soon! xoxoReplyDelete
Yeah mine too, nowadays it seems like I love all the trends! xoxoReplyDelete
Thank you! xoxoReplyDelete
Yeah that would be great if we could shop together! Or maybe a financial disaster ;-) haha! Have a great sunday dear! xoxoReplyDelete
- Margarida ReisJuly 29, 2012 at 3:48 PM
i'll follow you right now =)ReplyDelete
you look gorgeous, by the way. you peplum top is perfect!
Fabulous peplum top and all the other accessories are just awesome too!!ReplyDelete
Following you,follow back to keep in touch through comments!
- A Super Fashion girlJuly 29, 2012 at 4:37 PM
Love that look! peplum top is amazing! Follow you via Bloglovin, follow me back?ReplyDelete
- a super fashion girlJuly 29, 2012 at 4:40 PM
Love your peplum top!ReplyDelete
Follow you via bloglovin, follow me back?
- PatricjaJuly 29, 2012 at 4:47 PM
I follow you. How you too can follow me. Thank you for visiting the blog.ReplyDelete
Also, I wish you a nice Sunday.
- Style-IsleJuly 29, 2012 at 5:15 PM
Sure thing doll lets follow each other !ReplyDelete
- BarbaraJuly 29, 2012 at 5:57 PM
Love your blog!! I follow you now with google friend connect and bloglovin too! Hope you'll do the same!! I wait for you in my blog!! Kisses!ReplyDelete
- AdamAlexMommyJuly 29, 2012 at 6:16 PM
amazing outfit! love the peplum top and the necklace. great colors, l! :)ReplyDelete
hope you're having a great sunday!
I love your outfit, it's so bon ton and it's my favourite mood!ReplyDelete
thank you for your lovely comment, I am happy to follow you
looking good, love the peplum top, I'm your newest follower on bloglovinReplyDelete
- novelstyleJuly 29, 2012 at 7:32 PM
That H&M peplum top is beautiful! Love it :)ReplyDelete
Great outfit!!!
- miss luxurylavishlifeJuly 29, 2012 at 8:40 PM
You are so stylish, If you want visit my blogReplyDelete
- Lieselotte NechelputJuly 29, 2012 at 8:47 PM
Another great outfit!ReplyDelete
Just folowed your blog! Maybe you can follow mine?
- PaulinaJuly 29, 2012 at 9:00 PM
Thank you for your comment! OFC I'm following you now!ReplyDelete
- EleonoraJuly 29, 2012 at 9:02 PM
Love this look!!! Great mix! And great blog! Can we follow each other? :D I already follow you, hope you could do the same! :DReplyDelete
Once Upon a Time..
I love the peplum trend!!!!ReplyDelete
Thanks for your sweet comment.Yes we can follow each other, I'm your 447th follower, return love back?
- Kaye BeehJuly 29, 2012 at 10:16 PM
Gorgeous peplum top. (:ReplyDelete
- besugaranspiceJuly 29, 2012 at 11:16 PM
Que bonito!!! me encanta.ReplyDelete
Un beso
- alwand BlogJuly 30, 2012 at 1:26 AM
such a cute look, love the peplum top and the shoesReplyDelete
- martha zuñigaJuly 30, 2012 at 1:52 AM
Lovely outfit, nice clutch, blouse and necklace...I follow you and I would like each other...kisses.ReplyDelete
Martha Zuñiga
- Patti SantamaríaJuly 30, 2012 at 1:55 AM
Hello! I like your blog! Im following you now on GFC and Bloglovin, if you like my blog follow me back please.ReplyDelete
Love this look - those pants are seriously ah-mazing and loving the blinged out accessories.ReplyDelete
Thanks for visiting my blog and for the follow gorgeous! Following you right back too :o)
SDMxx | www.daringcoco.com
omg omg omg!!! i want that top!!!ReplyDelete
That peplum top is gorgeous!ReplyDelete
- clara turbayJuly 30, 2012 at 5:14 AM
Fun and easy, love it!ReplyDelete
- The scent of glamourJuly 30, 2012 at 10:20 AM
Lovely outfit!ReplyDelete
Great shoes! I love the peplum top!
I have followed you, waiting for you to follow back!
- Amy GoodeveJuly 30, 2012 at 11:54 AM
thank you for visiting my blog.ReplyDelete
I have followed you I would love a follow back
- Marella MonticelliJuly 30, 2012 at 12:38 PM
This combo is simply perfect!ReplyDelete
- vhutali ngwanaJuly 30, 2012 at 1:19 PM
love it and the colour is just perfect. beautiful dear.ReplyDelete
Lv.. V
- life is a shoeJuly 30, 2012 at 1:50 PM
such a pretty look! I love your top!ReplyDelete
- mercedesJuly 30, 2012 at 3:00 PM
wooow love your top! i have also seen it in H&M it is sooo nice!ReplyDelete
sure we can follow through bloglovin, i am already following u!
- Amy/bridechicJuly 30, 2012 at 5:27 PM
This is one of the most original outfits I've seen in a long tieReplyDelete
Beautiful!Following you nowoxoxoxoAmyhttp://bridechic.blogspot.com
really nice outfit, I love peplum tops! Of course I would like to follow each other. I'll make the first step and follow you via bloglovin and GFC.ReplyDelete
- RosalynJuly 30, 2012 at 6:59 PM
Thank you for stopping by my blog!! just joined yours...p.s. I love the peplum!!!ReplyDelete
- Fashionably MadeJuly 30, 2012 at 7:48 PM
Heel mooie combinatie! Heb die jeans ook maar nog nooit gecombineerd met mint.ReplyDelete
Moet ik zeker eens doen.
XoXo Nathalie
- Thorunn IvarsdottirJuly 30, 2012 at 8:15 PM
LOVE! the peplum top!! do you think they still have it at H&M?? let me know if you want to follow each other, love Thorunn www.double-pizzazz.comReplyDelete
- mentrendJuly 30, 2012 at 10:10 PM
Just followed you sweetie xoxoReplyDelete
-Men Trend
- guaxaraJuly 30, 2012 at 10:58 PM
love your looks and thanks for following, pretty¡¡ now I´ll backReplyDelete
kisses from Pasión Naïf
- Ang LamJuly 31, 2012 at 8:35 AM
Absolutely love this outfit!!!!! You look amazing dear!!ReplyDelete
Moet je zeker doen! xoxoReplyDelete
Thanks dear, following back! xoxoReplyDelete
Thank you so much for your compliment! xoxoReplyDelete
Haha, thank you doll!! xoxoReplyDelete
Thank you dear!! xoxoReplyDelete
Thank you! xoxoReplyDelete
Thank you, yes I will! xoxoReplyDelete
Will do! xoxoReplyDelete
Thank you, I'm following you 2! xoxoReplyDelete
Thanks dear!! xoxoReplyDelete
Thank you! xoxoReplyDelete
Thank you for visiting my blog and leaving a comment! I really enjoy reading each one of them and reply whenever I have time, sometimes it might take me a few days!

subset: commoncrawl


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Every one of us has to have a difficult conversation with someone at some time. How and when we have that difficult can make the difference between escalating the problem or finding a solution.
The first thing to think about is when to have that conversation. Most people want to procrastinate the conversation as long as possible. Maybe someone else will tell the person, maybe if I wait long enough I won't need to have that conversation. The problem is that the longer that you wait to have the conversation, the harder it gets for both you and the other person. In fact, I have seen legal cases where procrastinating a difficult conversation not only made the problem worse, but also created an additional legal liability and cost the organization hundreds of thousands of dollars. The reality is you have to have the conversation as soon as possible. The longer you wait, the worse it will be for you.
Second, it is also important to understand that the conversation is going to be unpleasant. You have to get used to that fact, and learn to accept that fact. Worrying that the conversation is going to be difficult or hard isn't going to do anything to solve the problem. It also won't change the fact that it will still be unpleasant. As I learned from my mother, a vegetable that I didn't want to eat for dinner, was still unpleasant in the morning when I had to have it for breakfast. Just like athletes, you have to get used to living with a little pain and being uncomfortable.
Third there are different styles of dealing with difficult conversations. But regardless of style, you must have compassion in having the difficult conversation. You cannot be oblivious to other people's feelings.
As far as styles of having a difficult conversation there is a difference of opinion. Some people like to build up to the conversation and leading with information completely irrelevant. In some sense they are building rapport with the other person and trying to put that person at ease. Studies have shown that the first four minutes of a conversation has the highest levels of "turbulence" or difficulty and anxiety. Allowing the turbulence to go by allows the conversation to flow better.
Other people like to take the band aid off quickly. In other words, they lead off with the bad news. Then they talk about solutions to that bad news.
It is also important that after you have given feedback that is critical or difficult, you need to solicit feedback from the person you are speaking to. You have to ask them to comment on the issue. This is not a monologue. It is a dialogue.
Finally, there are people that like to sandwich the conversation: Good news, bad news, and then good news. In other words, the bad news or meat of the conversation is surrounded by good news which is the bread. By doing so, you can start and end on a good note. Usually, people will compliment a skill, criticize, and then finish with a compliment.
The reality is that difficult conversations will be just that: difficult. But if you manage the situation, you can help to make an unmanageable situation less difficult.


text:
Tuesday, 12 June 2012
Chocolate saves the day!
So in a desperate plea to cheer up the rainy day, I decided that there was only one thing for it; make a chocolate pie. So that's what I did.
As if I needed an excuse to make something chocolately, right? Well my excuse was that I had some chocolate bars left over from a cake I made and the best before date was July 2012. So I needed to save these lovely chocolate bars from going over fast!
The method and more photos are coming up... just to wet your appetite, here are the ingredients and a photo of the ingredients pre-pie.
2 comments:
I'm excited to see the recipe! Anticipation!!!ReplyDelete
Cathy Trails
Me too Cathy, It's extra special! Happy Week to you! ;) xoReplyDelete
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text:
The Baptism of the Lord – Luke 3:15-16, 21-22
Mark's opening words in today's Gospel are striking. He writes: "The people were filled with expectation and all were asking in their hearts whether John might be the Christ." The Israelites had been waiting for centuries for "the Christ:" the One who would come and save them. To some of the people, John may have been a likely candidate for the Christ who was to come. He was a mesmerizing and ascetical man. He was an engaging speaker and he was a prophet.
However, John clarified his role for the people. He told them: "I am baptizing you with water, but one who is mightier than I is coming. I am not worthy to loosen the thongs of his sandals." Then John added, "He will baptize with the Holy Spirit and fire." John is speaking of Jesus whom he had just baptized.
After Jesus was baptized, he went off to pray. While he was in prayer, the heavens opened up and the Holy Spirit descended upon Jesus in the form of a dove. And then a voice from heaven said: "You are my beloved Son; with you I am well pleased."
Wouldn't have been wonderful to live when Jesus walked this earth? If we had lived then, we also may have been entranced by this man, Jesus. However, Jesus does walk the earth today. He baptizes with the Spirit and He is at our sides constantly. He walks with you and with me. Do we truly appreciate the gift of baptism?
Baptism is the basis of the whole Christian life. It is the gateway to life in the Spirit. Through Baptism, we are freed from sin and reborn as sons and daughters of God. We become members of Christ's Body, the Church. Thus, as members of Christ's Body, we are incorporated into the Church and made sharers in Church's mission. "Baptism is the sacrament of regeneration through water in
the word."
Most likely many of us were baptized as infants. Thus we likely do not have a memory of receiving this sacrament. Yet Baptism is the keystone for the other sacraments. Today sit quietly for five to ten minutes and reflect on the following questions: What gifts have I received from the Sacrament of Baptism? Am I grateful for this sacrament? Do I truly appreciate the Sacraments of the Catholic Church or do I take them for granted?
If you choose to do this, you may find a new appreciation for the gift of your baptism, and it may strengthen your appreciation for your parents, your faith, and for the love God has for you. You are a child of God. What more do you need or want?


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Pavlov's Dogs, Psychoanalysis, Milgram's Obedience Study, and Beck's Cognitive Therapy? Sure, you know what they all mean (that is, you've certainly heard of them), but do you understand enough about these psychology theories to join a dinner party debate or dazzle the bar with your knowledge? 30-Second Psychology takes the top 50 strands of thinking in this fascinating field, and explains them to the general reader in half a minute, using nothing more than two pages, 300 words, and one picture. While unraveling the inner workings of the human mind it also introduces many of the luminaries in the field along the way, including William James, Aaron Beck, and (of course) Sigmund Freud. From Behaviorism to Cognitivism, what better way to get a handle on your inner demons?
Editor Christian Jarrett is an award-winning journalist for The Psychologist magazine, which is published by the British Psychological Society, and he edits and writes the society's internationally renowned Research Digest blog. Christian also authored The Rough Guide to Psychology (2011), co-authored This Book Has Issues, Adventures in Popular Psychology (2008), and contributed to 30-Second Theories (2009).
Financial success is about getting all that you sought to have. It's discovering that you have accomplished your aspirations or accomplished your strategies and it's getting up in the morning feeling the winner rather than becoming defeated.The thoughts success brings will make you wander happily in the roadway with your head up high while being happy and satisfied. In spite of common beliefs, there are no successful or failed individuals but instead there are men and women who have the possibilities to become successful and who do activities that helps them realize this potential and there are many people with the same potential who do not do those things.The only thing you are looking for to do to realize success is to do exactly what successful people did. When you go thru all of the insight you will acquire the mentality of a successful person and this will help you achieve level of success. If you genuinely want to be highly effective then you need to have a sturdy understanding of particular concepts that can confine your future and that can make you defeated. If you don't have desired goals or campaigns then you are going to be a fraction of other some people's preparations. If you will not program to be the boss at your work then someone else in your department will do so and if you don't prepare to get that high status position then someone else who desired and worked for it will take it from you. If you don't plan you will get swept away by the people who do. The original detail that comes to the mind of most people with issues is that they begin to consider their disorders as boundaries to their successes. The moment you start off to perceive your dilemmas as hurdles, you start to have added predicaments because fear begins, panic begins, and these are different massive concerns on their own. The facts is, the method by which you see your issues confirms the ways they will impair you.


text: You are a horse whisperer! 🙂 I read about how with animals we must get out of our head and into our heart, they pick up on our energy like radar. It helped me understand how I need to be clear when I want to interact with them. Thankfully, dogs and cats are used to our insanity and forgive us our trespasses. 😉


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Buy Park Inn by Radisson Shannon Airport vouchers for deals on Shannon: Overnight Stay with Parking. Show availability Set within a walking distance from the Shannon Airport terminal, Park Inn by Radisson Shannon Airport offers contemporary accommodation, gym, and conference facilities. Golf aficionados can practice their swing at the nearby Shannon Golf Club, while those looking for a history lesson can visit the 15th-century Bunratty Castle. Boasting classic interiors, the en suite rooms come complete with tea- and coffee-making facilities, irons and ironing boards, work desks, and private bathrooms with showers or baths. The Blair's Bistro takes pride in serving authentic Irish dishes, while moments of relaxation can be enjoyed by the fireplace with a cocktail in hand. Bathed by the waters of the Atlantic Ocean, Co. Clare offers guests the chance to wander along its sandy stretches and admire its local Irish attractions. Visitors may enjoy a visit to the Cliffs of Moher, whose UNESCO-protected headlands reach heights of 214m, and play host to clamouring colonies of nesting seabirds. More geographical gems may be admired in the Aillwee Cave, where guided tours lead explorers across bridged chasms, amid rock formations, and beneath subterranean waterfalls. A sporting scoot further inland may lead to the Michael Cusack Centre located within The Burren, which pays tribute to the founder of the Gaelic Athletic Association with audio-visual displays, historic exhibitions, and an interactive experience within the mans childhood home.
Click Buy to Get Deal
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Valid: 02/07/2018 to 31/08/2018


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A vintage garden bench, the wooden rails supported on two wrought iron end supports with an angled tie bar underneath. This bench is in attractively shabby ex garden condition but is sound and comfortable to sit on.
Early 20th century
Warning: Last items in stock!
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Outside opening hours? Why not leave a message and we'll call you back...


text:
Jill Stark is an award-winning journalist, author, mental health advocate, and media strategist.
A natural-born storyteller, Jill is fascinated by the complexity of the human experience and has a unique ability to bring the issues that matter to life.
Jill's career in the media spans 20 years, with a decade on staff at The Age covering health and social affairs as a campaigning senior writer and columnist. Prior to that, she cut her teeth in newsrooms in Scotland, where she grew up.
Jill's latest book, When You're Not OK: A Toolkit For Tough Times, is a self-care manual for the days when you feel alone, broken or too weird to be normal. With compassion, humour and honesty Jill offers signposts to help you find the path back to yourself.
Her previous book, Happy Never After: Why the Happiness Fairytale is Driving Us Mad (And How I Flipped the Script), is a forensic examination of our age of anxiety and the relentless pursuit of happiness. In it, she explores why in a western world with more opportunity, choice and wealth than ever before, so many of us are struggling to find calm and contentment.
Jill's first book, the best-selling debut memoir, High Sobriety: My Year Without Booze, investigated Australia and Scotland's binge drinking culture and was short-listed in the Kibble Literary Awards and long-listed in the Walkley Book of the Year Awards.
Jill is also a sought after media consultant, bringing her journalistic eye to an organisation's brand, transforming its public image and helping to tell powerful, thought-provoking stories that leave a lasting impression.
She is a coveted public speaker, working as a host with The School of Life, and delivering keynote addresses in the corporate, academic and not-for-profit sectors.
As a freelance writer, Jill's work appears in The Age, The Sydney Morning Herald, The Saturday Paper, ABC Online, SBS Life and SBS Sexuality.
She is also a respected radio commentator, having co-hosted The Conversation Hour with Jon Faine on ABC Melbourne and making regular appearances on JOY 94.9 and Triple RRR. Her television appearances include The Project, Sunrise and ABC 24.


text: Japan is one of the few countries in the world whose work culture and work ethics offer some startling lessons to learn. Just go through some of the proverbs: Japan has a philosophy that the harder we work; the better life will be… Be not afraid of going slowly, be afraid of standing still. None of us is as smart as all of us. The day you decide to do it is your lucky day. If you try, you may succeed. If you don't try, you will not succeed. This is true for all things. Not succeeding is the result of not trying. Japanese workers are famous for their inexhaustible dedication to their tasks and ability to work long hours. For average Japanese a workday is around 12 to 14 hours. The exhaustive work culture is so common that they have a specific term for the death from overwork known as "karōshi". Just look at its prevalence, there is a national karōshi hotline, a karōshi self-help book, a karōshi law that provides financial help to the widow and children of the person who died of karōshi. 1.Venerate the business card : A meeting in Japan starts with a formal and highly ceremonious exchange of business cards, a ritual referred to as meishi kokan. When receiving a card, a businessman takes it with both hands, reads it over carefully, repeats the printed information aloud, and then places it in a cardholder or on the table in front of him, referring to it in conversation when needed. He never drops it in his pocket. That is considered disrespectful. 2- Defer to your elders : It's customary in a meeting in Japan to always direct one's initial comments to the highest-ranking person present. One never disagrees with him and always gives him his due attention. When bowing — the standard Japanese greeting — one should always bow deepest to the most senior man. 3- Instill motivation through slogans : Many Japanese businesses start their day off with a morning meeting, where workers line up and chant the company's slogans as a way of inspiring motivation and loyalty, and as a means of keeping the company's goals fresh in their minds. 4- The young Japanese working themselves to death Japan has some of the longest working hours in the world, and some young Japanese workers are literally working themselves to death. Now there are calls for the government to do more. 5- Clocking off: Japan is busy working culture for a long time The regulation eight hours in the office is over. The most important work of the day is done; whatever is left can wait until the morning. This is the point many workers would think about heading for the door. Yet for millions of Japanese employees, the thought of clearing away their desks and being at home in time for dinner is enough to invite accusations of disloyalty.


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- Inside the making of 'Elysium' (fernonline.wordpress.com)
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The School takes pride in being mentored by none other than its revered Chairperson, Shree 1008 Mahamandaleshwar Swami Santosh Puri Gita Bhartiji. The Principal is ably assisted in the administrative functioning of the school by a very dedicated team of eminent educationists and distinguished personalities, carefully chosen/appointed for their experience in all fields of administration and education. Their dedication to the Institution at large, speaks of volumes at the various functions the school has organized and its achievements including the 20th Year and 25th Year celebrations wherein the functions were graced by luminaries like Shri Navjot Singh Sidhu and Shri Tarun Vijay amongst others.
© Copyright 2015 by www.shpsdelhi.ac.in


text:
182 days until Election Day
Convention Dates: Republican July 18-21 2016, Democratic July 25-28 2016
Weekly Headlines:
- John Kasich suspends campaign for President
- Ted Cruz suspends his campaign for President
- Donald Trump says wealthy may see tax increase
Press Clips:
The GOP's 24 hour meltdown (Politico 5/8/16)
Donald Trump on Tuesday night assumed the mantle of presumptive nominee and declared: "We want to bring unity to the Republican Party. We have to bring unity."
Three days later, the GOP is tearing itself apart. Friday brought another day of incredible division and revolt with Jeb Bush and Lindsey Graham falling in line not behind Trump, but behind House Speaker Paul Ryan, who said a day earlier that he cannot yet support the brash real estate mogul as his party's standard-bearer. Trump, instead of trying to make peace, lashed out. He fired off a vicious statement, calling Graham an "embarrassment" with "zero credibility." Then he laced into both of his former rivals during his rally in Omaha, Nebraska, where he is continuing to campaign ahead of Tuesday's primary, despite having vanquished the rest of the GOP field.
Donald Trump's latest campaign shifts are not likely to be his last (LA Times 5/8/16)
One of the top reasons voters have flocked to Donald Trump's campaign has been because the tough-talking businessman "tells it like it is," polls have shown. But what, exactly, Trump stands for has become a shifting picture of policies and proposals that even he acknowledged Sunday may not produce the promised outcomes. It's not just that the billionaire's ideas are vague by traditional political standards: bring back jobs, build a "beautiful" wall, "make America great again." The political newcomer does not appear grounded in an ideology beyond assuring that America is "winning."
Hillary Clinton Says She Is Available for F.B.I. Interviews Over Emails (NY Times 5/8/16)
Hillary Clinton said Sunday that the F.B.I. had not asked to interview her as part of its inquiry into her use of a personal email server as secretary of state. But Mrs. Clinton reiterated on CBS's "Face the Nation" that she would make herself available to law enforcement officials as necessary. The investigation into Mrs. Clinton's email practices and her handling of classified intelligence has shadowed her presidential campaign, and CNN reported last week that she was likely to be interviewed soon by the F.B.I. Mrs. Clinton said on Sunday that no meeting had been requested or scheduled.
Trump: My tax plan is negotiable (Politico 5/8/16)
Presumptive GOP presidential nominee Donald Trump said in an interview aired Sunday his tax plan was negotiable, explaining that taxes for the wealthy needed to "go up" — a stance that appears to contradict what's in his plan. "For the wealthy, I think, frankly, it's going to go up. And you know what, it really should go up," Trump said on NBC News' "Meet the Press." His said his tax plan, which would lower tax rates for the wealthiest Americans, would be the opening bid of a negotiation with Congress and that his numbers were a "Floor."
Bernie Sanders rides 'political revolution' with thousands in N.J. (NJ.com 5/8/16)
He's down but not out, and his supporters are charged up. The math isn't on U.S. Sen. Bernie Sanders' side when it comes to securing the Democratic nomination, but thousands of eager supporters welcomed the underdog White House hopeful to New Jersey on Sunday and enthusiastically cheered on to "Light back and make a political revolution." The cheers that filled the room and echoed off the walls of Rutgers University's Louis Brown Athletic Center in Piscataway turned into roars of support when Sanders preached Lighting income inequality, the war or drugs and racial discrimination. "We have come a very long way in the past year," Sanders said. "Real change is coming to America."
Nevada has option to vote 'none of the above' in 2016 presidential election (Las Vegas Now 5/4/16)
The presidential race has narrowed and the only candidates still vying for the nomination are Hillary Clinton, Bernie Sanders and Donald Trump. Trump's the only candidate in the race for the GOP, but for a lot of Republicans, he's not their first choice. "I vehemently oppose our nominee in some of the comments and issues that he brought up during the campaign," said U.S. Senator Dean Heller, R-NV. "Things he said about Muslims; issues he brought up about women and the Hispanic community — I just cannot agree with some of his positions, but I will tell you that I will not be voting for Hillary Clinton. I stated that early on, I will not be supporting a candidate that is nothing more than a third term of the Obama administration. So I will be looking else where in November."
Trump: I don't know how people make it on $7.25 an hour (Politico 5/8/16)
Donald Trump said in an interview aired Sunday he wants to see the minimum wage increased but would rather it be done by the states than the federal government. The presumptive GOP presidential nominee's openness to increases in the minimum wage is a reversal from his previous stance that the minimum wage should not be raised, including when he famously pronounced during a debate last year that wages were "too high."


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Have you ever considered...
...fasting? Not eating food for a designated period of time can be an unpleasant or even scary concept for a lot of people (especially those of use who live in the land of plenty). If you're a foodie like me, then you most certainly enjoy healthy food, plain and simple. The prospect of depriving oneself of food for ANY length of time presents an interesting set of questions. Why should I fast? How long do I fast? Do I need to consult my doctor before I fast? Do I fast all food or only certain food? What do I drink during a fast? I will do my best to answer some of these questions and provide guidance on why and how to include fasting in your healthcare routine.
People haven't always had plentiful resources for food storage and food accessibility, such as refrigerators, freezers, and grocery stores. Nowadays, these things are readily available to most people, but they weren't 100 years ago. The human body has since evolved into a modern-day food processor of the not-so-healthy calorie glut that we are faced with consuming very day. It's not the way the human body was designed to function. It makes good health sense to tolerate and even embrace intentional periods of time with either little or no food to cleanse our body and boost our overall health.
You may be one of the lucky few with a great metabolism and who can go without eating and NOT experience a blood sugar crash. If you aren't, which is most of us, then fasting may be the solution you're looking for to improve your health and well-being. That being said, if you have adrenal or thyroid issues, or even other chronic health issues, I highly encourage you to work with someone to guide you through the fasting journey, or consult your doctor before beginning.
Clearly, fasting is not starvation. Long-term starvation slows metabolism, decreases energy, and negatively affects your adrenals and thyroid, among other side effects. On the other hand, you can safely "starve" for a short time period and gain health benefits, especially if you have ample fat.
One fasting method that has been found to be very beneficial is the Fasting Mimicking Diet, invented by Valter Longo. This method involves reduced calorie intake to 40% of your average calories for 5 days every month.
Intermittent fasting compresses the times of day that you are eating into a smaller span of time, such as a 6 or 8 hour eating window, i.e. between noon and 8pm, instead of the normal 10 to 12 hours or more. Optimally, you would have 16 hours of not putting food into your system. This promotes a hormonal reset, improving insulin and blood sugar levels.
Starting gradually is recommended - don't jump into it by doing a multi-day fast. If you feel so inclined to do a 3-5 day fast, work your way up to it. Start with 14 hours, then 18 hours, then 24 hours, and gradually work up to the multi-day fast.
The benefit of a longer fast is that it triggers autophagy, which literally means "self-devouring." One definition is "the maintenance of bodily nutrition by the metabolic breakdown of some bodily tissues." After 24-30 hours on a 3-5 day fast, autophagy kicks in. This process gets rid of all of the dead cells in your body that aren't functioning optimally, which allows your body to create new and robust cells. We all know that if you don't take out the garbage on a regular basis, your home or office will soon get very cluttered with junk.
It's important to note that you should not restrict overall calorie intake in the long term. On a 5-day fast, it's important to ease into it by gradually tapering off what you eat a few days before you begin. And on the days after the fast, really load up on calories. Be sure to consume sufficient water and healthy salt (Himalayan or sea salt).
In order to highlight what a fasting routine might look like, I'll share what has become my personal goals with regard to fasting. It involves doing a 24-hour fast once a week usually Sunday night after dinner to Monday night dinner. Then once a month I usually stretch that 24-hour fast into a 36-hour fast from Sunday evening after dinner until Tuesday morning when I break-fast. Then once a quarter my goal is to complete a 3-5 day fast.
An unexpected perk of adding regular and intermittent fasting to your overall healthcare routine is that it saves you money. How, you ask? Fewer trips to the grocery store, more money in your pocket! Be sure to watch the video below :)
Have a great week, and as always, please feel free to pass this along!
Medical Disclaimer: Information provided in this article is for informational purposes only. The information is a result of years of practice and experience by Yoshi Rahm, DO. However, this information is NOT intended as a substitute for the advice provided by your physician or another healthcare professional, or any information contained on or in any product label or packaging.
Do not use the information provided in this article for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or another healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read in this email.
Information provided in this article and the use of any products or services related to this article by you DOES NOT create a doctor-patient relationship between you and Yoshi Rahm, DO. or any other physician featured in this article. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.


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If you're not familiar with it, the Nissan Navara is the pickup offered by the Japanese manufacturer outside of North America. On our continent it goes by the name of Frontier, and this version is a frankly outdated one that first debuted in the mid-2000s (the European-sold Navara got a refresh in 2015).
When Nissan does finally decide to deliver a new Frontier, it will, barring any big surprises, be the Navara. Hence our interest in the AT32 off-roader unveiled by the manufacturer this week in Birmingham.
The backdrop to this is the rough-and-tumble current environment in the pickup segment. Since 2015, only Toyota and GM have renewed their product offering, along with Honda and its Ridgeline, a model with more modest ambitions we should point out. Ford will for its part be bringing back its Ranger shortly, while Hyundai and Volkswagen are both busy preparing their rivals for the Ridgeline.
In this context, it would be shocking for Nissan to keep its pickup entrant in hibernation much longer.
This week, the company introduced a new, tougher edition of the Navara. The AT32 Off-Roader will take on the Raptor version of the revived Ford Ranger, set to debut in the next few months.
The AT32 has increased ground clearance and larger wheel arches, as well as an anti-lock front differential. The name of the new off-roader, by the way, refers to the Icelandic firm Arctic Trucks, specialists in 4X4 trucks modified to operate in extreme conditions. The 32 signifies the size of the tires the new edition rests on.
Other changes made to the AT32 include a suspension raised by 2 cm, and an approach angle that at 35 degrees is 4.6 degrees steeper than the regular Navara. In back, the breakover angle is also increased. Under-vehicle skid plates help protect the gas tank, oil pan, transmission and differential.
Nissan had nothing to say about the mechanics of the new version, so we're going to assume at this point that it will stay the same as the regular Navara, which delivers 188 hp and 332 lb-ft of torque.
The Ford Ranger Raptor is expected to provide 210 hp and 368 lb-ft of torque.
For the moment, the Navara AT32 will be available in Europe only. But as mentioned, the pickup category is extremely active in North America at the moment, so we'll be keeping an eye on this off-road model.
First things first, of course: Nissan needs to come up with a new Frontier first.


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GuildWiki has been locked down: anonymous editing and account creation are disabled. Current registered users are unaffected. Leave any comments on the Community Portal.
Game updates/20090901
Update - Tuesday, September 1, 2009[edit | edit source]
Miscellaneous[edit | edit source]
- Nicholas the Traveler has been brushing up on his language skills.
- Kun Shao has gone on vacation until the Xunlai Tournament House is able to distribute points for the month of May.
- Fixed a bug that allowed teams to sync join in random PvP.


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Since You Can't Play a White DS Lite After Labor Day...
Nintendo has announced the fall colors for its popular DS Lite portable gaming device. On September 13th, Onyx and Coral Pink will grant users more ways to color coordinate their gaming and clothing solutions. In other Nintendo news, New Super Mario Bros. hit the 1 million unit sales mark in 12 weeks of release, making it the fastest-selling title for the player in that time frame. DS system and game sales were up 300% in July.
David Thomas Author's page
David Thomas, CEO at Evident, is an accomplished cybersecurity entrepreneur. He has a history of introducing innovative technologies, establishing them in the market, and driving growth – with each early-stage company emerging as the market leader.
Related Content


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Put an End to Dreaded Winter Hands
Winter hands season is in full swing and with it comes scaly skin, dry, brittle nails and peeling cuticles that makes wearing gloves at all times an appealing idea. Fortunately, skincare pioneer, EVE LOM and nail maven Jin Soon Choi have created the ultimate winter hand survival guide, ensuring that your digits will look and feel their best until spring can grace us with its presence.
Start with EVE LOM's Time Retreat Hand Treatment ($55) a powerful anti-aging treatment infused with Retinol, Vitamin A, and almond oil to increase collagen production, even skin tone and intensely moisturize skin.
Next, give cuticles some much-needed love with EVE LOM Cuticle Cream ($24). Teeming with beeswax, Chamomile and Vitamins A and E; this cream encourages healthy nail growth, improves the barrier to keep bacteria out and heals and soothes dried cuticles.
Finish off your hand care routine with a beautiful shade from Jin Soon Choi, the nail expert who's renowned for her chic colors and 5-free formulas. With JINsoon's "Make a Set" ($38) nail lacquer box you can mix and match any three lacquers to keep your nails looking amazing all winter long. Create an ultra dark box with shades Risque, Audacity and Nocturne, or go light and neutral with Muse, Nostalgia and Tulle – the possiblities are endless!


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For Sale $530,000 + - Condo
Gulf Shores Alabama Real Estate Sales
Resort Condominiums
San Carlos
List Price: $535,000
Details: 3 BR, 3 BA with approx. 1,415 sq. ft.
Address: 365 Beach Boulevard, Gulf Shores, AL 36542
Misc: Located in the heart of Gulf Shores, this direct Gulf front condo at San Carlos in Gulf Shores has breathtaking views of the Gulf of Mexico! 3/3 with over 1400 sq. ft. of living space. Condo features stainless appliances, granite counter tops, new vinyl flooring in main living areas, and a spacious balcony overlooking the white sandy beach.
List Price: $535,000
Details: 2 BR, 2 BA with approx. 1,160 sq. ft.
Address: 455 E Beach Boulevard, Gulf Shores, AL 36542
Misc: Nicely decorated 2 bedroom, 2 bath condo in Gulf Shores at The Lighthouse most popular rental complexes. This gulf front complex offers 2 outdoor pools (one w/zero entry), 2 hot tubs, indoor pool, fitness area, sauna, BBQ area, covered parking and is conveniently located in walking distance to many restaurants and shops in the heart of Gulf Shores.
Crystal Shores West
List Price: $530,000
Details: 3 BR, 3 BA with approx. 1,530 sq. ft.
Address: 931 W Beach Boulevard, Gulf Shores, AL 36542
Misc: Desirable east end condo at Crystal Shores West in Gulf Shores. Sit on your own 12th floor balcony overlooking the blue-green waters of the Gulf of Mexico. The master bedroom and the living room access the main balcony overlooking the Gulf of Mexico while a guest bedrooms overlooking the lagoon and intracoastal waterway.
Gulf Shores Condominium Homes, San Carlos, Lighthouse, Crystal Shores West
Find the Perfect >>> Gulf Shores Condo


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Complete the form below to request specific information regarding questions you have including course cost and course length.
Purdue University Global's Master of Science in Management and Leadership with a concentration in Health Care Management program is designed to help you develop the managerial skills needed to apply for leadership roles in various health care settings. Learn more about this online graduate degree here.
How are health policies formed? Which methods are used to ensure quality management in health care environments? What are some trends seen in global health? These are among the topics you could expect to explore when you enroll in the online Master of Science in Management and Leadership with a concentration in Health Care Management program at Purdue University Global. You will have the opportunity to study health policy evaluation methods, health care marketing strategies, quality control, and analytical practices in epidemiology and global health. Core courses focus on leadership theories, management principles, change management, management consulting, and communications.
Purdue University Global requires that applicants to this master's degree program hold a bachelor's degree in business or have completed undergraduate business courses in, among other areas, accounting, marketing, ethics, and economics. Applicants to Purdue University Global's master's degree programs should already have a bachelor's degree; some programs may have additional requirements.
To earn this master's degree, you must complete a total of 56 credits: 40 credits in the core curriculum and 16 credits in the Health Care Management concentration.
Core Courses (40 credits)
|Course Code
|Course Title
|Business Communications
|Strategic Human Resource Management
|Management Theories and Practices I
|Management Theories and Practices II
|Leadership Theory and Practice I
|Leadership Theory and Practice II
|Organizational Excellence and Change
|Action Research and Consulting Skills
|Strategic Financial Analysis
|Applied Research Project
Health Care Management Concentration Courses (16 credits)
|Course Code
|Course Title
|Health Care Operations and Quality Assessment
|Health Policy
|Health Care Marketing
|International Epidemiology and Global Health
As a graduate of the Master of Science in Management and Leadership - Health Care Management program, you might have built the understanding of health care operations and policy development needed to seek executive-level positions in this field. You might be prepared to assume responsibilities in areas of health care operations, health records management, facilities management, or health policy implementation.
Positions you might be able to pursue include:


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From the FMS Global and UK News Desk of Jeanne Hambleton
Courtesy of WebMD.com
By Bill Hendrick – WebMD Health News- Reviewed by Louise Chang, MD
March 25, 2009 — Many people with rheumatoid arthritis may have barriers that hinder optimal management of their pain, a study suggests.
Barriers to pain reduction, Canadian researchers say, include fear of medication side effects, fear of drug interactions, worry about drug addiction, concerns that the effects of medication might mask the disease, and aversion to taking too many pills.
McGill University scientists studied 60 patients with rheumatoid arthritis, all of whom were being treated by specialists. Of the rheumatoid arthritis sufferers, 53% described their pain as moderate to severe.
Forty-seven percent reported that pain was mild or absent. And 65% of all patients, including about half of those with moderate to severe pain, were satisfied with current methods to control suffering, the researchers report in the March issue of The Journal of Pain.
Although 87% of the patients reported that they expected to have "some" pain to "much" pain from their rheumatoid arthritis, only 13% didn't expect any pain or only slight pain.
The researchers, led by Mary-Ann Fitzcharles, MD, of Montreal General Hospital at McGill University, were interested in the potential barriers to reducing pain that kept some people hurting.
The top barriers to optimal pain management found in the study participants included:
Worry of medication side effects (80%)
Not wanting to take "too many pills" (63%)
Worry about medication interactions (57%)
Worry of addiction (35%)
The researchers found that more than half of the patients had at least three barriers.
The researchers conclude that people with rheumatoid arthritis should be questioned vigorously about their pain, and that clinicians should explore potential barriers to effective pain control.
News release, McGill University.
Fitzcharles, M. The Journal of Pain, March 2009; vol 10: pp 300-305.
© 2009 WebMD, LLC. All rights reserved.
Hand Exercises Aid Rheumatoid Arthritis
Muscle-strengthening exercises may ease pain and help individuals with RA improve their quality of life
By Gina Shaw -WebMD the Magazine – Feature Reviewed by Michael W. Smith, MD
For 25 years, New Yorker Carol Solomon, 69, ran a knitting store. In 2006, a few years into retirement, she was diagnosed with rheumatoid arthritis (RA) in both hands.
"I have movement in my thumb and in my pointer finger, but my other three fingers are pretty stiff," she says. Solomon did not want to give up the knitting and sewing she loves, so she sought help from her doctor and physical therapists at New York's Hospital for Special Surgery.
There is a saying about exercise and RA: Use it, but do not abuse it.
"Studies have shown that strengthening the muscles around the joints leads to overall improved function and better quality of life," says Heather Williams, DPT, a physical therapist in the Hospital for Special Surgery's Joint Mobility Center.
"Patients can be afraid to exercise those joints because of pain, but they really benefit from strengthening exercises."
RA is an autoimmune disease in which the body attacks its own tissues. It is a chronic disease, but when diagnosed and treated early with a combination of medication and physical therapy, joint damage can be limited.
When it affects the hands or wrists, like Solomon's, some helpful exercises include squeezing small exercise balls or putting the hand out flat, palm up, and bending each finger one by one into the palm. Take it slowly, advises the physical therapist. She says Solomon should try three sets of five repetitions of each exercise instead of 10 or 12 reps — and then work up to more as she builds her strength.
People with RA go through phases called "flare-ups," with extremely swollen and painful joints, and then "subacute" phases when the disease is less active. Modifying activity depending on what phase you are in is important, says Theodore Fields, MD, clinical director of the Gosden-Robinson Early Arthritis Center at New York's Hospital for Special Surgery.
"When you have a significant flare-up, the joints need more rest."
Whatever kind of exercise you do, be sure to discuss your exercise plan with a physical therapist who understands RA.
"Have your physical therapist work out a home-exercise program that fits your needs and respects the joints you have trouble with," says Fields.
Solomon knows her knitting needles will never fly like they used to, but she has started to work with yarn again and can even sew with a needle and thread, an impossible feat when she first was diagnosed.
"I am just seeing what I can do every day, and trying to adjust the way I do things to give myself as much function as possible," she says.
Hand Exercise for Rheumatoid Arthritis
The Exercise:
Fill an empty box with small items such as nuts, screws, and bolts. Reach in and, handful by handful, pick the screws and bolts out of one box, place them in your other hand, and place in a second box.
The Benefit:
This exercise helps strengthen muscles around joints for improved finger mobility and helps prevent future joint damage.
Originally published in the September/October 2007 issue of WebMD the Magazine. © 2007 WebMD, Inc. All rights reserved.


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Hello friends. Here's this week's invitation.
Vince Ercolomento, tenor saxophone Joe Chiappone, guitar Peter Chwazik, bass your host, drum set
I need your help with this if you can make it. Here's the deal: If we have a full house, Mike Milkie doesn't care what planet the musicians are from. But when I bring in cats from out of town, and we don't draw, I hear about it. Since this gig's inception, my simple philosophy has been to present accomplished musicians playing creative, indigenous music. Build it, and they will come. But I'm not responsible for paying the bills at Milkie's Elmwood. The curious dynamic here is directly related to human nature. When we book a local favorite, we get an audience. Simple. But if our guest artists don't have a local following because, well, they're not local, we need our faithful to have our back. Of the three names above, you probably know who Vince Ercolomento is. If you're a tenor player, you definitely do, because you have high regard for your esteemed colleague. Vince is an old school powerhouse - think Hank Mobley or George Coleman (who Vince studied with by the way). His sound and his fearless improvisations are the stuff of legend in his native Rochester. Ithaca's Peter Chwazik has done our gig before, but way back at our curiously lit Main Street location. And Joe Chiappone I'll meet for the first time this Tuesday. True, there's comfort in the familiar. But there's inspiration in that which is new. We do hope you'll join us. Milkie's on Elmwood is at the intersection of West Utica & Elmwood Avenue. 882-5881
Cindy Miller, vocals Lisa Hasselback, piano Wayne Moose, bass your correspondent, drum set
I just checked. The forecast for next Sunday calls for a 20% chance of precipitation, and a 100% guarantee of inspired vocals from a diminutive, hard-swinging singer. You've heard Cindy at all three of our Tuesday venues, but the larger Art Gallery audience will now hear just how extraordinary she is. Thanks to the generosity of Stan Lipsey and the efforts of contractor Don Metz, we likely hold claim to the longest running free jazz series in the country, if not the world over. I have a tiny bit of inside information that I'll risk sharing, at the expense of publicizing a confidence: The Buffalo News has not been the sole sponsor of this free concert series. Stan Lipsey himself has contributed a significant amount of his own money over these last thirty-plus years in order to offer this outstanding cultural event to his community. And as to his contribution, the jazz series is only the proverbial tip of the iceberg. His leadership and generosity were essential to the restoration of the Frank Lloyd Martin House restoration. Thank you Stan, for your vision, your leadership, and your philanthropy. Enjoy your well-earned retirement, and know that your community is indebted to you for your benefaction and your tireless energy.
next at Milkie's Elmwood 7:00 - 10:00
The Upstate Express
Ronnie Corsaro - piano & arrangements Tim Clarke - trumpet John Hasselback, Jr - trombone Russ D'Alba & Kenny Kuriscak - saxophones Wayne Moose - bass your host - drum set
Upcoming at Milkie's Elmwood
Tuesday, 7/16 Larry Covelli, Patty Flaherty & Craig Kastelnik
Tuesday, 7/23 Jay Bianchi & Gary Keller
Tuesday, 7/30 Mike Costley
Tuesday, 8/6 Mike Kaupa
Tuesday, 8/13 Kenny Kuriscak & Tim Clarke
Tuesday, 8/27 trioPAYAZZO plus 2
Tuesday, 10/15 Patty Flaherty & Craig Kastelnik
July 4, 1776...
I am well aware of the toil and blood and treasure it will cost us to maintain this declaration, and support and defend these states. Yet through all the gloom I see the rays of ravishing light and glory. I can see that the end is worth all the means. This is our day of deliverance.
- John Adams
Respect for life,


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El Wire - Electroluminescent Wire - 6 Feet (2Meter) - Portable-Battery / 12V DC Car / House Electric / USB
Electroluminescent wire (often abbreviated to EL wire) is a thin copper wire coated in a phosphor which glows when an alternating current is applied to it. It can be used in a wide variety of applications—vehicle and/or structure decoration, safety and emergency lighting, toys, clothing etc.—much as rope light or Christmas lights are often used. Unlike these types of strand lights, EL wire is not a series of points, but produces a 360 degree unbroken line of visible light. Its thin diameter makes it flexible and ideal for use in a variety of applications such as clothing or costumes.
Choose Optional Controller:
#1 Battery Operated Portable Controller
#2 12V DC Car Plug
#3 110-220V House Current


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TS Signs Commercial Deal with Tethys Technology
TethysAlgo Suite Provides TS Customers Broker-neutral Algos for Equities, Futures Options and FX
Tethys Technology, an industry leader in financial software development for the capital markets has announced a deal with TS to provide its customers with Tethys' broker-neutral algorithms for equities, futures, options and FX trading.
"We are thrilled to be working with Tethys," said Mike Bailleux, TS Director and Head of Hedge Fund Sales, Americas. By combining our EOMS business with Tethys' award-winning customizable trading execution algorithms, we will be able to service quantitative funds with our multi-asset, front-end and API capabilities designed for that market. Quant funds are taking more control of their execution quality and are looking for flexibility in how and when they reach various pools of liquidity depending on their strategy, concern for anonymity, costs and time horizon."
The TethysAlgo suite of algorithmic trading strategies spans across several asset classes including U.S. and international equities, options, futures and FX. Utilizing advanced quantitative logic and formulas, TethysAlgo maintains pure neutrality to all venues and brokers. Its embedded advanced statistical and game theory techniques, make these algorithms highly adaptive taking into consideration expected volume and volatility to reduce the slippage and remove the likelihood of being gamed or detected. This high-performance suite is designed to provide quality of execution to traders.
Read the entire press release here.


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South West Teams Meet Up
Published: 23rd July 2018
Last Thursday and Friday some of the Barnsdales & Barnsdales FM teams met up for the first time, this included people from our Gloucester office and our new Cirencester office and our Sheffield and Doncaster offices.
As well as spending the day doing some work to integrate the new Cirencester office of David Allberry & Co, the team had a great night out at Cote in Cirencester as well as a few other bars!
Unfortunately (or not) there appears to be no photographic evidence of the night out!