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Lack of cardiovascular risk assessment in inflammatory arthritis and systemic lupus erythematosus patients at a tertiary care center
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The purpose of this study is to evaluate cardiovascular risk assessment at a Canadian rheumatology center and describe the cardiovascular risk of inflammatory arthritis (IA) and systemic lupus erythematosus (SLE) patients using the Framingham risk score. A retrospective chart review of 504 patients attending nine rheumatology practices at the University of Alberta Hospital was performed. A pre-specified case report form detailed patient demographics, cardiac risk factors, variables for the Framingham 2008 score, disease activity, and medication use. In this group of 504 patients, 64 (12.7%) had SLE (male (M) to female (F) ratio = 60:4) and 440 (87.3%) had an IA (M to F ratio = 117:323). Of the SLE patients, 31 (48.4%) met four or more American College of Rheumatology (ACR) criteria, 33 (51.6%) had less than four ACR criteria. Of the IA patients, 156 (35.5%) were CCP positive and 257 (58.4%) were RF positive. Utilizing the chart data, retrospective Framingham risk scores were calculable for one (1.6%) SLE patient and three (0.68%) IA patients. The most common cardiac risk factors not documented in the medical records of both the SLE and IA patients included: (1) positive family history of MI, (2) diabetes, and (3) lipid status. The blood pressure was more frequently documented in the SLE patients (93.8%) compared to the IA patients (56.1%). While traditional cardiac risk factors only partially contribute to the increased cardiovascular risk in these patients, cardiovascular risk assessment was suboptimally performed amongst a large group of rheumatologists. A dedicated cardiovascular risk reduction clinic for inflammatory rheumatic diseases has been established at this site to fulfill this need and evaluate treatment strategies.
KeywordsCardiovascular risk reduction Framingham risk score Inflammatory arthritis Systemic lupus erythematosus
An increased risk of cardiovascular disease (CVD) in patients with rheumatic diseases including inflammatory arthritis (IA) and systemic lupus erythematosus (SLE) is well recognized [1, 2, 3]. While IA patients are treated with disease modifying anti-rheumatic drugs (DMARDs) and biologic agents that reduce disease activity, multiple studies have demonstrated increased cardiovascular (CV) risk despite conventional anti-rheumatic therapy [4, 5, 6, 7]. Several studies of rheumatoid arthritis (RA) patients with disease durations of less than 5 years demonstrated an increased CV risk, suggesting this excess risk is an early feature of RA [4, 8, 9, 10, 11]. The risk appears to accumulate over time and persists after adjustment for other cardiovascular risk factors (relative risk of MI is greater than three after 10 years of having the disease) [6, 12] suggesting that RA independently doubles the hazard for myocardial infarction and sudden cardiac death. The degree of increased risk of myocardial infarction in SLE patients varies, with risks as high as 50-fold in premenopausal women and decreasing to the risk of the general population in the elderly [13, 14, 15]. The nurses' health study found a slightly greater than twofold risk of cardiovascular disease in lupus patients [16].
Reasons for the increased risk of CVD in these inflammatory rheumatic disease patients include the co-existence of traditional cardiac risk factors, including diabetes, hypertension, and hypercholesterolemia; however, the additional factor of inflammation and endothelial dysfunction are also felt to be an important contributors to this risk [2, 17]. Abnormal lipid profiles, specifically reduced high-density lipoproteins (HDLs) and elevated triglycerides have been described in these populations [2, 17].
The severity of inflammatory activity predicts CV events and mortality in RA patients [6, 18, 19]. Certain medications used to treat IA and SLE may also contribute to the increased risk of CVD, including nonsteroidal anti-inflammatory drugs (NSAIDs) [20], COX-2 inhibitors [5, 20], steroids [21, 22], and anti-folate medications such as methotrexate [23, 24].
Given the mixed picture of contributors to the increased CV risk in SLE and IA patients, an active risk assessment and management is entirely appropriate in this population. The European League Against Rheumatism (EULAR) has already reflected this in their recent recommendations put forth by two different panels suggesting annual CV risk assessment for both RA patients and SLE patients respectively [25, 26].
Given the importance of CV risk assessment in inflammatory rheumatic diseases, the main objective of this study was to evaluate the extent of CV risk assessment in a university rheumatology center and determine the CV risk of SLE and IA patients followed by a diverse group of practicing rheumatologists. The main hypotheses included that (1) CV risk assessment and, therefore, management would be limited in the typical rheumatology practice and that (2) CV risk would be increased with intermediate to high Framingham risk scores for those SLE and IA patients where data were collected.
A retrospective chart review of nine rheumatologists at the University of Alberta was performed after obtaining a university ethics approval to access patient paper charts. A pre-specified case report form was created for the study to standardize data collection per chart. Data collection included cardiovascular-specific data and IA/SLE disease-specific data. The cardiac risk factors were recorded in a dichotomous format (i.e., "yes" or "no"); however, in instances where no data was present in the chart, a third option "not recorded" was chosen to account for the fact that many patients did not have the variable assessed, and one could not assume this meant they were lacking a particular risk factor.
The data collection included: patient demographics without personal identifiers, traditional cardiac risk factors included in the Framingham 10-year risk for general cardiovascular disease [27] (age, gender, systolic hypertension, family history, smoking, diabetes, dyslipidemia), obesity, cardiac medications (acetylsalicylic acid (ASA), anti-cholesterol agents, anti-hypertensives), history of cardiac evaluations, IA/SLE disease duration, normal versus abnormal CRP (normal, <8 mg/L) and ESR (normal, <20 mm/h), seropositivity (rheumatoid factor and anti-cyclic citrullinated peptide), number of swollen or tender joints, number of American College of Rheumatology (ACR) criteria met for SLE [28], anti-nuclear antibody (ANA), ds-DNA and extractable nuclear antigen (ENA) positivity, IA/SLE medication history, history of cardiac events under care of rheumatologist, and recorded blood pressures in the chart.
The presence of hypertension was recorded as "yes" only when the specific diagnosis was recorded in the chart and/or the patient was taking an anti-hypertensive medication. Diabetes was recorded as "yes" when documented by the rheumatologist or referring physician or confirmed by the presence of diabetes-related treatment(s). At the time of the review, there were no guidelines for lipid targets for inflammatory arthritis patients; therefore, we classified the patients as medium risk for CVD according to the Canadian 2009 dyslipidemia guidelines [29], therefore documenting dyslipidemia according to the following: the patient was on an anti-cholesterol medication and/or low-density lipoprotein (LDL) was equal to or greater than 3.5 mmol/L and/or the total cholesterol to HDL was equal to or greater than 5. Obesity was determined by the rheumatologists' documentation. Cardiac medication history involved the use of ASA, anti-cholesterol, or anti-hypertensive drugs. Rheumatologist-initiated referrals for cardiovascular risk reduction, including referrals for further cardiac investigations, specialist(s), or initiating cardiac medications were recorded. Any CV events (including myocardial infarction, cerebrovascular accident, congestive heart failure) occurring under the care of a rheumatologist in the chart were documented. The Framingham risk scores were calculated using an online calculator at http://www.framinghamheartstudy.org/risk/gencardio.html.
IA patients included those with seropositive or negative RA and psoriatic arthritis. For both IA and SLE patients, the diagnosis relied entirely on the rheumatologist's assessment and chart documentation rather than specific ACR criteria. Patients diagnosed with SLE by the rheumatologist were included (even if they did not meet the minimum four ACR classification criteria for SLE [28]) if the chart documentation was clearly SLE as defined by biopsy (e.g., renal) and/or there was no documentation of debate about the diagnosis or alternative diagnoses for the SLE features recorded in the chart. Any patient with a diagnosis including overlap syndrome, mixed connective tissue disease, undifferentiated connective tissue disease was excluded. Patients with early, undeclared inflammatory rheumatic diseases were excluded. All IA and SLE charts available at the time of data collection were included in the study. Data were entered into a Microsoft access database. Descriptive statistics including means and standard deviations were calculated using Microsoft excel.
Systemic lupus erythematosus patient characteristics
No. (%) of patients
Number of patients with SLE
64 (12.7)
Male to female ratio
4 (6.2):60 (90.4)
Meeting 4 or more ACR classification criteria for SLE
31 (48.4)
Anti-nuclear antibody positive
43 (67.2)
Double-stranded DNA positive
6 (9.4)
Extractable nuclear antigen positive
(1 or more of: SSA, SSB, anti-RNP, anti-Smith)
21 (32.8)
Malar rash
13 (20.3)
Discoid rash
6 (9.4)
9 (14.0)
Oral ulcers
14 (21.9)
31 (48.4)
10 (15.6)
27 (42.2)
3 (4.7)
Anemia (Hb < 120 g/L)
19 (29.7)
Leukopenia (WBC < 4.0)
15 (23.4)
Thrombocytopenia (platelets < 150)
6 (9.4)
Lupus anticoagulant positivity
7 (10.9)
Anticardiolipin positivity
5 (7.8)
Inflammatory arthritis patient characteristics
No. (%) of patients
Number of patients with inflammatory arthritis
440 (83.7)
Male to female ratio
117 (26):323 (73.4)
Rheumatoid factor positive a
257 (58.4)
Rheumatoid factor negative
107 (24.3)
Anti-cyclic citrullinated peptide positivea
156 (35.5)
Anti-cyclic citrullinated peptide negative
77 (17.5)
Seropositive rheumatoid arthritis (as defined by rheumatologist in chart)
363 (82.5)
Rheumatoid pulmonary disease
8 (1.8)
Rheumatoid nodulosis
37 (8.4)
Of the 440 IA patients, 363 were diagnosed as seropositive RA, 77 as seronegative RA, and seven as having psoriatic arthritis. The mean number of swollen and tender joints at first rheumatology visit were 8.6 (±6.4) and 11.7 (±9.1), respectively. Few extra-articular manifestations of IA were noted, the most common being nodulosis. The mean age at diagnosis was 45 years (±16.1), and the mean disease duration was 11.9 years (±11.5). Abnormal CRP (>8 mg/L) was noted in 19 (30%) of SLE and 259 (58.9%) of IA patients, whereas abnormal ESR (>20 mm/h) was noted in 27 (42%) of SLE and 282 (64.1%) of IA patients.
Medication use in the SLE and IA patients
No. (%) of SLE patients with past or current medication exposure
No. (%) of IA patients with past or current medication exposure
38 (59.4)
62 (14.1)
NSAIDs and COX-2 inhibitors
7 (6.3)
154 (35)
11 (17.2)
300 (68.6)
58 (90.6)
276 (68.1)
1 (1.6)
88 (20)
1 (1.6)
112 (22.5)
Gold (oral/injectable)
1 (1.6)
49 (11.1)
49 (11.1)
28 (6.3)
64 (14.5)
9 (2)
2 (3.1)
9 (2)
15 (23.4)
Mycophenolate mofetil
17 (26.6)
Number (%) of SLE and IA patients where traditional cardiovascular risk factors were not recorded
Cardiac risk factor
No. (%) of SLE patients
No. (%) of IA patients
33 (51.6)
261 (59.3)
58 (58)
377 (85.7)
2 (3.1)
123 (28)
Diabetes mellitus
62 (96.9)
421 (95.7)
Family history of premature coronary artery disease
61 (95.3)
433 (98.4)
59 (92.9)
422 (96)
Number (%) of SLE and IA patients taking cardiovascular medications when recorded
Lipid-lowering agents
SLE patients
7 (10.9)
25 (39.1)
8 (12.5)
(NR = 2 patients)
(NR = 2 patients)
(NR = 3 patients)
IA patients
34 (7.7)
80 (18.2)
41 (9.3)
(NR = 127 patients)
(NR = 123 patients)
(NR = 130 patients)
The Framingham risk score for a 10-year risk of general cardiovascular disease [27] was calculable for one SLE patient and three IA patients. The Framingham risk for any cardiovascular event in the next 10 years for the three IA patients was 48%, 21%, and 17%, respectively and for the SLE patient was 20%. The risk for all these patients would be classified as high except for one patient who would moderately be at risk (17%). Cardiovascular events were recorded in two IA patients, and rheumatologists ordered cardiovascular evaluations in ten patients.
This descriptive study effectively described the extent to which a large number of rheumatologists at one tertiary care center are not performing cardiovascular risk assessments for their IA and SLE patients. The study could not determine the cardiac risk of the majority of both SLE and IA patients as records did not include their traditional cardiac risk factors, and Framingham risk scores were, therefore, not calculable. Other existing risk scores were also not calculable due to the lack of documentation of traditional cardiovascular risk factors. The cardiac medications were poorly documented in the IA patients as compared to the SLE patients. Possible explanations for the discrepancy include the greater potential for comprehensive, multiphysician care in some SLE compared to IA patients, including those SLE patients with renal disease requiring ACE inhibition for renal protection.
For the four patients with calculable Framingham risks, three patients fell in the high-risk category where more aggressive cardiovascular risk reduction might serve useful, such as significant LDL lowering. However, the lipid status was not available on over half of the SLE and IA patients in the medical record suggesting this was not being assessed and treated. Hypertension was the most common traditional risk factor for both the SLE and IA patients. Possible explanations include the influence of medications including prednisone, NSAIDs, and leflunomide as well as disease activity (e.g., renal lupus) on blood pressure. Despite better documentation in medication use in SLE patients, their traditional cardiac risk factor evaluation was no better than the IA patient, as reflected by only one lupus patient with a calculable Framingham risk score in the whole study. The number of IA patients on steroids at any point in their disease (14%) may seem lower than expected compared to other sites but reflects the practice pattern adopted by the majority of local rheumatologists of limited steroid use in IA patients.
While this study is entirely descriptive and retrospective, a large number of rheumatology practices were audited, representing a broad range of clinical experience. The lack of risk assessment was common amongst all the rheumatologists, making it impossible to evaluate possible confounders in rheumatologists performing CV risk assessment, such as time from training (less than 1 year to greater than 35 years) and potential site and training bias. The sites involved in collecting prospective patient data or participating in many clinical trials may be more likely to evaluate traditional cardiac risk factors as part of their standard of care assessment. These sites would likely have more complete data and be able to risk stratify their patients. Interestingly, while many studies and clinical trials are performed at our site on an ongoing basis, the cardiovascular risk information was still lacking. The evaluation of the practice patterns of other tertiary and non-tertiary sites would be valuable to determine how extensive cardiac risk assessment is in the majority of rheumatologists' offices.
This retrospective chart review has some important limitations to acknowledge. For example, author interpretation of patient records may have led to underestimation of possible risks such as obesity (e.g., where no BMI was measured) or diabetes. The possibility that this information was available elsewhere was unlikely, as all rheumatologists at this site were functioning with paper charts at that time. Since approximately 50% of SLE patients did not meet the ACR SLE criteria [28], it is possible that some patients did not truly have a diagnosis of SLE despite measures outlined in the methods to limit this possibility. Early inflammatory arthritis patients without a definite diagnosis of rheumatoid or psoriatic arthritis would have been excluded, potentially leaving out an important population of patients to study in order to understand their CV risk.
The current lack of active cardiovascular risk reduction at our site reflects several important possibilities. Until 2009, no guidelines existed on how to evaluate CV risk in patients with inflammatory arthritis. The chart review, which was performed in this period, reflected the practice patterns of rheumatologists up to 2009. The EULAR guidelines for cardiac risk assessment in RA patients, however, have not been rigorously tested in a prospective, multicentered study to determine their utility in cardiovascular risk stratification [25]. Moreover, uptake of any guidelines in clinical practice will be variable amongst practicing rheumatologists. The aggressiveness to which the rheumatologist should pursue aspects of risk reduction, including lipid lowering, blood pressure control, smoking cessation, and weight reduction, remains in debate. Presently, calculating a risk score is not as routine as calculating a disease activity score for a joint assessment in an IA patient or an SLE disease activity index in an SLE patient.
Other possible explanations as to why cardiovascular risk reduction is not performed at this site to a satisfactory level include that many rheumatologists may assume this task should be the sole responsibility of the primary care physician. This assumption is problematic, however, because many primary care physicians are not aware of the increased CV risk in SLE and IA patients and also how to treat them [30]. The lack of CV risk assessment is pervasive as it was evident in two distinct rheumatology populations at this site—the SLE and IA patients.
The Framingham risk score may not be the best option for the risk assessment of these patient populations as it may not be sensitive enough to reflect the independent risk factor that these inflammatory rheumatic diseases represent. Attempts to correct this have been made with the EULAR guideline that suggested a multiplicative factor of 1.5, which is applied to whichever cardiac risk score is used for certain RA populations [25]. While the multiplicative factor does not apply to the SLE patient at this time, an annual CV risk assessment is recommended in the 2010 EULAR guidelines for monitoring SLE patients [26].
Rather than focusing on traditional CV risk factors, some rheumatologists may feel that aggressive disease control to suppress inflammation in SLE and IA patients may be pivotal in reducing cardiovascular risk rather than traditional risk factor assessment and reduction [2, 17]. Enough data, however, suggest that both SLE and IA patients have traditional cardiac risk factors that should be modified as they also contribute to future CV events [31, 32].
A dedicated cardiovascular risk reduction clinic for inflammatory rheumatic diseases has been established at our site as a result of this review to address the need for more effective CV risk stratification and risk reduction. The clinic will also serve to follow a prospective cohort of patients over time and evaluate existing guidelines and possible treatment protocols for patients while considering their DMARD or biologic therapies as well. Other possible solutions already suggested by the EULAR include incorporating a cardiovascular risk scoring system into the annual evaluations of IA and SLE patients and implementing aggressive risk reduction in the rheumatology clinic at that time. The results of this study suggest that currently, this strategy is ineffective, at least at our site. Efforts must be placed in educating both primary care physicians and rheumatologists on the increased CV risk in these patients and ensuring CV risk assessment is truly standard of care. At this time, simple measures such as traditional risk factor reduction and aggressive disease modification can be instituted until more clear data arise from prospective, large-scale cohorts on the best way to treat the increased CV risk in these patients with inflammatory rheumatic diseases.
The authors would like to thank the rheumatologists at the Division of Rheumatology, University of Alberta for granting permission to review their patients for this study.
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British priest stops Amazon logging giants
A Catholic priest, born in Portsmouth, who now works in the Peruvian rainforest, is behind an important victory for local people over the logging companies laying waste to large stretches of Amazonia. Last year, Father Paul McAuley, 57, helped a group of 70 parishioners in the settlement of Mazan, on one of the Amazon's main tributaries, to seek an injunction to protect large swathes of rainforest, containing valuable tropical timber. Last week a court in Iquitos, the capital of Peruvian Amazonia, ordered a halt to the government's sale of 40-year leases of forest land for only 22p an acre. The judgement could affect logging operations all over the region, although Fr Paul says he is concerned that the authorities have as yet taken no steps to enforce the decision. He told the Independent on Sunday: "The government first sold off the oil to foreign companies, then the forests, and now they say they'll be selling off the rivers. The authorities are supposed to make economic, social and environmental surveys before timber concessions are granted, but none has been carried out." Since April last year the government in Lima and the local authorities of the department of Loreto in Iquitos have decreed the sale of concessions over 12 million acres. Timber merchants bought 7.3 million acres. In the next round, 23 million acres were due to be put under the hammer. Tropical timber was piled high on the quayside at Iquitos last week, ready to be shipped down the Amazon for export. "This is a very sad sight," said Fr Paul, adding that in the first three months of this year, loggers felled more than five times as many trees as in the first three months of 2004. Although Peru signed up to the Convention on International Trade in Endangered Species (Cites), which includes flora and fauna, in 1975, a year before Britain did, timber is sold with no reference to the treaty, which was put in place to reduce deforestation. To evade regulations, some Peruvian woods are sent to the US through Mexico. "There's timber laundering as well as money laundering," said the priest, who served at a slum parish in Lima before moving to Iquitos. Fr McAuley said the privatisation of the rainforest was part of a scheme demanded by the World Bank and other financial institutions of the Peruvian President, Alejandro Toledo, a former World Bank employee, as a condition for loans. Though he succeeded the enormously corrupt Western-backed autocrat, Alberto Fujimori, in 2001 on a wave of popular enthusiasm, Mr Toledo has himself been tainted by reports of widespread government corruption. Campaigners say the logging companies' activities ruin the livelihoods of local peoples by destroying vegetation, frightening off the wild creatures they hunt and poisoning the rivers where they catch fish. Recently Peru fined Pluspetrol, an Argentine oil company, more than $1m for its pollution of the Corrientes, an Amazon tributary, and ordered it to shut 14 of its wells. The river is estimated to have received vast quantities of pollutants every day for the past 34 years from Pluspetrol and its predecessors. Note: If any readers know with order or diocese Fr Paul is with - could they let us know. None of the ones we've checked know him. Sources: IOS/CM

subset: commoncrawl


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Messprobleme bei der Ermittlung des Wachstums der Arbeitsproduktivität - dargestellt anhand eines Vergleichs der Schweiz mit den USA
The paper summarises and advances arguments made earlier by staff members of the Swiss Institute for Business Cycle Research in the current debate over the reasons for growth in Switzerland being weak. It is shown that the assessment of the speed of productivity growth crucially depends on how one chooses to measure both labour input and value added. Using the most adequate measures for both variables, and concentrating on the period between 1980 and 1997, we obtain a productivity growth for Switzerland that has been significantly higher than in the U.S. Since 1997, the U.S. have outperformed Europe in general and Switzerland in particular according to a widely held view. We show this view to rely - at least in part - on statistical artefacts. Approximately 0.5 percentage points of the annual growth rates of U.S. GDP (and hence labour productivity) result from revisions to deflation methods which have been introduced in the U.S. since 1998. Switzerland, however, has not introduced such revisions (or has not extrapolated backwards their impacts on the deflators). All in all, our results should help to put into perspective public concern over Swiss growth rates being behind those of other countries.
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- Dennis J Fixler & Marshall B Reinsdorf & Shaunda Villones, 2010. "Measuring the services of commercial banks in the NIPA," IFC Bulletins chapters,in: Bank for International Settlements (ed.), The IFC's contribution to the 57th ISI Session, Durban, August 2009, volume 33, pages 346-349 Bank for International Settlements.
- No authors listed, 2001. "New Economy," Wirtschaft und Gesellschaft - WuG, Kammer für Arbeiter und Angestellte für Wien, Abteilung Wirtschaftswissenschaft und Statistik, vol. 27(1), pages 1-1.
- Stefano Scarpetta & Andrea Bassanini & Dirk Pilat & Paul Schreyer, 2000. "Economic Growth in the OECD Area: Recent Trends at the Aggregate and Sectoral Level," OECD Economics Department Working Papers 248, OECD Publishing.
- Jochen Hartwig & Bernd Schips, 2004. "Verzerrungen von Konsumentenpreisindizes und ihr Einfluss auf das "reale" Wirtschaftswachstum - dargestellt am Beispiel der USA," KOF Working papers 04-94, KOF Swiss Economic Institute, ETH Zurich.
- Timothy J. Kehoe & Edward C. Prescott, 2002. "Great Depressions of the Twentieth Century," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 5(1), pages 1-18, January.
- Timothy Kehoe & Edward Prescott, 2002. "Data Appendix to Great Depressions of the Twentieth Century," Technical Appendices kehoe02, Review of Economic Dynamics.
- Timothy J. Kehoe & Edward C. Prescott(), 2007. "Great depressions of the twentieth century," Monograph, Federal Reserve Bank of Minneapolis, number 2007gdott.
- Timothy J. Kehoe & Edward C. Prescott, 2002. "Great Depressions of the Twentieth Century," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 5(1), pages 1-18, January.
- Yngve Abrahamsen & Roland Aeppli & Erdal Atukeren & Michael Graff & Christian Müller & Bernd Schips, 2005. "The Swiss Disease: Facts and Artefacts, A Reply to Kehoe and Prescott," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 8(3), pages 749-758, July. Full references (including those not matched with items on IDEAS)
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I leave it up to you to make sense of this police report, which, I think, involves a man getting very drunk, a man hitting on a married woman in a bar, a man getting tackled, a man getting hit with a bottle, and a karaoke DJ hearing that bottle break on something hard. My feeling is that any clearing of this confusion will only reveal the utter emptiness of the universe. But the end of the report does have something that's actually interesting:
While talking to [the victim], I [reporting officer Brandon Dorr] learned he is diabetic. I asked if he needed to check his blood sugar and if it could be adding to his memory issues for the night. He said it was. I called fire via radio to our location. Upon their arrival I learned they are not able to check a person's blood sugar per their policy. They asked questions and checked his eyes. They said they were satisfied that he was lucid, and left the scene.
Why can't the Seattle Fire Department check a person's blood sugar level? I called them to find out, and this is the answer I received from Susan Stangl, a lieutenant with the SFD:
This is how the line is drawn. We [the SFD] do not puncture the skin. We can check if you are fine or need more attention, but if you are in a situation that needs your skin punctured, we have to call the paramedics. It's just a certification issue. We are not certified to puncture skin and the paramedics are. That's why they puncture skin all the time.
- Charles Mudede
Human skin is the final border between you and the SFD.


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Get your FREE e-book
"67 Way to Help You Get Happy Now!"
I will also make sure to keep you update with any new stories I share!
Be Healthy, Be Wealthy, Be Wise!
Get your FREE e-book
"67 Way to Help You Get Happy Now!"
I will also make sure to keep you update with any new stories I share!
Be Healthy, Be Wealthy, Be Wise!
This is long but worth the read if you are struggling with osteomyelitis. (25 minutes)
I had maxiallary osteomyletitis but you may find this helpful regardless. I used western medicine but took a lot of my health into my own hands. When you look at the re-occurance rate post -op it is not good. I wanted to avoid those odds. Did I completely? Probably not but I did avaoid having a large piece of face removed which is pretty good in my books.
Disclaimer: I am not a doctor and I am definitely not your doctor. Below is a description of a list of things I did and things I wish I would've done sooner. It's what I did under doctor supervision. This should not be taken as advice but as a different experience. Whatever you decide to take from this please consult a medical professional first.
[click to continue…]
On April 16th, which also just happened to be my birthday :), I got to be part of a regular online radio talk show with the insightful Suzanne Hanna.
Our topic of discussion was "Breakdowns Lead to Breakthroughs".
This was a topic important to me because it was when I was at my worst that I realized that I really clued into the fact that I want to do things differently.
During our discussion one thing that came up for me was that even though you can be incredibly grateful (to be alive, to get diagnosed, to have your family) you can still feel horrible and miserable. In a Venn diagram these items heavily overlap!
Another really interesting line of discussion we took was the idea of non-negotiable tasks. When I was in the thick of it I made a huge list of non-negotiable things. Whenever I become unwell I bring them all back.
Making your health non-negotiable takes the stress out of it. Don't feel like going for that walk? Doesn't matter it's not up for discussion. Not sure if you should go stay later or go home and go to bed? Again, it's not up for discussion. (I've mentioned in a previous post about what happens when I don't follow them)
My non-negotiables change. And so they should. When I had the bone infection I needed to do different things then when my stomach is upset or when I am perfectly healthy.
Here's the interview! I was pretty nervous but I think you will enjoy it!
Let me know if you have any non-negotiable in the comments below.
Be Happy. Be Wealthy. Be Wise.
Liana xo
The book is here!
I have wanted to be author for quite some time.
I always thought that it would be too hard, too complicated and that I wouldn't be able to write something was interesting.
This past summer I started thinking that I should find a way to write a book. I had no idea what to do or how this could even happen but I knew that I would find a way to make it happen. I started thinking that maybe the best way for me to do this would be to do a book anthology. I would still get to be part of a great book but wouldn't be overwhelmed with figuring out how to get it all together myself.
When you know really want something your brain becomes trained to look out for it!
At the end of September someone posted on a Facebook group that I'm a part of that they had a friend that was looking for a couple more people to contribute to a book anthology. I had a skype meeting with the compiler, Lillian Ogbogoh, in London. We had a great talk and I knew I could write a great chapter for the book.
KAPOW! I was going to be an author!
I got started on my chapter right away and it was a good thing too. My chapter was due just 2 weeks later!
It all happened very fast and it's all very exciting. It feels great to be part of a project that was not only fun to contribute to but could help inspire many people.
If you decide you'd like to buy the book please keep the receipt and send it to me.
I will be making a program about goal setting that will be coming out sometime in May. From now until then I launch it I will send it out to you for free once it's complete.
You can click here to get the book.
Thanks for all your support!
This is for anyone who has struggled with the diet and lifestyle changes that one needs to make due to chronic illness, sensitivity, allergy or weight-loss . I wrote this just after Christmas and when I was feeling particularly sick.
It's days like this that I remember why I do all the things I do. [click to continue…]
Mark almost had his arm ripped off. He lived to tell the tale and was kind enough to share his incredible story with me so that I could share it with all of you!
Mark believes in sharing his story so that he can help as many people as possible.
1. Everyone can go through periods of depression but finding what really makes you excited about life can help pull you out of it.
2. Take care of yourself. We aren't invincible. There's no need to take unnecessary risks that could cost us our health or life.
3. Don't believe in the negative self talk. You might feel like your life is doomed but it will only stay that way if you keep believing it.
Now, this is a long one so settle in …but it's good!
Dreading the next two weeks Mark gets into his car to head to work. [click to continue…]
I watched the documentary 'Hungry For Change' for the first time last year. It was one of the many things I watched when I was sick. This movie inspired me to make huge changes and although I'm no longer committed to all the changes that I made I know that I can go back to them should I need to.
I love this video!
Anyone looking to make changes to their health should take the time in the next couple days to watch it because until Sunday, November 2nd you can watch it for FREE!. Click on the link below to see it but first….
Check out the trailer!
I have been offered an opportunity to be a co-author of a book anthology!
The book is called 'Born For This: The Journey to Success in Life, Love and Business'.
I just handed my chapter in and it's already in the editing process!
It will be a wonderful compilation of personal stories and advice in all aspects of life.
The book will talk about what success means to each author.
The motto is 'If I can do it, you can do it!' [click to continue…]
It's time for another TED Talk Tuesday!!!! Hooray!
So why is sleep so important?
If you asked me a few years ago and I would've said it's not that important.
"Obviously we need sleep but really, who cares?"
My mindset about sleep has changed quite a bit but I occasionally catch myself thinking old thoughts.
"Sleep is for the weak."
It always seemed like a waste of time.
My entire life I had rejected the idea of going to sleep. I always felt like I could be doing something more productive. Even worse is that it took me a long time to actually fall asleep. Which just contributed to my idea that being in bed was a waste of time.
If I felt tired I would say "suck it up". No one else ever seemed tired.
I like all the different parts of night. I particularly love 11pm and 4:30am. Being up at those times feels like magic to me. "But you think I should be sleeping….no way!"
But I've changed my view point. Sleep isn't a waste of time. Sleep is magic! [click to continue…]
In December 2012 my office building caught fire.
It was stressful.
At 8:30 in the morning I arrived at work to see firemen rush into our unit to cover all of our stuff with plastic. My office was untouched by the fire but the water was starting to seep through the ceiling.
I, the receptionist and the doctor whose office I shared, were allowed in to grab what we could carry. We had to get out and stay out until they said when (or if) we could go back, to get the rest of our belongings.
The day was frantic. The evening before, I had been given a cease and deist letter over my business name so my stress level was already high. The day involved cancelling patients, calling the lawyer, figuring out where I could set up a temporary office and quickly going to pack up my stuff.
As I drove round that day taking my stuff from place to place I listened to the radio. Each time I got in the car for my short drive the radio host made a remark about being shocked, horrified or speechless. [click to continue…]
It's quite easy for us to just bumble about life going with the flow of whatever comes our way. At first that doesn't sound that bad. "Going with the flow" has this relaxed and easy connotation to it. It seems that it would be something to be desired.
Although it's good to have a relaxed attitude towards life it's also true that not everything that comes our way is ideal for us. Not everything needs to be said "yes" to. We don't always need to "just go with it". Not everything was sent our way with our best interests in mind. [click to continue…]


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The Current "Jobless" Recovery
July 21, 2003
The U.S. economy has grown a little more than 2 percent in the past year, and most analysts believe that the nation is recovering from the 2001 recession.
Job losses, however, continue. A new report from the Federal Reserve Bank of Kansas City says that the U.S. economy is in the midst of a "jobless recovery." Like the other recent jobless recovery, following the 1990-91 recession, the current situation reflects a reliance on "just-in-time" employment practices, such as:
- Hiring temporary workers: The growth in temp jobs was 7 percent in the 1991 recovery and 2 percent in the current recovery, but the loss of nontemporary jobs greatly offset those gains.
- Substituting part-time workers for full-time workers in order to save on wages and benefits.
- Increasing overtime: Companies with highly-skilled workforces tend to adjust the hours of their full-time employees during jobless recoveries; thus, a year into each jobless recovery overtime hours were at least 10 percent higher than during the recession.
These practices allow companies to reduce costs and/or increase productivity. Productivity grew at average rates following both recessions, which means that firms either produced the same amount of goods and services with fewer workers, or produced more without adding employees.
Using temporary and part-time workers does not change overall unemployment figures - it merely shifts the composition of the workforce. Increasing overtime hours, however, allows companies to fire workers or postpone hiring new ones. For example, if businesses had hired full-time workers instead of increasing overtime during the 1991 recovery, 108,000 factory jobs could have been created.
Temporary and part-time jobs offer less job stability, lower pay and fewer benefits than full-time jobs; thus, say the authors, the increase in these jobs could slow consumer spending growth and extend the joblessness of this recovery.
Source: Stacey L. Schreft and Aarti Singh, "A Closer Look at Jobless Recoveries," Economic Review, Second Quarter 2003, Federal Reserve Bank of Kansas City.
For text
Browse more articles on Economic Issues


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WireFusion SlideShow
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WireFusion SlideShow Hosting Promo
This WireFusion add-on makes it easy to create a slide show for your web site from a series of images. 16 transition effects are available, for example a 3D liquid effect and one where an image is folded into an airplane and flies away.Visit publisher site: WireFusion SlideShow
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- Jan 31, 2003
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The Department of Materials Science and Engineering (MSE) is a distinguished department with a long history of leadership in education and focused research. There are currently 24 active faculty, including some with joint appointments in Biomedical Engineering, Electrical and Computer Engineering, and Engineering and Public Policy. In addition to the faculty, the department consists of 77 Doctoral students, 30 Masters students, 122 Bachelors students, 16 staff, and 14 research associates.
Video highlights of current MSE research
MSE Faculty Awards & Honors


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A new study says getting a good night's rest is like winning the lottery. Not even a multi-million dollar jackpot but a few hundred thousand.
Researchers at the University of Warwick found that improving sleep quality is just as beneficial to your health and happiness as winning a jackpot of £200,000 (or $330,491).
On the other hand, poor-quality sleep, as well as fewer hours slept and an increased use of sleep medication, results in worsening medical and emotional well-being.
So would you rather win a $300,000 jackpot but have crappy sleep the rest of your life OR no jackpot win and a good eight hours every night?


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Those who shook their heads at the chutzpah of Canada's 'Own the Podium' programme should look at the final medals table and take note of the number 14 against Canada's name.
It was the largest gold medal tally by any country at a single Games in the history of the Winter Olympics. Now they own the table.
If Canada can achieve that kind of success by spending £70 million on preparing its athletes, then Britain should have no qualms about extracting maximum value out of the £260 million in public money pouring into the coffers of its Olympic sport.
So, when the white-water canoeing course opens in Broxbourne next year, it must be for the exclusive use of British athletes in the run-up to 2012, with training runs for foreign canoeists restricted to the minimum.
The same goes for the BMX and mountain-biking courses and the sailing area at Weymouth and Portland – all venues where local knowledge could be the difference between gold and silver.
While we are about it, our shooters must be given exclusive access to the temporary ranges at Woolwich to get used to the wind and the sight lines, while our equestrian riders must be given the run of Greenwich Park.
If these two venues are to produce zero legacy after the Olympics, we may as well get full value before the Games.
Against the British sense of fair play? Well, of course there needs to be some balance. That was clearly missing from the Canadians' decision to limit training runs for foreigners on what was to prove a deadly ice track.
But there is a serious point here. The Vancouver Olympics would not have been such a success without 'Own the Podium'.
The victories on ice and snow by Canadian athletes galvanised a nation brought up on self-deprecation.
Old and young, male and female, all of them dressed in Canada shirts and waving maple leaf flags, had the time of their lives, turning Vancouver's bars and restaurants, its live entertainment sites and medal ceremony plaza into a hotbed of patriotism. And Canada's occupation of the podium was the catalyst.
So let's not be coy. Let's go and buy our own podium and start erecting the barricades. The more medals Britain wins, the better it will be for everyone.


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|Police aviation accreditation standards have gained backing from an insurer, an SMS specialist and the Pentagon.
Photo courtesy of the Huntington Beach Parade
It has taken the better part of a decade, but the Airborne Law Enforcement Association's vision for establishing common standards for police aviation units is being fulfilled.
In the last year, the work of the Public Safety Aviation Accreditation Commission (PSAAC) has gotten major boosts from a key global insurer and a safety management system (SMS) services company. Each entered into partnerships with PSAAC that should build its reputation as an arbiter of best practices in airborne law enforcement.
That reputation will grow even more if the U.S. Congress and the Pentagon follow through on plans to require police aviation units receiving surplus military aircraft to adopt certification standards swiftly.
The decision by insurer QBE North America to back the police aviation standards "was a big step, certainly, for PSAAC," said Jim DiGiovanna, president of the accreditation commission and a driving force in its creation. "It was a huge step in the insurer underwriting business." (DiGiovanna currently works for QBE as a loss-prevention specialist, or auditor of risk exposure among the insurer's clients.)
DiGiovanna and other safety advocates inside and outside ALEA have long pushed insurance companies to provide incentives for their helicopter clients to improve safety through training and accreditation. The typical response has been that the insurance market was too competitive to charge higher premiums to clients who didn't improve safety.
"QBE is the first to step up," said DiGiovanna, who will be taking over as PSAAC's full-time executive director and CEO after ALEA Expo 2015 this month. "The difference here is that they recognized that, instead of offering discounted premiums, they would be willing to pay a client's cost of accreditation, particularly for renewing clients."
QBE now supports PSAAC as the official accreditation authority for the airborne law enforcement community. PSAAC in turn recognizes QBE as an official sponsor of its Standards for Law Enforcement Aviation Units. QBE North America is part of QBE Insurance Group Limited, which is headquartered in Sydney, Australia and operates out of 38 countries around the globe.
ARGUS International also is supporting PSAAC as the official accreditation authority for airborne law enforcement. ARGUS' PRISM unit is aligning its SMS for Law Enforcement program to ensure its clients that use it will meet PSAAC's standards.
ARGUS is a specialized aviation services company; PRISM is a leader in SMS and certification services for fixed- and rotary-wing operators.
ALEA leaders in the mid-2000s envisioned establishing a certification standard for police aviation units. They launched the effort to create that accreditation function in the 2007 timeframe.
"It was the worst time you could ever think of," said Don Roby, a longtime ALEA member and currently the organization's training program manager. "Just when the economy tanks."
But the work continues to pay off. The U.S. Defense Logistics Agency, impressed by PSAAC's work, is directing its personnel to tell police agencies requesting surplus military aircraft that they must provide plans for training their staffs to standards and accreditations before they can take possession of their birds.
Edward Case, that agency's vice director, in November said PSAAC's standards "could be very useful in ensuring that aircraft" distributed by the agency "are operated safely."
"The word is getting out," DiGiovanna said.
Need to KnowMod Euismodio DioEquismod Tem in Ut Quat Ip Ero Et AlitLutpat ex Enissis ex Essim Aliquis Ad Diatem DiametNisit Sum Zrilis Siscidu Isisci TatPolice aviation accreditation standards have gained backing from an insurer, an SMS specialist and the Pentagon.Photo courtesy of the Huntington Beach Parade


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Children Trailer (1976)
01 January 1976 44 mins
Robert Tucker, a young gay man who is almost without affect, sits in various waiting rooms. As he sits, he recalls events from the year of his childhood when his father dies. He's ten or eleven that year, picked on by bullies at the Catholic school he attends. He seems friendless. At home, his mother is quiet, his father is ill and angry. After his father's death, there's a wake, the coffin arrives, the body is removed. The lad grieves, alone.
Watch the official Children 1976 trailer in HD below or find more Children videos on Vidimovie.


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Gothic ghouls and ghosts from the BFI
7 October 2013
From 6 October until January 2014, Gothic Sundays will feature a collection of the scariest, creepiest, most gruesome films that lift the lid on this dark storehouse of the imagination, which found its heart in Britain, and came to life on film.
These films feed into our deepest and darkest fears, bringing creatures of the night to life up on the screen. In the opening section of the season we'll be bringing you monsters, vampires, werewolves and more with 6 classic monstrous movies.
The season kicked off last weekend with 1941's The Wolf Man, starring Lon Chaney Jnr and Bela Lugosi.
Up next we have Karl Freund's The Mummy which stars the legendary Boris Karloff. With a depth and grandeur, that was completely missing from the modern adaptations, the long dead Imhotep is reawaken with dark magic to cause death and destruction.
On Sunday 20 October, the original and definitive Dracula returns to the big screen. Bela Lugossi's genre defining performance casts Dracula as an eerily hypnotic count, who arrives in London in search of more forbidden prey.
The original vampire movie, made 9 years before Dracula, returns to FACT again this year. Nosferatu: A Symphony of Horror, showing on 27 October, is a terrifying film of strange and unearthly beauty directed in F.W. Murnau's own distinctive style.
Completing the first portion of the Gothic Season is the critically acclaimed, The Elephant Man, screening on 3 November. David Lynch's nightmarish vision of John Merrick, based on a true story, see's the deformed John Hurt rescued from fairground exploitation by an eminent surgeon, played by Anthony Hopkins.
Details of the next portion of the season will be announced soon! Tickets for all the screenings are available online, by phone on 0871 902 5737 and at the Box Office.


text: Download Railroad Tycoon Full Game Be a Railroad Tycoon Download Now Freeware: Railroad Tycoon Full Game14.2 MB File Info for Railroad Tycoon Full Game Title: Railroad Tycoon Full Game Author: Mike Splechta Download type: Freeware File size: 14.2 MB Downloads: 122 Created: January 15, 2011 Description of Railroad Tycoon Full Game Railroad Tycoon Deluxe utilizes a manual-based copy protection system. This was common back when Microprose first released Railroad Tycoon. The game asks the user a question, which can only be answered by checking the physical manual. For this release we have provided the complete Railroad Tycoon Deluxe manual in PDF format, as well as a quick reference sheet that has all the trains you'll need to answer the copy protection answer. We recommend that you print out this sheet and keep it handy when playing the game, or switch to windowed mode (if you're running full screen it's ALT+ENTER) and open the manual or reference sheet in another window. You will have to do this every time you run the game. You can find both PDF files in the manual folder in your install directory, and shortcuts to each were created in your start menu during the installation proces From Around The Web Comments


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But I only managed two - the pink dress and, today, the orange scarf. The poor kittycat socks got left out in the cold because the dress I was going to wear them with needs repairs (another one for the mending pile! Argh).
I was super psyched when I found these black Converse at my local thrift store a few years ago, but I hardly ever wear them and it only recently dawned on me why. I almost never untie my shoes, preferring instead to leave them tied and slip them on and off. Of course, that doesn't really work with high-tops. So I think I'm sometimes just too lazy to be bothered to tie my shoes. Yup, I really am that lazy.
Orange turban-style headband and infinity scarf: Refashioned
Gray boyfriend cardigan: Vintage, thrifted
White v-neck T: Old Navy
Black skinny jeans: JC Penney
Black Converse: Thrifted
Total cost to me: Probably about $20
This week's giveaway closes in just a few hours (it's open until midnight Eastern time tonight). Here are all the ways you can enter (links to social media are to the left of this post):
To enter:1. Leave a comment on the original giveaway post
2. Like bon marche couture on Facebook or share this giveaway on your own wall
3. Follow bon marche couture on Twitter or retweet this giveaway
4. Follow bon marche couture on Instagram or leave a comment on my giveaway post
5. Follow bon marche couture on Bloglovin or like this post
6. New! Link to this giveaway from your blog (if you do this, be sure to email me at bonmarchecouture at gmail dot com to let me know so that I count your entry)
Winner will be posted tomorrow. Good luck to all who entered!


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- Please select a date to see the proper prices!
- Meal can be requested on the spot
Best offer
50 € / person / night, no meal
Description of the accommodation:
Rooms, services Hotel Seeschloss Wandlitz is welcoming all guests in Wandlitz with 48 comfortable rooms to stay in. In case you ever feel like eating in, you may taste delicious local dishes in the restaurant of the hotel. If necessary, parking is available nearby. The fans of actively spent leisure time may take the bike rental, bowling, billiard, diving and boat rental opportunities nearby. For meetings and nice evening chats the local café or the bar will provide an ideal location. Wireless Internet connection (WiFi) is available at the hotel, ensuring that you can stay up-to-date during your holiday. The exact equipment and the exact list of available services of Hotel Seeschloss Wandlitz can be read on the information sheet below.
Payment Depeding on the selected room, date and price, you may be asked to provide credit card guarantee or to pay by credit card in advance.
Arrival, opening hours The earliest time for arrival and check-in is 13:00, the latest time for departure and check-out is 11:00. The personnel of the hotel can speak with you in English and German languages.
Hotel Seeschloss Wandlitz rooms Rooms
- Please select a date to see the proper prices!
Accommodation services
Free WiFi in shared places
Relaxation: Billiard, Bowling, Bike rental at the accommodation
Scuba diving nearby, Boat rental nearby
- Finnish sauna
Pet friendly (10 €/night), Garden, Bar, Cafe
Own restaurant
Hairdryer, Desk in the room


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Privacy guaranteed - Your email is not shared with anyone.
Separate names with a comma.
Discussion in 'Political Issues' started by snerd, May 15, 2012.
The best Congress money can buy!
Thank you for ruining my day.
Every time I hear about or read about Nancy Pelosi, I spend the rest of the day obsessed with trying to figure out who in their right friggin mind would vote for that loon.
How are they trying to buy the seat? TV ads? That's not what most people associate with "buying a congressional seat".
I do agree with the goal of stopping Nancy.
I don't know how the House is even in play. Boehner may be weak, but there's a good chance of a small landslide in sweeping BHO to the trashbin.
If so, could be some coattails to give majorities in both houses.
Which is what we need to undo Pelnazi's damage.


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My Trackers
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Stream hundreds of free workout videos and track them in one click. Get fit at home, at work or wherever you are!
Today's Featured Video:
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Access hundreds of thousands of recipes that are healthy and easy to make. Get full nutrition info for every recipe and track with one click!
Today's Featured Recipe:
Gluten-Free 'Almond Joy' Macaroons
Visit SparkRecipes.com
Secrets of Success
Getting to Know You
Thursday, January 03, 2013
Thanks, MOMMACASSEY, for passing this along!
"Copy and Paste into your own blog, change the answers to suit you. Get an easy three SparkPoints, and help your SparkFriends get to know you."
Where is my cell phone?
On my desk.
Hopefully at his office, or home shoveling the driveway...
Your hair?
medium length light brown and baby-fine!
Your mother?
Sadly, gone for the past 8 years.
Your father?
A recent loss, only gone 5 months.
Your favorite thing?
My life!
Your dream last night?
Struggling to breathe in my dream; woke to find the cat sleeping across my neck....
Favorite drink?
Coffee (there's a surprise)
What room are you in?
Office at work
Your hobby?
Reading and hiking
Your fear?
Where do you want to be in 6 years?
Gosh, I have trouble deciding where I want to be TOMORROW! Probably volunteering, maybe working some, traveling, enjoying grandchildren...the list goes on!
Where were you last night?
Surfing SparkPeople at home!
Something that you aren't?
How can there be any question about muffins - of course!
Wish list item?
See more of the world with DH
Last thing you did?
Finished lunch
What are you wearing?
Blue jeans, tailored beige blouse, brown boyfriend sweater, and KILLER boots
Your pets?
Tobias, (chocolate lab who loves everyone), Tallulah (my shelter cat who loves everyone EXCEPT BeBe), and BeBe (my Dad's cat, who hates everyone except me)
A high-quality few
Your life?
Your mood?
Missing someone?
Sometimes lately, but not right now.
I'm in favor of it. Wait, you mean WHAT?
Your car?
Two vintage, 3 old but reliable
Something you're not wearing?
A frown. Rarely do.
Your favorite store?
Coldwater Creek. Internet shopping rescued us mountain folk!
Your favorite color?
Blue. Or yellow. Like green, too. Bright red. How can you pick one?!?
When is the last time you cried?
Wow, I cry more often now than anytime in my life! Since the loss of my parents I find small things touch me even more. Last time I cried? Two days ago. We were talking about finishing going through my Dad's boxes...
Five people who email me regularly?
The SPAM people and every retailer in America - all my friends and relatives are pretty sporadic!
Favorite place to eat?
Out. Any meal I didn't have to cook is a GREAT meal.
Favorite place I'd like to be right now?
I am content with where I am. I have a terrific life and enjoy each moment of it, wherever I am!
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My SparkPage
I like your blog, very clever and I like your spark page. Sounds like you have lots of energy and are very ositive, all good qualities. We live in Arizona, and I feel as lucky as you to be living here, I love the weather and the freedon the weather gives us. I think this site is the best anywhere, and when I remember it is free, I can almost not believe it. All I have to do is "my part", that's the hard part!!! Happy holidays, thanks for sharing!
1435 days ago
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My SparkPage
cool post!
1533 days ago
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My SparkPage
Thanks for stopping by! This was a fun post. I agree with the color thing, I LOVE colors, and never could decide on a favorite. So I just decided that my favorite "color" is rainbow! :-)
1717 days ago
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My SparkPage
Thanks for this fun way of sharing ;-). And thanks for posting a comment on my recent blog ;-). Sounds like we're at a similar place in life with grown kids, feeling healthy, enjoying life ;-).
1777 days ago
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Thanks for the lovely bit of support you gave me on my blog! Loves me some coffee too, and believe me, I have NO problem drinking about three or more pots of it a day. You seem to have a terrific sense of humor and wanted to say it was fun reading the "getting to know you post."
1782 days ago
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Where is my cell phone?
On my desk.
Sleeping. he has to get up at 4:45am...
Your hair?
Silver, wavy, thick and short!
Your mother?
Sadly, gone for the past 5 years.
Your father?
gone 7 months.
Your favorite thing?
My life, too! And my new Blackberry playbook... LoL
Your dream last night?
Nuttin honey...
Favorite drink?
Coffee (there's a surprise)
What room are you in?
Office at home, 11pm.
Your hobby?
Gardening and walking
Your fear?
Losing my hubby some day.
Where do you want to be in 6 years?
I'd love to re-visit the Austrian and Swiss Alps
Where were you last night?
Right here!
Something that you aren't?
Blueberry-Raspberry bran, warmed up, with café au lait!
Wish list item?
My daughter continues to survive her breast cancer
Last thing you did?
Fed the cat
What are you wearing?
Sweats and moccasins
Your pets?
Angora cat, Chloe
A high-quality few
Your life?
Your mood?
Missing someone?
My Mom.
A coffee... yes I know it's late.. so?
Your car?
Pontiac Aztec SUV
Something you're not wearing?
A frown. Rarely do.
Your favorite store?
Lee Valley!
Your favorite color?
When is the last time you cried?
With daughter during her chemo treatment.
1783 days ago
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text:
Release Date: May 18th 2012
From: Open Bar
Performers: Adam Killian, Vito Gallo
Adam Killian isn't interested in leaving the bar at closing time, and bartender Vito Gallo isn't one to complain. These hot guys have a lot of pent-up sexual energy, and their cocks are hard in their jeans as they're torn off, popping and bouncing out. Adam opens his mouth up and starts sucking on Vito's monster cock immediately. It's huge, one of the biggest Adam has handled, but he's always up for a challenge when a hot guy in involved. Vito likes having a cock down his throat, too, so they switch positions and the top uses his mouth and tongue to worship Adam's dick and balls. Adam is known for his godly ass, and it's a treat for Vito to see it up close and personal as the porn star bends over and puckers his hole up. Vito sets into Adam's cheeks like a starving man devouring a meal, but it's only a precursor to Adam showing off some of his most intense moves. With Vito hard as a rock and ready to fuck, he sits on the sofa in the empty dance club where Adam straddles him and lowers his ass. The grunts and moans that erupt from Adam echo throughout the club, enticing Vito to try out bottoming for the first time on camera. First Adam loosens him up with a tongue bath before grabbing a condom and testing out just how tight Vito is. It's difficult at first: Vito's face is clenched in pain, but Adam teaches him how to handle a dick as he rides him like an animal. The heavy breathing continues when Adam takes Vito's dick again, and these two muscular guys culminate their fuck with loads of cum!
Montreal's gay nightlife has a flashy tradition of lavish dance clubs and open bars loaded with alcohol. But the real fun happens behind the scenes as DJ Brandon Jones teaches us when the dark, sexy Edji Da Silva steals him away from the dance floor and pulls him back stage. Edji slams Brandon against the wall, holds his arms above his head and starts kissing him, whispering that before too long, he's going to fuck Brandon hard. They take their shirts off and compare chests: Brandon's body is gorgeous, lean and toned with every muscle sculpted. Edji is thicker and stronger, which matches his dominant personality. Edji pulls Brandon deeper into the darkness of the backstage where he takes off his pants and presents his erection to Brandon. Instead of returning to the floor, he opens up his throat and swallows Edji, servicing every inch the Arabic Parisian has to offer. Edji finds an empty booth after the club shuts down and bends Brandon over, eating out his ass before rubbing his erection along Brandon's ass crack, teasing him with what's to come. Edji stuffs his fat cock down Brandon's throat again before slipping on a condom and bending the toned DJ over and smearing his ass with lube. Brandon wants Edji to give it to him, and he does just that. Edji doesn't hold back as he starts thrusting deep into Brandon. Each thrust causes the bottom to moan; Brandon's made it his job to please Edji, and when he rolls onto his back with his legs spread eagle, the Arabic top penetrates him deep, only to pull out and enter again. All of the fucking and sucking brings Edji to climax, and he blasts his cum into Brandon's mouth!
Both Adrian Long and Tate Ryder know how to please their audiences: Adrian shows off the body of a model, while Tate's wild sex appeal is enough to make any man hard. Tate first demonstrates one killer pole dance before Adrian makes his move, wanting Tate to show him a new trick or two. They don't get far with practicing, though: Tate and Adrian start out with a heavy make-out session before Adrian looses all of his clothes and pushes Tate down toward his erection. Tate starts blowing Adrian while he shows off his round bubble butt, teasing Adrian to bite it through his black briefs. Tate continues to suck on Adrian's uncut cock until the Aussie pulls his briefs down and presents his hole for an excited tongue bath. Tate takes control of the situation when he stuffs his cock down Adrian's throat before telling him to bend over. Adrian grabs onto the pole as Tate slips inside him and shows little mercy as he slams his cock into the Canadian model. Tate bends over as Adrian resumes eating him out and slapping his cheeks before fucking Tate as hard as he deserves, and this bad boy deserves one hard rail after the other. Tate grapples the dance pole as he clenches his face up and groans with every pound Adrian delivers to his ass. The scene turns beyond hot when Adrian lies down on the stage and Tate simultaneously rides the dance pole -- and Adrian's pole, too! They both hold out as long as they can before blowing their cum all over each other's faces!
It was a successful night as far as Will Helm and Felix Barca are concerned: these guys are hot and they know it. They're the perfect bartenders, and they rule their counter with flowing booze and endless tips. While they're cleaning up, Felix gets frisky and sprays Will with some water. Their roughhousing turns sexy as Will moves in for the kill and plants a wet kiss on Felix. They start making out, and it couldn't be hotter watching their stubble-covered jawlines working at each other's lips. Felix moves his hands over Will's torso and peels off his shirt. Will's body is nearly perfect -- his legs, arms, pecs, and stomach (not to mention is beautiful uncut cock) are a feast for any gay man, and he has just the right down of course hair to compliment it all! Muscle hunk Felix takes great pleasure in pulling out Will's cock and slurping on it with wet sucks, giving him a blowjob he deserves. The boys move over to an empty part of the bar surrounded by club mirrors; Will isn't shy about pulling down Felix's pants and returning the favor of a hot, wet blowjob: watching Will's face suck and swallow the muscle boy's cock keeps him hard and erect, and Felix grows excited for more. Will takes the hint and bends the muscle cub over for a deep ass-pounding; Will loves to fuck a hot ass, and he doesn't show much concern for his bottoms. He pumps and rails away, sliding in and out of Felix's hole, enjoying how tight the muscle bottom is. Will gets Felix on his back and fucks him ragged until they reach their explosive cum shots!
What a lonely tourist Kyle King is: all he does is hang out in bars staring at the hot guys, fantasizing about what it would be like to have them all to himself. One night he's loitering at an empty bar at closing time when Issac Jones offers him another beer. Kyle's not interested in beverage or food, and a few horny looks tell Issac what it is Kyle wants. Issac hops onto the bar, shirtless, and starts making out with Kyle, who is sex-starved and ready to serve the French bartender's every need. Their kissing is intense and strong; Issac loves pushing Kyle around, forcing him to service his cock and body. Kyle takes down Issac's pants and shoves his erect uncut cock down his throat, gulping on it and only taking breaks to suck on his tight, smooth balls. The head of Issac's cock swells and turns sensitive the more Kyle sucks and strokes it. Issac wants to use his own mouth, so he has Kyle strip off his clothes and bend over. Kyle has a beautiful hole, and Kyle loves clenching it around Issac's tongue as he eats him out. Kyle is crazed the more Issac teases him, and starts begging his French top to fuck him. Issac would love nothing more: he bends over Kyle's killer body and with his ass high up in the air, starts thrusting and pounding deep inside Kyle's hole. All Kyle can do is groan and beg for it hard and deeper. With all of that hot action, how can either one of them hold out from a killer cum shot?
With his dark features, muscled body and chiseled face Adam Killian is a sex god to be worshipped. This versatile tattooed stud loves to show off in front of the camera and when he fucks he always changes into as many positions as his partner can take! Hailing from the California coast Adam Killian loves to fuck in water. The wildest place he has ever had sex was: in the Mediterranean Sea off the coast of Mykonos, Adam claims. Our bodies were under water but there were people everywhere around us. His favorite part of sex is feeling like and animal during the act. With his thick cut dick and full meaty ass Adam Killian's favorite place to have sex is in front of mirrors so he can watch every last thrust.
What a catch Vito Gallo is as Lucas Entertainment's newest exclusive: he's handsome, tall, muscular, and is endowed with one of the biggest cocks we've seen. Vito's only limitation in bed is safety, but aside from that he's up for anything if it will equal a good romp. This hunk usually tops, and with a dick like his, it shouldn't be any other way. And as Lucas Entertainment's next big pornstar in the making, Vito is certainly someone to keep a close eye on!
Don't miss out on all of the interviews, fun, and games that went on behind the scenes of Lucas Entertainment's "Open Bar"! If you thought the guys were hot when they were sucking and fucking, get to know them a little bit better when they're not choking on cock! For anyone who wants to know what goes on behind the scenes of a hardcore gay porn movie, look no further!
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MY GOD!..this vodeo MUST rate as one of the filthy,hottest,wetest,aggressive,HARDEST,DEEPEST most intimate & erotic Lucas Entertainment has ever produced.The two men are SO into it & SO into each other,Adam Killian is one hot man and he's perfectly matched with Vito.the fucking scenes are just so damned fluid drenched,Vito's beautiful,long,thick dick just plunging slowly in and out of Killian's asshole stretched around it all wet & glistening just brought me up short and saying WOAH!.The yelling,moaning and at times almost crying from Killian,the expressions on both men's faces,the looks of shock and intense pleasure on Killian's & hot,clenched teeth defiance and open mouthed,closed eyes looks from Vito as their fucking intensifies,their faces & bodies covered in sweat,their kissing and licking each others faces and deep looks into each others eyes as they fucked was pure erotic bliss.Vito's fucking is fluid and powerful.Killian's fucking of Vito is delicious to watch in his agony when taking Killian's huge dick,his vulnerable position,his hard dick exposed between his thighs,the looks of pain on his face as Killian shoves his dick into him..WOW! instant hardon.The boys are perfectly matched,perfectly built,perfectly hung and utterly,completely & unquestionably HOT.
Mr Lucas....you are the BEST!
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Kolkata, India (PressExposure) April 08, 2015 -- There's a bit of good news for all the parents out there in Kolkata. Confidental Care, a multispecialty pediatric dental clinic, has started operations in the city, and it is offering the best possible oral care for children, at affordable rates too.
The inauguration of Confidental Care dental hospital took place in the last week of March. At the event, Dr. Mariya Hussain, the head of the dental care team here, interacted with the media. She confirmed that leading pedodontists in Kolkata will be available for consultation at the clinic. While giving a brief overview of the facilities at Confidental, Dr. Hussain reiterated that the clinic boasted of state-of-the-art infrastructure, and provided all types of gum and dental treatment services.
Elaborating on the nature of oral treatments available at Confidental Care, Dr. Hussain mentioned dental restorations, implants, insertion of dental crowns and bridges, gum bleeding and toothaches as some of the most common problems treated at the clinic. More complicated issues, like baby bottle tooth decay and mouth sores/ulcers will also be diagnosed and treated by the dentists in Kolkata at Confidental.
Various types of dental surgeries, x-rays and scans will be conducted at Confidental, added Dr. Hussain. All operations will be done at the clinic with a noted dentist for children in Kolkata at the helm. One-on-one consultation sessions would also be organized, to provide post-surgical care tips and advice. Keeping the smiles of the city children nice, bright and healthy would be the motto of Confidental, reiterated Dr. Hussain.
During the media conference, it was correctly pointed out that there was a general lack of oral health awareness in India. Problems like bad mouth odor or toothaches or swollen gums are generally ignored, or are made worse by DIY treatments. Confidental would try to bridge this gap. Parents will be able to book appointments with leading child dentists in Kolkata at the clinic. Dr. Hussain strongly recommended all parents to bring their children for regular dental check-ups. She chuckled while saying that 'prevention is better than cure' is an adage she has always believed in.
The central location of the new dental hospital in Kolkata (at Muzaffar Ahmed Street) is likely to boost its popularity among caring parents. The clinic has the provision of booking appointments online, via its official website. A short online form has to be filled (for mentioning name, preferred date and time of appointment, and the exact nature of the problem), following which patients can come down to the clinic. Parents can put in dental appointment requests at any time - and avail the best tooth and gum care services for their children, with ease.
Dr. Hussain assured everyone that the dental treatment provided at her clinic will be at par with the latest international standards. There was a brief mention about the ongoing medical research conducted by the team of doctors at Confidental. Among the more advanced types of oral surgeries, smile redesigning, dental scaling and root canal treatments are already arranged for here. Dr. Hussain and her team are focusing on providing holistic, high-quality services to every patient who sets foot in the clinic.
Although Confidental Care specializes in pediatric dentistry, its services would not be limited to children only. Adults can get in touch with the renowned Kolkata dentists at the clinic, to get timely diagnosis and lasting relief from their dental ailments. Complete dental replacements are done at the clinic too, while cases of dental trauma and related injuries are also treated.
Here's hoping that Confidental Care clinic would live up to its promises of providing world-class dental care services. There are not many good dental hospitals in Kolkata - and the success of Dr. Hussain's clinic will certainly be welcome news.


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More leaked e-mails from Hillary Clinton's time as Secretary of State prove that she was taking foreign policy advice from left-wing billionaire activist George Soros.
EDITOR'S NOTE: George Soros is the puppet master of the New World Order, and he is using his vast wealth to spur Muslim migration in Europe, race wars in America as well as rigging digital voting booths. Now WikiLeaks reveals that he has had Crooked Hillary in his back pocket for quite sometime. To date, she has accepted $25 million in donations from the Soros machine.
An e-mail provided by WikiLeaks showed Soros reaching out to Secretary Clinton over a foreign policy dispute in Albania.
"Dear Hillary,
"A serious situation has arisen in Albania which needs urgent attention at senior levels of the US government. You may know that an opposition demonstration in Tirana on Friday resulted in the deaths of three people and the destruction of property.
"There are serious concerns about further unrest connected to a counter-demonstration to be organized by the governing party on Wednesday and a follow-up event by the opposition two days later to memorialize the victims.
"The prospect of tens of thousands of people entering the streets in an already inflamed political environment bodes ill for the return of public order and the country's fragile democratic process."
Soros urges the then-Secretary of State to get the international community involved and pressure the Prime Minister to "forestall further demonstrations" and "tone down public pronouncements" as well appointing a senior European official to act as the mediator.
WikiLeaks provides the smoking gun connection George Soros and Crooked Hillary:
The left wing billionaire also gave Clinton a list of potential nominees to appoint as mediator: Carl Bildt, Martti Ahtisaari and Miroslav Lajcak.
Crooked Hillary Says She Is Not "In Anyone's Pocket' After Taking Millions From George Soros:
Listen as Crooked Hillary's liberal interviewers actually laugh out loud as she tries to assert that she is "not in anyone's pocket".
The e-mail was sent from Soros' aide to Richard Verma, then the Assistant Secretary of State for Legislative Affairs who forwarded it to several of Clinton's top aides including Huma Abedin, Jacob Sullivan, and Philip Gordon. Sullivan forwarded it to Clinton.
Just three days after Clinton received the e-mail from Soros the EU ended up sending Soros' suggested nominee Lajcak to mediate the civil unrest, the BBC reported. source
Geoffrey Grider
NTEB is run by end times author and editor-in-chief Geoffrey Grider. Geoffrey runs a successful web design company, and is a full-time minister of the gospel of the Lord Jesus Christ. In addition to running NOW THE END BEGINS, he has a dynamic street preaching outreach and tract ministry team in Saint Augustine, FL.
- Donna R Brown
Every week we see more harm and destruction and evidence of Hillary's lies. I'm not surprised to see her in George Soros's pocket. I'm sure it's really cramped in there next to Barack.
That is a great comment Donna. And so veeeery true!
You can be sure your sins will find you out. That which is done in the dark will be brought into the light.
- DeniseC
Amen–and I hope we're still here to see her get her comeuppance. If not, we won't care! Maranatha!
- Leo
Who really runs America? 😯
—(just sharing)
You nailed it. Everyone else, be it bankers, politicians, kahbalists, intelligence and military officers,etc work solely for them, even if they don't know it. Satan is at the top of the pyramid, and just below him is the occultic spiritual power center of the world…called Rome.
- DeniseC
Sola, nice new picture. Did you guys find the fountain of youth, and where can I go to get a drink of that? 🙂 (Your kids? Very nice.)
You can be sure your sins will find you out. That which is done in the dark will be brought into the Light!
- finnigansmom
our country will really be in a shambles if she gets elected president. Our elected officials seem absolutely powerless to slow down the unimaginable corruption taking place..
- Robert Johnson
Clinton may have just as well answered, "You know…bowling balls don't have wheels!" It would've made just as much sense as the "answer" she gave – and have been just as eagerly accepted by her blind supporters.
Gee,what a shock! Why does George Soros want to take America down? I guess I should go onto Google and read about him. I never heard of him before this website and the HIldabeast.
- HeidisMom
Google: The Bilderberg Group, The Tri-lateral Commission, Council on Foreign Relations, Agenda 21, George Soros, any Rockefeller, Bill Gates, Zucker-baby, Ted Turner, Henry Kissinger, CERN. Switzerland tunnel dedication 'ceremony', etc.
Pretty chilling stuff for those who still have the capacity to think for themselves and connect the dots. Follow the money. They have sold their souls and our lives for filthy lucre.
- Marian
And don't leave out the Georgia Guidestones that lists depopulation as the #1 goal.
- Marian
What a surprise!! A member of the elite giving money to another "club" member/puppet… who'd a thunk it?!
- John
They are all criminals, put them in jail before we lose what we have in this country! Think of your children and your grandchildren, omg what is America thinking too allow this, get rid of the cancer before it eats us alive, Bravo TRUMP! F..K, broom hillda, what a snake she is, even steeling votes from the graveyards! Watch NewsmaxTV, channel 366 on Direct Tv.get the real news, instead of the lyes on Cnn and Fox news, all bought out by big corporations, when billy bob was in office past the law,they are both liars,husband and wife,( I did not have sex with that woman) Can this country endure another 4 to 8 years of the Clintons are you serious, plus Obamas, lying ass, so this stuff keeps going on!
- George
George Soros has untold wealth & poured money & backing to Obama for a long time. Now he is backing Hillary & Soros wants to rule the world & he just uses people like Obama & Hillary to help him with this & all they can see is the money he throws them while he can care less about them. Soros has been called the most evil & most dangerous man in the world by many good people in high places. .Soros uses his wealth & power to spread venom & terrible things all over the world because of his wealth & just because he loves being a evil man doing evil things. G.M.C.
- Tracy
Do these evil people not realize that they, too, will one day die? Even if the population of the world is decreased to 500 million, they are getting older, and what, exactly, do they think they are going to gain? Do these elitist believe in reincarnation? Geeeezzzz, my brain doesn't get this insanity.
1 Timothy 6:10 (KJV)
10 For the love of money is the root of all evil: which while some coveted after, they have erred from the faith, and pierced themselves through with many sorrows.
Hebrews 9:27 (KJV)
27 And as it is appointed unto men once to die, but after this the judgment:
- DeniseC
Tracy, I think all this transhumanism/singularity stuff is for those people to TRY to live forever, but even a robot can be destroyed by God's wrath. They are fools.
- DeniseC
I agree with all of you; Soros is evil, and "birds of a feather flock together." He's a Jew that turned other Jews in to the Nazis; Think he really cares about Americans?
- avidtrober
Keep praying in the authority Jesus Christ has given us:
"I have given you authority to trample on snakes and scorpions and to overcome all the power of the enemy; nothing will harm you." Lk 10:19
When you enter the Holy of Holies under the blood of Christ forgiven of your sins, you have more authority than Soros, Hillary Clinton, the Democratic Party, even the Obama Administration.
Every time I slack off praying this, Hillary's campaign gets smooth sailing. Every morning and evening when I'm face down praying by the authority of God's Word the headlines bring trouble to her.
"But the prince of the Persian kingdom resisted me twenty-one days." Dan 10:13
"The prayer of a righteous person is powerful and effective." James 5:16
- Stephen Trumble
This is good stuff. We've always known the system is rigged. What we need is to link our hearts in prayer to send Hillary to jail. If God will grant us (as a nation)one last blessing, we can still be the driving force of evangelism around the world. That's how we make America great again.
- belinda
Soros has sons that wil take the helm of his ineqity.
- david
The office of the President of the United States should at all times be occupied by a freely elected American who possesses dignity, honesty, integrity, and a high degree or morality. Neither Clinton nor Trump measure up. They both fall short albeit for different reasons.
- Donna R Brown
Thanks, edwitness, you too!
- Mike rozman
AMEN! Agree 100%