text:
In asbestos litigation, the plaintiffs' bar has apparently invented a perpetual motion machine that feeds on outrage that will never run out. Still, lawyers who have not filled their wallets with legal fees from asbestos cases sometimes attempt to replicate the machine. For the most part, the imitators have failed.
What accounts for the unreasonable success of asbestos litigation? Unlike pharmaceutical litigation, exposure does not require a prescription. Although asbestos insulators and applicators experienced the most exposure, other trades and occupations worked with, or near, asbestos materials. Anecdotal testimony of exposure suffices in almost every case. Add para-occupational exposure, and the sky's the limit for the class of potential plaintiffs. See Lester Brickman, "Fraud and Abuse in Mesothelioma Litigation," 88 Tulane L. Rev. 1071 (2014); Peggy Ableman, "The Garlock Decision Should be Required Reading for All Trial Court Judges in Asbestos Cases," 37 Am. J. Trial Advocacy 479, 488 (2014).
Then there is the range of diseases and disorders attributable to asbestos. Excessive exposure to asbestos minerals cause non-malignant pleural plaques and thickening, as well as lung fibrosis, asbestosis. Some asbestos minerals cause mesothelioma, and despite a differential in potency among some of the minerals (between amosite and crocidolite), the general and specific causation of mesothelioma is often uncontested. Furthermore, lung cancer in the presence of asbestosis may be the result of interaction of asbestos exposure and cigarette smoking. Plaintiffs' counsel and The Lobby have expanded the list of attributable diseases to include non-pulmonary cancers, only to find some defendants willing to pay money on these claims as well.
In addition to the ease of claiming, or manufacturing, exposure, and the willing cooperation of the occupational medical community in supporting medical causation, asbestos litigation is a lightning rod for moral outrage in the courtroom. Plaintiffs claim that "industry" knew about the hazards of asbestos, including its carcinogenicity, long before warnings appeared. Defending the knowledge claim requires nuanced explanation of shifting standards for establishing causality as epidemiology developed and was applied to putative asbestos-related cancer outcomes, as well as changing views about the latencies of asbestos-related diseases.
Every once in a while, plaintiffs' and defense counsel[1], the media[2], the academy[3], and the insurance industry[4] ask whether "silica" is the next asbestos. Although the prospects have been, and remain, dim, plaintiffs' counsel continue to try to build their litigation palace on sand, with predictably poor results. See Kimberley A. Strassel, "He Fought the Tort Bar — and Won," Wall St. J. (May 4, 2009).
There are many serious disanalogies between asbestos and silica litigation. One glaring difference is the inability to summon any outrage over suppressed or nondisclosed knowledge of alleged silica cancer hazards. The silica cancer state of the art, written by those who are lionized in the asbestos litigation – Hueper, Schepers, and Hardy, along with NIOSH and the Surgeon General, all appropriately denied or doubted silica as a cause of lung cancer. See below. When the IARC shifted its views in the 1990s, under the weight of determined advocacy from some partisans in the occupational medicine community, and with the help from some rather biased reviews, industry promptly warned regardless of the lack of scientific support for the IARC's conclusion. The manufacturing of faux consensus and certainty on silica and lung cancer is an important counter to the incessant media stories about the manufacturing of doubt on topics such as climate change.
[1] Robert D. Chesler, James Stewart, and Geoffrey T. Gibson, "Is Silica the Next Asbestos?" 176 N.J.L.J. 1 (June 28, 2004); Mark S. Raffman, "Where Will Silica Litigation Go?" 1 LJN Silica Legal News 1 (2005); Chris Michael Temple, "A Case for Why Silica Litigation Is Not the 'Next Asbestos'," LJN Product Liability Law & Strategy (2004).
[2] Jonathan D. Glater, "Suits on Silica Being Compared To Asbestos Cases," N.Y. Times (Sept. 6, 2003).
[3] Michelle J. White, "Mass Tort Litigation: Asbestos," in Jürgen Georg Backhaus, ed., Encyclopedia of Law and Economics 1 (2014); Melissa Shapiro, "Is Silica the Next Asbestos? An Analysis of the Silica Litigation and the Sudden Resurgence of Silica Lawsuit Filings," 32 Pepperdine L. Rev. 4 (2005).
[4] "Is silica the new asbestos?" The Actuary (2005).
Historical Statements – – State-of-the-Art
Maxcy, ed., Rosenau Preventive Medicine and Hygiene 1051 (N.Y., 7th ed. 1951) ("Thus, there is no evidence that lung cancer is related in any way to silicosis.")
May Mayers, "Industrial Cancer of the Lungs," 4 Compensation Medicine 11, 12 (1952) ("Nevertheless, silicosis is not, apparently associated with, or productive of, lung cancer, whereas asbestosis very probably is.") (Chief, Medical Unit, Division of Industrial Hygiene and Safety Standards, N.Y. Dep't of Labor)
Geritt Schepers, "Occupational Chest Diseases," Chap. 33, p. 455, ¶3, in A. Fleming, et al., eds., Modern Occupational Medicine (Phila. 2d ed. 1960) ("Lung cancer, of course, occurs in silicotics and is on the increase. Thus far, however, statistical studies have failed to reveal a relatively enhanced incidence of pulmonary neoplasia in silicotic subjects.")
Spencer, Pathology of the Lung (1962) ("Silicosis and lung cancer inhaled silica, unlike asbestos, does not predispose to the development of lung cancer.")
Wilhelm Hueper, Occupational and Environmental Cancers of the Respiratory System at 2-6 (N.Y. 1966) ("The bulk of the available epidemiologic evidence on the association of silicosis and lung cancer supports the view of a mere coincidental role of silicosis in this combination. *** From the evidence on hand, it appears that a well advanced silicosis does not seem to furnish a favorable soil for the development of cancer of the lung.") (chief of the National Cancer Institute)
Harriet L. Hardy, "Current Concepts of Occupational Lung Disease of Interest to the Radiologist," 2 Sem. Roentgenology 225, 231-32 (1967) ("cancer of the lung is not a risk for the silicotic. It is a serious risk following asbestos exposure and for hematite, feldspar, and uranium miners. This means that certain dusts and ionizing radiation alone or perhaps with cigarette smoke act as carcinogens.")
Raymond Parkes, Occupational Lung Disorders 192 (London 1974) ("Bronchial carcinoma occasionally occurs in silicotic lungs but there is no evidence of a causal relationship between it and silicosis; indeed the incidence of lung cancer in miners with silicosis is significantly lower than in non-silicotic males.")
Kaye Kilburn, Ruth Lilis, Edwin Holstein, "Silicosis," in Maxcy-Rosenau, Public Health and Preventive Medicine, 11th ed., at 606 (N.Y. 1980) ("Lung cancer is apparently not a complication of silicosis.")
Robert Jones, "Silicosis," Chap. 16, in W. Rom, et al., eds., Environmental and Occupational Medicine 205 (Boston 1983) ("The weight of epidemiologic evidence is against the proposition that silicosis carries an increased risk of respiratory malignancy.")
W. Keith C. Morgan & Anthony Seaton, eds., Occupational Lung Diseases 266 (1984) ("It is generally believed that silicosis does not predispose to lung cancer. * * * On balance, it seems unlikely that silicosis itself predisposes to lung cancer.")
1 Anderson's Pathology at 910b (1985) ("There is no evidence that silica increases the risk of lung cancer, nor does it enhance tobacco induced carcinogenesis.")
U.S. Dep't of Health and Human Services, The Health Consequences of Smoking – Cancer and Chronic Lung Disease in the Workplace: A Report of the Surgeon General at 348, Chapter 8 "Silica‑Exposed Workers" (1985) ("the evidence does not currently establish whether silica exposure increases the risk of developing lung cancer in men.")
J. Cotes & J. Steel, Work-Related Lung Disorders 156 (Oxford 1987) ("The inhalation of silica dust does not contribute to malignancy.")
NIOSH Silicosis and Silicate Disease Committee, "Diseases Associated With Exposure to Silica and Non-fibrous Silicate Minerals," 112 Arch. Path. & Lab. Med. 673, 707 (1988) ("Epidemiologic studies have been conducted in an effort to assess the role of silica exposure in the pathogenesis of lung cancer. *** Thus, the results are inconclusive … .")
Arthur Frank, "Epidemiology of Lung Cancer, in J. Roth, et al., Thoracic Oncology, Chap. 2, at p. 8 (Table 2-1), 11 (Phila. 1989) (omitting silica from list of lung carcinogens) ("The question of the relationship of coal mining to the development of lung cancer has been frequently considered. Most evidence points to cigarette smoking among coal miners as the major causative factor in the development of lung cancer, and neither a recent84 nor a British study of lung cancer among coal miners has found any relationship to occupational exposure.")


text:
Leave of Absence
- Leave of Absence Notification Form
- This form is required when a student will not be taking classes at UD during the fall or spring semesters or if a graduating senior is in their last semester and will be transferring in remaining courses. A student may take an educational leave of absence if taking a course at another school, participating in a non-UD study abroad, or work experience (HRIM and HSIM majors only). Documentation to support the request for an educational leave must be submitted with the form to the advising office in 103 Lerner Hall (i.e. transfer credit form).
- Transfer Credit
- This form is required if a student plans to take a course at another school for transfer to UD. The form should be completed prior to taking the course. See the Transfer Credit Instructions for more information.
- Application for Readmission
- This form is intended for students that were previously matriculated at UD and were discontinued, suspended, etc. and wish to re-enroll at UD.
- Check-list for students on Academic Probation
- This form must be completed by an advisor while meeting with a student on academic probation. The form should be delivered to Marcia Rollison or Kim Wilson to remove the student's registration hold.
- Senior Check-out
- Students should complete a senior check-out at least one year in advance.
- Voluntary Withdrawal Notification Form
- Students that wish to discontinue their studies at UD should complete this form and submit to the advising office in 103 Lerner Hall.
- Registration Form for Online Courses
- Out of state students only
Forms available through UDSIS advisor center – log on to UDSIS to access
- Course Substitution Form
- Change of Catalog Year Form
Forms available to students through UDSIS Student Center
- Change of expected graduation term
- Change of major/minor
- Change of Address
- Course Permit form (for late changes of registration)
- Enrollment Verification
- Official Transcript Order

subset: commoncrawl


text:
If you need more space for office work or other artistic activities, choose an L-shaped desk. It provides enough room for all the home office appliances and for comfortable work. Check the designs I've collected in the inspiration board below.
Farmhouse inspired high-quality L-shaped desk designed to offer maximum workspace for you. The table is constructed from wood and comes with a vintage recessed dark brown stain that will add immense character to your home office. The table can be matched with a stool or a chair.
Beautifully crafted L-shaped desk constructed from reclaimed wood and supported by a thick metal base. The table also offers a naturally stained vintage finish. You get loads of countertop too. The table should be a great addition to your home office and can be matched by a modern office chair or stool.
Reclaimed Urban Wood L Shaped Desk Made
Customized, reclaimed wrban wood L-shaped desk. Ideal for banquets or catering purposes. Table legs are made from wrought, dark iron. Huge countertop that allows you to keep there a lot of different things.
Modern L Shaped Desk Made Of Reclaimed
This minimalist, industrial-like set was hand made from reclaimed barn wood. It features an ample table in an L-letter shape and a simple chair. Both elements are supported on a solid metal construction.
Industrial L Shaped Desk Wood Desk Pipe
Dark gray walls until they ask for a piece of wood in the surrounding. The custom shape of the letter "L" is the base of this table, whose top is made of strong reclaimed oak wood and the frame is made of black metal. That brings a industrial tone .
This L-shaped desk made from reclaimed wood makes a perfect addition both to your home office or outdoors workshop. Based on iron legs, the whole creates a solid combination, that will withstand the test of time.
This wood L shaped desk will be perfect furniture in your office. It wonderful combination of rustic tabletop and modern, metal legs will add class to your office. The unique shape of the desk allows you a lot of space to work.
L Shaped Desk Wood Desk Pipe Desk
L shaped desk in industrial style. It is mounted on metal base and reinforced with solid supports. Top is made of wood. Great solution for work organization at home.
Minimalist L-shaped desk constructed from wood. The table offers a large workspace for you and is supported by a strong metal base, neatly finished in industrial black to match up to the natural wood grain at the top. Combine it with a padded stool or office chair for outstanding class.
L Shaped Desk Reclaimed Wood Steel
Are you planning to host your office? The ideal solution can be an "L" shaped desk - made of reclaimed floor beams and industrial steel. This desk has a great character, thanks to the materials used.The reclaimed wood is a big asset of this desk.
Simple contemporary computer desks featuring rectangular tops of reclaimed wood finished in brown shades. Their sturdy bases with straight legs are built of thin grey-finished square section metal tubes.
Reclaimed Pallet Wood Custom L Shaped
A DIY table made of an old wooden pallet. The pallet was reclaimed in such a way that it looks as if it was high quality wood. It's in the shape of letter L and it's supported on white legs. It might be used as a picnic or dining table.
Reclaimed Urban Wood L-shaped desk made from reclaimed farm wood-Gas pipe leg base-Endurovar finish-Fast Shipping!
This L-shaped slab desk is made from solid walnut wood, which guarantees sustainability. Its original design combines style and functionality. Allows to save space in the room, while providing you with sufficient surface to work.
This L-shaped desk offers functionality, beautifully presented in a solid wooden construction. Regardless whether you need a space for your office work or some artistic activity, it offers a wide range of space that can be divided into various areas.
Height-adjustable L-shaped solid wood stand-up desk. Design your own pairs our most popular three-legged adjustable height desk base with a one-of-a-kind wood top. The three-leg stand-up desk base is height-adjustable, using a motor to all.
Somerville Corner Executive Desk with Hutch
www.officefurniture2go.com, Solid Wood L Shaped Desk by Wilshire Furniture, $1679.00 plus Free Shipping
Reclaimed Urban Wood L Shaped Desk Made by UrbanWoodFurnishings
63" Curved Wood L-Shaped Desk
Request a custom order and have something made just for you.
Home Office
A pleasant home office arrangement that consists of a large desk in an L-shape, floating shelves and a cabinet. The legs of the desk are smartly crafted as they feature open shelves. The whole set is made of solid wood.
L shaped desk in elegant style. Construction is made of wood with antique finish. Includes keyboard tray and 4 drawers for storing documents and others needed stuff. Ideal solution for work organization at home.
L shaped desk mounted on decorative carving legs. It is completely made of wood. Top has large usable surface. Perfect solution for work organization at home.
Shaped Wooden Kids Desk Design with Bookshelf and Cupboard
Shaped Pedestal Executive Desk
I'll take 2! Bush Furniture Tuxedo L-Shaped Wood Computer Desk in Mocha Cherry - WC21830-03
L-shaped desk using hollow wood doors and filing cabinets that I painted white. Made by my hubby!!
L shaped corner desks help conserve space to maximum and besides they look sleek and trendy. This versatile desk sports white base and natural medium brown top; thanks to crisp simplicity, it matches dozens of interior layouts.
Computer Desk
It is very practical, corner computer desk. It is above all very practical. It is equipped with cupboards and drawers, which allow virtually organize the space. It is the perfect solution for office or youth room.
Bush Fairview Collection L Shaped Desk With Hutch Antique Black And Cherry
This collection includes stylish, solid, useful and ergonomic pieces of office furniture. An L-shaped desk provides a quite large working space, many drawers and storage compartments. The chair has got wheels and a swivel mechanism.
Bush Fairview Collection L Shaped Desk With Hutch Antique White
A pretty desk with a hutch of wooden materials in white but an L-shaped desktop in mid brown. A desk has a door cabinet and 2 drawers with metal shell pulls and an open niche. A hutch has a crown top, 2 cabinets with louvered doors, 2 open niches.
Bridgeport Executive Desk
Bush Cabot L Shaped Computer Desk With Hutch Espresso Oak
A perfect piece of furniture that plays a functional role in the home office. It is an L-shaped desk that fits in the corner of a room. It features many additional cabinets, drawers and shelves for enhanced storage.
Sierra HX Standing Desk
Industrial L Shaped Desk Wood Desk Pipe
Large wooden desk in the shape of the letter L is very practical and extremely useful solution. It is spacious, it gives a lot of space to work and the ability to hide and organize handy things. It is very practical.
home office furniture u desks | Classic Home Office L Shaped Desk
I love this glass/espresso wood combo. Just bought it for a home office decor, but it will be out in the sunny area of our house, looking onto our backyard and the Tortolita mountains.
A castle desk! You can write your play at it and then perform it with puppets.
Modern, L-shaped computer desk with a metal frame with a chrome finish and stained glass top. The built-in keyboard compartment makes it a handy addition to a study room or a home office , sure to give it a contemporary feeling.
1950´s French Mid-Century Side Table | From a unique collection of antique and modern side tables at
The tabletop weather glass barometer measures 6"L x 6"W x 13"H. Its rosewood stained wood stand w/ French finish features hand-turned brass feet. A handblown teardrop shaped weather glass is suspended from an elegant brass arch. Its design is reminiscent
L Shaped desk wood staining
Shape Desk
shaped wood veneer desk set
Executive L-Shaped Desk and Bookcase Set - OFG-LD1220 and other Office and Computer Desks


text:
Patching Tips for Parents
Patching is sometimes recommended to treat amblyopia or "lazy eye." By covering the "good" eye (or the eye with better vision), the brain is forced to use the "weaker" amblyopic eye.
Patching helps the neural pathways or "connection" between the eye and the brain to develop better vision.
What kind of patch should be used?
An orthoptic patch with adhesive backing is the most effective. The patch should be large enough to cover the child's eye completely. It should be firmly applied so that it is not easy for the child to find an opening and "peel" it off. There are many brands on the market, including Coverlet and Opticlude, which are flesh colored and look like a band-aid. These can be purchased in any pharmacy. There are also many brands of "decorated" patches, which sometimes make the process of patching more fun for the child. One brand is Ortopad, which can be ordered online or over the telephone. (We have a supply of these in our offices for your convenience.) The adhesive properties can vary between brands, so feel free to try a different brand if one is not working well. If the adhesive irritates the skin, applying "Milk of Magnesia" to the skin that the adhesive contacts, prior to placement of the patch, can be helpful.
There are several brands of cloth patches that slide over glasses, which can be used for some kids. Children are much more likely to "peek" around these patches, so check with your ophthalmologist about whether this type of patch would work for your child.
A Bangerter filter or opaque plastic film can also be used on the glasses if your physician feels this would be an appropriate treatment for your child. These are available for purchase in the physician's office.
Pirate patches are usually not effective because they do not fit tightly and it is easy to "peek."
How can I keep the eye patch on my child?
There is no doubt that the process will take patience, persistence, and determination. Commitment to patching on the part of the parent is critical. The message to the child needs to be "there are no options." Just as a child may not like to ride in a car seat or wear a seatbelt, the parent must insist on the child's well being. The rule should be that only a "grown up" such as Mom, Dad, a grandparent, nanny, etc., may remove the patch.
Choose a time of day when the child is not tired or hungry. Making patching a consistent part of the daily routine is helpful in encouraging a child to patch. One-on-one playtime may be necessary at the beginning for encouragement and support. It will be difficult for the child to see when you first put the patch on, and they will be easily frustrated. Offering a preferred activity while patching can help motivate the child. ("We will put the video on once the patch is on.") Establishing a reward system for successful patching (stars on a calendar, a favorite small treat to eat) can be helpful for older children. Distract younger children with activities that keep their hands busy. If the child pulls the patch off, simply put another one on and introduce a new activity. Be patient and understanding, but firm and consistent.


text: The Staggers 10 March 2016 Defeat over Sunday trading heightens the pressure on George Osborne's next Budget The Chancellor is developing an unwelcome reputation among Conservative MPs and activists as error-prone. Photo: Getty Sign UpGet the New Statesman's Morning Call email. Sign-up In 1986, the then-Conservative government was defeated over plans to liberalise Sunday trading. Margaret Thatcher, the sitting Prime Minister, had a majority of 144. Last night, the Conservative government was defeated over plans to liberalise Sunday trading. David Cameron, the sitting Prime Minister, has a majority of 12. 27 Conservative MPs broke the whip to hand the government a defeat. The government's whips have responded well to an election that was a Conservative victory, but a thumping reduction in the government's majority (down from 77 under the coalition to just 12 now), and in a way, the surprise is that a defeat hadn't happened before. (That said, Tory whips believed that, had tax credits returned to the House of Commons following its defeat in the Lords, passing it again would have proved impossible). But there's a particular sense that the government - and particularly George Osborne - blundered into a battle that they were only going to be defeated over. Changes to Sunday trading were not in the Conservative manifesto, and there isn't a great groundswell of public feeling about the issue one way or the other. One Tory MP recently reflected to me that, had it not been for John McDonnell's Little Red Book gaffe, the spending review would have been "an unqualified disaster" for Osborne, and that his pre-election Budget - which saddled the party with line that it would "cut spending to 1930s-levels" was not the stuff that dreams are made of, either. Osborne is developing a reputation for unforced errors. Among MPs, that is unlikely to matter. Conservative MPs believe that, while Jeremy Corbyn is leader, they will easily defeat Labour at the next election. But among Conservative members, there is an element that genuinely fears the prospect of a Corbyn-led government. A reputation for own goals could yet cost the Chancellor dear. › George Osborne's stock has fallen, but it's too soon to write off his leadership hopes Stephen Bush is political editor of the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to domestic and global politics. Subscribe For more great writing from our award-winning journalists subscribe for just £1 per month!


text:
NEW BLOG: How to become an offshore worker Ever wondered what offshore working life is like? In our latest blog we dive into what you can expect salary wise and how to kickstart your offshore career: #offshorework" title="https://t.co/bZH31yFlFL #offshorework">https://t.co/bZH31yFlFL #offshorework #oilandgasjobs #oilrigjobs #careeradvice https://t.co/OTan3Sny8q
Quick Job Application
In a rush? Simply drop off your CV by clicking on the button to your right, and we'll get in contact if we have a suitable vacancy.
The importance of keeping your CV up to date
Your CV is much more valuable than you may think. It's a platform to showcase your experience, an opportunity to prove you're right for a job at an employer's first glance, and you never know when you may need it.
You may only need to update your CV once in a blue moon when you are looking for your next career move, but here are 3 reasons why it is a great idea to keep your CV fresh and up to date.
- Internal opportunities
There may be a time where a new, exciting opportunity may arise within your current organisation, and you want to be the first one to be considered for the position. However, if you haven't updated your CV in a while but somebody else has, they have a good chance of getting in before you, which is why it's important to continuously update your CV when you have achieved something significant. Remember, a CV is a working progress.
- A sudden turn of events
One day you might come to the conclusion that your current job just may not be your dream job after all, or perhaps there have been a number of redundancies and you were hit with the same bombshell. Anything can happen, which is another reason why always having an up to date CV is so important, so that you are ready for anything.
- Acknowledging achievements
Updating your CV can help boost your confidence by reminding you of all the great work you've done over the last few months. Be sure to include any projects you have worked on and work you have done to help contribute to the company's success. Some of these accomplishments may get brushed to one side and forgotten about but if you make a note of them on your CV as you go along, it not only makes it easier to remember all the hard work you've been a part of, but also contributes to helping us feel good and confident in the work we do.
Things to think about when working on your CV
Some key things to help make your CV fresh and eye-catching is to go over your skills and add in any new ones you have learned and picked up along the way.
Be sure to include any significant achievements or successful projects you have been a part of as and when they come up. Also remember that with many CV's being found online in today's day and age, it's getting increasingly difficult to stand out from the crowd.
A good way to give you a head start is to include keywords where possible throughout your CV so that if an employer or recruiter are searching for someone with your particular skillset, you're more likely to be found quicker and easier.
If you're wanting to jazz up the look and feel of your CV, take a look at our CV writing tips article here.
"Their knowledge of the industry, our organisation and candidates is one of the leaders in the market. They have always been able to supply us with the right calibre of engineering candidate no matter what the discipline or regional location is.
"First Recruitment Group's service delivery has always been to a high standard and the customer service provided by the team has ensured that First Recruitment Group will remain a preferred supplier of engineering personnel to WorleyParsons on our future engineering projects."
"In my dealings with First I have found them to be responsive, knowledgeable, quality-focused and engaging in their approach. I would have no hesitation in recommending the services of First Recruitment Group to any prospective customers."
Global Engineering Consultancy
"We have a good working relationship with First Recruitment and they always put every effort in to filling our positions whether it's on a permanent or contract basis. First have an honest and open approach to recruitment and their clients which is refreshing. First offer an excellent payroll service which compliments their overall delivery service to MWH Treatment."
MWH Treatment
"As the biggest services supplier to the nuclear industry our demand for personnel is significant, when I have an urgent requirement I know I can rely on First Recruitment to rise to the challenge.
"As a preferred supplier for temporary labour and a fundamental part of our permanent recruitment process we get the right people at the right time. Whether its highly technical/specialist resources or back office support personnel the approach is to the same high standard."
Veolia Nuclear Solutions
"It's great to work with a recruitment agency we trust. The team at First Recruitment Group are friendly and straight talking and they continue to provide an excellent service. We're proud to still be working with them after 20 years."
Simon Carves Engineering Ltd
"First Recruitment are on the 1st Tier of Sweett Europe's preferred supplier list. We have found First recruitment to be hugely supportive and value adding partners to Sweett, helping us source a wide range of roles. The consultants at First are hugely knowledgeable and have a real desire to listen to, and understand, our needs. They have shown an unrivalled desire to work on hard to fill roles using innovative methods to ensure they always supply us with CVs.
"I have been hugely impressed by their willingness to support us, even when we have simply been after guidance which would not attract them a fee. I would be more than happy to recommend First Recruitment Group to any prospective organisation, and to discuss in more detail their capabilities."
Sweett Group
"We've worked with First Recruitment for over 12 years and have built up a great relationship with their team. They've helped us in sourcing contractors for our chemical division, maintaining consistently high standards in delivery, and we hope to continue building on this relationship in the future. I have no hesitation in recommending First to others."
Haden Freeman Limited
"We have used First Recruitment to support the recruitment of several key roles within our business. The quality of the candidates put forward were extremely high which helped enormously in our ability to fill all roles, also the candidates have all been a success since joining our business. They were prompt, knowledgeable and very professional and made the recruitment process for us extremely simple. The service we have received has been first class and I would highly recommend the services of First Recruitment to any Company looking to fill a vacancy."
Meadow Vale Food Group
"I have worked with First Recruitment frequently over the last couple of years. Their ability to understand our business and support me in terms of recruitment has been excellent. Candidates are screened initially to meet our requirements and taken through the process in a professional way. I would have no hesitation in recommending First Recruitment to any employer who needs that little extra support in their recruitment process."
Bokomo Foods (UK) Limited
"I have found First Recruitment to be very efficient and professional in their approach to recruitment. They were able to gain an in depth understanding of the needs of our business and source high quality candidates. I would highly recommend their services to anyone with a recruitment need."
"First Group are one of the key suppliers to Cobham. The team are quick to respond, friendly and professional, and as such have made a massive difference to the account. The team have supported and filled a variety of roles. Without hestitation I would recommend First."
Help us with our surveyDo you feel the jobs market has picked up?


text:
The Cool Kids team up with BBGun to direct their new video "Bundle Up", it also includes behind the scenes clips. They really over did it on this. The video is hella dope, the set looks crazy too. Watch the video below.
Behind the scenes video in the post. Continue reading


text:
Thoughts on the SGA's new look
By ARIADNE WILL
February 20, 2020
As the student body will soon vote on whether to keep the five SGA commons senator seats, I would like to argue in favor of these representative positions.
We need the commons system
By SANDHYA SEWNAUTH
September 12, 2019
I'd like to express why I think the commons should be here to stay.
College May End Commons System 'As It Exists Now'
By JAMES FINN
March 21, 2019
A steering committee has released recommendations that, if implemented in full, "would effectively mean the end of the commons system at Middlebury as it exists now."
Proposed Commons Changes Are a Good Start
February 28, 2019
The How We Will Live Together Steering Committee intends to address issues within the current residential system that have traditionally hampered students' experiences.
Commons May Soon Undergo Major Changes
February 21, 2019
The Residential Life System is poised to undergo major changes, which could include building renovations, a new student center, and the elimination of a commons dean. After a 10-month review, members of the How We Will Live Together Steering Committee charged with reimagining the system presented its ...
External Reviewers Assess Impact of Commons System
By JAMES FINN and SABINE POUX
January 17, 2019
An external review committee has released a report evaluating the commons system and delineating areas of potential improvement as a continuation of the college's "How Will We Live Together" residential life assessment.
Commons Review Shows Discontent in Student Life
October 4, 2018
An internal review of the college's commons system revealed a significant disconnect between students and their commons, and highlighted key areas of concern within residential life, including a lack of student spaces and a strong feeling of disconnectedness among minority students, low income students...
New Head of Atwater Commons
By Holden Barnett
April 8, 2015
Next fall, Sandra Carletti, professor of Italian at the College, will assume the position of Head of Atwater Commons. The previous Co-Heads, Peter and Michelle Nelson, are resigning after a long and successful run. Although terms for Commons Heads generally last five years, the Nelsons were given a on...
Commons System Creates Connections
By Renee Chang
September 24, 2014
On a day-to-day basis – especially as the fall semester gains momentum – students encounter a multitude of social interactions. From meetings with advisers to late night chats with friends, our lives are largely influenced by the relationships we forge with others. But what – if anything – is...
$100 Hallway Fine Unique to Brainerd
By Nate Sans
March 12, 2014
A Brainerd Commons policy of fining students for leaving items in the hallways of residence halls has led to Brainerd's levying fines of hundreds of dollars on students. Each Commons attempts to discourage students from leaving items in the hall, and when contacted for comment, representatives from...


text:
"Real Housewives of New Jersey" star Margaret Josephs is showing her range in a new holiday music video with a touching twist.
Josephs stars in "One Last Christmas Card" with producer Adam Barta, who recently shot to fame with his hit song "Free 2 Be Me" with Tan Mom.
The Christmas song serves as a tribute to Barta's mother, Marguerite, who has passed away. In the video, a young Adam Barta is played by Jonathan Salazar as he watches on.
Josephs didn't want to have all the fun by herself, and also included her mother and co-star, Marge Sr., in the production.
Barta apparently likes working with the NJ "Housewives," as he's also written a song with Joseph's on-screen nemesis, Danielle Staub.


text:
Your shopping cart is empty!
The Sigma Sports 60-600mm is the world's first 10× optical zoom telephoto lens with a telephoto end of 600mm. It incorporates multi-material (magnesium and carbon fibre-reinforced plastic) to achieve both portability (2700g) and durability.
Be the first to review this product!
The Sigma 60-600mm f/4.5-6.3 DG OS HSM Sports is the world's first 10x optical zoom telephoto lens with a telephoto end of 600mm. Incorporating 25 elements in 19 groups, excellent and consistent image quality can be achieved throughout the entire zoom range.
This lens' intelligent OS features the latest algorithm delivers an image stabilisation effect of 4 stops. Its optical design ensures maximum correction of magnification chromatic aberration encountered in hyper-telephoto shooting. This offers both high resolution and consistent edge-to-edge performance throughout the entire zoom range.
In addition, when shooting at the focal length of 200mm, the Sigma 60-600mm f/4.5-6.3 DG OS HSM Sports can also be used for telephoto macro photography, with a maximum magnification ratio of 1:3.3, thanks to its high rendering performance. Its multi-material build, which incorporates magnesium among other components, ensures durability and enhances portability, allowing for comfortable handling of the 10x zoom lens. The zooming mechanism has been engineered to make both smooth rotation and straight zoom possible. Versatile and robust, the new Sigma hyper-telephoto zoom lens is available in Sigma, Canon and Nikon mounts.
If you want to know more about this product, we know that you'll love these articles:
Talk to one of our friendly and knowledgeable consultants about this product. Call us on +27 12 348 3693 or Click to chat with one of our online consultants
Please fill out your contact details and he will contact you as soon as possible.
This login page is for the online store. If you wish to log in to the Community (Classifieds, Forum, Gallery) please login here.
Sign up for our Newsletter and receive R100 off on your next online purchase over R1000.
Please read and agree to our terms below.
Outdoorphoto will use the information you provide on this form to be in touch with you and to provide updates and marketing.
You can change your mind at any time by clicking the unsubscribe link in the footer of any email you receive from us, or by contacting us at [email protected] We will treat your information with respect. For
more information about our privacy practices please visit our website. By clicking below, you agree that we may process your information in accordance with these terms.
We use cookies to ensure you get the best experience on our website. Learn more in our Privacy Policy.
Send us your contact details and we'll contact you right away with an update on availability.
Please Note: Due to the item being out of stock, we cannot guarantee availability or price. All prices are subject to change without notice.
To request a rental product simply fill in and submit the form below.


text:
A Memory Tree.co.nz - a lifetime of memories
In Memory of
Natalie Joy Anderson
Tuesday, September 22, 2020
Looking for someone?
Book an Alert
- Back Home
New SearchFirst Names:Natalie Joy
- Last Name:Anderson
- Other Names:nee FLOCKTON
- Birth Date:25 December 1966
- Death Date:05 September 2009
- Age:42y
- Country:New Zealand
- Funeral Home:Harborow & Co Ltd Funeral Directors
- Published Notices:(9) Newspapers - view notices/order summary
Natalie was taking part in a motorcycle memorial rally for Donald Anderson, her brother-in-law who had tragically died in an air accident with his father. She was riding pillion passenger on her husband's motorcycle when it crashed at Lake Hawea during the rally to the West Coast.
This page is open and you can leave messages and memories for free until 13 April 2027
Keep this page open longer - sponsor page
MessagesMessages posted (132)
- Leave a Message << 8 9 [10] 11 12 ... 14 >>
Special thoughts at this sad time for the Anderson family. Natalie was such a lovely lady and always ready with a hello and a smile for you even if she didnt really know you that well.
A truly kind and caring lady who will be missed by many many people.
Thinking of you all at his sad time
Karen, Alan, Bethany, Jennifer and Stephen Whiteland
Murray, Asleigh & Matt
Our thoughts are with you at this sad sad time. Although we didnt know Natalie very well, she always had a smile for you, a wave and a hello.
We will miss seeing Natalie out doing her fabulous gardens and he early morning strolls to the Gym.
We are deeply sorry for your loss.
from your Neighbours
The Grahams. x
for Murray(Muzz) Ashleigh, Matt, and family and friends
what can you say about the lady who knew everyone and took the time to chat and be interested in all our lives. We have had the opportunity to live across the road and right beside the Anderson family twice now. Nat you always took the chance to say hello or just "had to pop over and say hello" and wave in the car when we were heading in and out with our kids.
I would also you you out in all places walking with your ipod or cell phone in hand, out gardening bobbing to your music......... the relay for life with your make up perfect and yes your cell phone in your hand, you made us all laugh........ the cleaning of the porta loo's at blossom fest when you made me hold your dazzling white jacket ankle deep in mud so you wouldn't get it dirty.....
everyone is going to miss you
god bless
To the family of Natalie
I only knew Nat to say hello to and have a brief chat but she always made an impression on me for how positive, cheerful and friendly she was - her characteristic hair was a delight to see down the street - her love for her family and for life was there to see - Alexandra will not be the same now that you are gone - my very heartfelt sympathy to Nat's family
To Murray, Ashleigh and Matt
Our deepest sympathy to you on such a tragic loss of a truly beautiful lady.
Natalie always had a smile and kind word for everyone - she was never too busy
to stop and say hello. The beautiful memories you have of her will live forever.
Love each other as she did. Nothing can ever take away that love.
Derek, Chrissy and Liam Turnhout (Alexandra)
Murray, Ahleigh, and Matt
Please accept the sincere sympathies of the President, office bearers, members, and parents of members of the Dunstan Arm Rowing Club.
No words can measure the feelings which you are suffering at this time - Natalie had a positive impact on those she met and the community will be the poorer without Nat's smiling face and effervescent personality.
- Back to Top All messages are approved before they are published. Report abuse << 8 9 [10] 11 12 ... 14 >>
- The Press
- Otago Daily Times
- Southland Times
- The Press
- Otago Daily Times
- Southland Times
- Southland Times
- Otago Daily Times
- Otago Daily Times
- view notices/order summary
Sponsor Page
- View Visitor Index
- Book an Alert
- Send a Gift
- Make Travel Arrangements
Share us via
Images courtesy of Dreamstime.com. Clip Art courtesy of Graphicsfactory.com.
This site contains copyright sensitive material and cannot be reproduced without written consent from copyright holders.
© A Memory Tree Limited 2006-2020.Site Credits


text:
Canaries pair in the frame after a month to remember
PUBLISHED: 06:00 05 October 2017 | UPDATED: 08:49 05 October 2017
©Focus Images Limited www.focus-images.co.uk +447814 482222
The manager of the month nominations are out and Norwich City boss Daniel Farke is up for his first award since moving to Carrow Road.
And in a welcome double for the Canaries, James Maddison – scorer of that magnificent free-kick at Reading on Saturday – has been nominated for the player of the month award.
Farke has guided the Canaries from a place in the relegation zone to ninth in the table and overseen a club record five clean sheets in a row.
The last City boss to win it was Alex Neil – who took the award last September – and is also in the running this time around.
Maddison's place was perhaps rubber-stamped by his magnificent free-kick at Reading last weekend and if he wins it will end a long wait – City's last Championship player of the month was Simeon Jackson, who won the award way back in April, 2011.
Manager nominations:
Steve Bruce (Aston Villa): Guided Villa to four wins and two draws from six games with an emphatic 10-1 goal differential.
Daniel Farke (Norwich City): Stung by the 4-0 loss at Millwall in late August, he placed the emphasis on defensive shape during the last international break. The result was just one goal conceded in six September games and 14 points gained.
Lee Johnson (Bristol City): His side took over as leading scorers in the Championship with 13 goals in six unbeaten games which yielded 14 points. Even more impressive was that their September fixture list included visits to Reading, Wolves, Norwich and Ipswich.
Alex Neil (Preston): Unbeaten in six unbeaten, collecting 12 points, to lead North End into the play-off positions.
Judging panel: former Ipswich manager George Burley, Sky Sports' EFL League expert Don Goodman; EFL Marketing Director Drew Barrand, League Managers' Association Director Olaf Dixon and Sky Bet EFL Trader Mikey Mumford.
Player nominations: Aden Flint Bristol City central defender; Sam Johnstone Aston Villa goalkeeper; Wolves midfielder Diogo Jota and Canaries young talent, James Maddison.
The judging panel is Sky Sports' EFL expert Don Goodman; League Managers' Association Director Olaf Dixon and Sky Bet EFL Trader Mikey Mumford.


text:
Deka Immobilien is the specialist for real estate investments within the Deka Group and is one of the largest globally active real estate fund companies in Germany. As an experienced real estate investor and asset manager, we possess proven expertise and comprehensive management competence for different market and investment cycles and have created sustained added value for our fund investors, tenants and business partners for more than five decades.
The DekaBank Real Estate Lending unit is responsible for commercial real estate lending, which is available exclusively to institutional real estate investors in selected markets and categories of real estate. The Real Estate Lending unit's broad market and investor access strengthens the activities of the Asset Management division.
More about our lending business
With a total of around 600 professionals, we focus on office, retail, logistics and hotel properties. Comprehensive market knowledge, broad investment experience, and a regional market presence and global network make us a strong partner.
1) Figures refer to the management companies Deka Immobilien Investment GmbH and WestInvest Gesellschaft für Investmentfonds mbH. As at 30 June 2020, unless indicated otherwise.


text:
Razor Clam Dig Approved for April 21-23 in Washington
OutdoorHub 04.16.12
State fishery managers approved a series of morning razor clam digs April 21-23 at several ocean beaches after the latest round of marine toxin tests showed the clams are safe to eat.
With the state's razor clam season nearing an end, Long Beach and Twin Harbors will be open for digging all three days, while Copalis and Mocrocks will be open on Monday, April 23 only.
No digging will be allowed on any beaches after noon.
"We have just enough clams available for harvest at Copalis and Mocrocks to offer one more weekday dig," said Dan Ayres, coastal shellfish manager for the Washington Department of Fish and Wildlife (WDFW). "We'll see where we are with the other beaches after this opening."
Copalis Beach lies south of the Copalis River and includes Ocean Shores, Oyhut, Ocean City and Copalis. Mocrocks Beach is north of the Copalis River and includes Iron Springs, Roosevelt Beach, Seabrook, Pacific Beach and Moclips.
Proposed beach openings for upcoming digs, along with morning low tides, are:
- April 21, Saturday (7:28 a.m., -0.3 feet): Long Beach, Twin Harbors only
- April 22, Sunday (8:01 a.m., -0.4 feet): Long Beach and Twin Harbors only
- April 23, Monday (8:35 a.m., -0.4 feet): Long Beach, Twin Harbors, Copalis and Mocrocks
Under state law, diggers can take 15 razor clams per day, and are required to keep the first 15 they dig. Each digger's clams must be kept in a separate container.
Diggers need a valid 2012-13 fishing license to participate in the upcoming opening, since all 2011-12 licenses expired March 31. The exception is young people under age 15, who may fish for free.
Licensing options range from a three-day razor clam license to an annual combination fishing license, which can be purchased on WDFW's website ( https://fishhunt.dfw.wa.gov ) and from license vendors around the state.


text:
The Best Spyware Protection Security Software for 12222
XNSPY provides users with a variety of comprehensive features. What are some of them? XNSPY allows the user to see emails, texts and all other types of communication on targeted phones. Track SMS, app activity, and call logs. GPS tracking. It has several essential features. They make it the best way to spy on cell phone without touching target phone.
Teensafe allows monitoring activities on different targeted phones: incoming and outgoing SMS messages, Instagram, WhatsApp, and internet. It allows tracking outgoing and incoming calls. Deleted messages can be viewed, using TeenSafe cell spy app. Parents can even access the location of their children, using a GPS tracking feature. TeenSafe spy apps for cell phones have a 7-day free trial. This suit has all features that parents need to track their kids. Most parents prefer this solution due to reliability and convenience: a great number of children can be traced under one subscription.
Besides, no bugs were detected during the testing procedure. No matter how hard the child tries, a caring parent will see each entered keystroke. Text message monitoring. Do not let the kid communicate with people you do not like by fixing or deleting target text messages of any type. The spyware for cell phones listed here has gained a lot of popularity recently and has a broad range of uses. Nevertheless, a user requires the best cell tracking software. This reverse spy software for mobile phones is the most accurate.
It provides information on activities taking place on target mobile devices after the interested party logs into the system. This review aims at creating a bigger picture of different mobile device trackers. It shows why they are in a top 10 list and why everyone praises them. Some phone owners believe spying on another cell phone is unethical, immoral, and illegal.
The first two issues are contradictive. Concerning the legal aspect of the activity, it is legal to use a cell phone spy app in most cases. It depends on whether the user applies such software after entering into a contract or receiving permission from the target phone owner or spies anonymously. The purposes predetermine if the activity is moral ethical or not. Thousands of cell phone spying devices are available on the market.
Do not hurry to invest your money! Choose the best paid or free spy software based on the list of 10 top-selling surveillance apps from gifted third-party developers. We have prepared the list based on several features. A company, which has no real location or hides one, looks suspicious no matter which type of industry it belongs.
Spy Software Reviews
It will be easier to contact the support or come to have a face-to-face conversation if something goes wrong after the app installation. Does the company post new content regularly? What about the FAQ section? A good, reliable developer will answer the questions ASAP, take care of the informative content, provide objective data, and initiate discussions with the users. Look at the list of guarantees. Try calling the company to discover whether the contacts are real. Before moving on to the list of top 10 tools to spy on a cell phone without installing software on the target phone, remember a few more aspects.
Also, mind that jailbreaking is not a good practice.
- Avast Security & Photo Vault on the App Store.
- mobile spy free download windows vista sp2 issues.
- 2 thoughts on "Top 8 Best iPhone Spy Apps".
It is time to observe the list! We have mentioned a couple of distinct features of each app to let a parent select a free spy on a cell phone without installing software for hours. Comprehensive reviews from professionals here at CellSpyApps. A few words about preventing a person form spying. Take these simple steps to ensure the safety of the personal mobile device:. People often ask about the best cell phone spyware app for personal use. This lookup provides essential information that enables you to make a smarter choice.
You can determine which program suits your needs best! Your information will be handled as detailed in our Privacy Policy. You can unsubscribe at any time. Learn more Try the Best Spy App. Visit site Read review. Read Review. Visit Site Read review.
Highster Mobile cheapest cell phone spy app Easy installation No jailbreaking or rooting needed Works on all devices 8. We Verizon Media and our partners need your consent to access your device, set cookies, and use your data, including your location, to understand your interests, provide relevant ads and measure their effectiveness. Verizon Media will also provide relevant ads to you on our partners' products. Learn More.
Spyzie Monitoring App Review | WebWatcher
To give you a better overall experience, we want to provide relevant ads that are more useful to you. For example, when you search for a film, we use your search information and location to show the most relevant cinemas near you.
We also use this information to show you ads for similar films you may like in the future. Like Verizon Media, our partners may also show you ads that they think match your interests. Learn more about how Verizon Media collects and uses data and how our partners collect and use data.


text:
It's almost time to grab that lawn chair out of your garage and make your way over to the intersection of Snelling Ave and I-94 in Saint Paul. According to Fred Melo of the Saint Paul Pioneer Press, construction on Minnesota United's new home may begin this week.
St. Paul Port Authority confirms Mortenson Construction hopes to start soil prep, early access work at @MNUFC stadium site by end of week
— FredMelo, Reporter (@FrederickMelo) June 13, 2017
If you're looking for a team to root for, might I suggest that you watch this Christos FC�video?
Spoiler: Christos FC lost last night, but not before�scoring a goal�against D.C. United! Eric Miller also grabbed a goal for Colorado Rapids in its�3-2 win over OKC Energy.
Not a bad way to open your account in burgundy @emillller!!!https://t.co/Nkk33wTgyf
2-2 | #USOC2017 pic.twitter.com/IAWVIO8Gam
— Colorado Rapids (@ColoradoRapids) June 14, 2017
Francisco Calvo scored for Costa Rica in the first minute of action last night.
Costa Rica scores after 50 seconds. Francisco Calvo with the header… pic.twitter.com/ZlY6yXeSTz
— LuisMiguelEchegaray (@lmechegaray) June 14, 2017
Not to be outdone, Kevin Molino pulled one back for Trinidad and Tobago. Costa Rica won the match 2-1.
�GOOOL! @NavasKeylor la toca pero no la para y @kevinmolino10 iguala el partido para @TTFootballAssoc 1-1 #Eliminatorias pic.twitter.com/eDc6DCGfEq
— beIN SPORTS Espa�ol (@ESbeINSPORTS) June 14, 2017
FiftyFive.One is now on Patreon. Do you like the independent coverage of soccer news from Minnesota and beyond that FiftyFive.One offers? Please consider becoming a patron.
Tags: Minnesota Stars FC, Minnesota United FC, stadium, us open cup, USMNT


text:
Record Store Day is coming 12.04.2010
This Saturday the 17th it's Record Store Day, a day to celebrate your local vinyl pusher, and support the format that shaped the first music industry, and created its own one in the process. Where would we be with no DJ Kool Herc and a set of old records at a block party?
In Dublin it's not that easy to find out what's happening this year, apart from a list of exclusive releases on the day from Universal records. According to the page for Dublin on the official website the following shops has things happening:
- Beatfinder Records in Temple Bar
- Road Records in Fade Street
- City Discs in Temple Bar (whose website seems to be b0rked at the moment)
- Tower Records
- And the always (but not for much longer) fantastic Freebird Records who still have their 50% off closing down sale.
If you like your vintage vinyl it's also worth mentioning the flea market in Ranelagh on the 17th, and if the weather next weekend looks anything like what it did this weekend, that's where you'll find me getting my fingers dusty.
Thomas | web / 11:06 / 16th of april / 2010
Thanks for the reminder of Record Store Day! I might go check out the local record store (Repo Man)—-they observe the Records Store Day and celebrate their three year birthday on Saturday.
zhangcaiyun99 | web | @ / 7:33 / 9th of september / 2010
Brandon Jennings, Andrew Bogut and most of the other Milwaukee Bucks players will be returning Tuesday as informal workouts begin at the Cousins Center training facility, with the start of training camp about three weeks away.
But a few players already have been working out, including rookie forward Larry Sanders and second-year forward Jon Brockman. They have been putting in time with coaches Kelvin Sampson, Bill Peterson and Adrian Griffin.
"I definitely want to get some conditioning in," Sanders said after a recent workout. "I don't want to use training camp to get in shape. And it's good just to get settled here in Milwaukee."
The 6-foot-11 Sanders made a solid showing in the Las Vegas summer league as he averaged 14 points, 8.4 rebounds and 3.2 blocks in five games with the Bucks squad.http://www.pop4inf.com/


text:
Want to study in USA? Stop now and read this first in ResourcesAbout 750,000 foreign students enter the United States of America each year. It is the most preferred destination for students all over the world. While USA does not have the world's oldest university (that distinction goes to University of Karueein, Morrocco), all of the "Ivy Le...
Tags (Separate tags with commas): study abroad, study in usa
Last updated
What is the minimum amount of cgpa required to get admitted to top US universities? in ResourcesHi, I am from India. I wish to know the minimum amount of cgpa required in engineering to get admitted to top universities of USA.
Tags (Separate tags with commas): Study in USA
If you have any questions or concerns, please get in touch here


text:
November 18, 2018
Hello friends!! kel here from sharing a teacher thank you card today!! I'm using the bus from the Learning is an Adventure set.
I colored it up with my Copics and then added it to some fun alphabet paper. Because the paper is so dark I wanted to make sure to pair it with shades of the same color, which this time was blue! And then I added that button for a pop of a different color!!
LOVE. I can't wait to make more cards with this set!! I still have a frizzy-haired teacher to play with from this set too! And make sure you come join us over at the Kindred Stamps FB Group to see the amazing makes everyone else is sharing!! Thanks for stopping by, see you again soon!!
lovies, =o) kel
September 23, 2020 3 Comments
September 22, 2020 1 Comment
Sign up to get the latest on sales, new releases and more …
Subscribe to our newsletter and always be the first to hear about what is happening.


text:
1/2 c blood drops (red hots)
1/2 c cats eyes (blanched almonds) or (gum drops)1/2 c cats claws (sunflower seeds)
1 c chicken toenails (candy corn)
1 c colored flies (M&M's)
1 c butterfly wings (corn chips)
1 c ants (raisins)
1 c earthworms (cheese curls)1 c cobwebs (Triscuits) or (Golden Grahams)
1 c snakes eyes (peanuts)
1 c bats bones (shoestring potatoes)
Mix everything together in a large bowl.
Serve with several pints of blood (cherry punch).
Southern Jewel's Fab Finds


text:
Business Brokers Queensland
During 2005, the founders of Business Brokers Queensland took on new partners to continue to grow the business and to ensure the future is as secure and rewarding as the past. Looking forward into 2007 and beyond, we are committed to: * Providing services which achieve (and if possible, set) industry best practice. * Actively contributing to the improved recognition & professionalism of our industry; and * Developing a sustainable and successful business in partnership with our staff, alliances, clients and customers.
+ Recent listings in this category: Business Sales
Loth Business Brokers is a professional business broking agency that is located in Brisbanes inner... more details
We are here to help you SELL your business!!
Business seekers visiting our site come from... more details
Online Business for Sale listing specialists with comprehensive resources and stacks of businesses... more details
Businesses for Sale | Business Broker Sydney | Sell my Business | Mergers and Acquisitions Australia
TGBN Mergers and Acquisitions Australia are a specialist firm help you sell a business in... more details
Stuckonyou.com.au provides gift finder service to select gorgeous gifts for kids and has been... more details
As experts in search engine marketing in Perth WA, we service local business for all web marketing... more details
Business Brokers and Advisors - Buy, Sell or Merge Across Australia. One Business Brokers is a... more details
Welcome to Wise Electrical Services. We are proud of our Residential Electrical Services &... more details
A shop filled with history and culture of Australia, its heritage and sense of belonging in the... more details
Australia's largest laser hair removal & IPL hair removal specialists. Book online now for laser... more details
from Solar Quotes Brisbane
BELLY DANCE for your next event
from Amoura Belly Dance
+ Popular Website Link Directory CategoriesBusiness Services Accommodation Business Health & Beauty Home Improvements Automotive Real Estate Web Designers Finance & Investment Weddings Other Sports & Recreation Health & Medical Food & Beverage Legal Building & Construction Cleaning Services Photography Computer Services Internet Marketing & Advertising Gifts Education & Training Entertainment Health & Medical - Dentists View More...
+ Recent Listings in the Website Link DirectoryPro Pest Control Gold Coast Altitude Aviation Truck Wreckers Melbourne Melbourne Cash for Cars Vic Recyclers Absolute-it Total Wreckers Noble Cash for Cars Doctor Drain North Melbourne Concrete Cleaning Toowoomba Adam Insights ANZ Lotto Cash For Car Scrap Sydney Hobart Cash for Cars Modular Storage Systems


text:
DJ Skizz provides the smoothed out backdrop as Your Old Droog drops science on his affinity for Jazz music. Off of Skizz' Cruise Control dropping on July 29.
DJ Skizz provides the smoothed out backdrop as Your Old Droog drops science on his affinity for Jazz music. Off of Skizz' Cruise Control dropping on July 29.
Mac Miller morphs into Larry Fisherman and puts some of his production behind Your Old Droog for "!Go Fish!"
Oh my goodness this is filthy. Your Old Droog, Styles P and Joey Bada$$ connect over a gutter Black Milk production for "Just Rhymin."
Your Old Droog spits hot fire on the Oh No produced "Dylan!"
Complex City Cyphers will travel to various cities to highlight local rappers and musicians. In this pilot episode, A$AP Ferg, Wiki, and Your Old Droog freestyle over music provided by Grammy nominated jazz musician Christian Scott. This cypher is deeply rooted in the traditions of freestyling in hip-hop and improvisation in jazz. The live collaboration provides a sonically unique and refreshing approach to the tried and true video format of the cypher.
Your Old Droog uses an Alchemist backdrop to tell the stories of young ladies who are in love with hip hop that happen to enjoy giving fellatio to hip hop guys. Get it?
After dropping the video for "42 (Forty Deuce)", Your Old Droog drops by the "Real Late With Peter Rosenberg" show and discusses the single before slaying the mic.
Your Old Droog drops the visuals for the joint paying homage to Times Square and the many staples of the New York City centerpiece.
Statik Selektah deploys the ill lineup of Conway, Your Old Droog, Westside Gunn and Termanology to explain exactly what "The Curve" is.
Your Old Droog pays homage to the intersection of Broadway and 42nd Street with "42 (Forty Deuce)" that deploys the Nu Shooz sample of "I Can't Wait."


text:
Jordan's Lobster Farm: Live, Fresh Seafood
Jordan's Lobster Farm in Long Island is an hour and a half away drive from the city. Although it is a fairly long trip I must say, it's always worth the travel time. Last Friday, Joel, Henri and I together with our friends Christina and Angelo took a road trip to get out hands on a killer 11-pound fresh lobster.
Jordan's is an outdoor restaurant and seafood deli right beside the water. The place smells like the sea...it reiterates the quality and freshness of their wide array of seafood offerings! If you go inside, you will see the stack of lobster tanks where you have the liberty to pick the particular lobster (the size and weight) you want. We didn't have to go through that though because my husband called that morning and reserved the biggest they had...pretty smart!
Too start our meal, we shared their fresh shrimp cocktail ($10.95) and fried shrimp basket with fries ($11.95). I also had my staple New England Chowder ($3.95 for a 12-oz cup)...hearty, creamy and generously filled with clams unlike the usual ones that have more potatoes than clams.
Then came the heavy-weight maine lobster ($89)...deep orange and black in color, so fierce and intimidating. It was cracked in the middle with the chunky meat peaking out. You would think that the meat of a lobster this size would be gummy and chewy but it was still moist and tender. It came with containers of butter, lemon wedges and steamed sweet corn wrapped in foil. The four of us were determined to conquer the whole thing...but failed. We threw in the towel after devouring 3/4 of it. It was just too much. We didn't want to walk out of there with an ugly feeling of throwing up. So we stopped when we were happily satisfied.
Jordan's Lobster Farm is undeniably a great place to go for live, fresh seafood. Ahoy! :)
* Just to give you an idea of how big the lobster was... it's was big as our son Henri! :) *
Jordans Lobster Farm
1 Pettit Place
Island Park, New York 1158-2276
(516) 889 3314


text:
Don't miss your email and connect your friends with TalkKing!
If you cannot view this email, please
click here
Vintasia special offer
The most famous second wines of Bordeaux first growths
***Above discounted prices for purchase minimum 6 bottles or more only.***
***All prices are vaild while stock lasts and stock available on a first come first serve basis.***
***All prices are in HKD and subjected to change without prior notice.***
More brands are available in store
For any enquiry, please reach us at (852) 2522 7122 or
email to
Vintasia Limited
Office Address :
10B Carfield Comm. Bldg.
77 Wyndham Street
Central, Hong Kong
Tel :
+852 2522 7122
Email :
Office Hours :
9:00am - 6:00pm,
Monday - Friday
except public holidays
Copyright© 2019 Vintasia Ltd. All rights reserved. |


text:
With just two weeks to go until Future Armoured Vehicles Central & Eastern Europe 2017, SMi Group have released a preliminary list of attendees ahead of the industry meeting set to take place on 15th and 16th May in Prague, Czech Republic.
Within the Central and Eastern European region, the land forces environment continues to receive renewed attention, the likes of which have not been seen since the end of the Cold War. This has been reflected in large scale international exercises to boost readiness, as well as the individual efforts of NATO member states to enhance their respective capabilities, through procurement and training.
The constant spotlights on the region creates a need for a platform to facilitate discussion regarding tactics and technologies that will enhance future combat vehicle effectiveness in the region. Now in its 3rd year, Future Armoured Vehicles Central & Eastern Europe will bring together a truly exceptional speaker line up featuring over 25 thought provoking presentations from United States Army Europe as well as the Czech Republic, Austria, Romania, Bulgarian, Slovenian, Lithuanian and Latvian Land Forces
An attendee list is available in the event download centre here.
Event highlights will include:
• An opening host nation address from the Czech MoD to provide updates on the current gaps and areas considered for capability development
• Lockheed Martin discuss the fightability and agility of the 21st century turret systems
• United States Army present PEO ground combat systems development of Stryker
• Insight into wheeled and tracked vehicles for modern forces with General Dynamics European Land Systems
• Romanian Armed Forces share key areas for growth and investment
• Austrian MoD provide attendees with plans and timelines in supporting procurement of BSV10
• German Army share feedback from joint exercises and potential for collaboration with NATO and regional partners
• Feedback on the new BOXER vehicles and advantages delivered over legacy M113 tracked APC by Lithuanian Armed Forces
• BOXER's manufacturer ARTEC discuss key success and future plans
• Turkish MoD present an overview of threats to the vehicle that the Turkish Land Forces must be prepared to face
• Norwegian Defence Logistics Organisation present finding from the recent white paper and subsequent future priorities
• Soucy Defense explains challenges for integration and maintainability of composite rubber track
• Czech MoD discuss plans for armoured vehicle procurement and systems integration
• Spanish, Latvian, Bulgarian and Slovenian Land Forces talk combat vehicles modernisation
• DSTL provide overview for project Medusa
• Feedback from collaboration with the German, Netherlands and Lithuanian Armed Forces with OCCAR
Further information including a brochure and full speaker line-up is available at: http://www.futurearmouredvehicles.com/telco
Future Armoured Vehicles Central & Eastern Europe
3rd Annual Conference: 15th & 16th May
Andel's Hotel, Prague, Czech Republic
Sponsored by ARTEC, Burgess Consulting, General Dynamics, IBD Deisenroth, Lockheed Martin, Pearson Engineering, Rheinmetall CHEMPRO, SOUCY Group and TenCate Advanced Armour
--- End ---
Contact Information:
For all media enquiries contact Theresa Chung on Tel: +44 (0)20 7827 6068 / Email: firstname.lastname@example.com
About SMi Group:
Established since 1993, the SMi Group is a global event-production company that specializes in Business-to-Business Conferences, Workshops, Masterclasses and online Communities. We create and deliver events in the Defence, Security, Energy, Utilities, Finance and Pharmaceutical industries. We pride ourselves on having access to the world's most forward thinking opinion leaders and visionaries, allowing us to bring our communities together to Learn, Engage, Share and Network. More information can be found at http://www.smi-online.co.uk


text:
Meta-analysis of data on costs from trials of counselling in primary care: using individual patient data to overcome sample size limitations in economic analysesBMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7401.1247 (Published 05 June 2003) Cite this as: BMJ 2003;326:1247
- Peter Bower, senior research fellow (peter.bower{at}man.ac.uk)1,
- Sarah Byford, senior lecturer2,
- Julie Barber, lecturer in medical statistics3,
- Jennifer Beecham, senior lecturer2,
- Sharon Simpson, research associate4,
- Karin Friedli, principal lecturer5,
- Roslyn Corney, professor of psychology6,
- Michael King, professor of primary care psychiatry8,
- Ian Harvey, professor of epidemiology and public health7
- 1 National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL
- 2 Centre for the Economics of Mental Health, David Goldberg Centre, Institute of Psychiatry, London SE5 8AF
- 3 Research and Development Directorate, University College London Hospitals NHS Trust, London NW1 2LT
- 4 Centre for Occupational Psychology, University of Cardiff, Cardiff CF10 3YG,
- 5 Centre for Research in Primary and Community Care, Faculty of Health and Human Sciences, University of Hertfordshire, Hatfield AL10 9AB,
- 6 University of Greenwich, Bronte Hall, London SE9 2UG,
- 7 School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ,
- 8 Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London NW3 2PF
- Correspondence to: P Bower
- Accepted 1 May 2003
Objective To assess the feasibility of overcoming sample size limitations in economic analyses of clinical trials through meta-analysis of data on individual patients from multiple trials.
Design Meta-analysis of individual patient data from trials of counselling in primary care compared with usual care by a general practitioner.
Setting Primary care.
Patients People with mental health problems.
Main outcome measures Direct treatment costs, depressive symptoms, and cost effectiveness.
Results Meta-analysis of individual patient data proved feasible. The results showed that the previous analyses of individual trials were underpowered to provide useful conclusions about the cost comparisons. The results are sensitive to assumptions made about the costs of sessions with a counsellor and the management of patients by a general practitioner.
Conclusions Meta-analysis of individual patient data may assist in overcoming sample size limitations in economic analyses. Although feasible, such analysis has shortcomings that may limit the validity of the results. The relative costs and benefits of this method, as opposed to further collection of primary data, are as yet unclear.
Economic evaluation is an increasingly important element of clinical trials. Several aspects of economic evaluations can make their addition to clinical trials problematic, but of particular importance is the sample size requirement.1 2 Trials are generally powered to detect clinically significant differences in outcomes, but since costs are often characterised by higher variability and skewness than clinical outcomes,3 economic analyses may be underpowered, resulting in type II errors— that is, failure to reject the null hypothesis that there is no difference in costs between treatments.
A recent example of this concerns counselling in primary care. Four trials reported no evidence of differences in the total costs of patients treated by counsellors compared with those who remained under the usual care of a general practitioner.4–7 None of these trials were powered on costs, however, so that firm conclusions about costs cannot be drawn. An adequately powered trial could be conducted, but this would need to be large, would be costly, and would delay access to relevant information for several years.
An alternative solution is to pool existing data in a meta-analysis. Analyses of data on individual patients are considered the gold standard for this technique and have several advantages, such as ensuring quality of randomisation and intention to treat analyses,8 but in the present context the primary advantage would be in increasing the sample size for economic evaluation and overcoming the limitations of previous analyses. We examined the feasibility of meta-analysis of economic data, using individual patient data on healthcare utilisation from trials of counselling in primary care.
Studies were identified from a Cochrane systematic review. Seven trials met the Cochrane eligibility criteria.9 Three studies were excluded after examination; two reported data on healthcare utilisation, but neither provided adequate detail.10–12 The randomisation procedures of these studies were of poor quality and likely to be associated with bias.9 The third trial is yet to report economic data but also used a comparison group of antidepressant treatment prescribed by a general practitioner rather than usual care by a general practitioner.12 This trial was also excluded, given that management by a general practitioner (and associated costs) were likely to be significantly different. Table 1 lists the included studies.4–7
Pooling data using meta-analysis requires studies to be broadly comparable, but the degree of legitimate difference is contentious.13 All four studies used counsellors meeting the criteria for accreditation by the British Association for Counselling and Psychotherapy, although the exact models of counselling differed (for example, non-directive, psychodynamic). In three studies, general practitioners recruited patients, whereas in the fourth patients were screened, and the trial was restricted to patients with chronic problems of six months or more. The time of follow up varied from three to 12 months.
Identification of comparable data
The perspective taken for the analysis was that of the healthcare system, and only direct healthcare costs were analysed. Available data on the utilisation of health care varied, but all trials included consultations with a general practitioner, prescriptions for psychotropics, and mental health referrals, which are the sources of cost most likely to be influenced by the provision of counselling (see table 1). Patient specific data were collected from medical records and patient self report.
Consultations—Not all trials collected data on all types of consultations in primary care, so consultations had to be limited to surgery attendances only, whereas other types of consultations, such as home visits or appointments with a practice nurse, were excluded.
Drugs—Recording of data on drugs varied. Two studies reported exact dosage and duration of use of all drugs, which allowed calculation of number of tablets prescribed and a cost per tablet to be applied. The remaining two trials recorded only whether a prescription for relevant psychotropics had been given. Standard duration of use and dosage for tricyclics, selective serotonin reuptake inhibitors, and anxiolytics were therefore imputed. Data on other drugs were excluded.
Mental health referrals—Data on mental health referrals also varied and were recoded as the number of attendances at four categories of services: inpatient psychiatry, outpatient psychiatry (including community mental health teams and psychotherapy), practice based psychological therapy (for example, psychologists and counsellors in primary care), and other providers of psychological therapy in community and voluntary groups, such as Relate and self help groups. Practice based psychological therapy (provided to patients in both groups as part of usual care by a general practitioner) was differentiated from protocol therapy (provided to the experimental group only). It was assumed that all protocol therapy sessions were completed in the first six months of the trial.
Data collection periods—The time periods covered by data collection varied (see table 1). Where required, costs were adjusted to represent standard periods of six months, allowing comparative analysis in the short term (six months after baseline) for all four trials and in the long term (12 months after baseline) for three trials. These adjustments assumed that service use remained constant over time and were applied to all variables apart from protocol therapy, since the length of such therapy in all trials was fixed.
Effectiveness In three studies the Beck depression inventory was the primary outcome measure.4 5 7 14 As with the cost data, clinical outcome data were collected at different periods (three, four, and six months for short term data and nine and 12 months for long term data). However, no attempts were made to adjust these data to standard periods of six months. The results may thus be subject to bias if differential outcomes between treatments change over time. Only one trial included a generic health status preference instrument.4
Calculation of costs
We applied standardised national unit costs for the financial year 1999–2000 to the data on utilisation of healthcare services (table 2). The costs of drugs were based on the British National Formulary, using the cheapest alternative available.15 Costs of protocol therapy and practice based counselling services were based on salary figures provided by a relevant national organisation (Counsellors and Psychotherapists in Primary Care). All relevant costs incurred by employers were included, plus capital and direct overheads (data not shown). All other costs were based on figures from the Personal Social Services Research Unit.16 Discounting was unnecessary as costs were all within the same time period and were not recorded beyond 12 months.
Data analysis
Not all trials reported long term data or usable effectiveness outcomes, and there were missing data in all studies. Therefore, the data available varied for analyses of costs alone, effectiveness alone, and cost effectiveness. Missing data on costs in the long term were not associated with randomised group, sex, or employment status in any trial but were associated with baseline score on the Beck depression inventory, age, and marital status in one trial in each case. Missing data on effectiveness were imputed using the last observation carried forward. Figure 1 shows the data available for the analyses.
Data on costs and outcomes were pooled separately in a fixed effects meta-analysis.17 This combines estimates of treatment effects from the individual trials into an overall weighted average, with weights given by the inverse of the variance of the difference in means for each trial. A fixed effects analysis was preferred because of the small number of trials available; however, these results were compared with those from random effects models. A test for heterogeneity was also conducted, although this may lack power given the small number of trials available. Analyses were conducted separately for the total direct costs and the total primary care costs, to enable primary care commissioners to assess the economic impact on their sector alone. All analyses were carried out with Stata (Release 7).
Meta-analysis assumes that the overall treatment effect is normally distributed. Costs were not normally distributed, but the validity of the results was confirmed using non-parametric bootstrapping.18 Such an approach was preferred to transformation or non-parametric tests, as it allows inference about the population mean.19
Relative cost effectiveness was described using incremental cost effectiveness ratios, the ratio of differential average costs of the two interventions to the differential average effects.20 21 Cost effectiveness acceptability curves were also calculated for both the short term and the long term. These plot the probability that counselling is cost effective compared with usual care by a general practitioner for a range of possible maximum values (the ceiling ratio) a decision maker might be willing to pay for an improvement in the Beck depression inventory score. The curves are based on an estimate of the joint distribution of difference in mean cost and difference in mean Beck depression inventory score obtained using bootstrapping.20–22 These curves incorporate the uncertainty that exists around the estimates of mean costs and effects as a result of sampling variation and uncertainty on the maximum cost effectiveness ratio that a decision maker would consider acceptable.
Cost outcomes
The main analysis of costs over the long term indicated that counselling was associated with significantly greater total direct costs per patient (weighted difference in means £110 ($177; €154), 95% confidence interval £38 to £182; fig 2) and primary care costs per patient (£146, £110 to £183) than usual care by a general practitioner. No evidence was found of heterogeneity (total costs P=0.70; primary care costs P=0.83), and random effects analysis gave similar results.
In the short term, counselling was again associated with significantly greater total direct costs per patient (£92, £57 to £126; fig 3) and primary care costs per patient (£135, £114 to £156) than usual care by a general practitioner. Some evidence was found of heterogeneity in the analysis of primary care costs (χ2=7.2, df=3, P=0.07). Interpretation is not substantially different if based on the results of random effects analysis (£133, £99 to £167).
Sensitivity analysis
Examination of the cost components indicated that the costs of consultations with a general practitioner and costs of protocol therapy were the main drivers of direct costs. Therefore, post hoc sensitivity analyses were conducted, systematically changing these variables.
Duration of general practitioner consultations—It has been suggested that referral to a counsellor may reduce the time general practitioners spend consulting with patients, as well as the overall rate of consulting.23 Therefore the effect of selectively increasing the duration of consultations in the group receiving usual care was tested in a threshold analysis. The significant differences found in total direct costs in the long term became non-significant (£72, -£1 to £145) when the duration of a consultation for the control group was increased to 11.75 minutes, equivalent to a 26% increase in the cost of a consultation.
Cost of protocol therapy—The cost of protocol therapy was based on the average of three different grades, ranging from standard counsellors to those in more senior management positions. It is likely that more counsellors in primary care are paid at the lower grade, in contrast to the counsellors employed within the trials included in our study. When costs for counselling sessions were reduced to those of the least expensive counsellor, the differences between the groups in total direct costs in the long term became non-significant (£69, -£1 to £139).
Effectiveness outcomes
Counselling produced superior scores on the Beck depression inventory in the short term (1.93, 0.14 to 3.71) but not in the long term (1.16, −0.65 to 2.97). Some evidence was found of heterogeneity in the short term data (χ2=7.3, df=2, P=0.03). The results using random effects analyses were similar.
Cost effectiveness analysis
The analysis of cost effectiveness was based on patients with data available on both cost and effectiveness. The incremental cost effectiveness ratio for counselling compared with usual care by a general practitioner over the long term was £196 per one point improvement on the Beck depression inventory (counselling minus usual care incremental mean cost £110, incremental mean effect 0.56). Figure 4 illustrates the uncertainty associated with the costs and effects of the two treatments in the long term, and shows that for willingness to pay values above £196, counselling has a greater than 50% probability of being cost effective compared with usual care by a general practitioner. The probability of counselling being more cost effective than usual care stabilises at about 69% for willingness to pay ratios greater than £2000.
The incremental cost effectiveness ratio for counselling compared with usual care by a general practitioner in the short term was £50 per one point improvement on the Beck depression inventory (counselling minus usual care incremental mean cost £109, incremental mean effect 2.16).
Meta-analysis of individual patient data can be used to overcome the sample size limitations often associated with economic analyses. The analyses may, however, be limited in several ways. The need to identify comparable data and apply standardised costs means that detail in individual studies may be lost. For example, non-psychiatric referral and drug costs were ignored, as were distinctions between particular services, such as between outpatient psychiatry and community mental health teams. The lack of data on costs of lost production meant that advantages associated with either treatment in returning people to work had been ignored. However, none of these issues may be as central to the effects of counselling (or as likely to show effects) as the measures of depressive symptoms and utilisation of mental health services.
We found significant variation between trials in standard deviations of costs. This may reflect more comprehensive estimates of service use in some trials, or differences between trials in the availability of certain services (for example, treatment for mental health outside the trial). Such differences have important implications for standard meta-analysis approaches, where estimates are weighted inversely by their assumed precision. Cost sources omitted or imputed in the current analysis would have also increased variance further if they had been measured. Adjusting costs to represent common time periods assumes service use is linear over time, when it may be that service use (such as consultation rates and drug use) reduces when an effective therapy is provided.
Such methodological compromises mean that the present analysis can never approach the precision of primary data collection. However, it is a matter of debate (and economics) whether this additional precision is worth the extra cost and time delay required to fund an adequately powered economic analysis, or whether secondary analysis provides a reasonably accurate estimate to inform policy and practice.
One compromise in future research is to attempt to ensure greater comparability in methodology in studies examining common cost effectiveness questions, through the use of the same outcome measures and the collection of data on service use on the same range and type of services. The prospective registration of trials might facilitate this. Researchers in the United States have gone further in explicitly preplanning meta-analyses of different interventions, deliberately standardising across studies where possible and identifying methods to deal with methodological heterogeneity.24
Several statistical issues also arise in meta-analyses of cost data. Specific features of economic outcomes (for example, skewness in the distribution of cost data) mean that further investigation into appropriate statistical methodology is needed.
Costs are affected particularly by missing data.25 Analysis of individual patient data allows imputation of missing values through several methods. Recent approaches that more accurately reflect the uncertainty associated with imputation of missing data have been described but were beyond the scope of our study.25 Data were also lost for the cost effectiveness analysis owing to use of different effectiveness measures in trials. In cases where outcomes are conceptually the same but measured on different scales, the meta-analysis approach of standardised differences might be used, allowing all trials to be included in the analysis.
Cost effectiveness of counselling
Caution should be exercised in drawing specific conclusions about the cost effectiveness of counselling, given that the validity of the current methodology is unclear. However, the main results indicate that the costs associated with counselling were higher than those with usual care by a general practitioner, which supports the argument that previous analyses were underpowered to detect these effects.2 The interpretation of figure 4 is complex, because typical ceiling ratios for a one point change in scores on the Beck depression inventory are not known. Such ratios are often assigned to quality adjusted life years (QALYs), but methods for translating Beck depression inventory scores into QALYs are crude at present.26
What is already known on this topic
Issues of cost effectiveness are an increasingly important part of clinical trials
Trials powered on clinical outcomes may be underpowered to detect important economic effects because of variability associated with data on costs
What this study adds
It was feasible to pool cost data from several trials to overcome the sample size limitations of previous studies on counselling in primary care
Previous studies may have been unable to detect differences in costs between counselling and usual care by a general practitioner
Results depended on assumptions made about costs of counsellor sessions and management of patients by a general practitioner
Given these limitations, the main analysis of differences in costs alone may be easier to interpret. These differences were found to be sensitive to increases in the duration of consultations with a general practitioner in patients not referred for counselling. However, no trials reported objective measures of duration of consultation, and thus this effect is speculative.
Results were also sensitive to the costs of counselling sessions. Tension exists between the desire to provide high quality counselling services by employing experienced (and thus more expensive) counsellors and the need to ensure that session costs do not jeopardise cost effectiveness. This has implications for other psychological therapies in primary care, such as cognitive behavioural therapy, where session costs may be even higher.4 Our findings may provide an additional stimulus to the development of "minimal" interventions, which reduce or remove the need for the therapist, if effectiveness can be maintained.26 27
Characteristics of included patients appear on bmj.com We thank Brendan Delaney, the referee, for identifying an important technical error in the first submission of the paper.
Contributors PB devised the study and wrote the paper and all authors commented on drafts; PB will act as guarantor for the paper. PB and SB wrote the protocol and performed the initial analysis, with additional economics advice from JBe. JBe, SS, RC, KF, MK, and IH provided data for the study and assisted in the development of the final database. JBa provided statistical advice and performed the bootstrapping and cost effectiveness acceptability curve analyses.
Funding PB is funded by the National Primary Care Research and Development Centre at the University of Manchester, through the Department of Health.
Competing interests None declared.


text:
Paperback 8.75" x 8.75"
by Riley Lewis and Erika Lewis
Illustrated by Erika Lewis and Jane Lewis
Three generations of the Lewis family come together to create this charming book. It started with Riley at the age of 3 and a question: "Can elephants hear our secrets, Mommy?" This was followed by her first trip to the zoo. Writing together, Riley and Erika create this story, while Jane (her grandmother) through her art, make the words come to life.


text:
You're going through a career transition.
You're feeling lost and unsure about this new shift in your career.
Left wondering how to tell the right story about your experience, you need guidance so you can land the perfect-for-you job.
Running through your head are thoughts like:
• Maybe I don't have enough experience yet, and I need to stay where I am a little longer.
• Changing careers seems like I would start from ground zero, I'm not sure where to begin. Maybe this isn't practical.
• Why aren't I passing interviews if I have the right experience and education? Where am I going wrong?
Working with a Career Coach is the best career decision for you if:
• You see an end goal in sight, but you're unclear how to get there and you need practical steps to end the overwhelm.
• You want the insider skills of a career coach to brand your resume, LinkedIn and cover letter so they speak for you and open up new doors.
• You're not sure if you have what it takes to make the next move and need someone to help you uncover the unique talents you've been taking for granted.
• You're making a career transition, recently moved to Canada or are a new grad, and you need help to reframe your experience to show how it applies to your future career goal.
• You're worried about the interview process, and it's blocking you from making your next career move.
That's where I come in.
With over 15 years experience in Human Resources, specializing in Talent Acquisition, with Home Depot and CIBC to mid-sized organizations and boutique companies, I've honed my career coaching skills by working with a wide network of clients and positions.
I've even got the LinkedIn testimonials to back it up (and I'll show you how to get them, too).
Jen is a true career savant. She is highly skilled in her field, able to jump into the deep end of an individual's professional spectrum and build out a usable, visually stunning platform for job searching. I have been looking for a new role for months with very little traction. I was at my wit's end, when I learned that Jen was a skilled resume writer. She was able to take my broken resume and build it into a work of art in a matter of hours. I have been getting 10-20 inquiries from employers a week since I started using my new resume. I highly recommend utilizing Jen's resume writing acumen if you are having trouble getting noticed. You won't be disappointed!
My career has always been focused on helping people find theirs. We'll walk through my proven process for gaining career clarity, building your career story, and a LinkedIn profile that turns heads.
Together we'll get you ready to answer the dreaded "Tell me about yourself" question and share your elevator pitch with ease.
You'll have guidance through every step of your job search process so you're not only presenting well online and on paper, you'll also impress in person.
The result?
A new job that suits the person you are today, and a salary to match.
So, if you're ready to make this transition the best part of your career journey, explore our career packages and then book a call to discuss your options.
As a recent graduate looking for my first job, Jen was beyond helpful in guiding me through crafting the perfect resume and cover letter, directing me to the right websites and places to hunt for job positions as well as preparing me for interviews! I ended up getting offers from every company I interviewed for and am so incredibly happy with the job I have today. Jen is an amazing career coach, I HIGHLY recommend!