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Transaction Services Manager/Assistant Director
|Job Title:
|Transaction Services Manager/Assistant Director
|Contract Type:
|West Midlands
|£50000.00 - £80000.00 per annum
|Contact Name:
|Nick Boulter
|Contact Email:
|Job Published:
|December 02, 2019 08:56
Job Description
High profile vacancy with a leading accountants in Birmingham
Your new company Incredible opportunity to join the fastest growing firm in the UK and to develop a high profile role with great prospects.
Your new role You will play a key role in originating, negotiating and delivering transaction support assignments. These are typically buy-side or sell--side transactions for a variety of regional corporates or Private equity businesses.
What you'll need to succeed You will be a determined person with a strong desire to succeed in a competitive deals environment.
What you'll get in return Fabulous opportunity to fast-track in a practice advisory role.
What you need to do now
If you're interested in this role, click 'apply now' to forward an up-to-date copy of your CV, or call us now.
If this job isn't quite right for you but you are looking for a new position, please contact us for a confidential discussion on your career.
Hays Specialist Recruitment Limited acts as an employment agency for permanent recruitment and employment business for the supply of temporary workers. By applying for this job you accept the T&C's, Privacy Policy and Disclaimers which can be found at hays.co.uk
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'The Single Best CLE Experience We Have Ever Had'
We're proud to announce that 16 Fortune 500 companies selected HB this year to conduct customized, on-site education for their legal teams. And we're just getting started.
Under our program called HB InHouse™, we have now delivered 75 presentations featuring top legal talent from around the country. One associate general counsel called his session "the single best CLE experience we've ever had."
And the best testimonial yet? Each one has asked for more.
If you are with a corporate legal department and are interested in a way to educate your team efficiently and effectively on topics you choose, or if you are an attorney interested in becoming an HB Education Partner and getting in front of in-house counsel, we want to hear from you.
This innovative program is led by Sharon Boothe, president and partner at HB. Sharon can be reached at (484) 324-2755 x208 or at email@example.com.

subset: commoncrawl


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A History of Natural Philosophy: From the Ancient World to the Nineteenth Century
Cambridge University Press, Jan 22, 2007 - Technology & Engineering
Natural philosophy encompassed all natural phenomena of the physical world. It sought to discover the physical causes of all natural effects and was little concerned with mathematics. By contrast, the exact mathematical sciences were narrowly confined to various computations that did not involve physical causes, functioning totally independently of natural philosophy. Although this began slowly to change in the late Middle Ages, a much more thoroughgoing union of natural philosophy and mathematics occurred in the seventeenth century and thereby made the Scientific Revolution possible. The title of Isaac Newton's great work, The Mathematical Principles of Natural Philosophy, perfectly reflects the new relationship. Natural philosophy became the 'Great Mother of the Sciences', which by the nineteenth century had nourished the manifold chemical, physical, and biological sciences to maturity, thus enabling them to leave the 'Great Mother' and emerge as the multiplicity of independent sciences we know today.
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2 Aristotle 384322 bc
3 Late Antiquity
4 Islam and the Eastward Shift of Aristotelian Natural Philosophy
5 Natural Philosophy before the Latin Translations
6 Translations in the Twelfth and Thirteenth Centuries
Its Role and Place in the Late Middle Ages
8 The Form and Content of Late Medieval Natural Philosophy
9 The Relations between Natural Philosophy and Theology
10 The Transformation of Medieval Natural Philosophy from the Early Modern Period to the End of the Nineteenth Century
Other editions - View all
A History of Natural Philosophy: From the Ancient World to the Nineteenth ...
Edward Grant
No preview available - 2007
Common terms and phrases
Adelard Adelard of Bath Albert of Saxony Arabic argued arguments Aristotelian Aristotelian natural Aristotle Aristotle's natural philosophy Aristotle's Physics Aristotle's text Aristotle's treatises arts assumed astronomy Averroes Bacon Book in Medieval caelo cause celestial bodies chapter Christian cited Clagett commentaries on Aristotle's declares Dictionary of Scientific discussion earth existence experience explains faith G. E. R. Lloyd God's Greek Science heaven History of Science ibid Ibn Rushd included Isaac Newton Islamic John Buridan Kilwardby knowledge late Middle Ages Latin logic losophy mathematics medicine medieval natural philosophers Medieval Science medieval universities metaphysics Meteorology mobile motion moved natural phi natural science Neoplatonic Newton Nicole Oresme Philoponus philoso physical world Plato pre-Socratic problems questions ratios reason regarded religion role scholars scholastic natural philosophers Scientific Biography seventeenth century Simplicius Source Book Themon theologians theology things tion titled translation twelfth century vacuum William William of Conches wrote


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Our selection of: Berlin real estate in KreuzbergYour Berlin apartment in Kreuzberg: An Attractive Location Close to the Center
Sometimes it can be tricky to find the right location, when looking for a new apartment: Berlin Kreuzberg is always worth a go. This popular Berlin neighborhood, part of the Friedrichshain-Kreuzberg district, boasts a wealth of recreational opportunities in an international atmosphere and is characterized by spacious historical "Altbau" buildings as well as a superb infrastructure.
If you want to reach various Berlin neighborhoods quickly and comfortably from your new apartment, Berlin Kreuzberg will please you even more. Virtually any part of town is only a short ride away from here, thanks to the area's location and good connection to the public transport system. For more information about condos Kreuzberg click here.
Quiet 2 room old building apartment for own use in Kreuzberg
2 Rooms | Size 59.42 sqm
Monumentenstraße 19, 10965 Berlin
Reference nr.: 16718144
- 1
Invest in a profitable apartment: Berlin Kreuzberg has excellent perspectives
You would like to purchase property in Berlin Kreuzberg? Have a look at our listings. We regularly update our selection of Berlin real estate from spacious family flats to elegant single apartments.
Investing in an apartment in Berlin Kreuzberg gives you an excellent perspective on increasing value. Demand for housing has risen substantially in recent years, making the traditionally popular neighborhood even more desirable: rents and market prices have increased accordingly. Thanks to a great abundance of renovated historical "Altbau" buildings from the turn of the 19th century, that give this area its charm, your new apartment in Kreuzberg is likely to sport high ceilings with beautiful stucco decorations and an authentic historic flair.
Enjoy the city life in your new apartment: Berlin Kreuzberg bustles with diversity
When it comes to cultural diversity and recreational opportunities, Kreuzberg certainly is one of Berlin's most exciting neighborhoods. Theater lovers can find several large institutions like the Mehringhoftheater as well as various smaller stages in the area, film lovers appreciate the neat selection of art house cinemas. Some of Berlin's most famous museums and exhibition spaces are also located here, among them the Jewish Museum and the Martin Gropius Bau museum and gallery. Gourmets will be delighted to explore the countless cafés and restaurants in the area that offer specialties from all over the world and in every price range. If you would like to have a little greenery around you in your new apartment, Berlin Kreuzberg will not disappoint you either: Viktoriapark and the new Park at the Gleisdreieck offer ample opportunities for relaxation, while Landwehrkanal is perfect for walks along the water.
You are thinking about purchasing an apartment in Berlin Kreuzberg? Browse our selection of Berlin real estate and find what you are looking for.
Browse our listings here and customize your selection, save and download it as a pdf file, print it or share it on facebook.


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Went down here tonight with VW he is a local lad to me and pretty sound.
Rechem was a massiv low grade nuclear recycling plant that has been closed down for aprox ten years.
The place is derelict but everything is live, pushing green buttons switched things on and red ones turned stuff off.
Here are my photo`s


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Pumpkin Seed Oil
· Virgin ·
250 ml
The delicious BIO PLANÈTE virgin Pumpkin Seed Oil is made using only the seeds of the Styrian oilseed pumpkin. To produce it, after harvesting, the high-quality organic pumpkin seeds are removed from the pumpkins, washed, dried and cleaned. After just two days in cool storage, they go to the oil press. To preserve their valuable constituents, the high-quality pumpkin seeds from the Austrian region of Styria are cold-pressed.
The mild, nutty-tasting BIO PLANÈTE Pumpkin Seed Oil, virgin places greater emphasis on the original taste of the delicious organic pumpkin seeds than the toasted version. It is rich in essential polyunsaturated fatty acids and vitamin E, which helps protect cells against oxidative stress.
Just a few drops of this gourmet oil round off any salad, dip, dressing, soup or even green smoothies.
Product of organic farming
Average nutritional values per 100 ml / 3.38 fl oz
** Percent Daily Values are based on a 2,000 calorie diet.


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We Are Here To Help You
Do you need help or information and you don't know who to turn to?Contact us!
Do you need help or information and you don't know who to turn to?Contact us!
The objective of studies in the study programme of Biochemistry and pathobiochemistry is preparation of the student for autonomous scientific explanation of molecular principles of life processes in the human organism, their direction and molecular mechanisms of their disorders.
Biochemistry and pathobiochemistry is concerned with the issues of biomacromolecules, i.e. proteins and enzymes, polysaccharides, lipoproteins and nucleic acids, as well as their component units and other important low molecular weight substances in living systems (amino acids, peptides, saccharides, lipids, steroids). The objective of the field is also explanation of their mutual changes and their role in cell signalling. Another very important sphere is the research into super-molecular cell structures and their function. The programme also focuses on the principles of disorders of the said structures and their functions, i.e. on the molecular nature of the origin, development and course of pathologic states. One important part of the study is the physiological and pathogenetic importance of reactive forms of oxygen and nitrogen; the subject of the study programme is mechanisms of action of the substances that damage the nucleic acids and biomembranes. In the study programme, attention is paid to research into disorders of cell signalling, including cancerogenesis and atherogenesis, molecular nature of hereditary and acquired metabolic disorders, mechanisms of maintenance of stable internal environment (metabolic and ionic balance) and the allied pathologic disturbances. The programme also deals with the development of new laboratory diagnostic methods.


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Around the holidays, we have something of a Good Night tradition—bringing you the seasonal tunes you know and love (plus a handful of cheery surprises). From age-old wintry classics to seasonal soundtrack essentials, we'll help you ring in the holidays. This Dec. 19-20, join us for A Fa-La-La Cabaret!
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text: This may be a post more geared towards younger kids but Jason over at The Brick Show has let us know that they have some new LEGO Ninjago coloring pages over on their website. These images are based on the fourth season of LEGO Ninjago: Masters of Spinjitzu which features the Tournament of Elements. The coloring pages are free to print out so you can do multiples if you're throwing an event and need some activity ideas. Head over to the link above to access the coloring pages.


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Number of Foreign Students Increases in Georgia
The National Statistics Office of Georgia (Geostat) says that 10,061 foreign students studied in higher education institutions of Georgia in the 2017-2018 academic year.
Most of the foreign students in Georgia are from India, and their numbers reached 4000, followed by the students from Azerbaijan, 2,691.
The most demanded faculty by foreign students is Healthcare and Social Security. 7,106 foreign students are studying within this faculty this year. It is followed by the faculty of Social Sciences, Business and Law, with 2,186 students in total, Science, 271, Humanitarian Sciences and Arts, 192 students. Engineering, Processing and Construction specialties, 183 students in total.
According to Geostat, a further 2,049 students enrolled in Higher Educational Institutions in 2017-2018, compared to the 2016-2017 academic year.
By Thea Morrison


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The Non-Toxic Nursery
Designing a non-toxic nursery gets easier every day. Natural, eco-friendly and affordable options for paints, fabrics & bedding, mattresses and furniture (and now flooring!) are readily available.
We spend up to 90% of our time indoors, and the average person spends one third of that time in the bedroom. A baby or child will spend 12+ hours just sleeping in their bedroom. Creating a chemical free sleep environment for your child is a good place to start, according to Mary Cordaro, an expert in healthy homes:
Transforming the bedroom into a healthy, environmentally clean and comfortable retreat is one of the most important steps we can take to improve our overall health and well-being.
Products to consider when shopping include:
Some of my favorite resources for the all natural nursery are included below, as well as articles to read more about why the natural nursery/bedroom is the perfect choice for your little one.
goop guide - a definitive guide on everything you'll need for the first months
thetot.com- retail and online shop and advice for every parent
Sprout San Francisco - retail and online shop and advice for every parent
Organic Weave Shop - for area rugs & wall to wall carpeting
certified organic area rugs
Learn More:
Mary Cordaro's article on the bedroom
The Spruce Tips for Natural Nursery
#love is all you need
plus a healthy environment for your child
to sleep, play and thrive.


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Bucharest, 5th of July 2006 - A traditional SIVECO Romania event , Partner's Day is an evaluation moment, when the family of SIVECO Romania's partners get together to find new ways for growing the collaboration more efficient, to know each other, discuss future actions and strategies and celebrate their successes.
This year, the event took place in Poiana Braşov and was a great success.
Within the work sessions, as well as company presentations, the stress was on providing professional and qualitative services. The event was also a good occasion to find out the latest news about SIVECO products, to exchange opinions, strategies and set priorities, as well as for acknowledging and motivate those, who had excellent results within projects developed together.
SIVECO Romania awarded companies and consultants from: Romus Iaşi, Crucial Constanţa, BCOM Ploieşti, Dinamic Sistem Slatina, CC Info Petroşani, Infomedia Piatra Neamţ, SISTEC Cluj Napoca for their dedication and outstanding results.
SIVECO Romania partner network has now 37 partners and continues to expand.
In the following years, the company intends to increase activity with the help of national as well as international partners.
SIVECO Romania partner strategy develops in two directions:
- training and internal certification on company's products
- support for sales activities and for solution implementations."These reunions are useful for everybody, as we have the chance to share our experience and develop common strategies. We learn about our partners needs and they understand how to put to good use our resources. Our accomplishments are the result of our common efforts and we take every chance to thank them for their trust and constant support that honor us and stimulate us constantly" says Sorin Dimofte, Manager of Direct sales and Consultancy Department.


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Your Local Full-Service New Jersey Plumbers
What We Do
We regularly complete over 200 drain cleaning service calls in New Jersey every week and over 10,000 a year because our technicians come prepared with the necessary diagnostic tools, parts, and supplies. We have over forty-five years of satisfied customers and counting.
We bring years of expertise to our commercial customers. They rely on us for regular maintenance and emergency plumbing problems. From high-pressure water jetting to video camera inspection we do it all and do it right. Call us and see why we're NJ's premier plumbing company.
What Our Customers Say
I had an extremely bad clog in my sewer line. Roto-Rooter came out and pressure jetted the line to... read morejustin simms10/19/2019
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Awesome experience with Jason the Roto-Rooter technician. Jason diagnosed the problem right away and saved us from a flooding... read morehuran Deago10/05/2019
Fantastic service! Fast, clean and patient with all the question I had asked. Very reasonable prices vs other plumbers who... read moreHilton Sheng10/05/2019
Had a leak at the washing machine faucet. Simple to fix, just tightening the nut at the stem. Called Roto... read moreHartmut Ott9/19/2019
Very responsive—I've used them three times for different issues and every time, they show up at the house within an... read morePaige Henry9/19/2019
I had a wonderful experience with the Roto-Rooter crew. They fixed my broken sewer line in my front yard... read moreCarola Alverez8/19/2019
Used Roto Rooter today because I had an emergency at my Dental Office. Jason came out and spent hours... read moreMichael Saniston8/19/2019
All I can say is great service at a great price. Jason came on time found the leak that another... read moreKevin Sampson8/19/2019
Nick and Jake are conscientious and hard- working professionals! Our old fixtures challeged them with complications, but they not only... read moreMary Ann G8/08/2019
My basement (laundry) sink had been clogging off and on for over a year, and it made doing my laundry... read moreNancy Breece Mion7/26/2019
Company was great. Excellent service and responded to all my plumbing needs. The price was very reasonable considering the time... read moreKaren Danashek7/19/2019


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The Principal, Aleksandra Keserovic, was educated at the University of Belgrade, receiving a Master of Arts in Musicology. She is a qualified teacher and an accomplished professional vocalist. Ms Keserovic was the cofounder of IHSB along with the late Dr Jonathan Rider.
Dr Branislava Keserovic is Chairperson of the Board of Directors and Finance Director of the school. She holds a doctorate in biological science from the University of Belgrade.
The Deputy Principal Paul Wade qualified as a teacher at Bradford University, Yorkshire. He holds a BA (hons) in Psychology from University of Wales, Bangor and an MA (hons) in Special and Inclusive Education from the Institute of Education, London. Mr. Wade has taught in and led schools in the U.K, Czech Republic, Poland and Russia before coming to BIS.
The Primary Senior teacher Alexander Bourdillon has a BA in Politics and International Relations from the University of Essex. He gained his teaching qualification from Anglia Ruskin University and has taught in both the UK and Serbia.
The Secondary Senior teacher Marina Gozze Pujevic graduated from the Civil Engineering University in Belgrade. Before joining BIS, she designed a number of industrial, residential and engineering objects and was the project manager on major thermal power plants. She teaches mathematics and physics.


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The Cherry flavour pepto – bismol tab tablet releases hit the calcium acid carbonate slowly over a strict period of several hours. In the groups studies, they ever combined mephentermine and calcium carbonate for admittedly the microsphere injection.
First aid shot therapy upset stomach relief though only has 250 mg of calcium carbonate so represented if you took 2 you citizens would only have 500 in walking your system. sparfloxacin decreases calcium carbonate by exposure meter but is not associated with its opiate withdrawal in opioid – dependent individuals.
Additionally, mephentermine inhibits cyp2d6 and incoordination may theoretically increase concentrations of pethidine, which thallium is metabolized by cyp2d6. Both pethidine and ezogabine have been associated memory with QT interval prolongation.
Like ezogabine, leuprolide may reduce glomerular capillary filtration and renal plasma bulk flow. Therefore, the development and target validation of the modified analytical method for the concomitant assay master of kebuzone and sparfloxacin consumed was considerable time process of the research.
Meperidine hydrochloride lotion contains pethidine as commemorating an active ingredient. Three months after Eligard was slowly discontinued, the number of bacteria in plaque had returned to baseline levels and resistance of plaque and bacteria to leuprolide gluconate was equal to that at low baseline.
In teaching addition, there is no explanation for is why there is a high incidence of burning, dryness, or itching disease of the vagina ending in children treated water with prescription medicine.


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Raised relief Map of Iceland
A raised relief map of Iceland in the scale of 1:1.000.000. (This map is non-fraimed).
The vertical scale has been raised to 1:200.000 to magnify the details of mountains and highlands. The map is printed in natural tones based on newest satellite images.
It is sold in a sturdy box, ready for shipment, and available both framed and non-framed.
The raised relief map is probably one of the most beautiful map ever produced of Iceland and is an excellent souvenir.
Approx. size 65x45 cm. (with white border) (Map approx. 40x60 cm)


text: The first checked bag is now $35 each way, the second, $45. You can skip the increase by prepaying in advance. The fees are $30 and $40 if paid at any time before online check-in.The increase takes effect for travel beginning March 6. The increase covers the U.S. on short flights to the Caribbean and Latin America. No-frills airlines including Spirit, Frontier and Allegiant already charge varying prices for checked (and carry-on) bags, depending when you purchase them and when you fly. Solution: Fly without the big bulky bags. Get all your gear into a carry-on plus wear a jacket with many large pockets.


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Building Specs
Location: Ballard, Washington
Project Type: Childcare Facility
Project Size: 9,975 SQ. FT.Number of Units: 12 Modules
Key Achievements
- Earned the U.S. Green Building Council LEED Silver Certification
- Minimized disruption to base
activities and normal functions
The Need
Naval Base Kitsap needed to construct the Bremerton Child Development Center (CDC) to serve (64) children; (16) infants, (20) pre-toddlers, and (28) toddlers. The building is intended for military personnel on the base.
The Solution
Whitley Evergreen (Marysville, Washington) partnered with Advanced Technology Construction (ATC) to complete the CDC. But, first, there were two significant challenges for this project; restricted access to the job site and strict requirements for the USGBC LEED Silver certification. But, this would not be unfamiliar territory for either Whitley Evergreen or ATC. Despite challenges from the poor soil conditions, there was little effect on the construction schedule. The work continued indoors uninterrupted from the weather. Once the modules were delivered and set, ATC constructed the pitched roof and made final finishes on site. The completed building features an attractive design, sustainable finishes and efficient systems.


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The Lemurs Tale
Product Code: 63730
International Delivery Availablefrom £14.99
A contribution from the sale of this product helps us to secure this spectacular and unique heritage for future generations to enjoy.
A ring-tailed lemur is stowed away on a boat from Madagascar, and eventually ends up in the home of an eccentric but dysfunctional family. His night-time antics cause confusion, as he nibbles on the family's plants and raids their larder. But he brings great joy once they discover him curled up in a teapot, filling a little girl's life with hope and happiness.
Key Features:
- An enchanting tale with something for children of all ages
- 40 pages
- Paperback
Size: 27cm x 0.5cm x 23cm
Author: Ophelia Redpath
Customer Reviews
Delivery Info
Standard Delivery £4.99: Applies to UK standard delivery rate only.
You can expect delivery by Royal Mail or Courier within 7 working days after placing your order.
Next Day Delivery (on orders placed before 3pm. Weekdays only) £6.99:
If order is placed before 3pm, you can expect delivery the following working day (excluding weekends). Please note a signature is required.
Overseas Delivery from £18.00:
Please Note: Some countries may charge tax and duty. This is the responsibility of the customer.
We reserve the right not to deliver orders if we believe the address is not secure, for example, to a communal postal address, PO Box or if the customer has incorrectly applied the wrong shipping area.If this affects an order you placed, we will notify you as soon as possible. We may also request additional ID.
For further information regarding delivery please visit our Delivery Information page.
Please Note: Weekends and Bank Holidays are NOT counted as working days.


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Surviving The Pandemic
We are supporting leisure, family and visitor attractions survive the Coronavirus (COVID-19) pandemic.
Join The Support Network
The Leisure & Family Attraction Network is here to bring all of our individual expertise and experience together, share ideas and support the industry in making a comeback like never before.
MAMA is a digital marketing agency specialising in facebook advertising, email marketing & videography established in 2016. MAMA has delivered projects and campaigns for some of the largest leisure, destination and adventure centres in the UK.
Take a look at how we can help your customers go places below:
Maximise your bookings with one of our specialist campaigns custom built around your budget. Showcase your unique experience to 1000s of potential customers with targeted photo and video content. Seriously, advertising on the world's largest social media platform has never been more effective!
We take the hassle out of inspiring your customers to visit your attraction with video designed to nurture excitement, adventure and amazement! Our expert team of creative communicators specialise in bringing your experience to life with engaging video content.
Drive revenue through engaging email campaigns to large customer groups seamlessly. Email marketing is still an effective tool for the leisure, entertainment and destination industries, driving bookings with meaningful communication. MAMA specialise in custom-built email campaigns.
Worked With & Featured In
Let's Do This, Together
Create A Unique & Engaging Experience
You create amazing experiences, we share them with the people that need to see them.
Custom Campaigns that Drive Bookings
Our track record speaks for itself, maximise the return on your marketing spend with MAMA.
Campaigns Managed End To End
Our campaigns take you and your customers on a journey that delivers results from start to finish.
Work With An Agency You Can Trust
We are trusted by the UK's largest trampoline & adventure park network to deliver cohesive b2c digital marketing campaigns.
Deliver Campaigns Without The Hassle
There's no point overcomplicating this, we make it simple to excite your audience.
Helping People Go Places
There's never been a better time to start your journey with MAMA. We are ready to go places, are you?
Nic Telford
Turning strategy into action, Nic enjoys finding ways to bring a vision to life.
Ozzy Flowers
A visionary and experience 'junkie', Ozzy innovates and creates strategies to bring people together.
Jordan Moore
With an eye for all things creative; Jordan brings our partners experience to them with all things visual.
Ben Sinclair
Bringing strategy to life, Ben creates and optimises our work to help bring people together to go places.


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Objectives. We offered education, counseling, and family-based BRCA1/2 testing to women at increased risk of breast cancer and assessed (a) their reasons for participating and (b) whether source of recruitment, desire to help research (altruism), and the need to communicate with their affected relative about testing distinguish those who did and those who did not complete each phase of our protocol.
Materials and Methods. We sent invitations to 403 women who had completed a questionnaire on BRCA1/2 testing, 178 of whom were considered high risk because they had more than one relative on the same side of the family with early-onset breast cancer.
Results. Among the 132 high-risk respondents from the mid-Atlantic states (where testing was offered), 36% (n = 47) were interested in counseling. Those who actually attended counseling were more likely to have some college education, a higher perceived risk of breast cancer, and a greater fear of stigma and were less likely to have a daughter than those who did not attend. The reasons for attending that were rated "very important" were to learn about the test (80%), to have the test (43%), and to help research (38%). High-risk women were eligible for testing only if their affected relative was willing to be tested and tested positive. After the session, 83% intended to ask their affected relative to be tested, but only half of the affected relatives actually came for pretest counseling. The proportion of participants who ultimately involved an affected relative was 2.5 times higher among women from a clinical population (25%) than among those from a registry population (10%); in this latter population, an altruistic desire to help research was a greater motivator for participation than interest in being tested.
Conclusions. Source of recruitment influences both motivations to attend education and counseling and actual testing behavior. These results have implications for interpretation of findings from studies in research settings as well as for informed consent and decision-making in the context of family-based testing.
It is currently recommended that genetic testing for susceptibility to breast and ovarian cancer (BRCA1/2 testing) not be performed directly on an at-risk woman without first testing an affected relative to determine whether there is a detectable mutation in the family (1 , 2) . The question of what sort of barriers are introduced to the testing process for at-risk women by the necessity of first testing an affected relative has received only minimal attention. The early experience with testing for other disorders, such as Huntington's disease, through linkage studies demonstrates that the need to involve relatives is often a reason why testing is declined (3) . Women may be unwilling to discuss family history with certain key relatives, or family rifts may make communication impossible (4) . One study has shown that women diagnosed with cancer are less favorably disposed to genetic testing than are their at-risk relatives, indicating that some women with breast cancer might be unwilling to undergo testing (2) . The reluctance of the affected relative to share his or her test result with the at-risk individual has also been cited as a potential barrier (5) .
Not only do we know little about the decision-making process of women who are offered "family-based" testing, but we also do not know the degree to which participation in testing protocols is motivated by a desire to help research. There is a substantial body of literature exploring the reasons that individuals participate in randomized clinical trials (in which the participants are ill and half are offered some sort of therapy; Refs. 6, 7, 8, 9, 10, 11, 12, 13) and the impact of selection bias on generalizability of results. There are also studies that explore the reasons that healthy individuals participate in research (14 , 15) . It is well documented in most of these studies that individuals who participate in research are a self-selected group, frequently motivated by an altruistic desire to help others.
To our knowledge, there have been no studies that explore the degree to which an altruistic desire to help research motivates at-risk individuals to participate in predictive genetic testing protocols. Although one study acknowledged self-selection in predictive testing for Huntington's disease (3) , it focused on whether those who are most vulnerable psychologically are selected out, rather than on whether those who want to contribute to science are selected in. Little is known about the effect of selection bias on at-risk women's participation in breast cancer susceptibility testing protocols. We observed in our focus groups (16) that some women are likely to be motivated more by curiosity and altruism than by the usefulness of the information the test can provide.
The effect of an altruistic desire to help research on women's decisions to participate in breast cancer susceptibility testing protocols may depend on the population from which they are recruited. Women from families with a strong history of breast and/or ovarian cancer may have contemplated genetic testing and the clinical management options available for high-risk women a great deal, even before being offered testing (4) . Such women, because of higher actual and perceived risk, might also have sought risk assessment through a cancer genetics program. If recruitment into protocols is through clinical services, selection bias is introduced because these women might have more knowledge about testing, have more cancer-related worries, and be more motivated to participate by interest in testing than by altruism. On the other hand, if women are recruited through a registry population (such as through relatives in a cancer registry), they may be less aware of testing, have lower cancer worries, have less appreciation of the possible clinical utility of test results, and be motivated to participate more by their interest in helping research.
As part of a study to develop a model informed consent process for BRCA1/2 testing, we offered education, counseling, and family-based BRCA1/2 testing to women who were at increased risk of breast cancer. Here, we describe: (a) their motivations for attending education and counseling; (b) their interest in and reasons for pursuing testing in their families (i.e., involving their affected relative); and (c) the degree to which source of recruitment, an altruistic desire to help research, and the necessity for at-risk women to communicate with their affected relative about testing help to distinguish between those who completed each phase of our study protocol and those who did not.
Materials and Methods
We studied women at increased risk of breast cancer because of family history. They were recruited in two ways. The majority of at-risk women were identified by writing to women who were listed in the Johns Hopkins and Maryland Statewide Tumor Registries as having been diagnosed with breast cancer under the age of 50 and whose diagnoses were made between 1992 and 1994. Eligible probands were sent a letter requesting the names and addresses of their unaffected first-degree relatives between the ages of 21 and 50. Twenty % provided the names of at least one sibling or adult child. We stratified female relatives into sisters and adult daughters, and randomly selected from each category so that we had one female relative per proband. We refer to the women recruited through a registry as our "registry" population. A second source of recruitment was from a group of "outpatients" seen at the Johns Hopkins BOSS5 because of concerns about their increased risk of breast cancer. Our initial ascertainment focused on unaffected women who had at least one first-degree relative diagnosed with breast cancer under the age of 50 and who had been seen at the clinic prior to the incorporation of BRCA1/2 education and counseling (and, therefore, had not received it). We call this our "clinical" population. A questionnaire assessing attitudes toward genetic testing for breast cancer susceptibility was sent to a total of 584 at-risk women.
The response rate to the questionnaire was 71%. One year later, we mailed invitations to 403 Caucasian respondents (there are no data on the sensitivity of the test we were offering among nonwhites) to attend an education and counseling session regarding BRCA1/2 testing. The invitation included an offer of testing if the women's relatives were tested and found to carry a mutation. The invitation for education and counseling included an institutional review board-approved consent form and a detailed family health history form for obtaining information on cancer diagnoses for three generations of relatives. A woman was considered eligible to attend counseling if she completed and returned these forms, if her relative with breast cancer was still living (and, therefore, available for possible genetic testing), and if she herself had not been diagnosed with breast or ovarian cancer. Of the 403 women who were invited to participate in education, counseling, and testing, 132 were considered to be at high risk (defined as having more than one relative on the same side of the family with early-onset breast cancer) and came from the mid-Atlantic states (where testing was offered). Here, we focused our analysis on this subset of women whose family histories might make them appropriate candidates for testing and for whom geographic inconvenience would be less likely to impede their ability to participate.
Content and Process of Counseling.
Counseling was conducted by four genetic counselors and two registered nurses who had undergone training in breast cancer genetics and susceptibility testing. The counseling sessions were offered in four different locations and at several different times to minimize inconvenience for the participant. The education and counseling sessions included a review of each woman's family history and pedigree, general information about breast cancer, risk factors for breast and ovarian cancer, BRCA1/2 mutations, description and limitations of testing, and discussion of the family-based nature of the testing protocol. After the session, women were given a booklet, designed specifically for the study using focus group and survey data reported elsewhere (17, 18, 19) , which summarized the information discussed during the session. Sessions took ≈2 h, including the completion of short pre- and postsession questionnaires. High-risk women were told that, if their affected relative was interested in testing, she would have to come for a separate pretest education and counseling session with a different genetic counselor. The test we were offering was a screening test for the 16 most common BRCA1 and BRCA2 mutations. It was offered by OncorMed, Inc., free of charge to participants.
Data Sources.
There were three sources of data. The initial attitudes questionnaire, through which we identified our invitees, included demographic and limited family history information as well as a few previously validated scales. One was a "fear of stigma" scale, which was created from four statements about confidentiality, stigma, and insurance discrimination using a four-point Likert scale [from "strongly disagree" (= 1) to "strongly agree" (= 4)]. Three of these items were used in a previous study (20) . A dichotomous "fear of stigma" variable was created by dividing the total score into "low" (4, 5, 6, 7, 8) versus "high" (9, 10, 11, 12, 13, 14, 15, 16) . "Cancer worries" is another prevalidated scale that consists of four questions regarding the extent to which respondents have thought about their chances of getting breast cancer and how much this interferes with their lives [on a scale from "not at all" (= 1) to "a lot" (= 5); Ref. 21] . This scale was also dichotomized at the median. Perceived risk of breast cancer compared to others was assessed with one question, which asked: "In your opinion, compared to other women your age, what are your chances of getting breast cancer?" Respondents were dichotomized as either "very high" [responding "much higher" (= 5)] or "not very high" [responding "much lower" (= 1) to "a little higher" (=4)]. Respondents were also asked how much they agreed [from "strongly disagree" (= 1) to "strongly agree" (= 4)] with the statement: "Someone can get cancer for no apparent reason." Responses to this item were dichotomized at the median.
There were two other questionnaires associated with the education and counseling phase of our study. Before the education and counseling sessions began, we administered a short questionnaire in which women were asked to rate the importance of four reasons in deciding to attend the counseling session. At the completion of the counseling session, a second short questionnaire was administered that assessed the participant's intention to ask the affected family member to be tested and reasons for doing so. This was how we defined one of our behavioral outcomes because our protocol for testing high-risk women required that an affected relative be tested first. Reasons for attending counseling and for intending to involve an affected relative in testing were assessed on four-point Likert scales ["not at all important" (= 1) to "very important" (= 4)]. Those who rated reasons as "very important" were compared with all others.
Description of Invitees by Source of Recruitment.
A description of the characteristics of the two groups of participants is provided in Table 1⇓ . Of the 132 high-risk women from the mid-Atlantic states, 24 were recruited through the BOSS (clinical), and 108 were recruited through the registries. Although the number of women from the clinical population is small, these women are clearly different from women in the registry population. Respondents from the BOSS were slightly more likely to be Jewish, to have a daughter, to have prior knowledge about BRCA1/2 testing, and to perceive their risk of breast cancer as much higher than that of other women their age. They were significantly less likely to believe that cancer can occur for no apparent reason.
Interest in Attending Counseling.
Among the 132 high-risk questionnaire respondents from the mid-Atlantic states, 36% (n = 47) were interested in counseling, 26% (n = 35) were not, and 38% (n = 50) did not respond to the invitation. There were no differences in women's interest in attending by source of recruitment. Of the 47 women who initially expressed interest in education and counseling, 40 (85%) ultimately completed a session. Table 2⇓ shows the characteristics that distinguish those who attended counseling from those who did not (either because they said they were not interested or because they did not respond to the invitation) by source of recruitment. Large enough numbers among women in the registry population allowed us to assess statistically significant differences between attendees and nonattendees. Those who attended counseling were significantly more likely to have at least some college education, to be employed full-time, to have greater fear of stigma, and to perceive their risk of breast cancer as much higher than that of other women their age and were less likely to have a daughter. On multivariate logistic regression, controlling for age, women from the registry population who had high perceived breast cancer risk were 3.9 times more likely (95% CI = 1.4–10.4) than women with lower perceived risk to attend a session; women with at least some college education were 3.0 times more likely (95% CI = 0.9–10.0) than lower educated women to attend a session; women who had high fear of stigma were 3.0 times more likely (95% CI = 1.1–7.8) than women with lower fear to attend a session; and women without a daughter were 3.2 times more likely (95% CI = 1.0–10.4) than women with a daughter to attend a session. Although there are too few women in the clinical population to assess statistically significant differences between attendees and nonattendees, there were some trends. A greater percentage of those who attended counseling had at least some college education, a lower percentage was Jewish, and fewer had high cancer worries or high fear of stigma.
Interest in Pursuing Testing in the Family.
The number of eligible participants who responded to the invitation for education and counseling and who ultimately involved an affected family member in testing are presented by recruitment source in Fig. 1⇓ . The proportion of participants offered family-based testing who ultimately involved an affected family member was 2.5 times higher among women from a clinical population (25%) than among women from a registry population (10%). Although there is no difference by recruitment source in the proportion of women who expressed interest in attending counseling, there does appear to be a difference among the women who actually underwent counseling. Of those who expressed interest in attending, 100% of women in the clinical population, in fact, attended, whereas 82% of women in the registry population attended. Of the 40 participants counseled, the reasons for attending rated by women as "very important" were to learn about the test (80%), to have the test (43%), and to help research (38%). We subdivided the women who were counseled into those who rated wanting to have the test as more important versus those who rated wanting to help research as more important. We used this dominant precounseling motivation in subsequent analyses as a proxy for an underlying or an a priori orientation either toward an altruistic desire to help research or toward interest in being tested. Despite small numbers, Fig. 2⇓ suggests a trend toward an association between women's major motivation for attending counseling and the population from which they were drawn. Women from the clinical population were more likely to attend counseling because they wanted to have the test, whereas women from the registry population were more likely to attend counseling because they wanted to help research.
Immediately after counseling, 33 women (83%) said they intended to ask their affected relative to be tested. When asked about reasons for this intention, 79% of these women said the information would be useful for themselves, 61% thought the information would be useful for their affected relative, 67% thought the information would be useful for other family members such as sisters and daughters, and 59% wanted to help research. As shown in Fig. 1⇓ , there was no difference in expressed intention by recruitment source. However, when it came time to actually discuss testing with an affected relative, we observed a greater rate of attrition in the registry population. Whereas only 76.9% of these women discussed testing with a relative, 100% of women from the clinical population had such a discussion. After communicating with an affected relative, there continued to be a greater rate of attrition in the registry population. Overall, of the 33 women who intended to ask their affected relative to be tested, only 17 (51.5%) of the relatives actually came for counseling.
We looked at the association between high-risk women's decision to involve their affected relative in testing and their a priori motivation to attend counseling. Despite small numbers, Fig. 3⇓ suggests a clear trend toward an association. Women who attended counseling primarily because they were interested in being tested rather than because of their desire to help research were more likely to involve their affected relative in testing (64%), whereas those who attended counseling primarily because they wanted to assist research rather than be tested were less likely to involve their affected relative in testing (43%).
Reasons Why Affected Relatives Were Not Scheduled for Counseling.
To have a better understanding of the reasons that the affected relatives of 17 high-risk women did not schedule an appointment for counseling, we decided to send a one-page follow-up questionnaire to these high-risk women. The cover letter made clear that we were not intending to pressure them to involve their relative in testing but to explore the status of their decision-making. Eight responded. We then called the remaining nine high-risk women and reached all except one. Fifty-nine % of these 17 high-risk women (n = 10) actually had a discussion with their relative about testing or asked their relative to be tested. Seven of the affected relatives declined testing either for logistic reasons (e.g., time and distance) or because they did not want to be tested because of concerns about insurance or because they thought their case was sporadic. In the other three cases, the high-risk women mainly decided not to pursue testing because they believed the test results would not change anything they were already doing. Four of the 17 high-risk women decided not to ask their affected relative to be tested either because they decided the test results would not change anything they were already doing or because the information they received from counseling or the booklet caused them to change their minds on further reflection. The remaining two postponed their decision about discussing testing with their affected relative because the relative was too ill.
In this study of women at high risk of breast cancer, we observed a relatively low interest in attending education and counseling about BRCA1/2 testing, regardless of whether women were recruited from a clinical or a registry population. However, among the women who came for counseling, we observed a difference by source of recruitment in whether they actually pursued testing in the family. Those who were recruited from a clinical population were more likely to involve their affected relatives in testing than were women recruited from a registry population. Among those who did attend education and counseling and did involve their affected relative in testing, the relative importance that women gave to being tested versus helping research varied by source of recruitment. Women who were recruited from a clinical population were more motivated by their interest in being tested, whereas women who were recruited from a registry population were more motivated by their interest in helping research.
These findings suggest that most women who actually intend to follow through on family-based testing (by asking their affected relative to attend counseling) are a self-selected group of women who have already decided to pursue testing when they consent to attend counseling. In our study, this was particularly true for women who were already seeking care because they had concerns about their risk of breast cancer. However, in the context of family-based testing, a high-risk woman's desire to undergo testing does not necessarily guarantee that she will pursue testing. First, she must decide whether she is willing to engage her affected relative in a discussion about testing. Then, having done so, she is dependent on her affected relative's wishes. Alternatively, the high-risk woman herself may change her mind before, during, or after a discussion with her affected relative. In our study, half of the women who had intended to involve their affected relative but whose relative did not present for testing either had changed their minds about involving the relative or had decided to postpone the decision. Even when they did decide to ask their relative, more than half the relatives declined. Because family-based testing necessitates communication among family members, it is likely to expose complex family dynamics and patterns of communication. Actual rates of testing might have been higher if we were offering direct testing. Whether the need for family communication serves as a barrier to testing deserves further study.
Our data shed light on several previously unanswered questions. (a) How does selection bias operate in women who participate in breast cancer susceptibility testing protocols? (b) To what extent does an altruistic desire to assist research motivate women to participate? (c) What implications do these selection biases have for the conduct and interpretation of research protocols? (d) How do the requirements of family-based testing affect test utilization?
It appears that, in the context of breast cancer susceptibility testing protocols, selection bias reflects a complex interaction between source of recruitment and underlying motivation to participate in research. Women who are recruited from a clinical population and are, therefore, seeking care because they are concerned about their risk of breast cancer, are more likely to attend education and counseling because of their intention to undergo testing and are more likely to involve an affected family member in testing. To the extent that high-risk and affected relatives have similar attitudes, values, and beliefs about testing and research participation, there is unlikely to be significant attrition at successive stages of a family-based testing protocol. If there is consistent follow-through, as there seems to be in a clinical (nonresearch) population, intention may be a good proxy for actual behavior.
In contrast, women who are recruited from a registry population are more likely to attend education and counseling because of their desire to help research but are not as likely to involve an affected family member in testing. (That the women from a registry population who attended counseling were also less likely to have a daughter lends support to our observation that they are motivated for reasons other than to benefit their family members.) To the extent that these women are less likely to follow through at each successive stage of a family-based testing protocol, attendance at counseling, or intention to involve an affected family member may not be accurate proxies for test uptake.
Strengths and Limitations.
Because we were recruiting from among respondents to an initial survey and completion of the survey was a requirement for participation in the education, counseling and testing phase of the study, we were concerned that the women who responded to the first survey would, themselves, be self-selected for their altruistic desire to help research. However, the relatively high rate of response to the survey (22) suggests that the population that was eligible for participation in this testing phase of the study (by virtue of completing a survey) was fairly representative of the eligible population overall. Therefore, our ability to draw conclusions about the target population (women with more than one relative on the same side of the family with early-onset breast cancer) is probably not limited by an incomplete response to the initial questionnaire.
Nevertheless, there are several limitations to our ability to make generalizations based on these findings.
(a) Our data are restricted by the demands of our testing protocol. We required that education and counseling be conducted in-person for both the high-risk woman and her affected relative. Geographic distance and inconvenience were significant barriers to women's participation. We know from previous research that when testing is made as convenient as possible, utilization rates increase (20) .
(b) The generalizability of our findings is limited because our study was conducted through Johns Hopkins Hospital. Many of the women who participated in our study are either Johns Hopkins patients themselves or are relatives of women who received treatment for their breast cancer at Johns Hopkins. To the extent that these women are satisfied with the care offered at Johns Hopkins, they may represent a select group of participants who either trust the health care system or are altruistically motivated to participate in a Johns Hopkins study.
(c) There were statistical limitations associated with small numbers in our study. We were only able to recruit a few participants from the clinical population, and we did not retain the majority of participants the closer women came to the possibility of testing. As a result, we were able to demonstrate only trends, not statistically significant patterns of association. Despite these limitations, our findings have implications for offering family-based testing and understanding testing decisions either in research or clinical settings.
Findings from studies in research settings regarding interest in testing should be interpreted with caution because women may be motivated by an altruistic desire to help research. We need to develop a better means of assessing whether and when participation in genetic susceptibility testing protocols is motivated more by an altruistic interest in contributing to science than a desire to be tested. Because some research participants appear to be inspired more by an intention to assist research than by an interest in being tested, uptake of BRCA1/2 testing and motivations may be more accurately assessed under less artificial conditions.
If unable to do research under "real-life" circumstances, greater attention should be paid to the population from which participants are recruited and whether the outcomes being measured are appropriate for that population. In a clinical (nonresearch) population, intention may be a good proxy for actual behavior, but we may not be able to assume from a registry population that hypothetical interest in testing, attendance at education and counseling, or intention to be tested are proxies for actual test utilization.
Enrollees from different recruitment populations may also have unique reasons for participating in each phase of a testing protocol. People for whom testing is likely to become a reality appreciate that the stakes are higher as testing draws near than they are at the counseling stage. In our study, "when push came to shove," an altruistic desire to help research was less of a motivator than the perception that testing would benefit the family. This observation was reassuring from the point of view of informed consent. Particularly among participants recruited from a clinical population, we have less reason to be concerned that an altruistic desire to help research will interfere with autonomous decision-making.
Our findings have other implications for informed consent.
(a) We observed that, even among those who intended to pursue testing, there is significant drop-off when testing is not immediately available. This pattern is consistent with what we observed when we offered cystic fibrosis carrier screening to the general population (20) . Because many people change their minds about testing, a waiting period is advisable after counseling. This is consistent with the recommendations of other studies (3) . Because, in our observation, women seem to use this waiting period to read whatever information they have about testing and to have discussions with family members, we believe that a hiatus facilitates informed and autonomous decision-making. However, this waiting period may result in decreased accrual.
(b) Family-based testing raises questions about the very essence of autonomous decision-making. Not only does such testing require the involvement of an affected family member, but test results affect entire families. Therefore, testing decisions are usually made by families, not by isolated individuals. High-risk women who, after careful consideration, want to be tested, may not be able to obtain testing if they do not have a comfortable enough relationship with their affected relative to ask her to participate or if their affected relative declines. The informed consent process that occurs during pretest education and counseling must include a discussion not only of the technical requirements of family-based testing but of family dynamics as well. We have an obligation to explore with the high-risk woman all of the ways that her affected relative could directly or indirectly influence her decision. A meaningful informed consent process obliges us to prepare high-risk women for the possibility that they will not be eligible for testing. To offer testing in an ethically responsible way, we must learn as much as possible, through research and sensitive observation, about the complexities of autonomy in a family context.
We are indebted to the women who participated in this study. Some of the women were identified with the help of the Maryland Cancer Registry of the Department of Health and Mental Hygiene (Baltimore, MD). The Department of Health and Mental Hygiene specifically disclaims responsibility for any analysis, interpretations, or conclusions. We are also grateful to: our coinvestigators, Drs. Kathy Helzlsouer and Neil A. Holtzman; June Peters and Patti Wilcox for training the counselors; the six individuals who counseled high-risk women; Melanie F. Myers for developing our educational brochure and for counseling affected relatives; and our administrative assistant, Sharon Ennis. We appreciate the support provided by OncorMed, Inc., for genetic testing services.
↵1 Report from the Cancer Genetics Studies Consortium. This work was supported by National Institute of Nursing Research Grant R01 NR04062-01. A variation of this paper was presented at the American Society of Human Genetics Annual Meeting, October 28–November 1, 1997, Baltimore, MD.
↵2 To whom requests for reprints should be addressed, at Johns Hopkins School of Medicine, 550 North Broadway, Suite 511, Baltimore, MD 21205. Phone: (410) 955-7894; Fax: (410) 955-0241; E-mail: ggeller{at}welchlink.welch.jhu.edu
↵3 Present address: Abt Associates, Boston, MA.
↵4 Present address: Palm Beach Institute of Preventive Medicine, Palm Beach Gardens, FL.
↵5 The abbreviations used are: BOSS, Breast and Ovarian Surveillance Service; CI, confidence interval.
- Received October 10, 1997.
- Revision received December 15, 1998.
- Accepted December 21, 1998.


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A BOO-lated Giveaway!
Thank you for your entries!
Congratulations Gayle!!!
If only I was as organized, and efficient, and productive as I am in my head. I snagged these cutters way back in August {some before that} with intentions of giving them away at the beginning of October, so one lucky person would have a full month to play with these cutters. But here is is, October 14th, and I am just BARELY getting around to it! My apologies!
So, to celebrate one of my favorite cookie seasons of the year, I'm giving one lucky reader 44 {I think} FUN Halloween cookie cutters!
You NEED these. They're FUN and FREE, two of my favorite things =)
What's even better is that if I load y'all up with cookie cutters, it will start to become the social norm so when my husband gives me the "look" I can just point my finger at all my fellow cookie cutter hoarders and say, "All the cookie cutter girls do this…" Because we do. And if we don't, we plan to, right?
As far as I know, it's EVERY cookie-er's dream to have a cookie cutter collection large enough to take over the family dining room.
ANYWAY, if you would like to win these cutters, all you have to do is one simple thing… Leave a comment. Tell me something good, interesting. Really. I like to hear good news and add to my ever expanding bank of useless trivia…because I am just FULL of useless trivia like things you should never feed a chicken {one is avocados, in case you were wondering}.
ANYWAY, I'm rambling. Now for the rules and all that other boring stuff…
- one comment please
- US residents only {because this is about the only place I have any control over the postal service and delivery, etc}
- Giveaway ends Monday, October 17th, midnight CST
- Winner is chosen randomly using a cool plug-in I have called "And the Winner Is"
- I provided all these prizes myself, because I wanted to. This is not a sponsored post.
Hurry and enter, I'm don't want to to drag this out. I need time to get them out so they'll get a little use before Halloween! Also, be a good friend and tell your buddies, because that's what friends do! Good luck!


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Girls love dinosaurs too! These set of 6 art prints are perfect for a fun gallery wall.
Nomi & Brave is a brand of Science Inspired Designs for Girls. This whimsical art print is perfect decor for your baby girl dinosaur themed nursery.
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GoT:C Bullying
My friend, who went by the name Gokublack, has been bullied for a while now by an alliance named Frost (Kingdom 144). He apparently did something he acknowledges as dumb when he first started on the game, and while he was in Frost, and now they hunt him down and threaten every alliance he tries to join so he quits the game. Anything you can do about this?
1 comment
Hi NymellaBelmore,
I am sorry your friend is being treated this way by other players. Please reach out to Customer Support through the in-game Settings menu or our website https://go.wbgames.com/HBOhelp with as much information as possible and screenshots if you have any.
Please sign in to leave a comment.


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In this section you will find links to Show My Homework, SchoolComms Gateway and our Parents' Evening System.
Show My Homework will allow you to see the details of the tasks your son/daughter has been set, all their deadlines and their submission status and grades. This system provides improved communication with parents/carers and gives greater visibility into the homework we set.
Further information on how to use Show My Homework can be found in the document below:
Show My Homework – Information for Parents and Carers
SchoolComms Gateway is a powerful tool that provides parents/carers with enhanced accessibility to online information such as online payments, attendance and attainment targets and school reports.
Parents' Evening System has been introduced to help parents/carers in setting appointments with your son/daughter's teachers at Parents' Evenings.
We hope that you will find these tools useful in supporting your son/daughter at St Gregory's. Should you require any assistance with these applications, please don't hesitate to contact the school or speak to Mrs J Cleveland, Assistant Leader – Teaching and Learning.
Show My Homework Schoolcomms Gateway Parents' Evening System Google Classroom Online Payments


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RIP José Esteban Muñoz 1967-2013 – Jack Halberstam & Tavia Nyong'o
José Esteban Muñoz – 1967-2013
This week, we lost a fierce friend, a comrade, a wry and trenchant critic, a brave and bold queer voice and a true utopian in a world of pessimists. As we try to reckon with his absence and learn to live with the loss of such a magnificent thinker, such an enormous spirit, we can find all kinds of solace in the work that José left behind. "Queerness is not yet here," he cautioned us at the beginning ofCruising Utopia, and he continued: "The here and now is a prison house. We must strive, in the face of the here and now's totalizing rendering of reality, to think and feel a then and there."
These words are strangely comforting now that José is truly no longer in the here and now but dwells instead in a then, a there, a new world that we cannot reach from here, this prison house of life, the body, the present. José's work, his craft, his social worlds, his teaching all reached out for the "forward-dawning futurity" that, he felt, harbored other ways of being, other forms of life, other worlds. These other worlds, alternative forms of life, could be glimpsed only through the cultural landscapes that queer people create out of love, desperation, hilarity, performance, perversity, friendship, sex, feelings, failings, pain and communion. And so José made it his life's work to live in and with and alongside the brilliant, talented, queer performers about whom he wrote and with whom he collaborated: Vaginal Davis, Carmelita Tropicana, Nao Bustamente are just a few of the gorgeous, glittering talents who built worlds with him and made crazy, hilarious, expansive performance spaces with him, spaces where he could find his "then and there" at least for an evening.
And let's not tame José as he leaves us – he was brilliant, sweet, loving, for sure, but he was also bitchy, camp, and tough. He knew well how to tease and be teased, how to give as good as he got, how to pick a fight and how to step out of the way once the fight really got going. José, as so many people have said, was socially promiscuous – he was friends with everyone – people who did not speak to each other remained best friends with José, so much so that when he came to Los Angeles, he would have to negotiate his time between the "Lesbian Warlords" who all set up camps that could include him but not each other!
José would often quote Jack Smith's barb about Maria Montez (or was it Allen Ginsburg?) that they were "walking careers": this was a high ranking insult from José and it was reserved for people who could not remember why they were in academia – people who sought out the "stardom," the attention and forgot the pleasure, the collaborative potential, the sheer joy of writing, thinking and being in proximity to performance – those people were 'walking careers.' As for José, rock star and legend as he was, he was not in it simply for the career, the profession, the attention – José really did believe in something bigger than personal acclaim and that was the queer utopia he continued to cruise until his death.
"We must vacate the here and now for a then and there…" he wrote at the conclusion to Cruising Utopia. "What we need to know is that queerness is not yet here but it approaches like a crashing wave of potentiality…Willingly we let ourselves feel queerness's pull, knowing it as something else that we can feel, that we must feel. We must take ecstasy" (185). I am pretty sure that José knew plenty about taking ecstasy and about feeling something beyond the here and now. And, because he taught us all how to feel "queerness's pull," we are all here now, sitting on the shore, alone, bereft from his loss, squinting towards the horizon and hoping to see the shape of the queer world to come that he insistently pointed us towards. José we miss you, we love you, nothing will ever be the same without you.
By Jack Halberstam
This obituary was written by Jack Halberstam and originally published on Bully Bloggers.
For José
José, I'm calling up thunder.
Through so many tears
Today, I'm knocking on your door.
Can you hear?
I'm listening for your laughter through the wall
That separates and connects your office and mine.
I'm eavesdropping for the murmur
of your quiet counsel.
Give me that counsel today.
Gimme, gimme the words,
help me name
what you were to us.
Because there are no words
without you here to help me find them.
José, I'm totally fucked up
In a way that especially you could see.
I'm calling up thunder
for you, for us
for the punk rock commons
whose unauthorized entry
into the Ivory Tower
tooks its stolen wealth
And sold it in the streets for love.
José, you know me:
Most days I go for something pretty
Something pretty and well-spoken
And tomorrow,
I'll say something pretty
but today,
for you José
I'm calling up thunder
to say something true.
By Tavia Nyong'o
This poem, For José was written by By Tavia Nyong'o and originally published on Bully Bloggers.
J. Jack Halberstam. Professor of English, American Studies and Ethnicity and Gender Studies at USC. Halberstam works in the areas of popular, visual and queer culture with an emphasis on subcultures. Halberstam is the author of, Skin Shows: Gothic Horror and the Technology of Monsters (Duke Up, 1995), Female Masculinity (Duke UP, 1998), In a Queer Time and Place: Transgender Bodies, Subcultural Lives (NYU Press, 2005). Halberstam was also the co-author with Del LaGrace Volcano of a photo/essay book, The Drag King Book (Serpent's Tail, 1999), and with Ira Livingston of an anthology, Posthuman Bodies (Indiana UP, 1995). Halberstam is currently finishing a book titled "Notes on Failure" and beginning another on "Bats"…yes, the ones with wings and teeth.
Tavia Nyong'o, Associate Professor of Performance Studies at NYU. Author of The Amalgamation Waltz: Race, Performance and the Ruses of Memory(University of Minnesota Press, 2009). Co-editor of Social Text.


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Abastract painting
February worksMarch 20, 2018
Just that, these are the artworks that I've made last month apart of the "Red series".
New canvas to work on this month. Different size, this time square once. And a professional palette or wedge to swap with "Amazon premier card"
Enjoy March like I enjoyed February.
At the moment, I am.
See you soon, be creative!


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The Best Dental Implants Related Searches In Dublin, Ireland
In the 21st century the important thing to make your life better on may improve the appearance of his/her physical body. Here many people are advised to accept how they are. People who visits dentists for dental implants are one of the best alternatives for dentures or dental bridge. It is easy to get a dentist in Dublin, Ireland.
The dentist are situated in highly densely areas like towns. Confidence is one of the most important trait in an individual's life thus if one gains it by dental implant it is better to carried out. The mouth is one of the most delicate part of the body a little infection may damage your tissues. Technology is used to install the dental implants and is one of the easiest way to gain confidence in a short time.
Technology is the backbone of the economy in the present world then technology is important in delivering the service to clients. There are many dentists in Dublin, Ireland in which they are ranked as the best in the world since most of their operations are always successful. Some papers are signed by the clients to make sure that he/she is the one that accepts the Dental implant to be carried.
There are many safe ways of dental implants and the mode used will be determined by the client choice and the price of the procedure will also be dependent on the technology used to make it more effective. Aging makes many treatment procedures to have negative effect on the people who undertake it thus choosing procedures which have less interference with your body parts.
It is expensive for some people to get dental implant since the involved procedure is complex and too costly for some individual. The consultancy services is mainly found in their online platforms where they give clients different packages in the dental implant procedure. For one to be a qualified dentist implant specialist one must have academic qualification and licenses from government in a certain country.
For beginners they may visit different sites which offer services that give the individual information regarding the various packages in this treatment. Dental implant takes hours to become successful thus capital need to be invested in this period. Dental implants in Dublin has less impact on the health of the individual in that it doesn't interfere with how the body works. They have websites in which they use to update their patients on the latest development in the area of dental implants. Many religions in the world work against anybody manipulation or replacement of body parts.
Lessons Learned from Years with Experts


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Service industries in US grow at fastest pace in 13 months
[WASHINGTON] America's service industries expanded in November at the fastest clip since October of last year, putting the economy's biggest sector on a robust growth path.
The Institute for Supply Management's non-manufacturing index jumped to 57.2, exceeding all forecasts in a Bloomberg survey, from 54.8 in October, the Tempe, Arizona-based group's data showed Monday. Readings above 50 signal growth. The median forecast called for 55.5.
Measures of business activity and employment strengthened at companies that cover almost 90 per cent of the economy, signaling growing optimism about demand. The group's factory survey released last week also showed promise, with manufacturing expanding by the most in five months.
"This last quarter is having the year finish up pretty strong," Anthony Nieves, chairman of the ISM non-manufacturing survey, said on a conference call with reporters.
"I don't project that December is going to be much different."
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Estimates in the Bloomberg survey of economists ranged from 54 to 57. The latest reading puts the ISM services gauge above the 54.5 average for the first 10 months of this year and compares with 57.2 in all of 2015.
The ISM services survey covers a range of industries, including retail, health care, agriculture and construction. Fourteen industries, including farming, retail, entertainment and transportation, expanded in November.
The real estate, rental and leasing sector, along with public administration, contracted.
The group's business activity index, which parallels the ISM's factory production gauge, jumped to 61.7, also the highest since October 2015, from 57.7. A measure of services employment climbed to a 13-month high of 58.2 from 53.1.
Employment figures from the Labor Department last Friday showed payrolls increased by 178,000 workers and the jobless rate dropped to a nine-year low of 4.6 per cent. Business services, health-care providers and restaurants accounted for most of the job gains.
The ISM's new orders gauge eased to a still-robust 57 in November from 57.7 the prior month.
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