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Take it 1 day @ a time I could go for a turkey leg right about now Join Date: Aug 2002
Location: Bergen County, New Jersey
Posts: 2,259
Clam Dip - Hot
Saute a large onion and a small green bell pepper (both chopped) in a stick of butter until softened. Add a can of chopped clams with juice...bring to a boil. Then add italian bread crumbs to the consistency you would like...serve with crackers, DELICIOUS!!! (We prefer it with either saltine crackers or triscuits) Clam Dip - Cold Bring a package of cream cheese to room temperature. Drain a can of clams (reserve juice) and mix together with the cream cheese. Add garlic powder to taste and the reserved juice, a little at a time until you get the consistency you prefer (you want to make it a little looser than you actually want, because it will thicken up again when you refrigerate it). Refrigerate for about an hour. Great with potato chips or pretzels.
Just because life doesn't live up to your expectations means it's letting you down!! 1979-2000 off-site Kissimmee 07/01 Contemporary 07/02 Wyndham Palace & Spa (4 days) 07/02 Polynesian |
Curse this time difference!
You show me yours I'll show you mine! Now I just want to go home and spread my bits of paper about Join Date: Sep 2004
Location: Scrapper's Desert, UK
Posts: 9,471
I haven't got the recipe or link to hand but the Pampered Chef hot broccoli dip is a big favourite - also good for haloween!
| | ||||
DIS Veteran
Join Date: Jan 2005
Location: ONTARIO,CANADA
Posts: 649
As a former Pampered Chef Consultant, here is this AWESOME recipe:
Hot Broccoli Dip: 1 Cup fresh broccoli florets, chopped 2Tbsp onion chopped 2Tbsp red pepper chopped 1 oz Parmesan cheese 1/4 Cup Parmesan Cheese divided 1 clove garlic, pressed 1 cup shredded cheddar cheese 1/2 cup light sour cream 1/2 cup light mayo Fresh ground pepper Pita chips, crackers, or nacho chips Preheat oven to 375F. Chop broccoli, onion and red pepper. Add 2Tbsp of grated parmesan cheese to vegetable mixture. Press garlic into a separate bowl. Add cheddar cheese, sour cream and mayo.Season with black pepper and mix well. Spread vegetable mixture evenly in a small casserole dish or stone casserole. Bake 20-25 minutes or until heated through. Sprinkle remaining Parmesan Cheese over top and surround with pita chips, nacho chips, fritos, crackers, or bread pieces. So easy, enjoy!
2014 Windsor Hills 2012 CSR/POR 2008 WL/Pop 2007 FW 2007 ASMU 2005 Land & Sea-CBR/Disney Wonder 2004 FW DH DWDD-16 DD-14 |
DIS Veteran
Join Date: Mar 2004
Posts: 17,139
Ritz Holiday Bell
Ingredients: 6 slices OSCAR MAYER Hard Salami 1 pkg. (6 oz.) KRAFT Cracker Cuts Mild Cheddar Cheese 18 RITZ Crackers 18 thin red pepper strips 2 tsp. chopped fresh parsley Preparation: CUT 3 small bell-shaped pieces out of each salami slice and 1 small bell-shaped piece out of each cheese slice, using small cookie cutter or sharp knife. TOP crackers evenly with the salami and cheese. DECORATE with the peppers and parsley |
DIS Veteran
Join Date: Feb 2007
Location: 2,300 km north of the World
Posts: 654
OK I'm new to DIS and just stumbled onto this thread, so here is one a my signature roadhouse, football party type get your fingers into the goo appetizers!! Enjoy. Hot Spinach & Artichoke Dip 10 ounce package frozen spinach, thawed, drained well, coarsely chopped 28 ounce marinated artichoke hearts, drained, coarsely chopped 3/4 cup roasted garlic flavoured mayonnaise 3/4 cup sour cream 1-1/2 cup Monterey Jack cheese, grated, reserve ½ cup for garnish 1-1/2 cup Parmesan cheese, finely grated, reserve ½ cup for garnish 5 drops hot pepper sauce Spray a 9 10 ceramic or glass pie baking dish with non stick spray. Place artichoke hearts in large mixing bowl. Break up the spinach evenly over top. Add the remaining ingredients except cheeses for garnish. Add hot pepper sauce depending on likeness, can be eliminated. Mix well so that the spinach is evenly distributed. Place in baking dish spread out evenly. Sprinkle first with Jack cheese and then Parmesan. At this point can be covered with plastic wrap and refrigerated overnight. When ready to serve remove plastic and place in preheated 350F oven and bake for 25 30 minutes or until cheese begins to melt and brown on top. Serve with bagel, pita or tortilla chips.
[IMG]http://www.********************/timers/tickers/c3uisdwg0f9vz3r8.png[/IMG] |
DIS Veteran
Join Date: May 2005
Location: Allison Park, PA
Posts: 735
Cheesy Bread Dip:
Pre-heat oven to 325 degrees. One (1) large, round loaf of sour dough bread. Slice of the top and gut-out and cube the pieces inside. (Get an extra sourdough roll or two to have extra bread.) Mix together the following ingrdients: One (1) cup of Hellman's Mayonaise. One (1) cup of sour cream. Two (2) cups of shredded cheddar cheese. Two (2) cups of shredded mozzarella cheese. One (1) small onion - finely chopped. One (1) can or bottle of Real Bacon Pieces (Be sure to use Real Bacon Pieces, not bacon bits. Bacon pieces can normally be found near the salad dressings.) Once mixed, fill the empty loaf of bread with the mixture. Place the filled loaf on a baking sheet and bake in the oven at 325 for fifty (50) minutes. Then add the cubed chunks of bread around the loaf and bake for an additional five (5) to seven (7) minutes. Serve warm. |
My head looked like a brillo pad
DH gave me roses ... just because :) Someone please take pity on me, and send me a small piece of pecan pie Join Date: Aug 2003
Location: 5 miles from Pocono Raceway.
Posts: 47,165
Crab Stuffed Mushroom En Croute
(courtesy Paula Dean) 1/2 cup herb flavored cheese (recommended: Boursin) 1/2 cup finely minced crabmeat (may use imitation) 18 uniform sized mushrooms, stem removed 1 box phyllo pastry (will need at least 18 sheets) 1/3 cup butter, melted Salt and freshly ground pepper 1 egg, beaten Preheat oven to 400 degrees F. Combine cheese and crab in a small bowl. Divide crab mixture among the upside-down mushroom caps, stuffing the mushrooms. Carefully lay 6 sheets of phyllo dough on top of one another, brushing every other sheet with melted butter. Cut phyllo lengthwise down the center and then cut each half into 3 pieces to make 6 rectangles. Place a mushroom, cheese side up, in the center of each square. Season with salt and pepper. Lift sides of pastry over mushrooms to resemble small bundles and form a "neck," pinching edges together to seal. Repeat the entire procedure 2 more times. Place on a greased baking sheet and brush with beaten egg. Bake for about 15 minutes until pastry is crisp and golden. Serve hot. ---------------------------------------------------------------------------------- Jalapeno Deviled Eggs 12 large eggs 1/4 c. pickled jalapenos chopped fine cayenne pepper 1/4 tsp. dry mustard 4 green onions chopped fine Mayo Salt Mix together all but the cayenne pepper. Fill eggs and sprinkle with the cayenne pepper. Last edited by Pooh67_68; 09-22-2008 at 08:16 AM. |
Join Date: Jul 2010
Location: Northern New York
Posts: 182
Here are my three most requested Appetizers when I am catering:
Clam Dip 8 oz Cream Cheese 1 can Minced Clams-drained 1/3 cup freshly Grated Parmasean Cheese 1 tsp Garlic Powder Milk to thin Worchestershire sauce Pumpernickle bread and Rye Bread 1. Microwave Cream Cheese 30 seconds at a time until melted. 2. Combine remaining ingreadients 3. Heat in Microwave; Serve warm with bread cut into cubes. Chinese Chicken Wings 5 lbs of Wings 1/2 bottle of Teriyaki Sauce 1 tsp ground ginger 2 tbsp Soy Sauce 1 tbsp lemon juice 1/2 tsp hot sauce 1. Mix sauce ingredients together. Pour over wings in covered roaster. 2. Bake at 400F for 30 - 40 minutes (longer if still frozen). Stir frequently to keep basted. Dilled Shrimp 1 1/2 cup Mayonnaise 1/2 cup lemon juice 1/4 cup sugar 1/2 cup sour cream 1 red onion diced 1 tbsp Dill Weed 1/4 tsp salt 2 lbs peeled and cooked shrimp 1. Combine all ingredients and chill 2. Serve with crackers
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This alarmingly bad parking job occurred on July 3, 2014, in New Delhi, India, at the five-star Le Meridien hotel. The valet was returning the car, and is shown arriving at high speed, not slowing or stopping, but hitting another car and finally crashing into a concrete wall. The hotel is calling it driver error.
The family of an Indian guru has asked a court to decide whether or not he is dead, or alive and just meditating. His family believes that he has been dead since January, but his followers say he is in a deep meditative state, and the fact that his estate is estimated at over $167,640,000 makes no-never-mind.
Fighting fire with fire, authorities in India are taking back the streets from public urinators with high-powered hoses. Their solution to an all-too-common urban problem is not just effective, but is sanitary, doesn't create a lot of paperwork, and provides amusement for all those electing to hold it in.
Over 600 complaints of corruption involving the police in Delhi, India, were forwarded to police by the Central Vigilance Commission (CVC) in 2006 — and sat there because no one at police headquarters knew the password, or how to operate the system.
It happened last Saturday night that that a man named only as Jayaraj in reports was walking home very drunk in Ashoknagar, India, when apparently nature called. Jayaraj, 45, reportedly stopped to take a leak at Field Marshal Cariappa Road near Shoolay Circle. Unfortunately, he managed to pee on an electrical fuse box in the process.
Many Americans associate laundry hanging from windows and balconies with cherished vacations in the more charming places of the Old World. Last week, however, a woman and a man both died in Salarpur Village, India, in a tragic and weird accident that occurred while she was hanging the laundry out on the line.
The overwhelming majority of Indians seem to feel that justice has been served, though it is not at all clear if and when the punishment will be meted out. For now Indian women are calling this a victory.
A case of unrequited love in India ended in a bloody campus assault and suicide when a male student entered a classroom armed with an axe, a knife, poison and a pistol, singled out the female student, who he felt had snubbed him, attacked her with the axe and then slit his own throat.
Gross school lunches are responsible for snarky terms like "mystery meat" and "murder burgers" finding their way in the English language, but all jokes aside, a recent free school lunch served in India was so bad that 25 so far have died from eating it — including the cook.
Accused serial killer "Motta" Navas was arrested on November 1, 2012, after a series of grisly murders in Kollam, Kerala, India, committed between June and August. His targets were street people, all killed in their sleep. There seems to be no motive for these exceptionally controlling, brutal murders of the city's most vulnerable targets.

subset: commoncrawl


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Douay-Rheims (RHE) | New International Version (NIV) |
2 Therefore thus saith the Lord the God of Israel to the pastors that feed my people: You have scattered my flock, and driven them away, and have not visited them: behold I will visit upon you for the evil of your doings, saith the Lord. | 2 Therefore this is what the LORD, the God of Israel, says to the shepherds who tend my people: "Because you have scattered my flock and driven them away and have not bestowed care on them, I will bestow punishment on you for the evil you have done," declares the LORD. |
The Douay-Rheims Bible is in the public domain. (Douay Rheims Catholic Bible Translation Online) | Scripture quoted by permission. Quotations designated (NIV) are from THE HOLY BIBLE: NEW INTERNATIONAL VERSION®. NIV®. Copyright © 1973, 1978, 1984 by Biblica. All rights reserved worldwide. (New International Version Bible Online) |


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HOUSTON, April 4, 2011 /PRNewswire/ -- Hamlin Memorial Hospital is planning to leverage Prognosis ChartAccess® Comprehensive EHR to move toward a number of goals such as improving clinical care, meeting the government's meaningful use requirements, and enhancing community health through participation in a growing Texas Regional Health Information Organization (RHIO).
"Like all other providers, we want to improve care and at the same time meet the government's requirements for the incentive payments that are associated with the HITECH provisions of the American Recovery and Reinvestment Act," said Jim Barnett, CEO of Hamlin (Texas) Memorial Hospital. "To do so, we realized that we not only needed to get a system up and running quickly but we needed a solution that our doctors and nurses would really want to use on a daily basis."
After reviewing several electronic records solutions, Hamlin leaders realized that the ChartAccess Comprehensive EHR offered exactly what the 25-bed, acute care hospital needed. ChartAccess is a shared web-native EHR system, delivered via a "cloud computing" model, where the software applications are made available as a service over an encrypted health information network. The EHR provides clinicians with a complete view of patient data to support optimal and safe clinical care. Users can simply access the system by using a standard operating system and a secure browser.
"The physicians and nurses really like the system and feel that it is much easier to use and understand than some of the other solutions that we looked at," Barnett said. "You could tell that whoever designed the system had knowledge of exactly how a hospital works and exactly how nurses and physicians want to enter notes into medical charts. It's just very intuitive. Some of the other systems we looked at felt like they were designed by people who didn't know anything about medicine. They looked like they were designed by accountants
SOURCE Prognosis Health Information Systems, Inc. Copyright©2010 PR Newswire. All rights reserved |


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Spent a weekend in this hotel to enjoy St Johns party. The hotel is very well located for my purpose (near downtown and near parque do povo). The rooms are very large and full of space altough the hotel is old and need mainentance. The breakfast is good and qith regional options.
Brazil >
State of Paraiba >
Campina Grande
Price Range (Based on Average Rates):
Hotel Class:3 star — Hotel Onigrat Express 3*
Number of rooms: 214
- Reservation Options:
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- Also Known As:
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text:
Morrisons need to sell single packets of SKIPS!!
This may seem like a joke, but this is no joke! We need to stop these terrible trips to Morrisons, to find that our skip mission has come to an end! Join the petition now, and this will soon change =) if not for you, then for your kids!!
Recent signatures
annie fordham, United Kingdom
5 years ago -
Sally Chase, United Kingdom
5 years ago -
jessica chadwick, United Kingdom
5 years ago
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Latest News
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Shonda Rhimes isn't playing around when it comes to her opinion about Katherine Heigl!
In an interview with The Hollywood Reporter, the ABC powerhouse tal… READ MORE
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I don't know if this has been posted before, but you need to see this!Fastest gunman on planet. [VIDEO]
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He seems cocky.....
"This is my rifle, this is my gun." "This is for fighting, this is for fun." -Full Metal Jacket "I joined the Navy to drink in foreign countries and fornicate." -unknown
Those settlers seem scared.
Not Registered? Register now! - It's free and helps the community grow.
When you're that fast, you've got a right to be cocky.
The truth will set you free, but first it's going to piss you off. "Time to nut up or shut up." - Tallahassee "Life is tough, it is even tougher if you are stupid." - The Duke
That's an old video. His name is Bob Munden. He shows up on some shooting/gun programs now and then. ...and yes, he really is that fast and accurate.
This guy is fat...Oh, wait, you said fast. Well, he is fast too.
It ain't bragging if you really done it.
What we have here is... failure- to communicate.


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Reviewed Cream Cheese Frosting
Jun 23, 2011 in Food Network Community Toolbox on FoodNetwork.com
"I really can't believe this has so many 5 stars. It tasted like straight butter and sugar, YUCK! I had to add 4 oz. more (8 oz. total) of cream cheese just to get it taste better. After I did this it did taste good but not great or "amazing." It is sweet but I like sweet stuff. You need all that sugar to counter the butter taste. I do not re""


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Freedom Flix
Saving Lives: Challenging the Ban on Compensating Bone Marrow Donors
Every year, 1,000 Americans die because they cannot find a matching bone marrow donor. Minorities are hit especially hard. Common sense suggests that offering modest incentives to attract more bone marrow donors would be worth pursuing, but federal law makes that a felony punishable by up to five years in prison. Read more
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Freedom Flix
The Institute for Justice is always looking for new ways to promote the message of freedom. To that end, IJ produced the following videos in-house to tell the stories of our clients and their fight for individual liberty.
None of this — the cases or these videos — would be possible without the continued generosity of our donors. We hope you enjoy them and share them with those who need a little inspiration.
Subscribe to our videos via iTunes or YouTube.
Property Rights Protected, but More Needs to Be Done
Governor Christie Remains Silent About 100,000+ Signers Of Petition to Save Charlie's Long-time Atlantic City Family Home
Federal Judge to Texas: Irrational Laws Violate the Constitution and Cannot Stand
For the 13th consecutive year, IJ earned a coveted 4-star rating with the nation's largest evaluator of charities.


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Pulley Kit, Serpentine, Aluminum, Clear Powdercoated, Chevy, Small Block, Kit
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Brand: March Performance
Manufacturer's Part Number: 22023
Part Type: Pulley Kits
Product Line: March Performance Chevy Small Block Serpentine Conversion Kits
Summit Racing Part Number:
Pulley Style: Serpentine
Pulley Set Style: Performance ratio
Pulley Material: Billet aluminum
Pulley Finish: Clear powdercoated
Crankshaft Pulley Included: Yes
Crankshaft Pulley Grooves: 6-groove, serpentine
Crankshaft Nose Cover Included: No
Water Pump Pulley Included: Yes
Water Pump Pulley Grooves: 6-groove, serpentine
Water Pump Nose Cone Included: Yes
Power Steering Pulley Included: Yes
Power Steering Pulley Grooves: 5-groove, serpentine
Power Steering Pulley Attachment: Keyway
Power Steering Pump Style: Saginaw
Power Steering Brackets Included: Yes
Alternator Pulley Included: Yes
Alternator Pulley Grooves: 6-groove, serpentine
Alternator Fan Included: Yes
Alternator Nose Cover Included: Yes
Alternator Brackets Included: Yes
Air Conditioning Pulley Included: No
Air Conditioning Cover Included: No
Air Conditioning Bracket Included: No
Idler/Tensioner Included: No
Idler Cover Included: No
Idler Brackets Included: No
Hardware Included: Yes
Bracket Finish: Clear powdercoated
Bracket Material: Billet aluminum
Quantity: Sold as a kit.
Notes: Fits standard rotation water pumps.
In-Store Pickup: Choose In-store pick-up (OH, GA, NV) on our web site.
March Performance Chevy small block serpentine conversion kits are mid-mount pulley kits that place your alternator and power steering pump below the centerline of the water pump. They are simple to bolt on, while still retaining your standard-rotation long water pump. Serpentine belts eliminate belt throwing. The kits are available with performance pulleys for increased horsepower, high water flow ratios for increased cooling, or mid-performance ratios for a combination of both. The pulleys are CNC-machined from solid billet 6061-T6 aluminum for a spectacular looking machine finish with a perfect fit and extra-high strength. All March Performance billet pulleys and brackets have a maintenance-free clear powdercoating. These performance pulleys will increase your engine by approximately 12-15 hp, depending on the accessories driven. The kits are available with a driver side mounted A/C option. The use of a combination bracket in these kits allows for the addition of an alternator idler, which provides excellent belt wrap around the alternator and A/C compressor pulleys.
Some parts are not legal for sale or use in California on any pollution-controlled motor vehicles
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Webster, TX 77598
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Webster apartments for rent are less than 25 miles southeast of downtown Houston. While living in the area, you will have easy access to an exciting city life, but also find yourself a short trip from Clear Lake and the Galveston Bay for a refreshing day on the water. The city is a perfect spot for families to settle down, with a variety of kid-friendly activities to enjoy throughout the seasons.
When choosing Webster apartments for rent, you will find that you get to enjoy everything from space to sports and all that's in between. At the Houston Space Center, take a trip into outer space with the kids to see what the astronauts experience. At the Kemah Boardwalk, you'll get to enjoy amusement rides and games during several weekend trips.
Over at the Armand Bayou Nature Center you can take in all that Mother Nature has to offer. apartments for rent in Webster near the center have year-round access to natural beauty courtesy of the Gulf Coast. Head through the nature trails to spot a number of live animals, including alligators, hawks and bison! You will have the chance to explore landscaping that ranges from forests and marshes to prairies during each visit.
Residents of Webster apartments enjoy an average cost of living that is 9 percent less than the national average. The average prices for gas and espresso beverages are 5 percent and 9.4 percent, respectively, less expensive than the national averages. In addition, the national average price of pizza is 9.1 percent greater than the average cost in Webster.
For residents in need of low income apartments for rent in Webster, you can go to the Harris County Housing Authority for assistance. This department provides Housing Choice Vouchers for area residents as well as family housing assistance.
In the final four months of 2012 the unemployment rate in Webster continued dropping. At the end of the year, the figure was just 6.1 percent. As the city continues seeing an increase in job opportunities, residents of apartments in Webster will enjoy a continually lowered unemployment rate.
With such close proximity to Houston, many area residents choose to further their education in the city. Some of the popular choices for students living in Webster apartments for rent include the University of Houston, Texas Southern University and Rice University. No matter what your field of interest is, you will have no trouble locating a great college within a short drive from Webster.
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knit Simple (Published Quarterly)
Overview - Knit Simple is the market's best-selling magazine for new knitters and busy, experienced knitters looking for quick, easy and inspirational projects. Knit Simple is the yarn retailer's magazine of choice for class ideas, basic skill-building techniques and pleasing patterns. Read more...
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Est. 1972 Family Owned On the Water (Weirs Beach) 8.5 acre Full service Marina. New and used Boats, Motor... more
Spinnaker Cove Yacht Club is a privately owned condominium association located on the shores of Paugus Ba... more
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Yovani Gallardo is an ace in the Brewers' rotation. A sub 3.00 era and 200 plus innings a season is nothing for the All-Star pitcher. Head to the game supporting your Brewers and your favorite player in this Yovani Gallardo tee by Majestic. This comfy tee replicates a Brew Crew jersey and features a printed team name on the front with Gallardo's name and number on the back. Represent your favorite Brewers hurler in style during their chase for the Pennant and a World Series.
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The euro rose against the dollar before a meeting of the U.S. Federal Reserve that may push back expectations for an interest rate rise.
The euro hit a fresh 11-year low after Draghi announced the launch of an open-ended expanded monthly 60 billion euro bond-buying program.
The currency war is being played like a chess match, but that will eventually change, veteran trader Art Cashin told CNBC.
Commodity currencies may face a race to the bottom as the Bank of Canada's surprise rate cut may pressure Australia's central bank to follow suit.
The yen rebounded against the dollar after the Bank of Japan stood pat on monetary policy.
Times are tough for Australia's junior miners as plunging iron ore prices squeeze them out of the market, but oil's decline may provide respite.
The dollar hit a one-week high against the yen after China growth data was not as bad as many had feared, curbing demand for the safe-haven Japanese currency.
The European Central Bank could take its boldest steps yet to revive the euro zone's moribund economy.
Dennis Gartman, along with Deutsche Bank's David Bianco, talk about who is hurt by the Swiss central bank's move.
Fallout from the Swiss National Bank continues to haunt the euro, bringing the currency down to new lows.
Switzerland's franc soared by almost 30 percent in value against the euro after the Swiss National Bank abandoned its three-year old cap.
Switzerland's franc soared by almost 30 percent after the Swiss National Bank abandoned its cap against the euro.
The dollar fell against the yen following after newly released data showed retail sales fell 0.9 percent, its biggest drop since January 2014.
Sterling fell towards an 18-month low against the dollar, after data showed British inflation at its lowest since 2000.
The yen hit a one-month high against the dollar on Tuesday, buoyed by steady demand for safe-haven assets against a backdrop of plunging oil prices.
Australia took a double-whammy from record-low interest rates and commodity-price drops, but the selloff has left its market attractive to yield chasers.
Sterling recovered some ground on Friday, pushing back above $1.51 as the dollar retreated broadly.
The euro extended losses into a sixth straight day to trade near a nine-year low, as investors bet the ECB was getting closer to adopting QE.
The euro hit another nine-year low against the dollar on Wednesday, after data for the euro zone revealed that prices were falling in the region.
The U.K. pound hit a fresh 17-month low against the U.S. dollar on Tuesday and currency experts are split on which way the currency will head next.
The safe-haven yen rose as investor risk aversion mounted following a sharp drop in crude oil and stocks.


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- 1/2" NPT x 42"
- 13/16 OD x .625 Thick
Additional Brasstech Links
This Brasstech item can also be referenced by the following color/finish specific model #:
- Brasstech 517-42/06
Antique Brass - Brasstech 517-42/08A
Antique Copper - Brasstech 517-42/15A
Antique Nickel (Pewter) - Brasstech 517-42/07
English Bronze - Brasstech 517-42/56
Flat Black - Brasstech 517-42/10B
Oil Rubbed Bronze - Brasstech 517-42/03
Polished Brass Coated - Brasstech 517-42/26
Polished Chrome - Brasstech 517-42/24
Polished Gold - Brasstech 517-42/15
Polished Nickel - Brasstech 517-42/01
PVD Forever Brass - Brasstech 517-42/04
PVD Satin Brass - Brasstech 517-42/10
Satin Bronze - Brasstech 517-42/26D
Satin Chrome - Brasstech 517-42/24S
Satin Gold - Brasstech 517-42/15S
Satin Nickel - Brasstech 517-42/20
Stainless Steel - Brasstech 517-42/03W
Weathered Brass - Brasstech 517-42/08W
Weathered Copper
*Discontinued model or finish
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Discover the best online deals for the 517-42 and everything else for your home from the leading online home improvement store.
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Installation Resource Center
Whether you are installing the product yourself or hiring a professional, our installation Resource Center has everything you need to get your project done. Visit the Installation Resource Center to get started.


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Last Updated: January 30, 2013 12:04pm ET
Exclusive Video Can Multifamily Sustain Rental Rates?
PALM SPRINGS, CA-New product coming on the market may exert downward pressure on multifamily rental rates, says Rick Graf, CEO of Pinnacle. Graf spoke with Carrie Rossenfeld at the recent NMHC Apartment Strategies Conference here. Topics included:
- Challenges to multifamily management this year
- The lifespan of the sector�s strength
- Trends emerging in the sector
Start your day well-informed with GlobeSt.com's National AM Alert. Sign Up Today!


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Still Swinging Golf Tournament
Fore! Victory Boxing Club is accepting foursomes for our 3rd Annual Golf Scramble. For just $75 a person ($300 a foursome) you can spend a day on the golf course and help support a great cause. Entry gets you a cart, two drink tickets, and a chance at some fantastic prizes. Spots are limited, so don't hesitate. Registration closes August 8th. To register, email Tony Aguilera at firstname.lastname@example.com. For sponsorship opportunities, call or email Virgil Patlan at 402-714-0274 or email@example.com.
Miracle Hills Golf Course
1401 North 120th Street, Omaha, NE 68154-1303


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Faculty & Research
Faculty & Research
Curiosity about the world and a commitment to solving important problems are the passions that motivate faculty at the School of Informatics and Computing. Students at both the undergraduate and graduate levels have the opportunity to work side-by-side with internationally renowned scholars on a wide range of cutting-edge research.
Centers and Areas of Concentration
Bio, Health and Life Sciences Informatics
Complex Networks and Systems
Cyberinfrastructure/High Performance Computing
- Center for Data and Search Informatics
- Center for Research in Extreme Scale Technologies
- Data to Insight Center
- Digital Science Center
Human Computer Interaction Design
Social Informatics
Breadth of Research
Our School is one of the broadest schools of its type in the US. That breadth is reflected in the amazing range of our faculty's research:
Applied Logic and Computation Theory
Cloud Computing
Computer Mediated Communication
Cyberinfrastructure and e-Science
Digital Environments
Digital Humanities
Digital Library
Information Architecture
Information Retrieval
Information Theory
Information Tools and Technology
Information in Digital Environments
Information Theory
Information Visualization, Computer Vision, and Graphics
Network Analysis
Parallel and Distributed Computing
Scholarly Communication
Science of Science
Semantic Web


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The Doris Day Show: Season 5, Episode 6Forgive and Forget (16 Oct. 1972)
(awaiting 5 votes)
Reviews: write review Doris pens a piece critical of the divorce epidemic, calling on couples to forgive and forget hurts and betrayals. But Doris finds it difficult to heed her own counsel when she suspects Peter of a fling with a beautiful young actress. Director:William WiardWriter:Laurence Marks |
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Skip Maine state header navigation
Skip First Level Navigation | Skip All Navigation
Home | Contact DMR | Forms | Maps | Online Services | Other links | DMR Intranet |
DMR Home
> About DMR > Bureau of Marine Science > Sea-Run Fish > Programs and Projects > Salmon Water Temp & Quality
Atlantic Salmon Thermal Habitat and Water QualityWater Temperature in Atlantic Salmon RiversThe Maine DMR monitors water temperature in approximately 20 sea-run Atlantic salmon drainages across the state of Maine. The extensive network of inexpensive, highly accurate data loggers provides over 1,000,000 temperature measurements annually. The data gives the department the ability to evaluate the extent to which water temperature limits growth and survival of juvenile Atlantic salmon in habitat reaches thoughout these 20 rivers and helps the Commission to prioritize river reaches for fry and parr stocking. For example, the Narraguagus River in the Route 9 area of Beddington constitutes a large portion of the overall habitat available to juvenile Atlantic salmon in this particular river. Temperature monitoring in this section has shown it to be at times susceptible to critically high temperatures during summer heat waves. However, nighttime lows usually provides juvenile salmon with an important recovery period that allows them to survive through these warm spells. The 24-hour temperature coverage allows us a more complete picture of what is happening to fish. Water Quality in Atlantic Salmon RiversIn 2003, the Atlantic Salmon Commission began collaborating with the Senator George J. Mitchell Center for Environmental and Watershed Research at the University of Maine (GMC) in creating seasonal snapshots of pH related water chemistry in Maine salmon rivers. Water samples were collected in spring, summer and fall by staff from the ASC, GMC, NOAA, DEP and volunteers from watershed councils from approximately 70 sites throughout 13 Maine Atlantic salmon rivers including: the Dennys, Machias, East Machias, Narraguagus, Pleasant, Ducktrap, Cove Brook, Kennebec and Sheepscot rivers. In addition, a more intensive study investigating the effects of land use on water chemistry is being conducted in tributaries of the Union (relatively undisturbed) and the Narraguagus Rivers (managed forest land). These surveys document that rivers east of the Penobscot River have lower pH and alkalinity than rivers to the west, and that storm events have the potential to lower the pH in the eastern rivers to levels where it may be affecting the survival of out-migrating Atlantic salmon smolts. |
Copyright © 2012 All rights reserved. |


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Southern Living MARCH 2007
1. Prepare pasta according to package directions. Toss pasta with remaining ingredients. Serve immediately, or cover and chill up to 2 days.
Fresh Citrus Salad Dressing: Whisk together 1/2 cup light olive oil, 3 Tbsp. Greek seasoning, 3 Tbsp. fresh lemon juice, and 3 Tbsp. mayonnaise.
Go to Full Version of


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Comfort Inn & Suites Sea-Tac Airport 19333 International Blvd SeaTac, WA 98188 Phone: (206) 878-1100 Fax: (206) 878-8678 |
- Smoke Free
- Free Airport Shuttle
- Free Breakfast
- Fitness Center
- Free Internet
- Laundry, Guest
Comfort Inn & Suites Sea-Tac Airport hotel near Emerald Downs
Enjoy a wealth of amenities in a convenient location when choosing the Comfort Inn & Suites® in SeaTac, WA. We are ideally located just south of the Seattle-Tacoma International Airport and near many of the area's top attractions, which include:
- Museum of Flight
- Wild Waves theme park
- Emerald Downs
- KeyArena at Seattle Center
- Safeco Field
Get refreshed in our inviting guest rooms, some of which feature whirlpool bathtubs, refrigerators and microwaves along with expanded cable television channels, coffee makers and hair dryers. Additional amenities include:
- Free airport transportation
- Free wireless high-speed Internet access
- Free coffee
- Exercise room
Your Morning Breakfast is full of hot and delicious options, making breakfast at the Comfort Inn & Suites® the perfect way to start your day. Enjoy our free hot breakfast featuring eggs, meat, yogurt, fresh fruit, cereal and more, including your choice of hot waffle flavors!
Take care of basic business needs with access to computer and fax services, and for added convenience, guest laundry facilities, valet cleaning services and a tour desk are available onsite.
Make your reservation today at the Comfort Inn & Suites® in SeaTac, WA for a memorable stay in a great location, all at an affordable price.
Points required for Choice Privileges® reward night redemption:
Features and Amenities
- Bus Parking
- Computer w/ Internet *
- Courtesy Transportation
- Elevator(s)
- Exercise Room
- Free Airport Transportation
- Free Coffee
- Government Travelers: FEMA Approved
- Guest Use Fax Machine *
- Guest Laundry *
- In-Room Coffee Maker
- Interior Corridors
- No Pets Allowed
- Parking Available
- 100% Smoke Free Hotel
- Tour Desk
- Valet Cleaning Service *
- Free Hot Breakfast


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William John Feight Sentenced in U.S. District Cour
Bill Mercer, United States Attorney for the District of Montana, announced today that during a federal court session in Missoula, on May 21, 2009, before U.S. Magistrate Judge Jeremiah C. Lynch, WILLIAM JOHN FEIGHT, a 45-year-old resident of Bozeman, appeared for sentencing. FEIGHT was sentenced to a term of:
- Prison: 151 months
- Special Assessment: $100
- Supervised Release: 10 years
FEIGHT was sentenced in connection with his guilty plea to conspiracy to distribute 500 or more grams of a mixture or substance containing a detectible amount of methamphetamine.
In an Offer of Proof filed by the United States, the government stated it would have proved at trial the following:
In 2004, FEIGHT, who has a prior conviction from 1996 for conspiracy to distribute methamphetamine, began buying "eight balls" of methamphetamine from an individual, hereafter referred to as "John Doe," generally for personal use. "John Doe" was eventually arrested and his Mexican sources of supply approached FEIGHT about selling the methamphetamine that they were bringing into the Bozeman area. FEIGHT agreed and began receiving one ounce of meth from another individual, hereafter referred to as "Tom Doe," every one to three days from the summer of 2007 until September of 2008. FEIGHT normally received the methamphetamine from "Tom Doe" at Lindley Park in Bozeman. During an interview with law enforcement, FEIGHT estimated that he met "Tom Doe" at the park 20 to 50 times to obtain ounce quantities of methamphetamine.
Various individuals who purchased methamphetamine from FEIGHT were interviewed by law enforcement. One individual said he received at least one pound of meth from FEIGHT between April and October 2007. "John Doe" told officers that FEIGHT told him that he (FEIGHT) could obtain as much as five pounds of meth from his Mexican sources at one time, but "John Doe" suspected the actual amount to be substantially less than that. Another individual estimated that he received between two and one-half and three pounds of methamphetamine from FEIGHT from approximately the summer of 2007 until March 2008.
On November 28, 2007, FEIGHT and another individual were stopped by the Montana Highway Patrol and FEIGHT'S vehicle was impounded. Before law enforcement officers could obtain and execute a search warrant on that vehicle, FEIGHT and his passenger broke into the impound lot and the vehicle. Witnesses and FEIGHT later said that a quantity of methamphetamine was removed from FEIGHT'S vehicle during the break-in.
On December 21, 2007, FEIGHT'S vehicle was again impounded following a traffic stop. Law enforcement officers searched the vehicle and seized approximately 40 grams of methamphetamine (18.6 grams of actual meth).
On July 20, 2008, FEIGHT was arrested following a vehicle pursuit with a Gallatin County Sheriff's deputy. His car was searched and law enforcement seized approximately 37 grams of methamphetamine (11.1 grams of actual meth).
On September 22, 2008, FEIGHT was arrested for driving with a suspended license. Just prior to the arrest, FEIGHT got out of his car and put a quantity of methamphetamine in the back of a truck parked next to his car.
Because there is no parole in the federal system, the "truth in sentencing" guidelines mandate that FEIGHT will likely serve all of the time imposed by the court. In the federal system, FEIGHT does have the opportunity to earn a sentence reduction for "good behavior." However, this reduction will not exceed 15% of the overall sentence.
Assistant U.S. Attorney Timothy S. Racicot prosecuted the case for the United States.
The investigation was a cooperative effort between the Drug Enforcement Administration and the Missouri River Drug Task Force.


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About Transnova
By providing grants and advice for pilot and demonstration projects, Transnova encourages new and future-oriented sustainable mobility solutions. For 2013 Transnovas budget is 87,2 million NOK (app. 11,75 million Euros)
Priority areas for Transnova
Transnova supports climate efficient transport by promoting:
• New technologies
– development and availability of transport technologies based on renewable energy
• Increased use of climate efficient means of transport
– more public transport, more walking and cycling
– increased freight transport by sea and rail
• Reductions in transport
– better utilisation of transport capacity
– solutions that reduce transport needs


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Spy Shots: 2016 Acura NSX Prototype
Motor Authority has posted some spy shots of the "new" 2016 Acura NSX Prototype that was recently seen testing at the Nürburgring. These photos were taken on the surrounding roads outside of the track. There are some minor changes from the last prototype, and if you head over to motorauthority.com they have both cars posted in the gallery for comparison.
See the full post at motorauthority.com – 2016 Acura NSX Spy Shots And Video.
[Source: Motor Authority]
Filed under: NSX, Spy Shots
Tags: 2016 Acura NSX, Acura Nurburgring, Honda NSX, Motor Authority, NSX PrototypeNo Comments


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Use your mouse on most surfaces and help save the environment with this eco friendly mouse pad.
Login Here to rate and review this product.
66118 - Stylus Pro LED Flashlight
HIGH-POWERED LED PENLIGHT. Streamlight's new high flux LED light with Proprietary Micro Optical Systems has "Battery-Booster" electronics to provide a super-bright beam.
291-345 - 357-303TS Button Cell Watch Battery SR44W
Energizer silver oxide low drain button cell batteries for watches, calculators, small electronics, toys, lasers & medical devices. Sold individually.
293-635 - 24 Pack "AA" Duracell CopperTop Alkaline Batteries
Get dependable, long-lasting power from CopperTop batteries. These batteries have been engineered to deliver the power you need for all your household devices. And because Duracell is the #1 trusted brand of parents, pharmacists, and first responders, you know it'...
MCM Cat 57, Page 341
MCM Cat 56, Page 358


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Piano, music theory and clarinet lessons
Hi, I am a piano teacher with 12 years teaching experience. I also teach clarinet. Music theory is taught as part of the lesson. I have vacancies for new pupils. I teach any age from 5 years up. I specialise in teaching beginners. I am based in


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New King James Version (NKJV) | New International Version (NIV) |
28 So Balak took Balaam to the top of Peor, that overlooks the wasteland. | 28 And Balak took Balaam to the top of Peor, overlooking the wasteland. |
Scripture taken from the New King James Version. Copyright © 1982 by Thomas Nelson, Inc. Used by permission. All rights reserved. (New King James Version) | Scripture quoted by permission. Quotations designated (NIV) are from THE HOLY BIBLE: NEW INTERNATIONAL VERSION®. NIV®. Copyright © 1973, 1978, 1984 by Biblica. All rights reserved worldwide. (New International Version Bible Online) |


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The Mack Cycle Escape to Miami Triathlon is proud to support and cooperate with various local, national and international charities. Runners can choose from an array of charities, allowing for thousands of dollars to be raised each year. We encourage those interested in running with a charitable organization.
National Parkinson Foundation
Every year, thousands of people participate in NPF's Team Hope community fundraising events to increase awareness of Parkinson's disease. Successful Team Hope events take place around the country – from skydiving to marathons and dances. No matter how you choose to get involved – you can make a difference.
For more information about how you can set up or join a Charity or Group please contact Sal Sandate at firstname.lastname@example.com.


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Hauser Global Fellows
The Global Fellows Program brings academics, researchers, scholars, practitioners and post-doctoral students from around the world to NYU for up to one year to conduct and present their research for future publication.
Susy Frankel
Global Research Fellow
Fulbright Senior Scholar
New Zealand
Susy is Professor of Law and Director of the New Zealand Centre of International Economic Law, at Victoria University of Wellington, New Zealand. She is also Chair of the Copyright Tribunal (NZ). She has been a visiting Professor at the University of Iowa, University of Western Ontario and Fellow of Clare Hall and visitor to the Centre for Intellectual Property and Information Law, University of Cambridge (UK). She is a member of the Executive Committee of Association for the Advancement of Teaching and Research in Intellectual Property (ATRIP) and of the editorial boards of Journal of World Intellectual Property, Queen Mary Journal of Intellectual Property and the University of Western Australia Law Review. She has published widely on the nexus between international intellectual property and trade law, and particularly focusing on international treaty interpretation and the protection of traditional knowledge. Her books include Intellectual Property in New Zealand (LexisNexis 2011), with Peter Drahos Indigenous Peoples Innovation: Intellectual Property Pathways to Development (ANU epress, 2012; with Meredith Kolsky Lewis International Economic Law and National Autonomy (Cambridge University Press, 2010). Susy's research expertise extends to regulatory theory and particularly the impacts of international trade of regulatory autonomy over knowledge assets and innovation. She was Project Leader of the New Zealand Law Foundation Regulatory Reform Project (funded to NZ$2million) from 2011-2013. That project's publications include two books Susy Frankel (ed) Learning from the Past, Adapting for the Future: Regulatory Reform in New Zealand (Lexis Nexis, 2011) and Recalibrating Behaviour: Smarter Regulation in a Global World (Lexis Nexis 2013).
Susy holds an appointment as a Neutral for the World Intellectual Property Organization Arbitration and Mediation Centre, Geneva, Switzerland. She has previously been an Assistant Commissioner of Trade Marks, Patents and Designs for the Intellectual Property Office of New Zealand, 1998-2006. In that capacity she acted as an independent Hearings Officer, mostly relating to trade mark oppositions. She was specialist intellectual property adviser to the Waitangi Tribunal on the claim brought against the New Zealand government by Maori about the protection of traditional knowledge and Maori intellectual property. Susy qualified as Barrister and Solicitor of the High Court of New Zealand in 1988 and as a Solicitor of England & Wales in 1991 and has practised law in both jurisdictions.
Research Project: Supporting Intellectual Property's Innovation and Creativity Goals through Dynamic
Interpretation of International Agreements
Barbara Lauriat
Global Research Fellow
United Kingdom
Dr Barbara Lauriat is a Lecturer in Law (Assistant Professor) at King's College London. Previously, she was the Career Development Fellow in Intellectual Property Law at the University of Oxford and a Fellow by Special Election of St. Catherine's College, Oxford. She holds a BA and JD from Boston University, where she served as an editor on the Boston University Law Review, and a DPhil from the University of Oxford, where she was the General Editor (Editor-in-Chief) of the Oxford University Commonwealth Law Journal.
Dr Lauriat's research is broadly concerned with intellectual property, and particularly the history of copyright. Her doctoral thesis was on the subject of the 1878 Royal Commission on Copyright. In her legal historical research, she aims to employ less traditional legal methods and sources, such as biography, personal correspondence, journalism, royal commissions and executive committees, and literature. Currently, Dr Lauriat's research focuses on the relationship between theories of copyright and political ideologies. In addition to her academic work, she occasionally publishes journalistic articles and limericks.
Research Project: Copyright, Left, and Center: Studies of Anglo-American Copyright in a Political Context


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not to be rudee &+ i totally lovee lovee lovee the both of u butt isnt that the sae dresss khloe wore to the QuickTrim signingg? i meannn comeeonnn!?
@chantty … this was the same day as quick trim .. Lol
That is soo cute-u two holding hands.
Is that Kimmy on the left…walking behind? Why would you girls leave her behind like that? lol
why would that be kimmy kimmy is like wayy hotter lol ur lost??
whoever buys clothes and wears them only once is an idiot.
I thought Khloe was upset about something in these shots, Kourtney, so I'm glad this one proved me wrong!
i just have a question that has been bugging me for a while. kourt whats up with u and khloe ditching kim? is that u guyz are not close to her? thats really unfair u guys will make her feel unwanted. plus the way u have been raving about missing khloe.- what about kim?
uyyyyyyyy that beautiful little sisters
khloe is looking absolutly beautiful..she has lost so much weight and is looking like a super model..(",) please give her the msg…mwa much love all the way from South Africa..
You look so pretty!!!!!!
I like your long hair and your short hair, it's good to switch it up a bit! With or without extensions, you're gorgeous either way (: Congrats on the baby boy Kourt and congrats on the Marriage Khole! I'm excited for both of you. I can't wait until November 8th to see the Marriage Ceremony and then in December the new season of Keeping Up With The Kardashians! I really really want to meet you guys! Kourtney reminds me of myself, but obviously famous and I'm not. Plus I'm more young than you. You're my idol because you're so successful and you're beautiful! Keep it up girl


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Tangled Feet
Tangled Feet are an ensemble of theatre practitioners committed to making original work. The company has developed a trademark style of experimental performance, which always begins from a process of physical improvisation and play. Find out more about us.
Tangled Feet News
We hit the ground running as we start 2013 with two projects laying the foundation for the year. First off we have a one week residency at ARC in Stockton as we develop some new site specific work and a return to inside spaces with the possibility of some national touring in 2014.
The second of our projects see us collaborating with Rainbow SIBS, a support group for children who have a brother or sister with autism. Over 6 weeks we will join Rainbow SIBS to create a Therapeutic Theatre Group. Working within a drama therapy setting the group will work towards creating a performance together.
We are thrilled to have received a grant to support our core costs from The Foyle Foundation to support our 2013 work. This is an exciting development and our first core grant. Thank you Foyle Foundation! We would also like to thank Arts Council England for recent funding towards our Artistic and Organisational development in early 2013.
Now Booking
We are taking bookings for Inflation, our political comedy, for this Summer.
A bouncy castle sits in a public space. On it Tangled Feet try to solve the recession, understand currency trading and keep the darn thing up! Every attempt at order and structure is undermined by the shifting financial landscape and the actions of others. Using an evocative soundtrack, physicality and slapstick comedy Tangled Feet explore the uncertain ground our world is standing on.
Audience Feedback
"Absolutely fantastic. It was the most original event show I've seen in a very long time. Very sophisticated too."
"Funny, clever, thought provoking"
"Fantastic fun idea with serious political content"
"Inflation should be mandatory viewing for everyone"
New Projects
We are currently developing some new projects and surprises that will create our 2013 summer season as well as possible projects in the Autumn and beyond so keep your eyes peeled and follow us on twitter or facebook
Summer 2012 was Tangled Feet's busiest ever as we mounted our first ever season of free outdoor work – Tangled Feet Take To The Streets.
More about All That Is Solid here
As an integral part of our Take To The Streets season, Tangled Feet were joined by 10 young theatre-makers who came together for 12 days of intensive workshops and a 360 degree introduction to making devised/outdoor work. The young company visited five of the major outdoor festivals at which Tangled Feet were performing, seeing an incredible range of outdoor work as well as getting a good picture of behind-the-scenes touring.
We support recent graduates in the first steps of their career with specially-tailored internships in an area or areas of theatre production which they are particularly keen to get expertise in. Our (paid) interns are an absolutely vital part of the Tangled Feet production team.
Tangled Feet are delighted to announce that The Foyle Foundation have offered us a grant to help support our core costs. This is a very exciting development and we are looking for other charitable trusts and foundations to match this gift.


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I'm going to be making mmf. I'm out of the regular Crisco, but have the butter flavor Crisco on hand.
Can I use that instead to make my fondant or does it absolutely have to be regular Crisco?
Okay, I was wondering if that would happen. I'm going to be coloring some of it green, but will also be needing white, so looks like I'll need to make a trip to the store. Thank you :)


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Access your personal favorites account here Log In or Register
Browse through our real estate listings in Harper, TX. Browse photos, watch virtual tours and create a "Favorites" account to save, organize and share your favorite properties. Also review up-to-date market research and local market conditions as well as neighborhood and school information.
Harper, TX 78631
$1,500,000 3 BR, 2 full BA, 1 ½BA Offered By: Dottie Johnson Fore Premier Properties
$735,000 3 BR, 3 full BA, 1 ½BA Offered By: Fore Premier Properties
$590,000 3 BR, 2 full BA Offered By: Carey Bond RE/MAX - Kerrville
$155,000 Offered By: Krista Bennett Key Hill Country Real Estate & Reservations
$115,000 4 BR, 2 full BA Offered By: Paula Holtzendorf Kerrville Realty
$1,500,000 Offered By: Dottie Johnson Fore Premier Properties
$735,000 Offered By: Fore Premier Properties
$636,500 2 BR, Offered By: Brad Mechler Nixon Real Estate
$636,500 2 BR, 1 full BA Offered By: Vic Nixon Nixon Real Estate
$590,000 3 BR, 2 full BA Offered By: Carey Bond REMAX Kerrville
Create a personal scrapbook of favorite listings and services.
Homes & Land Magazine provides you with extensive real estate listings including homes for sale, rental properties, condos, land for sale and building lots from cities across the United States and Canada.
Homes & Land of The Texas Hill Country
Or view our extensive online magazine directory.


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In this article
How Open Should I Be When We Talk?
Some parents are uncomfortable talking to their kids about sex. It may help to practice what you are going to say before you sit down with your son or daughter. Be sure to pay attention and listen to what your child says and asks. It may be helpful to have both parents present for support.
Some kids may be embarrassed to talk about sex or to admit they don't know something. So they may not ask direct questions. Look for opportunities to bring up sexuality issues with your children. Opportunities may come from a scene on TV or in a movie, a book or an article, or the appearance of visible changes in your son or daughter, such as the growth of breasts or facial hair. Explain the physical maturation process and the sexual arousal process. Remember to respect your child's privacy and try to show that you trust him or her to make good decisions.
Teen Sexual Rights
When talking with your teen, consider the following teen sexual rights, which were developed by the Sexuality Information and Education Council of the United States (SIECUS). Let your child know these rights belong to him or her and no one else has the right to take them away:
- The right to accurate information about sexuality and HIV/AIDS
- The right to stop being physical or sexual with a partner at any point
- The right to say no to an unwanted touch of any kind
- The right to make decisions about sexuality, in your own time
- The right to express your sexuality safely, without risk of pregnancy or STDs, including HIV/AIDS
- The right not to be pressured into being physical or sexual
- The right not to express your sexuality unless you want to
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BioMed Research International
Volume 2014 (2014), Article ID 458678, 11 pages
Psychometric Properties of Questionnaires on Functional Health Status in Oropharyngeal Dysphagia: A Systematic Literature Review
1School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, QLD 4811, Australia
2Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
3School of Occupational Therapy and Social Work, Curtin University, Perth, WA 6845, Australia
4RehaA Wil and RehaA Winterthur, RehaClinic, 5330 Bad Zurzach, Switzerland
Received 31 January 2014; Accepted 31 March 2014; Published 29 April 2014
Academic Editor: Nam-Jong Paik
Copyright © 2014 Renée Speyer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction. Questionnaires on Functional Health Status (FHS) are part of the assessment of oropharyngeal dysphagia. Objective. To conduct a systematic review of the literature on the psychometric properties of English-language FHS questionnaires in adults with oropharyngeal dysphagia. Methods. A systematic search was performed using the electronic databases Pubmed and Embase. The psychometric properties of the questionnaires were determined based on the COSMIN taxonomy of measurement properties and definitions for health-related patient-reported outcomes and the COSMIN checklist using preset psychometric criteria. Results. Three questionnaires were included: the Eating Assessment Tool (EAT-10), the Swallowing Outcome after Laryngectomy (SOAL), and the Self-report Symptom Inventory. The Sydney Swallow Questionnaire (SSQ) proved to be identical to the Modified Self-report Symptom Inventory. All FHS questionnaires obtained poor overall methodological quality scores for most measurement properties. Conclusions. The retrieved FHS questionnaires need psychometric reevaluation; if the overall methodological quality shows satisfactory improvement on most measurement properties, the use of the questionnaires in daily clinic and research can be justified. However, in case of insufficient validity and/or reliability scores, new FHS questionnaires need to be developed using and reporting on preestablished psychometric criteria as recommended in literature.
1. Introduction
Oropharyngeal dysphagia is associated with high mortality rates [1]. Dysphagia can lead to increased risk of dehydration, malnutrition, aspiration pneumonia, and death. Oropharyngeal dysphagia may also have a major impact on a patient's health-related quality of life and well-being [2–4]. Early detection through screening is an essential first step in the management of dysphagia [5, 6]. After being identified as being at risk of having dysphagia, further assessment of the swallowing function is required. Videofluoroscopy (VFS) and fiberoptic endoscopic evaluation of swallowing (FEES) are mooted in literature to be the gold standards in the assessment of dysphagia. Another important step after screening is the completion of patient self-administered questionnaires. Such inventories are designed to measure either health-related quality of life (HR-QoL) or functional health status (FHS) [6]. HR-QoL refers to the unique personal perception individuals may have of their health, taking into account social, functional, and psychological issues, whereas FHS is the influence of a given disease on particular functional aspects [7]. Within the context of oropharyngeal dysphagia assessment, FHS questionnaires aim to quantify the symptomatic severity of dysphagia as experienced by the patient.
The use of a particular tool to evaluate a patient's current health status or the effects of a medical intervention, whether for screening or assessment of oropharyngeal dysphagia, can only be justified if it has demonstrated reliability and validity. Systematic literature reviews have been published on the psychometric properties of oropharyngeal dysphagia screening [8, 9] and HR-QoL questionnaires [10] but not on FHS questionnaires.
The purpose of this systematic literature review is to (a) provide an overview of existing FHS questionnaires, (b) determine the corresponding psychometric properties, and (c) provide recommendations for the use of FHS questionnaires in both clinical practice and in research.
2. Methods
A systematic literature search was performed by two independent reviewers using two electronic databases: Pubmed and Embase. All appropriate journal articles up to June 2013 were included. To ensure that a comprehensive approach was adopted to retrieve relevant publications, mesh and thesaurus terms were supplemented by free text words (see Table 1). Only original research articles describing FHS questionnaires in oropharyngeal dysphagia were included. The search was limited to publications and questionnaires written in English. Reviews, case reports, and editorials were excluded, as well as questionnaires not related to oropharyngeal dysphagia (e.g., esophageal dysphagia or gastroesophageal reflux disease) or questionnaires mainly focusing on health-related quality of life (HR-QoL), generic questionnaires, or questionnaires targeted at population groups other than adults with oropharyngeal dysphagia (e.g., children or health care providers). Reference lists of all included articles were searched for additional literature. Differences of opinion about the inclusion of articles were settled by group discussion and reaching consensus.
Next, an extended search was conducted for each of the included questionnaires to ensure that all articles on their development and validation were retrieved using the names of each questionnaire in combination with their respective acronyms. The psychometric properties of the included questionnaires were determined using the COSMIN taxonomy of measurement properties and definitions for health-related patient-reported outcomes [11] (see Table 2). The COSMIN checklist [12] was used as a standardised tool to evaluate the methodological quality of studies on psychometric properties. The COSMIN checklist consists of nine domains, each dealing with one of the following psychometric properties: internal consistency, reliability (relative measures: including test-retest reliability, interrater reliability, and intrarater reliability), measurement error (absolute measures), content validity (including face validity), structural validity, hypotheses testing, cross-cultural validity, criterion validity, and responsiveness. Interpretability is not considered to be a psychometric property. Each domain of the COSMIN checklist contains 5 to 18 items on aspects of study design and statistical methods. The methodological quality scores per psychometric property were calculated using a 4-point rating scale according to Terwee et al. [13]: excellent, good, fair, and poor. An overall methodological quality score per psychometric property is obtained by taking the lowest rating of any item in the corresponding domain. Psychometric ratings were discussed and agreed upon during consensus meetings. If applicable, evidence from different studies on the psychometric properties of the same questionnaire was summarised by combining the results as proposed by the Cochrane Back Review Group [14].
3. Results
3.1. Systematic Literature Search
The findings of the literature search using both Pubmed and Embase resulted in a total of 2,703 abstracts. Twelve original questionnaires were identified (see Table 3). Of those, two questionnaires were excluded because they contained mainly items on health-related quality of life: the Dysphagia Handicap Index by Silbergleit et al. [15] and the MD Anderson Dysphagia Inventory by Chen et al. [16]. Four questionnaires were excluded because they were developed in a language other than English: the French Deglutition Handicap index [17], the Dysphagia Short Questionnaire [18], the Dysphagia in Multiple Sclerosis questionnaire [19], and the Swallowing Disturbance Questionnaire [20] were developed in French, Swedish, Italian, and Hebrew, respectively. The target population of the Mayo Dysphagia Questionnaire-30 [21] consisted of patients with reflux related disorders and was therefore excluded. Similarly the Dysphagia Disorders Survey [22], a questionnaire used by speech pathologists during mealtime observation of residential populations with intellectual disabilities, was excluded as well as the Caregiver Mealtime and Dysphagia Questionnaire [23], a questionnaire that focused on caregiver compliance.
Finally, three self-administered questionnaires were included: the Eating Assessment Tool (EAT-10) [24], the Swallowing Outcome after Laryngectomy (SOAL) [25], and the Self-report Symptom Inventory [26]. The Sydney Swallow Questionnaire (SSQ) [27] is identical to the previously published Self-report Symptom Inventory by Wallace et al. [26]. All three questionnaires represent original English-language FHS Questionnaires for adult patients with oropharyngeal dysphagia.
3.2. Functional Health Status Questionnaires
Table 4 provides information on the development of the EAT-10, the SOAL, and the Self-report Symptom Inventory. Initially, a Prototype Self-report Symptom Inventory was developed by Wallace et al. [26]. During the validation and reliability process of this prototype, the final version or the Modified Self-report Symptom Inventory was created. As the SSQ [27] is identical to the Modified Self-report Symptom Inventory, the SSQ is subsumed under the Modified Self-report Symptom Inventory. Table 5 gives an overview of the studies that were involved in the validation of the questionnaires. Both Tables 4 and 5 list the questionnaires included, the developmental and/or validation studies, the applied study designs, the study populations involved, and the subject characteristics of the target population.
Finally, Table 6 includes the characteristics of all three FHS questionnaires. All questionnaires contain one domain with the exception of the SSQ. Although the Modified Self-report Symptom Inventory is identical to the SSQ, Dwivedi et al. [27] distinguish the domain of physiological swallow function from two separate items: one item on overall swallowing function and another on swallowing-related quality of life (HR-QoL). Upon closer inspection, the items of the other questionnaires also included similar questions on HR-QoL. For example, the EAT-10 items, "The pleasure of eating is affected by my swallowing" and "Swallowing is stressful" could be considered to be HR-QoL questions rather than FHS questions. A similar observation could be made in the case of the SOAL-item, "Has your enjoyment of food reduced?." However, as the majority of items of all the questionnaires focus on FHS, the influence of a few HR-QoL items was considered to be unimportant.
The number of items varies between 10 and 19 items per questionnaire. The EAT-10 includes ten items using 5-point Likert scales (from "no problem" to "severe problem"), whereas the SOAL consists of 17 items using three response options: "no," "a little," or "a lot." Both the Self-report Symptom Inventory and the SSQ consist of mainly visual analogue scales. The lowest score for all questionnaires is zero (last impaired), whereas the highest possible scores range between 34 (SOAL) and 1708 (Prototype Self-report Symptom Inventory).
3.3. Psychometric Properties
The psychometric properties of all three FHS questionnaires were examined using the COSMIN taxonomy of measurement properties and definitions for health-related patient-reported outcomes [11]. Using the COSMIN checklist [12] and the 4-point rating scale according to Terwee et al. [13], overall scores of methodological quality for each measurement domain were obtained. The cross-cultural validity domain was not evaluated as only original English-language questionnaires were included in the systematic literature review. The summarised psychometric consensus ratings of all questionnaires are depicted in Table 7. All statements on the rating of the methodological quality per measurement domain of each questionnaire in the next few paragraphs refer to the "worse score counts" criteria as described by Terwee et al. [13].
No factor analysis was performed to determine internal consistency. As Belafsky et al. [24] are the first to report on the EAT-10, no reference was provided to another study that would provide this information. Reliability scored poorly as no weighted or unweighted Kappa and no percentage agreement information were reported. Pearson product moment correlations were calculated instead of ICCs. Therefore, the authors did not account for possible systematic differences in their data. Because no Standard Error of Measurement (SEM) was determined, measurement error scored poorly. No reference to age, gender, disease characteristics, country, or setting was considered during item selection. No evaluation was conducted to determine if all ten items reflected the construct (dysphagia). As a result, content validity scored poorly. No information was reported on structural validity. No information was provided on describing the constructs or measurement properties of the comparator instruments resulting in a poor rating on hypotheses testing. Criterion validity was not assessed. In relation to responsiveness, no information was provided on the description of the constructs or measurement properties of the comparator instruments. The criterion used could not be considered an adequate gold standard. No information was available on sensitivity or specificity, and thus responsiveness scored poorly. Although interpretability is not considered a psychometric property, some comments can be made. No floor and ceiling effects were described. No Minimal Important Change (MIC) or Minimal Important Difference (MID) was calculated.
Internal consistency scored poorly for similar reasons as the previous questionnaire: no factor analysis was performed and no other studies were available that provided this information, as Govender et al. [25] were the first to report on the SOAL. Reliability was not assessed. No SEM was calculated resulting in poor rating of measurement error. Again, as no reference to age, gender, disease characteristics, country, or setting was considered during item selection nor was any evaluation conducted to determine if all 17 items reflected the construct (dysphagia), and content validity received a poor rating. No information on structural validity was reported. The sample size was considered small (less than 30 subjects per analysis), thus resulting in a poor rating of hypotheses testing. When considering criterion validity, the authors used Pearson correlation coefficients instead of Spearman's Rho for correlations between ordinal data. Furthermore, it was not clear how missing responses to items were handled. Therefore, criterion validity scored fair. Responsiveness on the other hand scored poorly because no longitudinal design was used. As far as interpretability was concerned, no floor and ceiling effects, MIC, or MID were calculated.
3.3.3. Self-Report Symptom Inventory/SSQ [26–29]
When determining internal consistency, Wallace et al. [26] used a moderate sample size but presented only a Pearson's product moment correlation matrix. No Cronbach's alphas were calculated. Thus internal consistency scored fair. In determining reliability and measurement error, small sample sizes were used (less than 30 per analysis). The percentage agreement was calculated but no weighted Kappa calculations were reported; SEM data were also missing. Both reliability and measurement error scored poorly. Content validity received a fair rating because the authors did not assess if all items were relevant to the purpose of the application of the questionnaire. In terms of structural validity, it was unclear how missing items were handled, resulting in a fair rating. Because no information was provided on the description of the constructs or measurement properties of the comparator instruments, hypothesis testing was considered poor. Information on criterion validity was not reported. In determining responsiveness, a moderated sample size () was used, but no information was provided on how missing data were handled. Responsiveness was rated fair. Again, no floor and ceiling effects, MIC, or MID was reported (interpretability).
Dwivedi et al. [27] did not calculate internal consistency, but referred to another study in which factor analysis was performed, but not in a similar study population. Internal consistency was rated fair. The authors used a moderate sample size () when determining reliability. Spearman correlation coefficients were calculated without providing evidence that no systematic change had occurred or with evidence that systematic change did occur. It was unclear whether the patients were stable. Reliability was considered to be fair. Measurement error was rated poorly as no SEM was calculated. Content validity, structural validity, or hypotheses testing was not assessed. Criterion validity was rated as fair, although it was unclear whether the criterion used could be considered an adequate "gold standard." Responsiveness was not evaluated. Similar remarks as stated before regarding interpretability: no floor and ceiling effects, MIC, or MID was calculated.
Finally, two studies need to be mentioned briefly although their information on psychometric properties of the Self-report Symptom Inventory or SSQ is very limited. Dwivedi et al. [28] did not evaluate any psychometric properties, but calculated change scores (i.e., means and standard deviations) for relevant (sub)groups (e.g., for normative groups and subgroups of patients). Such information fits under interpretability, but again, no information on floor and ceiling effects, MIC, or MID was presented. Manjaly et al. [29] considered responsiveness using a small sample size (). No correlations were calculated nor did they use a criterion. Responsiveness was rated as poor. As in all previous studies, no floor and ceiling effects, MIC, and MID were calculated.
4. Discussion
When considering the restricted number of published FHS questionnaires available (Table 3) and the overall poor ratings on their psychometric properties (Table 7), it is evident that more research is needed in the area of FHS in oropharyngeal dysphagia. First, frequently authors did not evaluate all psychometric properties as defined by Mokkink et al. [11] resulting in missing data ("NR"). Secondly, when assessing the psychometric properties, authors seldom met the criteria as described in the 4-point rating scale [13]. Most studies simply failed to meet the "worse score counts" criteria. It seems that even though Terwee et al. [13] and Mokkink et al. [11] specialise in the evaluation of psychometric qualities of health-related questionnaires, their rating system appears to be so severe that it is unable to differentiate between the more subtle psychometric qualities of instruments. Although all the FHS questionnaires lacked sufficient validation, a need to distinguish between all the "poor" ratings seems desirable.
In general, most FHS questionnaires reported on in this study received poor overall methodological quality scores per measurement domain. However, when reevaluating the reliability and validity of these questionnaires according to preset quality criteria on psychometrics, it is possible that the methodological outcome per measurement property may show significant positive changes. If the overall methodological quality shows satisfactory improvement on most measurement properties, the use of the questionnaires in daily clinic and research can be justified. Conversely, without satisfactory improvement on measurement properties, new FHS questionnaires need to be developed using and reporting on preestablished psychometric criteria as recommended in the literature.
5. Conclusions
(i)A systematic literature search retrieved three original English-language FHS questionnaires: the Eating Assessment Tool (EAT-10) [24], the Swallowing Outcome After Laryngectomy (SOAL) [25], and the Self-report Symptom Inventory [26]. The Sydney Swallow Questionnaire (SSQ) [27] is identical to the previously published Self-report Symptom Inventory by Wallace et al. [26].(ii)The psychometric properties of all three FHS questionnaires were determined using the COSMIN taxonomy of measurement properties and definitions for health-related patient-reported outcomes [11], the COSMIN checklist [12], and the psychometric criteria using a 4-point rating scale according to Terwee et al. [13]; all three FHS questionnaires obtained poor overall methodological quality scores for most psychometric properties.(iii)All FHS questionnaires need psychometric reassessment; if the overall methodological quality shows satisfactory improvement on most measurement domains, the use of the questionnaires in daily clinic and research can be justified. However, in cases of insufficient validity and/or reliability scores, it is recommended to develop new FHS questionnaires using and reporting on preestablished psychometric criteria as suggested in literature.(iv)In general when assessing the validity and reliability of FHS or health-related questionnaires, researchers must use preestablished quality criteria like Terwee et al. [13] when reporting on psychometric properties of their instrument.(v)Arguably the most important conclusion may be that academics should be educated on the psychometric domains that require reporting when developing and validating a FHS questionnaire or any other health-related questionnaire.
Conflict of Interests
The authors declare that there is no conflict of interests regarding the publication of this paper.
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