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We aimed to explore the impacts of individual and environmental socioeconomic status (SES) on the outcome of peritoneal dialysis (PD) in regions with significant SES disparity, through a retrospective multicenter cohort in China.
Overall, 2,171 incident patients from seven PD centers were included. Individual SES was evaluated from yearly household income per person and education level. Environmental SES was represented by regional gross domestic product (GDP) per capita and medical resources. Undeveloped regions were defined as those with regional GDP lower than the median. All-cause and cardiovascular death and initial peritonitis were recorded as outcome events.
Poorer PD patients or those who lived in undeveloped areas were younger and less-educated and bore a heavier burden of medical expenses. They had lower hemoglobin and serum albumin at baseline. Low income independently predicted the highest risks for all-cause or cardiovascular death and initial peritonitis compared with medium and high income. The interaction effect between individual education and regional GDP was determined. In undeveloped regions, patients with an elementary school education or lower were at significantly higher risk for all-cause death but not cardiovascular death or initial peritonitis compared with those who attended high school or had a higher diploma. Regional GDP was not associated with any outcome events.
Low personal income independently influenced all-cause and cardiovascular death, and initial peritonitis in PD patients. Education level predicted all-cause death only for patients in undeveloped regions. For PD patients in these high risk situations, integrated care before dialysis and well-constructed PD training programs might be helpful.
Citation: Xu R, Han Q-F, Zhu T-Y, Ren Y-P, Chen J-H, et al. (2012) Impact of Individual and Environmental Socioeconomic Status on Peritoneal Dialysis Outcomes: A Retrospective Multicenter Cohort Study. PLoS ONE 7(11): e50766. doi:10.1371/journal.pone.0050766
Editor: Matthias Eberl, Cardiff University School of Medicine, United Kingdom
Received: July 30, 2012; Accepted: October 24, 2012; Published: November 30, 2012
Copyright: © 2012 Xu et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This study is supported by Baxer Clinical Research Award from Baxter Corp, China and ISN Research Award from ISN GO R&P Committee. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have the following interests. This work was supported in part by the Baxer Clinical Research Award of Baxter Corp. There are no patents, products in development or marketed products to declare. This does not alter authors' adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.
Recently, the China National Survey of Chronic Kidney Disease Working Group reported that the prevalence of chronic kidney disease was 10.8%, close to that in Western countries [1]. It is predicted that end stage renal disease (ESRD) will increase rapidly and become highly prevalent [2]. In China, medical insurance will be extended to cover all ESRD patients as proposed in a government working report in 2012 (http://english.gov.cn/official/2012-03/15/content_2092737.htm). Because peritoneal dialysis (PD) is less expensive [3], has a comparable survival rate [4], [5] and can confer a better quality of life than hemodialysis (HD) [6], [7], a series of healthcare policies have been considered to increase the penetration of PD (http://www.moh.gov.cn/publicfiles/business/htmlfiles/chenz/pldjh/201107/52373.htm). At present, the possibility of popularizing PD treatment for ESRD patients urgently needs to be explored.
As a home-care therapy, PD requires patients to self-monitor and self-manage their treatment [8], [9], [10], abilities that are closely associated with socioeconomic status (SES) [11], [12]. SES has been investigated for its association with the outcomes of treatment in the general population and in patients with chronic kidney disease at the individual [13], [14], [15], [16], [17] and environmental [13], [15], [16], [17], [18] level. A few large-scale multi-center cohort studies have also explored this issue in PD patients and shown inconsistencies in the impact of individual [19], [20], [21], [22], [23] and environmental [21], [22], [24], [25], [26], [27] SES on PD outcome. In China, we have experienced great economic development in the last 20 years, with an increase in gross domestic product (GDP) of around 10% per year, but there are imbalances between regions. Individual income and education levels also vary markedly within regions and probably lead to diverse availability of medical facilities and health-care services. Given this situation, a specific model is needed to determine whether variations in individual or environmental SES influence PD outcome. Moreover, the interaction between individual and environmental SES on PD outcome, which has never been studied in a dialysis population, should be explored.
This multicenter large-scale retrospective cohort study will be helpful in providing evidence for clinicians deciding whether PD is suitable for individuals with differing SES, and for health policy-makers exploring potential strategies for establishing PD programs in regions with varying SES in China and other developing countries.
Center Enrollment
Centers with professional PD doctors and nurses and well-developed databases maintained for least 3 years, recording baseline characteristics and follow-up data for Chinese patient every 1~3 months, participated in this study voluntarily. Nine centers were qualified, and seven of these, accouting for about 70% of all incident patients attending the nine centers, agreed to participate. The included PD centers were located in five different provinces and four geographical regions (north, northeast, northwest, and east) of China. Data from each center were collected within a strict quality control framework and further inspected and optimized to ensure the integrity and accuracy of the database. All study investigators and staff members completed a training program that taught them the methods and processes of the study. A manual of detailed instructions for data collection was distributed. The ethics committee of Peking University First Hospital approved the study.
Subject Selection
All incident patients receiving chronic PD between the date of intact database creation and August 2011 were enrolled into this study. After starting PD, each patient signed informed consent agreeing to the use of their demographic and laboratory data in future studies. All subjects began the PD program within 1 month after catheter implantation and were given lactate-buffered glucose dialysate with a twin-bag connection system (Baxter Healthcare, Guangzhou, China). Patients who had been on PD for less than 3 months were excluded, as in previous studies [20], [21].
*Adjusted hazard ratio with 95% confidence interval (adjusted for confounders such as age, gender, body mass index, diabetes, cardiovascular disease, hemoglobin, serum albumin, and residual renal function, and stratified by center size) **Undeveloped region: gross domestic product (GDP) per capita <¥95,000 ($15,009); developed region: GDP per capita≥¥95,000 ($15,009).
Data Collection
Demographic and clinical data including age, gender, body mass index (BMI), primary renal disease, history of cardiovascular disease (CVD), and presence of diabetes mellitus (DM) were collected at baseline. CVD was recorded if one of the following conditions was present: angina, class III/IV congestive heart failure (New York Heart Association), transient ischemic attack, history of myocardial infarction or cerebrovascular accident, or peripheral arterial disease [28]. Baseline biochemistry data including hemoglobin and serum albumin were calculated as the mean of measurements made during the first 3 months. Dialysis adequacy and residual renal function (RRF) were measured during the first 6 months. RRF was defined as the mean of residual creatinine clearance and residual urea clearance. Dialysis adequacy was determined from the total Kt/V and total creatinine clearance. Center size was also recorded according to the number of enrolled patients from each center.
SES data were collected for each patient. Individual income level was defined as the yearly household income per person and was divided into low (<¥20,000, <$3160,), medium (¥20,000–40,000, $3160–6320) and high (>¥40,000, >$6320); because most of the subjects were from urban areas, these groups were defined according to the average income for the urban population in 2011, obtained from the Bureau of Statistics (http://www.bjstats.gov.cn/nj/main/2011-tjnj/index.htm). The exchange rate of the US dollar ($) to the Chinese Yuan (¥) was set at 6.3293 on November 1, 2011. Education levels were recorded according to diplomas obtained based on school level, that is, elementary school or lower, middle school, high school, or above high school. Other individual SES data included the proportion of individual income used for medical expenses (the percentage of yearly household income per person spent each year on self-paid medical expenses), occupation, rural or urban residence, living alone or not, travel distance from the PD center, and frequency of visits to the PD center. A frequent visitor was defined as someone who saw a doctor at least once every 3 months. Regional SES included regional GDP per capita and regional medical resources such as number of registered doctors and available hospital beds per inhabitant. Data were obtained from the Bureau of Statistics in each province; Beijing data were downloaded from http://www.bjstats.gov.cn/nj/main/2011-tjnj/index.htm. Regions were divided into undeveloped regions and developed according to the median of regional GDP per capita (¥95000, $15009).
Definition of Outcome Events
The Primary outcome was all-cause death or cardiovascular death. Cardiovascular death was defined as death due to myocardial infarction, congestive heart failure, cerebral bleeding, cerebral infarction, arrhythmia, or peripheral arterial disease, or sudden death. The secondary outcome was initial peritonitis, which was diagnosed according to International Society for Peritoneal Dialysis 2010 guidelines [29]. In all analyses, we censored follow-up at transferring to HD, loss to follow-up, renal transplantation, or the end of the study (November 1, 2011).
Statistical Analysis
Continuous data were presented as means with standard deviation except for distance to PD center, RRF, and total Kt/V, which were presented as the median (interquartile range) because of high skew. Categorical variables were presented as proportions. Relevant characteristics were compared between different individual income groups and between different education groups, respectively. Patient data were compared using the t-test or the analysis of variance F-test for normally distributed continuous variables, the chi-square test for categorical variables, or the Mann–Whitney U test for skewed continuous variables.
To determine predictors of outcome events, univariable Cox regression models were first constructed to explore individually the potential risk factors for all-cause death including demographic and bioclinical data, individual income, education level, and regional GDP per capita. Risk factors identified from univariable Cox regression models were included in multivariable analyses with all-cause death, CVD death and initial peritonitis as events. In multivariable analysis, stratified Cox regression models with center size as the stratified factor were employed to adjust for center effects. The center effect was reflected not only in disparity of center size (ranging from 78 patients to 815 patients), which has been demonstrated to be an independent predictor of PD outcome [30], [31], [32], but also in differences in practice patterns and biochemical assays between centers, which differed from the regional effect. The regional effect was defined by regional GDP per capita and reflected differences in SES between regions. To determine whether individual income or education level interacted with regional GDP per capita, we explored their two-way interaction effects on the likelihood of patient survival and peritonitis-free survival. When an interactive effect was observed, subgroup analysis was performed.
We reported the multivariable adjusted hazard ratios (HRs) with 95% confidence interval (CI). All probabilities were two-tailed, and the level of significance was set at 0.05. Statistical analyses were performed using SPSS for Windows software version 13.0 (SPSS Inc., Chicago, IL).
Baseline Characteristics
Data from 2409 patients were collected. One hundred and forty-five patients were excluded because they began the PD program before the date of intact database creation or more than 1 month after catheter implantation. Another 93 patients who had been receiving PD for less than 3 months were also excluded. The included 2171 patients had a mean age of 58.0±15.5 years and BMI 22.9±3.6 kg/m2; 37.6% were diabetic and CVD was present in 40.9% of the subjects at baseline. Chronic glomerulonephritis (CGN) was the most common cause of ESRD (34.9%), followed by diabetic nephropathy and hypertensive nephropathy. The proportions of patients with low, median and high income were 36.5%, 39.8% and 23.7% respectively; 44.3% had a diploma from high school or above. There was significant regional economic disparity across the whole cohort, with GDP per capita ranging from the 10th percentile at ¥24,768 ($3913) to the 90th percentile at ¥175,495 ($27,722). Undeveloped regions were areas with GDP per capita lower than the median (¥95,000, $15,009) and had fewer registered doctors than developed regions but comparable numbers of available hospital beds per thousand inhabitants (4.5±2.3 vs 6.2±1.7, P<0.001 for doctors; 7.7±5.1 vs 7.8±3.0, P = 0.49 for beds).
Socioeconomic and Clinic Characteristics
Patients with low individual income were less likely to be elderly (33.0%) and have a history of CVD (37.5%). The lowest individual incomes were associated with the lowest education level and highest proportion of individual income used for medical expenses. The poorest patients were also more likely to live in rural areas and undeveloped regions at the greatest distances from hospital. Accordingly, the percentage of frequent visitors was lowest in the low individual income group. At baseline, hemoglobin and serum albumin were lowest in the low individual income group. However, gender, BMI, prevalence of DM and CGN, living alone, RRF, baseline dialysis dose, and total Kt/V did not differ significantly between income groups (Table 1).
Patients who lived in undeveloped regions were significantly younger, poorer, and less educated and lived further from hospital. There were more cases of diabetes and fewer cases of CGN in this group. Hemoglobin and serum albumin were lower, but RRF and dialysis dose were comparable to those in developed regions. Undeveloped regions had fewer registered doctors per thousand inhabitants than developed regions. These data are shown in Table 2.
Follow-up and Outcome
The median follow-up time was 27.7(15.5–45) months. As shown in Table 3, among 553 patients who died, 210 deaths (38%) were due to CVD and 140 (25.3%) to infection; other causes were malignancy, gastrointestinal bleeding, malnutrition, miscellaneous, and undefined. Of the 210 patients who died from CVD, the leading cause was myocardial infarction (46 cases, 21.9%); other causes were congestive heart failure, cerebral bleeding, cerebral infarction, arrhythmia, peripheral arterial disease, sudden death, and undefined. One hundred and sixty-eight patients were transferred to HD, most due to PD-associated infection (77 cases, 45.8%); other reasons were leakage, hernia, catheter disposition, ultrafiltration failure, severe congestive heart failure, inadequacy of dialysis, miscellaneous, and undefined.
The time to first-episode peritonitis was 23.7 (11.9–40.4) months. Four hundred and fifty-five episodes of initial peritonitis occurred during the study period; 160 episodes (35.2%) were due to Gram-positive organisms, 94 (20.7%) to Gram-negative organisms, and six (1.3%) to fungi; 12 (2.6%) were polymicrobial, 130 (28.6%) were culture negative and 53 had no culture result (11.6%).
Association between SES and Outcome
On univariable Cox regression analysis, individual income and education level but not regional GDP per capita were significantly associated with all-cause death. The predicted role of these factors were further explored by multivariable Cox regression analysis. Age, BMI, DM, CVD, hemoglobin, serum albumin, RRF, and center size were also found to be significantly associated with all-cause death on univariable Cox regression analysis. After stratification by center and controlling for all of these confounders and gender, compared with the low income group, the adjusted HRs for all-cause death in the medium and high income group were 0.62 (95%CI 0.48–0.79, P<0.001) and 0.44 (95%CI 0.33–0.61, P<0.001) respectively. Medium income and high income were also associated with significantly lower risks for cardiovascular death, with adjusted HRs of 0.60 (95%CI 0.41–0.90 P = 0.012) and 0.47 (95%CI 0.29–0.76, P = 0.002) respectively. The high income group, but not the medium income group had a significantly lower risk for initial peritonitis, with an adjusted HR of 0.69 (95%CI 0.50–0.94, P = 0.02) compared with the low income group (Table 4).
Compared with patients with an elementary school education or lower, patients with higher education levels did not show a constant trend toward lower risk for all-cause death. Only a diploma above the high school level predicted significantly lower risk for all-cause death, with an adjusted HR of 0.68 (95%CI 0.50–0.93, P = 0.02), and for cardiovascular death, with an adjusted HR of 0.54 (95%CI 0.32–0.91, P = 0.02). Otherwise, education level had no effect on cardiovascular death or initial peritonitis (Table 4).
Compared with patients living in undeveloped regions, patients in developed regions had similar risk of cardiovascular or all-cause death and initial peritonitis, even after controlling for all of above mentioned confounders such as age, proportion of patients with diabetes, serum albumin, and so on (Table 4).
In addition, we explored the interactive effect between individual income, education level and regional GDP per capita. We found that individual education but not income level had a significant interactive effect with regional GDP per capita on all-cause death (adjusted HR 0.79, 95% CI 0.65–0.97, P = 0.024), and this influence was further explored after stratifying the patients according to regional development. In undeveloped regions, an education level of high school or above predicted a significantly lower risk for all-cause death compared with elementary school or lower, with adjusted HRs of 0.56 (95% CI 0.34–0.94, P = 0.03) and 0.36 (95% CI 0.20–0.63, P<0.001), respectively. In developed regions, education level did not predict all-cause death (Fig. 1). No interaction effects were observed between individual income or education and regional GDP in terms of cardiovascular death and initial peritonitis.
From this first large-scale multi-center cohort of incident Chinese PD patients, we found that individual rather than regional income independently predicted all-cause death, cardiovascular death, and initial peritonitis. Education level was only significantly associated with all-cause death in undeveloped regions but not in developed regions. An interaction effect of individual education level and environmental SES is reported for the first time.
Consistent with former studies [19], [33], [34], [35], lower individual income emerged as an independently significant risk indicator for death and initial peritonitis. Although poorer patients were younger and had less comorbidity, they bore a heavier burden of medical expenses and had access to fewer medical resources, which strongly supports increasing the personal medical coverage rate for PD patients in China. Of note, poorer patients were prone to be anemic and malnourished at baseline, probably due to inadequate health care and late referral to nephrologists before the development of ESRD. Given that the standard chronic kidney disease program is helpful in retarding progression to ESRD and improving complications such as anemia, malnutrition and bone mineral disease [36], [37], the timing of and strategies used for medical support before dialysis in China need to be urgently investigated. We note that effective medical support aids the establishment of successful PD programs for disadvantaged minorities [38], [39].
By contrast, no impact of regional GDP per capita on PD outcome was observed, the opposite of previous findings showing an independently negative effect of regional SES on outcome in chronic disease [15], [16], [17]. One potential reason for our finding is that, in the undeveloped regions in our study, the patients were younger, there were fewer cases of diabetes, and baseline serum albumin levels were higher than in the developed regions. Given that age, diabetes and serum albumin have been recognized as the strongest predictors by most studies [40], [41], [42], these favorable individual factors in our study possibly offset the disadvantages of regional SES. A similar finding was obtained in a study from the USA [24], in which the risk of technique failure was significantly lower in remote-dwelling patients than in those living closer to the hospital, because the former were younger and had fewer complications from diabetes. However, no association between regional SES and cardiovascular or all-cause death or initial peritonitis was observed, even after adjustment for age, proportion of patients with diabetes, serum albumin, and so on. We hypothesize that unknown confounding factors related to regional SES are also associated with PD outcome. In addition, only baseline characteristics, and not the change trend in clinical variables, were analyzed for the prediction of outcome during follow-up. This choice may have influenced the reliability of our results.
Our analysis indicates that education level had no effect on risk of initial peritonitis. This result is consistent with the analysis of a US regional ESRD registry in which 1595 new PD patients were observed over 2 years [23], but is contrary to recently published data from Brazil and Canada [21], [22]. One possible explanation is that our selected centers had professional PD doctors/nurses and well-constructed training programs. Patients and their home-care helpers were often trained simultaneously, which probably led to stronger family support [43]. Whether better compliance in Asian people [44], [45] plays a role in this phenomemon is unclear. However, lower education level still significantly predicted death in undeveloped regions. The causes for this finding are unknown, but it has been shown that PD networks linking developed and developing units might be a means of improving the quality of therapy [46]. Whether the establishment of a standardized PD program in undeveloped regions will benefit less-educated patients needs to be investigated. More trials are also needed to explore new strategies for improving the efficacy of training for less-educated patients.
Our large-scale multicenter PD cohort gave us a valuable opportunity to explore the association of SES and outcome at both the individual and the environmental level. Our results will be helpful for PD clinicians and health policy-makers in generating appropriate strategies to improve the use of PD in developing countries such as China. Compared with former studies, this study has the advantage of more detailed information on individual SES. The enrollment of representative centers in a rapidly developing country with huge diversity in regional economic development is also a merit. The interactive effect between individual and regional SES has never been investigated in a dialysis population.
This study has some limitations. First, based on estimates of the size of the dialysis population (no registry data available as yet), only about 10% of PD patients in China were enrolled in the study and thus we cannot confirm the generalizability of our results. However, all incident patients were enrolled from 'core' PD centers of medical school-affiliated hospitals and came from provinces and counties with varied level of SES and penetration rate of PD therapy. Therefore, it is reasonable to conclude that the range of SES of our study population reflects the overall situation to a certain degree. A national dialysis registry has been initiated recently, so more representative data will be obtained in future years. We Hope our study will provide useful cues for the analysis of national data in the future. Second, individual SES is a general index and many SES-related physiological and non-physiological factors were not measured. We cannot verify whether worse nutritional status, deficient pre-dialysis care, less access to standardized training courses, or poor compliance contributed to the worse outcome observed in poorer patients. Regional SES-related information such as local hygiene status, availability of medical services and social support systems was not assessed in detail. Third, we should be aware of the possibility of ascertainment bias (4.1% of eligible patients were not included), vintage bias (different centers created their databases at different times), and residual confounding and recall bias because of the retrospective nature of this study. Furthermore, an observational study cannot demonstrate cause–effect relationships.
In conclusion, our findings strongly support the present health-care strategies implemented by the Chinese government to improve the medical coverage rate for ESRD patients. Our data also suggest that, under the present training program, the risk for peritonitis in less-educated patients is comparable with that in patients with higher diplomas. A series of strategies should be applied to improve the quality of treatment for poorer patients and less-educated patients in undeveloped region. Constructing an integrated care system for chronic kidney disease patients to prevent various complications and developing PD networks to standardize training programs may be potential approaches to improving the quality of therapy.
The authors express their appreciation to the patients, doctors, and nursing staff of the peritoneal dialysis center of Peking University First Hospital, Division of Nephrology of Peking University Third Hospital, Division of Nephrology of Huashan Hospital, Fudan University, Division of Nephrology of the second affiliated hospital of Harbin Medical University, Division of Nephrology of Peking University People's Hospital, Division of Nephrology of the first affiliated hospital of Zhejiang University School of Medicine, Division of Nephrology of General Hospital of NingXia Medical University, for their participation in this study. The authors also thank ELIXIGEN (Shanghai) Corp. for native English speaking proofreading of the manuscript.
Author Contributions
Conceived and designed the experiments: HYW JD. Performed the experiments: RX QFH YPR TYZ JHC HPZ MHC YW CMH RZ XHZ MW NT. Analyzed the data: RX. Wrote the paper: RX JD.
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- 34. Rubin J, Ray R, Barnes T, Teal N, Hellems E, et al. (1983) Peritonitis in continuous ambulatory peritoneal dialysis patients. Am J Kidney Dis 2: 602–609. doi: 10.1038/ki.1983.10
- 35. Raaijmakers R, Gajjar P, Schroder C, Nourse P (2010) Peritonitis in children on peritoneal dialysis in Cape Town, South Africa: epidemiology and risks. Pediatr Nephrol 25: 2149–2157. doi: 10.1007/s00467-010-1592-0
- 36.
D Batlle PR, M J Soler (2006) Progress in retarding the progression of advanced chronic kidney disease: Grounds for optimism. Kidney International: S40–S44.
- 37. Pereira BJ (2000) Optimization of pre-ESRD care: the key to improved dialysis outcomes. Kidney Int 57: 351–365. doi: 10.1046/j.1523-1755.2000.00840.x
- 38. Carruthers DM, Whishaw JM, Thomas M, Thatcher G (1996) Planes, kangaroos, and the CAPD manual. Perit Dial Int 16 Suppl 1S452–454.
- 39. Carruthers D, Warr K (2004) Supporting peritoneal dialysis in remote Australia. Nephrology (Carlton) 9 Suppl 4S129–133. doi: 10.1111/j.1440-1797.2004.00348.x
- 40. Avram MM, Goldwasser P, Erroa M, Fein PA (1994) Predictors of survival in continuous ambulatory peritoneal dialysis patients: the importance of prealbumin and other nutritional and metabolic markers. Am J Kidney Dis 23: 91–98.
- 41. Blake PG, Flowerdew G, Blake RM, Oreopoulos DG (1993) Serum albumin in patients on continuous ambulatory peritoneal dialysis–predictors and correlations with outcomes. J Am Soc Nephrol 3: 1501–1507.
- 42. Leinig CE, Moraes T, Ribeiro S, Riella MC, Olandoski M, et al. (2011) Predictive value of malnutrition markers for mortality in peritoneal dialysis patients. J Ren Nutr 21: 176–183. doi: 10.1053/j.jrn.2010.06.026
- 43. Xu R, Zhuo M, Yang Z, Dong J (2012) Experiences with assisted peritoneal dialysis in China. Perit Dial Int 32: 94–101. doi: 10.3747/pdi.2010.00213
- 44. Blake PG, Korbet SM, Blake R, Bargman JM, Burkart JM, et al. (2000) A multicenter study of noncompliance with continuous ambulatory peritoneal dialysis exchanges in US and Canadian patients. Am J Kidney Dis 35: 506–514. doi: 10.1016/s0272-6386(00)70205-8
- 45. Taira DA, Gelber RP, Davis J, Gronley K, Chung RS, et al. (2007) Antihypertensive adherence and drug class among Asian Pacific Americans. Ethn Health 12: 265–281. doi: 10.1080/13557850701234955
- 46. Yang X, Mao HP, Guo QY, Yu XQ (2011) Successfully managing a rapidly growing peritoneal dialysis program in Southern China. Chin Med J (Engl) 124: 2696–2700.


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Originally written on
Last updated 11/19/14
- Below is the latest promo for Bray Wyatt and The Wyatt Family:
- Speaking of Wyatt, he tweeted last night:
"The only way to rebuild society, is to destroy it at its foundation. Follw me, I'll show you….. #RAW #FollowTheBuzzards. Tomorrow began yesterday."
- World Heavyweight Champion Dolph Ziggler tweeted after last night's RAW:
"the world champ gets no love from @WWE brass or the fans, OBVS now my bitter rage targets you del rio, no offence #PAYBACK"
- WWE has posted an injury update on Kofi Kingston, noting that he will be out of action for up to eight weeks. As noted, Kofi had elbow surgery last week.
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subset: commoncrawl


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This is very gooooood :3
Team » Young Justice appears in 169 issues.
yeah, but the fact that they mention a kickstarter seems that they're trying to extort us somehow. as much as i want young justice back i feel as though they're trying take advantage of us.
If this kickstarter means a quality cartoon that isn't at the mercy of toy sales, I'm for it.
I really hope all things go well
considering Toonami got resurrected anything is possible so keep your heads up people
Since Cartoon Network likes screwing over action shows so much, I hope GL: TAS and Young Justice get picked up by a better network like the hub.
I really hope all things go well
considering Toonami got resurrected anything is possible so keep your heads up people
Toonami isn't ressurected. It's the same cartoons, Just under the Toonami name with 30 minute reruns of Naruto Part 1
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NEW ORLEANS WILL Get Involved with Professional OrganizationsConnections are an important part of building your career. Even if you don't plan on networking, professional organizations can introduce you to influential members of the community, help you build friendships, and possibly even [..] |
NEW ORLEANS WILL Brush Up on Its History with Walking Tour ClassesHaving a firm grasp on this city's past can be hard – established almost 300 years ago, New Orleans has a rich culture and history full of remarkable events, memorable architecture, and fun facts. Perhaps you've resolved to [..] |
NEW ORLEANS WILL Learn More about Hospitality with Specialized Classes at UNOTourism is one of our biggest sources of revenue and greatest assets. We know by now that every dollar a tourist spends touches our lives directly – whether we work in the hospitality industry or not. The University of New Orlea [..] |
"I hope that we use [tourism] to diversify to bring other kinds of industries here," Iftikhar Ahmad. @NO_Airport http://t.co/XQaDEK0PUv | @onesweetspot That's a good one! | Here in #NOLA, we have some of the best food in the world! What's your favorite dish? #TourismIsHow http://t.co/nRBl8S6PJD |
NEW ORLEANS WILL is a campaign created by the New Orleans Convention and Visitors Bureau and the New Orleans Tourism Marketing Corp to advocate for the tourism and hospitality industry. NEW ORLEANS WILL is raising awareness amongst locals that while visitors may come and go, their dollars stay here — and ripple through the community to fund city services, police, schools, people salaries, and ultimately, improve the quality of life for every New Orleanian.
We love our city. We love our way of life. And so does the world. Those visitors from all over the world are our city's single greatest resource. Investing in that resource means more money for jobs, roads, schools, safer streets and a better quality of life.
You are New Orleans, and you can make a difference. It's as simple as staying informed and supporting tourism. Spread the word to your neighbors and be welcoming to all our visitors. They bring gifts. You can also become a part of NEW ORLEANS WILL, and here's how:


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John Davis Photography
Mayhem # 1738166
About MeI am a model working for Midwest model management in Canton Ohio. I have recently started and am looking to get myself out in the market by using web sights like this. I am hoping to be successful in the modeling industry and will work hard to get there.Friends |


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Flyers Prospect Accused Of Sexual Assault Has Had Some Really Tough…
What the hell is this?
What the hell is this? » 2/14/13 3:00pm 2/14/13 3:00pm
Flyers goon Ian Laperrière had seven replacement teeth stolen en route to tonight's game. This reminds me of a horrible dream I had about a stupid movie starring the Rock. What do you mean, that's a real thing? [via The700Level] » 1/22/10 12:30am 1/22/10 12:30am


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Whitehaus Collection WH37CR Floral Shaped Cabinet Knob, Crystal
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Floral shaped crystal knob with gold base.
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that show was one to be wreckened with!
it was ok like i said before , but had some porbs with the baby dude and all
1st Sig finished 12-20-09
i will agree that 001 (the baby ) was a little strangeOriginally Posted by anime_being_god
002 was my favorite charater
Itenera Diurna Nocturaque~~~ i travel day and night
Sane, Paululum Linguae latinae dico!
A decent show but not as good as anything I have on DVD. But in Cyborg 009 defence it is better than all that crap on CN now a days. All in all Cyborg 009 is a good show but most of the episodes are depressing because people are always dying.
I couldn't really get into the series. I didn't like the drawing style. To astro boyish
Thanks alot Sasurihell and Kedar for the sigs and thanks Sammy 65 for the changing pics
(just remove the "x" from the [x/img] tag!
Woohoo, 003 was awesome ^_^ And the song was quite cool as well....... All in all, it was much better than most other old animes out there
I miss this series on AdultSwim.


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1955 Chevy title
I think I posted something sometime ago, as far as where I could find the VIN# on my 1955 Chevy car, well I got the VIN # but have not been able to work out a deal with the so called Title Recovery Companies, since we have the original VIN Plate lost inside the house & can not find it, they have told me to keep looking for it, even though I give them the frame VIN #, so now I'm looking for a wrecked 55 with a VIN Plate & Title so I can buy the whole car & make one car out of two, so if anybody has one near in Texas(I'm in Laredo) let me know where & how much!! I've tried uploading pics of my project in progress but I can't get a hang of it, can somebody lead me on as how to upload pics here??
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55 title
That would be nice if it could be that easy in Texas, have you or anybody you know ever gone through this,what steps were taken & info need to comply?? You see cause this car is not hot, stolen or other wise, I've had it for almost 30 years, my friend the previews owner had it for over 10 years & his cousin had it for about 10 years, so I got me & 2 preview owners to vouch for the car, so it's not hot. But I wonder if TX DMV would want to issue me a real title for it!! I'll do whatever they want, as long as I'm garanteed a title.
Wiki time
There is a Wiki article here on Hotrodders How to title a hot rod, Texas is one of the states listed with Info. and report back, add your info to the Texas Wiki
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# leinster-rugby - Tuesday 24 February, 2015
With almost 20 internationals away, Leinster's young guns are looking to cement their place
Tadhg Furlong and Luke McGrath are two guys who've benefited from the available game time.
# leinster-rugby - Monday 23 February, 2015
'Front rows always have a nemesis and Cian has had some pretty good days against Dan Cole'
Leinster scrum coach Marco Caputo on the task facing the Irish front row against England on Sunday.
Promising ex-Leinster back row Gilsenan signs new contract with London Irish
The 22-year-old left Leinster last summer to join the Premiership club.
# leinster-rugby - Saturday 21 February, 2015
'We're going to have to improve an awful lot' says Leinster's Luke Fitzgerald
Fitzgerald scored one of Leinster's four tries against Zebre.
Leinster fans present Nigel Owens with a new passport
We're not sure this would get the referee on an aeroplane either.
'Leinster must get better' insists O'Connor
The Blues' head coach insists his side need to improve after their win over Zebre.
# leinster-rugby - Friday 20 February, 2015
Fitzgerald provides the spark as sluggish Leinster get bonus point against Zebre
Fitzgerald scored one try and created another, while Cian Healy also made his return to provincial colours at the RDS.
Leinster will lose a key leader with retirement of cult hero Jennings
The 33-year-old yesterday announced his decision to hang up his boots at the season's end.
Has the scrum become a blight on modern rugby?
What is supposed to be a means of re-starting the game after one team makes a mistake has somehow evolved into an interminable wait, write Whiff of Cordite.
'Cian is a special athlete' – Leinster boosted by Healy return for Zebre clash
Matt O'Connor welcomes a number of international players back into his side to face the Italians.
Aer Lingus to the rescue as Ryanair won't let Nigel Owens fly in to ref Leinster
The high-profile referee brought a driving licence instead of a passport to the airport this morning.
# leinster-rugby - Thursday 19 February, 2015
Leinster open to the idea of signing Munster legend Peter Stringer
The 37-year-old is a free agent at the end of the season and Matt O'Connor says it 'might be an opportunity for us'.
Three-time Heineken Cup winner Shane Jennings to retire at the end of the season
The Flanker announced his decision today.
Cian Healy is back in Leinster colours – Here's the team to face Zebre tomorrow
Healy named among the replacements after more than five months out with hamstring tear.
# leinster-rugby - Tuesday 17 February, 2015
Robbie Henshaw will see out his contract with Connacht next season
The 21-year-old's immediate future has been resolved, but Munster, Ulster and Leinster are hovering.
# leinster-rugby - Sunday 15 February, 2015
Leinster were upset by the Dragons in their first RDS loss since March 2013
Tom Prydie's boot helped the Welsh side to a 16-14 win.
# leinster-rugby - Saturday 14 February, 2015
Exercise quality always above quantity for Leinster Rugby's head of fitness
The top man in the province's S&C department isn't interested in weightlifting records or punishing workloads.
# leinster-rugby - Friday 13 February, 2015
'I have a lot to learn' – Jack Conan knows what's required for World Cup contention
A lot done, more to do for the Leinster star.
A talented Leinster back row is joining Munster next season
Duncan Williams and Ronan O'Mahony have signed new contracts with the souther province.
Yes, there are Pro12 games this weekend – Dave Kearney returns and Keatley starts for Munster
Also, Connacht have named their team to face Scarlets
'Players who have had concussions are struggling through everyday life'
Jimmy Gopperth is grateful for Leinster's excellent medical staff.
# leinster-rugby - Thursday 12 February, 2015
Ever wanted to sit courtside at an NBA game? Leinster's offering the same experience
Four lucky fans can win the chance to watch Leinster in luxury.
# leinster-rugby - Friday 6 February, 2015
Leinster won't be playing their Champions Cup quarter-final on Good Friday after all
The times and dates of the first round of European knockout fixtures have been confirmed.
# leinster-rugby - Monday 26 January, 2015
Here's our Irish team of the weekend after the last round of the Champions Cup pool stage
It was an unbeaten weekend for the Irish provinces in Champions Cup action.
# leinster-rugby - Sunday 25 January, 2015
Here is the complete quarter-final line-up in the inaugural Champions Cup
Leinster have a home quarter-final for the first time since 2012 but will be on the road for a potential semi-final.
# leinster-rugby - Saturday 24 January, 2015
O'Connor disappointed with Leinster's inability to close out Wasps clash
However, Leinster's head coach took some encuragement from the first-half performance in Coventry.
5 talking points after Leinster secure a Champions Cup quarter-final
Matt O'Connor's men were brilliant in the first half, but Wasps fought back powerfully after the break.
Leinster into Champions Cup quarters after hanging on for draw at Wasps
Matt O'Connor's men top Pool 2, but their second-half display was worrying.
As it happened: Wasps v Leinster, Champions Cup
We went minute-by-minute through Leinster's season-defining tussle in Coventry.
# leinster-rugby - Friday 23 January, 2015
We'll Leave It There So: Fed's a shadow of himself, tragedy in Derry and all today's sport
Other stories include Jamie Heaslip starting for Leinster this weekend and ITV 'parting ways' with Adrian Chiles.
Douglas and Ryan to start Leinster's winner-takes-all clash with Wasps
Win on the road would clinch home quarter-final for Matt O'Connor's side.
# leinster-rugby - Wednesday 21 January, 2015
Analysis: Matt O'Connor's Leinster beginning to show true hand
However, there will need to be further improvement if they are to win away to Wasps.
# leinster-rugby - Tuesday 20 January, 2015
Versatile Ireland-capped prop Bent proving his value to Leinster
The 28-year-old has proven himself at loosehead in the absence of Cian Healy and Jack McGrath.
# leinster-rugby - Monday 19 January, 2015
One of Leinster's possible quarter-final opponents looked very dangerous in destroying Toulouse
There are a lot of permutations ahead of this weekend's rugby.
# leinster-rugby - Sunday 18 January, 2015
Leinster's high-tempo gameplan aided by McFadden 'steel' out wide
The winger was a thorn in the side of Castres, and got a pain in the neck for his troubles.
# leinster-rugby - Saturday 17 January, 2015
'Luxury' of early bonus has Leinster in rude health for pool decider
Matt O'Connor was holding some of his players back for Wasps.
Wasps upset Harlequins to set up winner-takes-all clash with Leinster in Coventry
Leinster are in pole position after Wasps' surprise victory at the Stoop.
Cannonball Cronin and more talking points after Leinster put 50 on Castres
The hooker scored arguably the try of the night as Leinster took the driver's seat in Pool 2.
Leinster turn on the style with seven-try show as Castres collapse
Matt O'Connor's side attacked with real intent from the start at the RDS.
As it happened: Leinster v Castres, Champions Cup
Leinster will be gunning for a bonus point win at the RDS this evening.


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Certain Change: How the Roberts Court is revising constitutional law
In It Together?
It's moot, but it matters: Scalia helps to judge Law School case competition (video)
Third-year Harvard Law School students clashed in the high drama of the venerable Ames Moot Court Competition on Tuesday under the jurisdiction of visiting federal judges, including one of the nation's foremost legal authorities, U.S. Supreme Court Associate Justice Antonin Scalia. "It was fully as good as one would expect at Harvard Law School," a pleased Scalia […]
Gallery: A look inside the 2014 Ames Moot Court Competition
The final round of Harvard Law School's annual Ames Moot Court competition was held this year on November 18, and was presided over by the Hon. Antonin Scalia '60, associate justice of the Supreme Court of the United States; the Hon. Adalberto Jordan, U.S. Court of Appeals Eleventh Circuit; and the Hon. Patricia Millett '88, U.S. Court of Appeals District of Columbia Circuit.
Freeman, Lazarus discuss legal fate of EPA proposal to toughen emissions rules (video)
Court sense: Kagan provides peek into Supreme Court's everyday workings (video)
In an entertaining talk in HLS's Wasserstein Hall with Dean Martha Minow on Wednesday, Associate Justice Elena Kagan '86 displayed her trademark wit and wisdom, honed during her years as a Harvard Law School student, professor, and dean, her work with the Clinton administration, and her stint as solicitor general.
Margaret H. Marshall to receive 2014 Thurgood Marshall Award
Margaret H. Marshall, Harvard Law School senior research fellow and lecturer on law, will receive the American Bar Association's 2014 Thurgood Marshall Award. A retired chief justice of the Massachusetts Supreme Judicial Court, Marshall is being recognized for her long-term contributions to advancing civil rights, civil liberties and human rights in the United States.
Tushnet analyzes Supreme Court's Hobby Lobby ruling
In Burwell v. Hobby Lobby Stores Inc., the U.S. Supreme Court ruled in a 5-4 decision that closely held, for-profit corporations have a right to exercise the religious beliefs of their owners and therefore cannot be required by the Affordable Care Act (ACA) to provide contraception coverage to employees if it conflicts with those views. The Gazette spoke with Harvard Law School Professor Mark Tushnet about the decision and what it means for future corporate challenges to the Affordable Care Act.
Brown-Nagin reflects on Schuette and justices' differences on racial discrimination (video)
Following the U.S. Supreme Court's decision in Schuette v. Coalition to Defend Affirmative Action, upholding Michigan's ban on the use of race in university admissions, Harvard Law School Professor Tomiko Brown-Nagin appeared on MSNBC's "Last Word" to discuss the divide in the Supreme Court's on race.


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Rebecca Macieira-Kaufmann, President Of Citibank California (Photo: Business Wire)
Nearly half of Californians believe 2012 will be better than 2011, according to the latest Citi California Pulse®, a sign that the state's residents are increasingly optimistic about the coming year. Thirty-three percent expect this year to be about the same as last year, and only 17 percent say it will be worse.
Rebecca Macieira-Kaufmann, President of Citibank California (Photo: Business Wire)
Additionally, Citibank's latest quarterly survey found that the outlook is improving among residents regarding the California economy, jobs and their personal finances. Looking ahead 12 months, 66 percent of Californians say their personal financial situation will be better, 52 percent say the California economy will improve, and 51 percent say job opportunities will brighten. When asked how they feel about the state, 85 percent say they are proud of California and 63 percent say it is an excellent or good place to live.
"We are pleased to see this optimism going into the new year and that many Californians are looking forward to improving conditions in 2012," said Rebecca Macieira-Kaufmann, President of Citibank California. "Our survey continues to show the incredible resilience and pride of Californians, which is a great sign for the state's future."
When asked about California's leadership position in certain industries, 66 percent say the state remains a leader in the Entertainment Industry, 47 percent in Technology, 43 percent in the Green Industry, 43 percent in Fashion/trend-setting, and 20 percent in Education.
Citi California Pulse® Optimism Index The Citi California Pulse Index of Optimism rose to -4 in the fourth quarter of 2011, up from -7 in the third quarter. At 0, the index would be on the exact middle point of all possible scores, which range from +100 to -100.Check Out Our Best Services for Investors
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Trav - My Nina Feat. Maino
My Nina Trav Feat. Maino
Editor Rating: HOTTTTT
User Rating:
Trav gets some help from Maino on his latest offering "My Nina".
Trav grabs a verse from fellow New York resident Maino for his latest release "My Nina". Track is produced by The Superiors. The second installment in Trav's P.U.S.H. mixtape series is due out later this year. Listen and download the track below.
Quotable Lyrics:
"I'm a hold it down, please down hold me up/ When I look around, all we got is us/ If its goin' down, you the only one I trust/ I believe in God, but I believe in us"


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Vermont gives No. 6 Duke a scare in 91-90 loss
Nobody expected Vermont to give No. 6 Duke much of a scare.
Yet the Catamounts found a way to score seemingly at will against a program built on defense, and they came perhaps a moment shy of pulling the biggest upset of the young season.
Duke needed a free throw from Rodney Hood with 5 seconds left and one final defensive stand to hold off Vermont's upset bid and beat the Catamounts 91-90 on Sunday night.
Hector Harold scored 24 points and Clancy Rugg finished with 20 for Vermont (1-5).
The America East favorites lost their fourth straight, dressed only nine healthy players but gave Duke all it could handle with by far its best shooting performance of the season.
They ''came into Duke with no pressure on us, and we played like there was no pressure on us,'' coach John Becker said. ''Maybe this is a lesson learned for our guys.''
Vermont shot 64.8 percent - by far, its best performance of the season and the worst defensive showing by Duke.
''We compete and play defense every game and every day at practice,'' Becker said. ''Tonight, the ball went through the basket, and we were able to hang around with a really good team.''
Candon Rusin's four-point play with 10.4 seconds left for Vermont tied it at 90. Hood brought the ball downcourt, drove the lane and drew contact from Rugg. Hood bounced his first free throw off the rim, then swished the second.
Sandro Carissimo hurried the Catamounts downcourt and found Rusin in the corner, but he couldn't get a shot off before the buzzer.
''We didn't win this game,'' Hood said. ''We kind of deserved to lose the game, and we got lucky.''
Duke coach Mike Krzyzewski said the Catamounts ''were terrific.''
''And we were awful,'' he added.
Jabari Parker scored 26 points in his sixth straight 20-point performance. Hood finished with 22 for Duke (5-1), which extended its nonconference winning streak at Cameron Indoor Stadium to 106 games.
''We played like a team that thought we would just show up and win,'' Krzyzewski said. ''That's how you get beat.''
Andre Dawkins scored 16 points and Quinn Cook added 14 for the Blue Devils. Cook broke a tie with a 3-pointer with just under 2 minutes left that made it 86-83.
They stretched their lead to 88-84 on Rasheed Sulaimon's free throw with 40.8 seconds to play before Carissimo made it a two-point game with his tip-in with 29 seconds remaining.
Cook seemingly gave Duke a cushion when his two free throws with 19.4 seconds left made it 90-86 - but when Sulaimon fouled Rusin on his deep 3-pointer, the Catamounts had another chance.
Carissimo finished with 16 points and Luke Apfeld had 10 for Vermont, which fell to 3-17 against ACC schools and is winless against all of them except for Boston College.
Yet the Catamounts looked plenty capable of taking advantage of a ripe Duke team that struggled all night to stop them.
''We're not connected on the defensive end,'' Hood said.
When the Blue Devils built a 61-49 lead on Parker's steal and fast-break dunk with 15 1/2 minutes left, that looked like the spark that would get the sluggish Duke defense going.
Instead, Vermont reeled off 10 straight points after that as part of a 13-2 run. Harold's three-point play pulled the Catamounts to 63-62 with just over 11 minutes left.
Carissimo's free throw with 7:50 left tied it at 71. Harold's 3 from the key about a minute later put Vermont up 74-73 - its first lead since early in the first half - and neither team led by more than four points the rest of the way.
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NCAA BK Headlines
No. 3 Michigan State beats Indiana with Payne sidelined again
Buffett, Gilbert team to offer $1 billion for perfect bracket
Holmes beats buzzer with 3-pointer to send Texas over K-State
No. 14 Kentucky rolls past Texas A&M behind Poythress, Johnson
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Chicken Fajita Bake
1 large green bell pepper
1 large red bell pepper
1/2 large onion or one small onion
2 boneless chicken breasts
1 Avocado sliced (optional)
Preheat oven to 350 degrees F.
Slice the peppers, onion and chicken into strips. Spray a 9 x 13 glass pan with Pam Olive Oil Spray. First place your strips of chicken on the bottom of pan and then evenly spread out the veggies on top. Season with salt, pepper, chili powder and Mrs. Dash original blend.
Bake uncovered for 45 minutes (with 5 minutes left of cooking I added the sliced avocados) or until chicken is done and veggies are done to your liking. Serve on a whole wheat tortilla or over brown rice. Garnish with 0% plain greek yogurt (I used sour cream) and reduced fat shredded cheese.
I found this recipe onKari Burghardt's website.
1 trimmed 1 pound pork tenderloin
1/2 thinly sliced white onion
1/2 cup BBQ sauce
whole wheat sandwich buns
Cover bottom of slow cooker with sliced onions, place tenderloin on top and cover with BBQ sauce. Cook on low setting for 7-8 hours (make ahead the night before for lunch). Take tenderloin out, shred with two forks and add back to sauce and onions. Serve on whole-wheat buns.
I found this recipe on youbeauty.com
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text: Chris Baumgartner, Associate Dufford & Brown, P.C. 1700 Broadway, Suite 2100 Denver, CO 80290-2101 Phone: (303) 837-6347 Fax: (303) 832-3804 email@example.com Chris Baumgartner, Associate Practice Areas Chris Baumgartner brings a wide variety of litigation experience to Dufford & Brown. He began his career primarily in the areas of medical Litigation & Trial malpractice and personal injury litigation. Chris subsequently expanded Contract his practice into the commercial arena and now handles a diverse Commercial range of civil litigation in addition to advising clients on general business Insurance Defense matters. Education For Chris, few things compare to the satisfaction that comes with University of Colorado School of Law, achieving a great result for a client, whether it be obtaining a substantial J.D., 1999 recovery on their behalf or eliminating a potential liability. Chris often finds it more rewarding to assist a client in resolving problems without resorting Colorado Journal of International to formal litigation, or better yet, advising a client as to how to avoid Environmental Law and Policy, Board potential problems altogether. of Editors (1998-99) Career Highlights University of Michigan, B.A., 1995 Graduate of the National Institute for Trial Advocacy's Hanley Advanced Advocacy Skills Admissions Law Clerk to the Honorable John P. Leopold, 18th Judicial District of Colorado (1999), U.S. District Court for Colorado, 1999-2000 District of Colorado (2001), U.S. Court of Appeals 10th Circuit (2001) Publications Editor for Dale A. Oesterle, The Law of Mergers, Acquisitions, and Reorganizations (2nd ed. 1999) Support Staff Teresa Johnson Authored The Demise of the Multilateral Agreement on Investment, 303-837-6350 Colorado Journal of International Environmental Law and Policy, email@example.com 1998 Yearbook Carol Kelly Awards 303-837-6329 Named a 2009 Rising Star by Law & Politics and the publishers of firstname.lastname@example.com 5280 Magazine. Community Involvement & Affiliations Member of the Colorado and Denver Bar Associations Thompson Marsh Inn of Court Faculty of Federal Advocates Colorado Lawyers for the Arts 1700 Broadway, Suite 2100 | Denver, CO 80290-2101


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Charity shops 'more popular than eBay', according to survey
27 Feb 2015
A survey conducted by nfpSynergy has found that Britons prefer to shop at charity shops rather than using...
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Reversing the funding cuts to the Charity Commission, restricting public fundraising licences to FRSB members only and comprehensive self-regulation are just three of the many recommendations put to Lord Hodgson in his Charities Act Review consultation.
Lord Hodgson advises that he has received 150 responses to his call for evidence to the Review which is looking at whether changes are required to the legal and regulatory framework for charities. 110 of these were from organisations and 40 from individuals.
The consultation is divided into 13 specific areas associated with the Act - from exempt charities, through the future of the Charity Commission, to reporting and accounting requirements. Umbrella bodies have submitted responses on behalf of their members but opinions are divided on a number of matters, not least the issue of self-regulation.
While the Institute of Fundraising (IoF) and Fundraising Standards Board FRSB are united in their calls for comprehensive self-regulation of fundraising, the Directory for Social Change (DSC) and the Wales Council for Voluntary Action (WCVA) highlight a number of current and potential flaws in the system.
The IoF calls for a "unified system of self-regulation" between separate umbrella bodies, with the Charity Commission at the helm. This would take responsibility for monitoring and regulating fundraising activities away from local authorities, which the IoF says are "inconsistent" in their approach, and towards collaborative regulation from within the sector:
"The inconsistency of the application of current licensing laws is costly for both the charities who have to jump through a variety of hoops, and the local authorities who 're-invent the wheel' to respond to perceived problems," the IoF submission advises.
However the Wales Council for Voluntary Action, representing over 3,350 member organisations, questions the capacity of the sector umbrella bodies to pick up sub-regulation responsibilities, and whether the measure would reduce confusion over regulation:
"There is a concern that along with the role that the Commission has already requested that umbrella bodies take in dealing with increased numbers of telephone queries... organisations such as WCVA may be asked to take on an additional role as sub-regulator.
"As well as the obvious issues of cost and staffing levels to meet such an additional role, there would be a concern that sub-regulation could potentially lead to increased inconsistency of approach in regulation of the sector."
But while WCVA is concerned about capacity issues, the FRSB, already a regulatory body itself, calls for an extension to its functions under a new "Self-Regulation Plus" model, further enforcing its own regulatory powers and encouraging a larger membership for the organisation.
Currently only the 1394 members of the FRSB fall under its regulatory powers, which include fines for those breaching its code of practice. But the organisation has struggled to increase its membership in line with expectations, preventing a universal regulation system for fundraising activities. Its recommendations call for the restriction of public fundraising licences to FRSB member charities only, and a programme of promotion through the Charity Commission and other strategic partners to increase membership, and therefore the reach of its regulatory powers.
While the DSC advises that "in an environment of reduced resources, the only way forward is to rely even more heavily on self-regulation", it warns that risks of sub-regulation by umbrella bodies include the possibility of "whole classes" of charities being removed from the central register. It also warns that the boundaries between informal advice and formal regulation are under threat of being blurred.
Its preferred option is for a late reversal of the government's budget cuts to the Charity Commission, calling for the regulator to remain as it stands with legal regulator status in order to "maintain the integrity of the register of charities".
"The biggest factor defining current debate is the government's short-sighted decision to drastically cut the budget of the Charity Commission," said DSC in its submission.
"Although the savings are paltry in terms of overall government spending, they are massive in terms of the Charity Commission's budget and the ability of hundreds of thousands of charity trustees to ensure their organisations conduct their affairs within the law.
"Crucially, the cuts also threaten to undermine public trust and confidence in charity, as the Commission will simply have far less resource available to ensure charities are operating properly. Decisions taken in the name of short-term efficiency are likely to have long-term negative consequences.
"We would urge the government, even at this late stage, to reverse the cuts to the Commission's budget," it said.
If this is not possible, DSC added, the government should "find a way to fund continued access to free help and advice for smaller charities about relevant law and regulation".
The IoF warns that "Whatever system is put in place should ideally be cheaper and as a minimum be no more expensive for a charity than it is at present,"advising that some of the larger charities incur membership costs in excess of £150,000 a year.
While the consultation was set to close at the end of the day on Monday, Lord Hodgson advises there is still time to respond: "We are now reaching the end of the evidence-gathering stage of the review. We are learning a lot about the views of the sector on key regulatory issues and we are most grateful to everyone who has let us know their views so far. There is still time to contribute by filling in the online questionnaire on the Cabinet Office website but please don't delay!"
Lord Hodgson's full report on the review is expected to be complete and laid before Parliament before summer recess in mid-July.
Terms of reference for the Charities Act Review can be found on the Cabinet Office website.
Charities Act Review: IoF moots comprehensive self-regulation of fundraising
PASC chair hints at statutory regulation of fundraising
PASC puts fundraising self-regulation 'on notice'
Fundraising self-regulation comes under Charities Act Review
Navca: Mixed-motive investments 'risk putting profit before purpose'
Withdraw gift aid if accounts submitted late, says Charity Commission
Councils call for greater control of face-to-face in submission to Hodgson
More than half of public want fewer charities, research finds
Single public-facing self-regulatory scheme is needed for fundraising, says Hodgson
27 Feb 2015
A survey conducted by nfpSynergy has found that Britons prefer to shop at charity shops rather than using...
26 Feb 2015
The Charities Property Fund has grown to £865m after reporting £100m of new transactions in December...
26 Feb 2015
New public contract regulations which come into force today will help charities win government contracts...
27 Feb 2015
Tesco employees, suppliers and customers raised over £18m for Diabetes UK between March 2013 and December...
26 Feb 2015
Coffee mornings are the most popular ways for supporters to raise money for charity, according to new...
26 Feb 2015
Some of the sector's largest foundations are discussing creating a map of all charitable grant funding...
13 Feb 2015
Daniel Phelan, owner and editor-in-chief of Civil Society Media, passed away on Wednesday following a...
6 Feb 2015
Charities in the UK will be able to advertise volunteer opportunities to 250,000 LinkedIn members who...
5 Feb 2015
Two Bitcoin organisations have launched a website and free guide to promote the use of the digital currency...
Attending our one day courses is a highly effective way of ensuring new and existing trustees fully understand their role, responsibilities and liabilities.
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text:
good chemistry is complicated, and a little bit messy -LW |
PerlMonks |
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Cute idea, but your output from P(11) is..ambiguous.
And P(12) has the incorrect "1011" entry for 10, 11.
UPDATE In reply to Re (tilly) 2: (Golf as well): List of Partitions
by tilly


text:
Series starts 1/8
Game 1: Friday, January 8th | ||
Magic | 97 | Final |
Wizards | 104 | |
Recap »Boxscore » |
Game 2: Friday, February 5th | ||
Wizards | 92 | Final |
Magic | 91 | |
Recap »Boxscore » |
Game 3: Saturday, March 13th | ||
Magic | 109 | Final |
Wizards | 95 | |
Recap »Boxscore » |
Game 4: Wednesday, April 7th | ||
Wizards | 94 | Final |
Magic | 121 | |
Recap »Boxscore » |
Coverage: NBATV
7:00 PM ET, March 13, 2010
Verizon Center, Washington, DC
Top Performers
Orl: D. Howard 28 Pts, 15 Reb, 5 Ast, 1 Stl, 2 Blk
WSH: A. Blatche 32 Pts, 4 Reb, 4 Ast, 2 Stl, 2 Blk
WASHINGTON -- After the game, J.J. Redick was dishing out geography trivia and talking about Duke's run in the Atlantic Coast Conference. Too bad his conversational versatility doesn't also include hockey -- because it was a stat usually associated with the sport on ice that stood out in the Orlando Magic's eighth straight win.
Redick led the Magic in plus-minus, his team outscoring the opponent by 21 points while he was on the floor, part of another solid bench effort in Orlando's 109-95 victory Saturday over the worn-down, back-to-back-to-back Washington Wizards.
Dwight Howard had 28 points and 15 rebounds, but it was Redick (18 points), Brandon Bass (16 points, nine rebounds), Mickael Pietrus and Jason Williams who led the rally when the Magic found themselves trailing by 15 in the second quarter.
Redick said the second group has been focused anew since a 95-85 loss to Dallas on Feb. 19.
"We were all horrible that night, and after that game we kind of all got together and said 'We've got to be better," Redick said. "Even during the first quarter tonight, MP looked at me and said something to everybody, that we needed to pick things up for the starters."
Since the Dallas game, the Magic have won 10 of 11, and the eight-game run is the franchise's longest winning streak since April 2006. Against the Wizards, Redick scored 10 points in a 24-6 spurt that gave Orlando the lead for good, and the Magic shot 74 percent from the field in the second quarter.
"That's what got us going," Howard said. "Guys came in and played defense and we hit shots and was able to run and be effective in transition, and that's the way we got back into the game and ended up winning the game."
Vince Carter also scored 18 points for the Magic, who are 4 1/2 games behind the Cleveland Cavaliers for best record in the Eastern Conference. Howard went 11 for 13 from the field and also had five assists.
Andray Blatche scored 32 points for the Wizards, who lost their season-high seventh straight game. Washington wrapped up a stretch of three games in three nights with a road trip in the middle, a rare scheduling quirk caused when a game was postponed by a February blizzard.
"There's no question we got fatigued," Washington coach Flip Saunders said. "Halftime, we came in to rest, it's like we thought about how long we'd been playing, and we had no juice to start the second half."
Shaun Livingston had 18 points and eight assists off the bench for the Wizards, who aren't getting any kind of break in the schedule. They'll spend Sunday traveling, then play back-to-back games at Utah and Denver on Monday and Tuesday to start a four-game road trip. Saunders called it "ridiculous" that his team will have only one day off at the end of that trip, then just only one home game before hitting the road again.
"I guess it's like that commercial," Saunders said. "'Give it to Mikey. He'll eat it, he'll do anything."
The Wizards didn't start the game like a team needing rest from playing an AAU schedule. They ran up and down the court with the Magic, pulling off a 14-0 run to take a 35-20 lead early in the second quarter.
But Redick, Bass and Pietrus took over for the rest of the half, then Howard stole the show to start the third quarter. He made a hook shot, slammed an alley-oop on a pass from Jameer Nelson, recorded a steal, blocked one of Blatche's shots and hit a free throw -- all during an 8-0 run during the first two minutes of the second half.
Another alley-oop from Nelson to Howard pushed the lead to 16 points. The Wizards cut it to nine late in the third quarter while Howard was on the bench, but Redick scored eight points in a 15-4 run to open the fourth quarter to put the game away.
Game notes
Redick's geography trivia questions: Name nine countries starting with the letter "I", and name the four states whose capitals start with the same letter as the state. ... Regarding Duke basketball, he referenced the bragging rights he has this season over North Carolina product Carter. "Vince and I made a very small bet on the game, and Duke wins by 32 and he takes a week to pay me," Redick said. "I didn't even charge him interest. I think it should be double if a team wins by 32." ... Pietrus returned after missing one game with a strained neck muscle. ... Saunders called JaVale McGee's performance "very poor." "You can't have a starting center not get a defensive rebound," the coach said.
Team Stat Comparison
Points | 109 | 95 |
Rebounds (Offensive-Total) | 15-46 | 9-30 |
Assists | 20 | 24 |
Turnovers | 17 | 10 |
Steals | 5 | 4 |
Blocks | 7 | 6 |
Fast Break Points | 10 | 11 |
Fouls (Tech/Flagrant) | 20 (1/0) | 19 (1/0) |
Largest Lead | 23 | 15 |
Top Performers
Game Leaders
Points | D. Howard 28 | A. Blatche 32 |
Rebounds | D. Howard 15 | A. Gee 5 |
Assists | J. Nelson 8 | S. Livingston 8 |
Steals | J. Nelson 2 | M. Miller 2 |
Blocks | D. Howard 2 | A. Blatche 2 |
Team rosters: Orlando | Washington |
Next 5 Games
Orlando | Washington |
03/14 CHA 6:00pm 03/17 SA 8:00pm 03/18 @MIA 7:00pm 03/22 @PHI 7:00pm 03/24 @ATL 7:00pm |
03/15 @UTAH 9:00pm 03/16 @DEN 9:00pm 03/19 @POR 10:00pm 03/21 @LAL 9:30pm 03/23 CHA 7:00pm |
Complete Schedule: Orlando | Washington |


text:
The property was better than it has been in the last 12 years. The manager was well above expectations, she went many extra miles to make our stay better. Our truck broke down and she was very helpful.
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CALL depends on its members for its very existence. From the executive to committee membership to facilitating or moderating programs, CALL is member led. Become part of this innovative, dynamic and friendly group of volunteers.
- Register for programs and special events.
- Receive e-mail updates of programs and special events.
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- Be an interest group facilitator. Please send an e-mail to firstname.lastname@example.com.
- Join one of our committees — program planning, fund development, special events, community and public relations, and website — by sending an e-mail to firstname.lastname@example.com.
Membership is open to individuals age 45+. Yearly membership is $50 per person. Memberships purchased now are valid until August 31, 2015. The one exception for a first time, new membership purchased after May 1 is valid until August 31 of the following year.
**Please note:
- the only method of communication between the membership committee and new and existing members is through email, CALL does not have the ability to respond to inquiries by telephone or conventional mail;.
- CALL does not provide transportation for members to interest groups or activities.
The CALL Membership Fee is $50.00 per person.
CALL Annual Membership year is from September 1 through August 31 (e.g. Sept. 2014 though Aug. 2015). All new or renewed memberships purchased at any time during the year are valid through August 31.
The one exception for a first time, new membership purchased after May 1 is valid until August 31 of the following year.
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Berkshire buys $US1.2bn in stock from single investor
PUBLISHED: 13 Dec 2012 05:54:41 | UPDATED: 13 Dec 2012 05:54:41PRINT EDITION: 13 Dec 2012Warren Buffett's conglomerate Berkshire Hathaway bought back $US1.2 billion in stock from the estate of an unnamed investor, one day after Buffett advocated for a higher estate tax when the wealthy die.
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The Office of Institutional Advancement strives to provide the College's alumni with a variety of resources to support their professional development and help them network with students, faculty, graduates, and friends of the College.
Update Your Contact Information
If you have recently moved, earned a new degree, took on a new job, received a promotion, had an addition to the family, opened a new email account, purchased a new phone, etc., e-mail email@example.com and we will make sure your contact information at the College is current!
Social Media Groups
The College has created a number of social media and online resources for you to stay connected to your fellow alumni and campus.
- ACPHS Cribsheet and Mobile Application download for the latest ACPHS news and fun tips
- ACPHS Alumni Facebook Page and Group
- ACPHS LinkedIn Group
- ACPHS Alumni Outreach Group
These social media platforms are FREE resources and a great way to stay up to date and connected to the College.
Continuing Education
Visit the Continuing Education web page to view a calendar of upcoming CE events being hosted by the College. Please note that our CE events are open to all professionals, not just ACPHS alumni.
Free CE App Center
Visit the CE App Center web page to access local, regional, statewide, and national online applications and resources to enhance your professional network and health care connections.
Post Job Openings
The "ACPHS Career Zone" provides students with access to exclusive job postings and the ability to post their resumes or CV's for review by prospective employers. It also represents an excellent platform for alumni looking to post open positions. Please visit the ACPHS Career Zone to register for the site. To contact the Office of Career Services, e-mail Luke Schmonsky.
Financial Planning
ACPHS partners with financial experts AXA Advisors to help alums looking for the latest information on financial planning, business, retirement and estate planning, college planning, life insurance, annuities and mutual funds. AXA has financial advisors throughout the United States and our partnership connects you with this group of highly talented and knowledgeable professionals. For more information, please e-mail Bill Jabour, Director of Alumni Relations.
Order a Transcript
If you are heading back to school to pursue an advanced degree, you will likely need to provide a copy of your ACPHS transcript. Our Online Transcript Service makes obtaining a copy of your transcript easier than ever.
ACPHS E-mail Account
When you leave the College, your ACPHS student e-mail account goes with you. But now there is another option to maintain that link to the College and stay in touch with your classmates. All graduates are eligible to get an ACPHS alumni e-mail account through Google (email@example.com) that will literally last a lifetime. Best of all, there are no costs associated with this service. To get your ACPHS alumni e-mail address, please send an e-mail to email@example.com. Please bookmark this link to access your e-mail account.
Alumni Directory
Lost touch with a former classmate? Want to update your contact information? No problem. Click this link to visit the ACPHS Alumni Directory.
And don't forget to check out the mobile version of the Alumni Directory!


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SpyPoint Sport Accessories Pack for X-Cel Video Camera
Sale price: Clearance price: Starting at: Sale starting at: Clearance starting at: Reg. price:
Perfect for filming great footage in a variety of sport activities, the Sport Accessories Pack for X-Cel Video Camera from SpyPoint helps you capture great steady footage. This handy pack makes it easy to attach your X-Cel HD video camera to a car, boat, bike, ATV, helmet, and more for great footage from different points of view. Pack includes clear waterproof housing, 360° roll bar mount, 90° extender, straight extender, quick release stand, curved adhesive mount, and flat adhesive mount.
Manufacturer model #: XHD-SPORT ACC.
- Increases the versatility of the high performance X-Cel camera
- Perfect for mounting on a car, boat, bike, ATV, helmet and more
- Includes 6 mounting brackets and 1 clear waterproof casing
- Great for active sports enthusiasts and other active outdoors enthusiasts
- Helps provide steady footage from different vantage points