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The Cooper Institute, Dallas TX 75230
Roundtable held February 4–7, 1999, Indianapolis, IN.
BLAIR. S. N. and S. BRODNEY. Effects of physical inactivity and obesity on morbidity and mortality: current evidence and research issues. Med. Sci. Sports Exerc., Vol. 31, No. 11, Suppl., pp. S646–S662, 1999.
Purpose: The purpose of this review was to address three specific questions. 1) Do higher levels of physical activity attenuate the increased health risk normally observed in overweight or obese individuals? 2) Do obese but active individuals actually have a lower morbidity and mortality risk than normal weight persons who are sedentary? 3) Which is a more important predictor of mortality, overweight or inactivity?
Methods: We initially identified more than 700 articles that included information on the exposure variables of body habitus (body mass index, body composition, or body fat pattern) and physical activity habits, and on outcomes such as morbidity or mortality. To be included in the review, we required that an article include an analysis of one of our outcomes by strata of the two exposure variables. We excluded review articles and reports of cross-sectional analyses. We used an evidence-based approach to evaluate the quality of the published data.
Results: We summarized results from 24 articles that met all inclusion criteria. Data were available for the outcomes of all-cause mortality, cardiovascular disease mortality, coronary heart disease (CHD), hypertension, type 2 diabetes mellitus, and cancer. Summary results for all outcomes except cancer were generally consistent in showing that active or fit women and men appeared to be protected against the hazards of overweight or obesity. This apparent protective effect was often stronger in obese individuals than in those of normal weight or who were overweight. There were too few data on cancer to permit any conclusions.
Conclusions: There are no randomized clinical trials on the topics addressed in this review. All studies reviewed were prospective observational studies, so all conclusions are based on Evidence Category C. The conclusions for the three questions addressed in the review are: 1) regular physical activity clearly attenuates many of the health risks associated with overweight or obesity; 2) physical activity appears to not only attenuate the health risks of overweight and obesity, but active obese individuals actually have lower morbidity and mortality than normal weight individuals who are sedentary, and 3) inactivity and low cardiorespiratory fitness are as important as overweight and obesity as mortality predictors. Research needs include extending current observations to more diverse populations, including more studies in women, the elderly, and minority groups, assessment methods need to be improved, and randomized clinical trials addressing the questions discussed in this review should be undertaken. Owing to size, complexity, and cost, these trials will need to be designed with valid noninvasive measures of subclinical disease processes as outcomes.
Overweight and obesity are directly related to increased risk of several chronic diseases and impaired physical function, whereas physical activity and cardiorespiratory fitness are most often inversely associated with similar increased risks (25,38). In observational studies both overweight and obesity are correlated with physical activity and cardiorespiratory fitness, with sedentary and unfit persons having greater weight for height, body mass index (BMI, kg·m−2), and percent body fat (2,5–8,11,14,15,17,32). Data from controlled clinical trials have shown that increases in physical activity result in weight loss and changes in body composition and fat distribution (4,9,16,35,36,40–42). Thus, it is possible that some, perhaps much, of the overweight and obesity seen in U.S. populations is caused by a sedentary, physically inactive lifestyle. This topic is reviewed in detail elsewhere in these proceedings.
It is difficult to know how much of the higher morbidity and mortality seen in overweight or obese individuals results from the elevated weight and how much results from inactivity. Whereas most observational studies of the relationship between physical activity or cardiorespiratory fitness and morbidity or mortality include adjustment for some aspect of body composition, many of the studies of overweight or obesity and morbidity and mortality have not included data on physical activity.
Barlow et al. (2) published the first report that included analyses specifically designed to evaluate the relation of cardiorespiratory fitness to mortality in individuals classified as normal, overweight, or obese based on their BMI. Based on their results these investigators suggested the hypothesis that moderate to high levels of cardiorespiratory fitness protect against much, if not most, of the increased mortality that accompanies overweight and obesity. This hypothesis is the basis for this review of the available evidence.
The material presented in this review addresses three specific questions:
1. Do higher levels of physical activity or cardiorespiratory fitness attenuate the increased risk of morbidity and mortality in overweight or obese persons?
2. If the evidence supports the hypothesis that higher levels of physical activity and cardiorespiratory fitness attenuate the increased risk associated with overweight and obesity, do overweight or obese individuals who are physically active or fit actually have a lower risk of morbidity and mortality than normal weight individuals who are sedentary (i.e., what is the magnitude of the protective effect of activity or fitness in overweight and obese individuals)?
3. Which is a more important predictor of mortality in individuals, overweight and obesity or inactivity and low fitness?
We evaluated several different measures of health, overweight or obesity, and sedentary habits. Outcome variables considered for this report include all-cause mortality, the presence or development of cardiovascular disease, hypertension, stroke, CHD, type 2 diabetes mellitus, cancer, and functional health status. We found no articles on stroke or functional health status that met the inclusion criteria described below, and these variables are not mentioned further. Exposure variables included body habitus (BMI or body composition as estimated by hydrostatic weighing or skinfold thickness, and fat distribution as estimated by waist girth), and evidence of a sedentary life style (low levels of self-reported occupational or leisure-time physical activity or low levels of cardiorespiratory fitness as determined by objective laboratory assessment). These exposure variables have limitations. Current opinion holds that it is the amount and distribution of body fat that are the principal causes of high rates of chronic disease seen in overweight or obese individuals, but few studies have included direct measurement of these parameters. Physical activity is difficult to quantify, and self-report of activity patterns is the most common measurement approach used in studies of physical activity and health. Although many of the activity questionnaires and procedures have established validity, the amount of variance explained in criterion measures of energy expenditure by these methods is low to moderate (27). Cardiorespiratory fitness is assessed objectively, but it is relatively expensive and logistically complicated to perform in epidemiological studies. Limitations of cardiorespiratory fitness assessments are that these measurements only reflect activity over recent months before the assessment and are at least partly determined by heredity.
Our objective was to identify all published reports that were from prospective investigations and included one of the outcome measures listed above, in which results were presented in strata of body habitus cross-tabulated by categories of physical activity or cardiorespiratory fitness. We excluded reports in which outcomes were given by strata of body habitus with adjustment for activity or fitness or by strata of activity or fitness with adjustment for body habitus. Such reports typically did not include sufficient information that would allow us to fully characterize the independent effect of one exposure variable across the full range of the other. We also excluded review articles and cross-sectional analyses.
Another problem that arises in considering the questions under review in this report is that many of the major studies on obesity and health did not include measurement of physical activity or fitness. In reports on obesity and health in which investigators indicated that they adjusted for physical activity, there is often no, or at best an incomplete, description of how the physical activity was measured. In other instances activity was assessed so crudely, perhaps with a single global question, that little confidence could be placed in the measurement. In these circumstances determination of the true independent effects of body habitus and energy expenditure on outcomes is impossible because of the great difference in the reliability of assessment of the two exposure variables. For these reasons, we believe that the most valid approach to evaluate the independent contributions of body habitus and energy expenditure to health is to use objective and valid measures of each. Measurement of body habitus and cardiorespiratory fitness in a laboratory or clinical setting meets this criterion, although we also include reports in which physical activity was measured with a standardized method that has been shown to have a strong and graded association with health outcomes.
We began with papers identified in the 1996 publication, Physical Activity and Health: A Report of the Surgeon General (38). Next, we performed computer searches with keywords related to our identified outcome measures in combination with keywords related to energy expenditure (physical fitness, cardiorespiratory fitness, exertion, exercise, or physical activity) and body habitus (BMI, overweight, obesity, or fat distribution). We also searched our personal files and reference lists in identified published articles. We initially identified more than 700 potentially relevant articles. After exclusions based on the above criteria, this process identified 24 articles that are included in this report.
Both authors reviewed each article on the final list. We summarized results from the articles in Tables 1–6, with a different table for each outcome measure. Each table includes the study reference; a brief description of the study population; the method of assessing physical activity or fitness; the method of assessing body habitus; a description of outcomes, the number of events, and the length of follow-up (where applicable); confounding variables considered in the analyses; and a summary of the study results. We used the evidence-based approach for rating the quality of evidence that was described in the report on obesity treatment guidelines from the National Institutes of Health (25). There are no randomized controlled clinical trials that provide data on the questions under consideration in this report (Evidence Category A or B), and we did not include any consensus judgment reports (Evidence Category D). Therefore, all reports included in our results are classified in Evidence Category C (prospective observational studies).
{tabft}BMI, body mass index (kg·m−2); py, person-years; RR, relative risk; CI, confidence interval.
{tabft}BMI, body mass index (kg·m−2); py, person-years; RR, relative risk; LTPA, leisure time physical activity; CHD, coronary heart disease.
{tabft}LTPA, leisure time physical activity; BMI, body mass index (kg·m−2); py, person-years; RR, relative risks; CI, confidence intervals.
{tabft}LTPA, leisure time physical activity; BMI, body mass index (kg·m−2); py, person-years; RR, relative risks; CI, confidence intervals.
We present separate tables on the relationship of body habitus and physical activity or cardiorespiratory fitness to the outcomes of all-cause mortality, cardiovascular disease mortality, CHD, hypertension, type 2 diabetes mellitus, and cancer.
A summary of the review of reports on all-cause mortality is presented in Table 1. There are four separate reports on cross-tabulations of cardiorespiratory fitness and BMI, body composition, or fat distribution. All these reports are from the Aerobics Center Longitudinal Study (ACLS). The first of these papers, published in 1989, had a short period of follow-up and the number of deaths was small, especially in women (3). Another limitation of this report is that the characterization of body habitus was limited to BMI categories of underweight, normal weight, and moderately overweight. The primary purpose of the study was to evaluate the relation of cardiorespiratory fitness to mortality, and detailed analyses are lacking to clarify the independent effects of the two exposures. Nonetheless, fit men and women tended to have lower all-cause mortality rates than unfit individuals in each BMI stratum. In this population, the highest mortality occurred in individuals with a BMI < 20. This is most likely a result of a lack of adjustment for smoking status and the presence of chronic disease at baseline.
The later reports from the ACLS focus specifically on the questions addressed in this review (2,18,19). These reports are from extended follow-up in the ACLS cohort, but because the number of events remains low in women, the reports include data for men only. Different selection criteria were used for the three studies, with the principal difference being whether individuals with chronic disease were excluded at baseline. The studies also differ in the classification and in the specific measure of body habitus used in analyses. Results, nevertheless, are consistent across the three studies. Men with higher levels of BMI, percent body fat, fat mass, fat-free mass, and waist girth who also were fit had lower death rates than unfit men with similar levels of body habitus measurements. In fact, in all analyses fit men with higher body habitus measurements, indicating obesity and/or overweight, had death rates not significantly different from fit men with low body habitus measurements. In these data men with high body habitus measurements had elevated mortality only if they also were unfit.
We also found two studies that used all-cause mortality as the outcome and physical activity and BMI as the exposure variables (28,32). The results were similar to those seen for cardiorespiratory fitness in the ACLS cohort. Active men in each BMI stratum had lower death rates than inactive men in the same stratum, and active men in the high BMI group had lower death rates than sedentary men in the low BMI group. A limitation of these reports is that the upper BMI categories included individuals with only mild to moderate overweight.
We only found three reports on cardiovascular disease mortality (defined as ICD-9 codes 390 to 449.9) that met our review criteria (see Table 2). These include two studies from extended follow-up in the ACLS cohort discussed in the section on all-cause mortality (18,19) and one additional report from the same study (10). Results of these analyses were similar to that for all-cause mortality. Unfit men had substantially higher cardiovascular disease death rates than fit men in the same body habitus group (BMI, percent body fat, fat mass, and fat-free mass). Although there was an inverse trend for cardiovascular disease deaths across fitness categories in individuals with a BMI ≥ 27.0 (rates 17.9, 10.6, and 9.5/10,000 man-years), the trend was not significant (P = 0.24) (10). Fit men in the highest body habitus groups had lower death rates than unfit men in the lowest body habitus groups. However, there was a tendency, even in the fit men, for cardiovascular disease death rates to be higher in higher body habitus groups than in the lower body habitus groups, which suggests that higher fitness does not eliminate excess cardiovascular disease mortality in individuals in the higher body habitus groups. This is in contrast to results from the studies on all-cause mortality where no excess risk was seen in the fit men who were overweight and/or obese (Table 1).
There were seven studies that included CHD as an outcome (Table 3), sometimes combined as fatal and nonfatal events and sometimes as fatal events , and BMI and physical activity as exposure variables. BMI was determined by self-report in five of the studies and measured in the other two studies. Physical activity was estimated from self-reports of leisure-time physical activity in all studies, and one study also included data on self-reported occupational activity (33). All reports included data for men, but only one study included data for women (33). The report on women includes only 12 events, and the results are inconsistent, both within exposure groups for the women and in relation to the results for men in this and other papers.
Results of the cross-tabulation of body habitus and physical activity in relation to CHD were similar to those described earlier for all-cause and cardiovascular disease mortality. Physically active men had lower rates of CHD than inactive men in all studies, and in all BMI strata. In general, active men in the high BMI group had lower CHD rates than inactive men in the low BMI group. In some studies the difference between these divergent groups was striking. For example, Morris et al. (23) reported that men with a BMI ≥ 27.0 who regularly participated in vigorous exercise had a heart attack rate of 1.3/1000 man-years, and men with a BMI < 24.0 who were inactive had a rate of 5.5/1000 man-years. Salonen et al. (33) reported that men with a BMI ≥ 27.0 in an active occupation and with high leisure time physical activity had a CHD mortality rate of 7.4/1000. In contrast, men with a BMI < 27.0 who were sedentary at work and in leisure time had a mortality rate of 25.9/1000. Regular physical activity appeared to provide substantial protection against CHD, especially in overweight men.
We found only two papers with hypertension as the outcome that met our inclusion criteria (Table 4). Paffenbarger et al. (26,30) followed two cohorts of college alumni for up to 15 yr for the development of incident physician-diagnosed hypertension. Validity of self-report of both exposure and outcome assessments was high in these well-educated men. In general, active men in both studies had a lower risk of developing hypertension than sedentary men in different BMI categories, although this difference was significant only in the two highest BMI categories in the Harvard men. Among the inactive University of Pennsylvania alumni, the incidence of hypertension was greater than among active men in all BMI categories. None of these differences were statistically significant.
In summary, regular physical activity appears to reduce the risk of developing hypertension in men with elevated BMI, but this association is less marked than was observed for the mortality outcomes reviewed earlier. Reduction in risk for active men was greatest in men in the high BMI categories.
Five studies with type 2 diabetes mellitus as the outcome variable are summarized in Table 5. One study was in women and four studies included only men. Four of the studies relied on self-reported physical activity, height and weight, and presence of type 2 diabetes mellitus from mail-back questionnaires. Active individuals in these studies had a lower incidence of type 2 diabetes than sedentary participants, and this association tended to be stronger among those in the highest BMI categories. For example, there was a 39% lower risk (P = 0.005) in the active men with a BMI > 26.4 when compared with sedentary men in the Physicians' Health Study, and this association was absent or much weaker in the lighter men (21). Data from the Honolulu Heart study were similar to those reported in the Physicians' Health Study, with the additional observation that the trend across activity categories in men with a BMI ≥ 28.2 was not significant for all men combined or men with a glucose < 225 mg·dL−1 (6). Results for men and women were similar in these studies.
Studies relating physical activity and type 2 diabetes mellitus that rely on self-reported physical activity and presence of diagnosed diabetes may underestimate the true risk of sedentary habits in relation to this disease. This is because of the limitations of self-reported exercise habits and also because approximately 50% of the prevalent cases of type 2 diabetes are undiagnosed, which leads to substantial misclassification on both the exposure and outcome variables. Wei et al. (39) recently reported a greater than 3-fold increased risk for developing type 2 diabetes in men with low cardiorespiratory fitness when compared with high fit men. The odds ratio was 3.7 when adjusted for age, history of parental diabetes, and length of follow-up, and this was only reduced to 3.2 after additional adjustment for BMI, high blood pressure, high density lipoprotein (HDL)-cholesterol, total cholesterol, triglycerides, cigarette smoking status, alcohol intake, and change in fitness. In addition to an objective measurement of the activity exposure, diabetes in this study also was determined objectively by measuring fasting plasma glucose concentrations at baseline and at follow-up. These authors reported a steep inverse gradient of risk across fitness categories among individuals with BMI of < 27.0 (P < 0.001) and ≥ 27.0 (P < 0.006) (see Fig. 1). Fit men with a BMI of ≥ 27.0 had a slightly lower incidence of type 2 diabetes than unfit men in the BMI < 27.0 group. Wei et al. (39) also reported a substantially increased risk of developing impaired fasting glucose (fasting plasma glucose ≥ 110 to < 126 mg·dL−1). The odds ratio for impaired fasting glucose in men with low fitness when compared with men with high fitness was 2.1 in the fully adjusted model. The results were similar among men in high and low strata of BMI.
Being active and fit appears to reduce the risk of type 2 diabetes, at least in heavy individuals. This association was strongest in the study with objective measures of both exposures and outcome.
We found four studies in which cancer was the outcome (Table 6). Physical activity was assessed in all studies by self-report. Self-reported height and weight were used to calculate BMI in one study. Two studies were in women only, and the other two studies included both women and men. In general, we consider the results for cancer inconclusive. In several of the analyses cancer risk was higher in sedentary individuals, but the results in the highest BMI groups were not consistent. For example, sedentary women with a BMI ≥ 25.0 had nearly five times higher endometrial cancer risk than highly active women in the same BMI category (20). However, there was a nonsignificant trend of higher risk of breast cancer across activity categories in women with a BMI > 25.7 (37). In the same study, a steep inverse gradient of breast cancer risk across activity groups was found in women with a BMI < 22.8. It is difficult to generalize the results presented in Table 6 because of the inconsistent results associated with different cancer outcomes. In some studies the outcome was a single type of cancer, and in one study cancer at all sites was the outcome of interest.
The review performed for this report addressed three questions:
Do higher levels of physical activity or cardiorespiratory fitness attenuate the increased risk of morbidity and mortality in overweight or obese persons?
Overweight and obese individuals who are active and fit have lower rates of disease and death than overweight and obese individuals who are inactive and unfit. This inverse gradient of risk across activity or fitness categories is present in various strata of body habitus and frequently is steeper in the higher categories of body habitus variables.
Active and fit individuals in nearly all the studies summarized in Tables 1–6 had lower rates of morbidity and mortality than sedentary and unfit individuals in all strata of body habitus. These findings remained after adjustment for age and other potential confounding variables and were seen for the various specific outcomes included here. An active and fit way of life apparently provides protection against several chronic diseases, and this association typically is present in all strata of body habitus. The inverse gradient of risk across levels of activity or fitness often was steeper in the higher strata of body habitus than among leaner individuals. For example, Morris et al. (23) report heart attack rates in men with a BMI ≥ 27.0 of 7.3/1000 man-years in sedentary men and only 1.3/1000 man-years in regular vigorous exercisers. Corresponding rates in men with a BMI < 24.0 were 5.5/1000 man-years in sedentary men and 1.9/1000 man-years in regular vigorous exercisers.
2. Do overweight or obese individuals who are physically active or fit actually have a lower risk of morbidity and mortality than normal weight individuals who are sedentary (i.e., what is magnitude of the protective effect of activity or fitness in overweight and obese individuals)?
Overweight or obese individuals who are active and fit are less likely to develop obesity-related chronic diseases and have early death than normal weight persons who lead sedentary lives.
Overweight or obese individuals who were active and fit had morbidity and mortality rates that were at least as low, and in many instances much lower, than normal weight individuals who were sedentary. Perhaps the strongest evidence supporting this conclusion comes from the reports by Lee et al. (18,19). These investigators followed a large cohort of men for an average of 8.5 yr. The strength of this study is that objective measurements were available for cardiorespiratory fitness and several measures of body habitus, including BMI, percent body fat, fat mass, fat-free mass, and waist circumference. Furthermore, the study was large enough to allow for analyses in smokers and nonsmokers, with exclusion for early mortality and with adjustment for several important potential confounders. In this report unfit men in the normal range of body habitus (BMI 19–25, percent body fat < 16.7%, or waist circumference < 87 cm) had more than a two-fold higher mortality risk than fit men in the highest category of body habitus (BMI ≥ 27.8, percent body fat ≥ 25%, or waist circumference ≥ 99 cm). This apparent protection of moderate to high cardiorespiratory fitness extends to men who clearly are obese (BMI > 30) (2).
3. Which is a more important predictor of mortality in individuals, overweight or obesity or inactivity and low fitness?
Inactivity and low cardiorespiratory fitness are as important as overweight or obesity as predictors of mortality, at least in men.
The question considered here relates to risk for individuals and not to the importance of either of these exposures as public health problems. It is clear that overweight and obesity are associated with increased risk of morbidity and mortality (25) and that an active way of life protects against morbidity and mortality (38). Because many studies on obesity and health have not adequately accounted for the possible confounding effects of physical activity, the independent effects of these two exposures are unclear. It is tempting, based on the reports reviewed here from the ACLS (2,18,19), to conclude that low fitness is a more important predictor of mortality in individuals than overweight or obesity, because excess mortality risk is largely eliminated in overweight or obese men who are also fit. In our judgment, such a conclusion would be premature. Other reports reviewed here did not have the specific purpose of addressing this question, and there are limitations on some of the analyses that did not focus specifically on this issue. In addition, data from the ACLS are available only for men, and this cohort is from middle to upper socioeconomic strata, with few members of minority groups. This homogeneity is an advantage in relation to internal validity of the study but presents limitations for generalization. Replication of the studies reported from the ACLS is needed.
All studies reviewed here are from Evidence Category C. It is unlikely that there will ever be randomized clinical trials to address specifically the questions posed in this report because of the required size, complexity, and cost. Thus, the best evidence we are ever likely to have on this issue will come from prospective observational studies.
Although the results reviewed here are remarkably consistent for various endpoints, because different measures of habitual physical activity or fitness, different strata of body habitus, and different populations were used in the various studies, conclusions must remain tentative. Few studies included women, and for some that did, the number of events was small. There are virtually no data available from minority groups. Health status or change in health status often was not considered or was inadequately addressed, although results are similar for studies that excluded unhealthy individuals at baseline and those that did not. Only reports from the ACLS had the specific purpose of addressing the questions considered in this review. While other reports had some data related to the issue, the lack of focus on the relevant question often led to incomplete analyses insofar as the present review is concerned.
Crude measurements of self-reported physical activity are an important limitation of many of the studies. In some studies, physical activity appears not to have been a very important variable under consideration during the planning phase of the study. When only one or two very simple questions on habitual physical activity are included as part of the study measurements, it seems reasonable to conclude that this was not a high priority item for the investigators. Under these conditions it is not realistic to expect that adequate and appropriate analyses can be performed with physical activity as an exposure. As an extreme example, suppose that an investigator wanted to address question 3 that is posed in this report. Further suppose that in that study the investigator measured physical activity by the question "Are you physically active or not?" and assessed body habitus by computed tomography scanning. One could hardly expect to find that inactivity is as important as body habitus as a predictor of mortality in such a study, even if inactivity actually were more important. Therefore, one of the limitations to keep in mind when evaluating results from the studies reviewed here is the relative validity of the exposure measures used.
Another of the major limitations of several of the current studies is that the upper body habitus stratum often began in the mild overweight range and may not have included many truly obese individuals. The conclusions presented here should not be extended to individuals with Class II or Class III obesity (BMI ≥ 35.0).
Additional research is needed to address the questions posed for this review. We recommend that the following types of studies be conducted:
1. Replicate prospective observational studies of the predictive validity of physical activity or cardiorespiratory fitness and body habitus for morbidity and mortality in diverse population groups. It is especially important that studies be conducted in women, older persons, and minority groups.
2. Prospective observational studies with other outcome measures need to be conducted. Overweight and obesity increase risk for functional limitations associated with aging and for knee osteoarthritis. It is not clear that regular physical activity might reduce these risks in overweight or obese persons.
3. Improve the assessment of physical activity in prospective observational studies of populations so that less misclassification occurs for this exposure. Ideally, objective measurements of activity by electronic monitoring should be considered.
4. Develop creative designs for randomized clinical trials to determine the independent and interactive effects of physical activity and body habitus on subclinical markers of chronic disease. Random assignment to activity interventions with blocking on strata of body habitus is one possible approach. Because controlled trials with morbidity and mortality as outcome measures are unlikely to be carried out in relation to the issues addressed in this review, investigators should incorporate more direct measures of disease processes in smaller, logistically-feasible clinical trials. Examples of such measures are ultrasound measures of carotid wall thickness, coronary artery calcification by electron beam computed tomography, near-infrared spectroscopy assessment of lipid content of atherosclerotic plaque, endothelial function of the coronary circulation by phase contrast, magnetic resonance imaging (MRI) with infusion of adenosine, endothelial function of the peripheral circulation by reactive hyperemia in response to ischemic exercise, left ventricular function by MRI, and mechanical function of vasculature by pulse wave velocity measurements.
We thank Milton Z. Nichaman, M.D., Sc.D., for helpful comments on an earlier draft of the manuscript, Melba Morrow, M.A., for editorial assistance, and Stephanie Parker for secretarial support.
Our work is supported in part by grants from the National Institutes of Health AG06945, HL48597, and HL58608; Polar Electro Oy; and Kellogg Company.
Adress for correspondence: Steven N. Blair, The Cooper Institute, 12330 Preston Road, Dallas TX 75230. E-mail: email@example.com.
© 1999 Lippincott Williams & Wilkins, Inc.
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We`ve been providing solutions to the problems of industrial safety and environmental pollution for 25 years. Our team have over 50 years of experience in gas detection. We take safety very seriously. With our technical expertise and knowledge of worldwide industrial markets, Euro-Gas meets the essential needs relating to the safety of personnel and pollution control. We ...
Reserve Resource Ltd
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Reserve Resource is a retail technology solutions provider. Our specialisation is in Energy Monitoring and Retail Technology. We bring an additional set of options to Energy Consultants, Property Managers and Energy Providers. As a retail technology provider all of our systems are PCI compliant and have integrated temperature monitoring. We have offices in London, UK and ...
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based in Concorezzo, ITALY
Founded in 1997, Enviroware provides advanced consulting services in atmospheric impact assessment, industrial risk evaluation, development of modelling tools and development of environmental software. The expertise of Enviroware guarantees to the Clients the achievement of their objectives, with complete satisfaction. The company can develop modelling tools specifically ...
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subset: commoncrawl


text:
NLC Official Transcripts are now housed at the Maryland Higher Education Commission (MHEC). Transcript and Verification requests should be directed to the MHEC.
To request a copy of student records from a closed Maryland postsecondary school, or a transcript, download, complete, sign and submit a Transcript Request Form to the Maryland Higher Education Commission at email@example.com or to the home office at:
Maryland Higher Education Commission
Division of Planning and Academic Affairs
Attn: Transcript Request
6 North Liberty Street, 10th Floor
Baltimore, MD 21201
Phone: (410) 767-3301
Fax: (410) 332-0270
Maryland Postsecondary School Closures and Closed School Transcripts
If you obtained a Bachelor of Arts Degree in Labor Studies through the National Labor College – Antioch University partnership program (1997 – 2007) you should direct your transcript request to:
Phyllis Gerhardt
Records Administrative Asst.
University Administration
Phone: 937-769-1087
E-mail: firstname.lastname@example.com


text:
Amy Winehouse Album Sales Surge After Troubled Singer's Death
Category: Entertainment
/ Jul 27, 2011 11:30AM EDT
Amy Winehouse's death surprised millions over the weekend, but her legacy lives on stronger than ever. The sales of Amy's albums and singles, like the smash hit 'Rehab,' have skyrocketed since the death of the 27 year old British jazz and blues musician. The sales push has sent her second album, 2007's Breakthrough Back to Black, into the #9 spot on the Billboard 200 albums chart this week, selling 37,000 copies. According to Nielsen SoundScan, Winehouse sold more albums in the past week than she did in the first six months of this year. Sales of Winehouse's 2003 debut, Frank, were also up, reaching the #57 spot with nearly 8,000 in sales. Both Black and Frank sales were nearly all digital, with online purchases accounting for more than 95% of all Winehouse's sales this week. Back to Black also topped iTunes and Amazon charts in the days following her death. Her radio airplay also increased by at least 170% The album sales surge is reminiscent of Michael Jackson's passing in June of 2009, when fans around the world raced to buy his music after his death. The five time Grammy winner, and troubled singer, known for her erratic public behavior, arrests, and drug problems, was found dead in her London apartment Saturday. A memorial was set up outside her London home and friends and family, some sporting Amy's famous bee hive hair doo, met for a private funeral service for Winehouse yesterday.
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I am expecting twins and they are the result of fertility treatments. I just told my co-workers and everyone seems to ask if twins run in my family. I don't want to lie about it, but also don't want to disclose my fertility issues with people I hardly know. Any suggestions on how to handle this question?
Thank you.


text:
Clarified Butter
Published: October 1, 2007
Servings: Makes about 1 1/2 cups
Clarified Butter
Servings: Makes about 1 1/2 cups
- 2 cups (4 sticks) unsalted butter, each stick cut into quarters.
Place butter pieces in 4-cup glass measuring cup. Mircowave on high 2 minutes. Remove from microwave and let stand 1 minute. Spoon off foamy top layer. Spoon clear (clarified) butter into small bowl. Discard any milky liquid at bottom of measuring cup.


text:
you are viewing a single comment's thread.
Minimum wage had its beginning in 1935. We will always have a minimum wage as long as there are liberals to vote to pass one. As several friends were discussing wages paid by Wal-Mart, their feelings were that W-M should be paying $20+/hour. When gov't got involved in wages, labor became rediculous. Gov't-liberals idea of minimum wage is to pay an individual what he needs, just like welfare, not what he is worth or produces. (By an ex-welfare employee that saw recipients getting more benefits for staing home than some of the employees.)
I have to get ready to go out to a birthday party right now. Are you going to be around later when I have time to tell you what a misinformed moron you are?thanks
How could we as a Nation possibly go wrong - - First we have Obama and now we have billy to bleat about it. p.s. in case you don't know what that means either?? - - That's the noise a Goat makes.


text:
Standard Grade VHS Videotape Cassette, 6 HoursItem#: YYAZ-TDK36330 | Model#: 36330
Currently Out Of Stock!
You May Consider This Alternative
TDK Standard Grade VHS Video Tape Product Details
This VHS video tape is designed for repeated record/erase cycles. Produces an amazingly clear picture. Excellent sound quality. Cassette Type: Video; Grade/Quality: Standard.
What It Is And Why You Need It
- Standard grade VHS video tape for repeated record/erase cycles.
- Repeated record/erase cycles.
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- High sound quality.
Manufactured by: TDK
Warranty provided by: TDK
UPC No: 020356363307
Mfg Part No: 36330
Box Size:
( Length:0, Width:0, Depth:0)
Shipping Weight: 0.5200 pound(s)
Click here for full warranty and support information
- TDK logos are registered trademarks of TDK. All others trademarks and copyrights mentioned herein are the property of their respective owners.


text:
HourlyLess than 30 hrs/week
Start DateSeptember 21, 2013
We are a 5 star oDesk provider who is looking for an experienced academic writer to help support a number of academic applications and journal submissions.
How to apply
Please respond with a cover letter that includes the following:
1. Please confirm the time you are available today. As a spam measure please include I am human not a computer in the first lines of bid.
2. You must have Skype. Please include your Skype availability so we can arrange an immediate interview.
3. Please attach your CV. We would prefer if you have already completed a PhD from a reputable univeristy and our available to speak today or tomorrow on Skype.
4. We prefer candidates from a Western English speaking country (US, British Isles, Canada, South Africa etc
We are a 5 Star ODesk provider and we look for long term relationships and provide excellent feedback and references. With over 185 reviews.
About the Client
Dublin 11:47 AM
Jobs Posted
25% Hire Rate, 1 Open Job
Over $50,000
Total Spent
524 Hires, 1 Active
Avg Hourly Rate Paid
4,938 Hours


text:
Supervisors, Officers Disciplined in HPD Homicide Probe
Chief calls out bad HPD homicide cops.
Four high-level homicide investigators and four officers have been disciplined after an extensive internal investigation of the Houston Police Department's homicide division.
The investigation found that 24 cases dating back to 2004 "were identified with deficiencies including not conducting proper follow-up, not entering documentation in a timely manner, insufficient documentation, or none at all," according to an HPD statement released Friday after HPD Chief Charles McClelland held a press conference announcing the results.
"The majority of the deficiencies occurred between 2008 and 2012," according to the press release, which "determined the major problems identified were the direct result of the actions of one individual, Sergeant Ryan Chandler, and not pervasive throughout the division."
Twenty-one of the 24 cited cases were "connected" to Chandler, who was indefinitely suspended, according to the release.
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Chandler "was less than forthright with his supervisors and fellow employees, failed to conduct proper follow-up in the manner in which he was trained and expected to perform, and appeared to have taken advantage of the trust placed in him as a supervisor in the Homicide Division," according to the statement. "Also, during the Internal Affairs investigation, Sgt. Chandler was untruthful."
Continue for video of the press conference announcing the findings in the HPD homicide investigation.
Also disciplined were the following supervisors: Lt. J. McGalin (one-day suspension), R. Lakind (written reprimand) and Sergeant B. Roberts (five-day suspension).
The disciplined officers were: K. Carr (ten-day suspension); B. Oxspring (written reprimand), R. Moreno (two-day suspension) and L. Lovelace (five-day suspension).
"I want to let the public know that in no way is this indicative of the 5,300 men and women who work hard every day in protecting and serving this city," McClelland stated in the release. "I also want to state that I have complete confidence in the Homicide Division. I fully expect all my commanders to constantly look for ways to make things better and improve processes and procedures. This investigation is an example of how we look for deficiencies and develop better processes."
The release also explained that "new processes and procedures have been put in place as a result of this investigation, such as stricter mandates/controls regarding file submissions, improved file preparation, tighter security controls and documentation of the file room, and creation of automated management reports."
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text:
Spiced Cookie Strips Recipe
Convenient refrigerated cookie dough and a few spices from your cupboard are all you need to bake these yummy cookie strips. Your family will want to gobble them up right out of the oven.
- 1 tube (16-1/2 ounces) refrigerated sugar cookie dough
- 2 tablespoons all-purpose flour
- 2 tablespoons butter, melted
- 1/2 teaspoon ground nutmeg
- 1/4 teaspoon ground cinnamon
- 1/4 teaspoon ground cloves
- 1. Remove cookie dough from package and coat with flour. Shake excess flour onto work surface. Roll out dough on floured surface into a 12-in. x 8-in. rectangle. Using a pizza cutter or sharp knife, cut rectangle in half lengthwise. Cut widthwise into 1-in. strips. Carefully transfer strips to two ungreased baking sheets.
- 2. Combine butter and spices; brush over strips. Bake at 425° for 10-12 minutes or until edges are golden brown. Cool for 2 minutes before removing from pans to wire racks. Yield: 2 dozen.
Nutritional Facts
2 each: 208 calories, 11g fat (3g saturated fat), 17mg cholesterol, 199mg sodium, 26g carbohydrate (11g sugars, 0 fiber), 2g protein.
Reviews for Spiced Cookie Strips
Reviewed Aug. 3, 2012
"A quick way to use pre-made refrigerator sugar cookie dough, to brush with melted butter & spices=a free cut cookie to give you 24 cookies yield."
© 2016 RDA Enthusiast Brands, LLC


text:
If you need Nursing Uniforms or Medical Uniforms or even Scrubs in AR, look no further. www.hotfrog.com showcases more than 8 Nursing Uniforms businesses across AR. To find more related businesses and to filter by locality, use the left navigation menu.
blytheville, ar
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Created in this Craftsy class
Easily outdo even the finest store-bought sauces as Italian cooking expert Giuliano Hazan takes you on a culinary tour through Italys most treasured recipes.
Other projects made as part of this class:
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|Food & Cooking
|Pasta, Vegetables
Share a little about the ingredients and techniques used to create this dish/item. I used pureed tomatoes. I was a little skeptical on how this was going to taste. I don't like using canned or even jarred tomatoes. I wasn't able to find whole tomatoes in a jar, and just couldn't feed canned tomatoes to my family so opted for pureed tomato. It had an acidic smell while it cooked like canned tomatoes but I just crossed my fingers and it turned out amazing! It was the most delicious pasta I've had and so easy! I couldn't find artisan pasta that was thin so used parpadelle instead. This was my first time eating egg pasta, I usually get whole wheat and it was love at first bite!


text:
Stop lifting heavy tanks of water. Using ths Drain Adapter Kit, you can easily empty water from your Shop-Vac wet/dry vac without lifting the tank! Just attach the kit to your Shop-Vac's tank drain and then a garden hose (not included) to the adapter.
Fits all Shop-Vac wet/dry vacs that have a tank drain. The kit attaches to the tank drain opening, and the garden hose (not included) attaches to the adapter.


text:
graphic novel
This project received 21 bids from talented freelancers with an average bid price of $4508 USD.Get free quotes for a project like this
Skills Required
Project Budget$750 - $1500 USD
Total Bids21
Project Description
seeking illustrator for graphic novel project, 120 pages. Style I'm interested in is [google Chris Ehnot]. Interested in collaboration with someone passionate about having work out, or agreed upon fee is paid.
Looking to make some money?
- Set your budget and the timeframe
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text:
HourlyLess than 30 hrs/week
Start DateApril 10, 2013
We are looking for experienced DIY'ers who can answer questions related to DIY projects, auto repairs, home repairs, construction, appliances repair etc. All topics or some of them.
We are having a lot of questions posted on our website in those subjects, and we need experienced people to help answering them. Most questions are originated from the US, so a high level of english writing skill is required. I would estimate the work load to be around 2 hours a day (12 hours a week).
Contractors would be bonused if found doing their work to our users satisfaction.
Please only contact us if you have experience in those subjects and write english well. Candidates would be required to answer several questions so we can evaluate their level.
Best and thanks,
Skills: english
Activity on this Job
Last Viewed by Client: 3 years ago
Hired: 1
About the Client
Tel Aviv 06:56 AM
Jobs Posted
66% Hire Rate, 1 Open Job
Over $50,000
Total Spent
53 Hires, 8 Active
Avg Hourly Rate Paid
13,265 Hours


text:
Click here for the Prince George Public Library website
A municipal library is to be managed by a library board. The members of the library board and their successors in office are a corporation with the powers and duties given in the Library Act. Library Board members are appointees of City Council and operate under provincial legislation as detailed on the Public Library Services website.
Recruitment for the Prince George Public Library Board is currently closed. Please review the Committees main page for information on current volunteer opportunities with Council Committees.
Application Packages for the Prince George Public Library Board are available here
Applicants are asked not to submit applications until both of the following steps are complete.
All applicants are required to undergo an RCMP Criminal Record Check as part of the Library Board appointment process. To request a Criminal Record Check, applicants may:
2. Complete the Volunteer Application Form
Pursuant to Section 5 (2) (a) of the Library Act, all applicants to the Prince George Public Library Board must be residents or electors of the City of Prince George.
The Act also states that all appointments are for terms of two (2) years, and that no member may serve on the Library Board for more than 8 consecutive years.
In addition to completing a Library Board Application Form, all applicants should attach additional relevant materials (resume, curriculum vitae, and supporting material) to the application form, and a covering letter outlining your reasons for applying and potential contributions to the Prince George Public Library Board of Trustees.
Note: Supporting documentation (i.e. resume/CV and cover letter) must be submitted with all applications regardless of whether you are a new applicant, returning applicant or existing board or council committee member.
For further information or to have an application package mailed to you, please call 250.561.7602 or email firstname.lastname@example.com
Confidentiality Notice: The personal information requested on this form is collected for the purpose of considering applications for appointments to City boards, committees and commissions. Personal information contained on this form is collected under the authority of and in accordance with the Freedom of Information and Protection of Privacy Act. Applications and associated documentation will be forwarded to Council in their entirety for inclusion on a Council agenda and may become part of a public record.
All reports linked below are in PDF format.
These minutes are posted here for your convenience only and are not legal versions. The legal versions are available from Administration at City Hall, 1100 Patricia Blvd., Prince George, BC. All minutes linked below are in PDF format.


text:
Call for Papers: What Is Art Good For? The Role of Literature and the Arts in Contemporary Society
International Conference
26-29 June 2015
Faculty of Letters, University of Suceava, Romania
The Modernist Literature and Economic Theory collective based at the English Department, University of Suceava invites contributions for a conference focusing on the role of literature and the arts in today's world in relation to religion, the economic crisis, activism, terrorism, public impact, personal value, and economic value and production. The scope of presentations is broadly inclusive: proposals for papers on the role of literature and art of any period will be considered as long as they address one or more of the following topics:
- Art as a Form of Religious Experience: is the artist a priest of the imagination?
- Art and Economic Materialism: can art help us to overcome the economic crisis?
- Art and Social Change: is the activist an artist (in women's rights organisations, environmental protection organisations, Greenpeace, etc.)?
- Art and Violence: does art play a role in terrorism, mass-murders, or war?
- 'Words never ground a grain of corn': Is art useful for material production?
- Can Art Be Quantified in Material Terms?
- Art and the Urban Distribution of the Self: Is architecture a reiteration of a mirrored reader?
- Buildings as Texts: How can we draw an artistic identity in an urban co(n)text?
- Consuming Cities: Mechanical gestures of consumerist acting (tourism, shopping, promenade, etc.) re-produced within literature.
The deadline for abstract submissions is 15 March 2015.
The deadline for conference fee payments is 31 March 2015. Once your abstract is accepted you will receive an email with payment instructions. Unfortunately the University does not have an online payments system, but payments can be made by bank order to a specified account.
Participation fee: 45 Euro; includes: tea/coffee breaks, reception, dinner, and festive dinner
Accommodation is available in a wide range of local hotels. We recommend Villa Alice or Daily Plaza . Rooms in Student Halls are available at the rate of 12 EUR/person/night (double occupancy) or 24 EUR/person/ night (single occupancy).
Updates and a final conference schedule due to be decided by the end of April 2015 shall be published here.


text:
Fractal Circus
User Stats
Profile Images
User Bio
Hi, we're Fractal Circus! A Philadelphia production company that loves making awesome videos for people of all shapes, sizes, ages, and everything in between. Check out all our videos and tell us how much you love them! We'll be adding more and more frequently so keeps your eyes peeled.


text:
NEW YORK (AP) - AL Rookie of the Year Carlos Beltran was suspended without pay Thursday by the Kansas City Royals for refusing to report to the team's Florida training complex for rehabilitation.
The players' association immediately promised to file a grievance Friday and a default notice if the 23-year-old center fielder doesn't receive his full paycheck on Aug. 15.
If the Royals don't pay Beltran and arbitrator Shyam Das rules in the union's favor, Beltran could become a free agent.
"The team is saying when you are injured in the line of duty for the Kansas City Royals, you can no longer be with your major league teammates but go to some outside colony," said Beltran's agent, Scott Boras.
"The best trainers the Royals have are in the big leagues. The old Royals didn't do this. The (manager) Tony Muser Royals have set up a policy that if you are injured, you are prevented from being with your teammates and you're prevented from being with the major league team."
The team cited a provision in each player's contract citing its right to determine where he's treated. The Royals said the suspension would last for 30 days or until Beltran reports to its Haines City, Fla., training camp, whichever is earlier.
"This is an assignment to the minor leagues," union lawyer Michael Weiner said, "and you can't assign a player on the disabled list to the minor leagues other than a rehabilitation assignment, and he can't be put on a rehabilitation assignment without his consent."
Beltran has been on the disabled list with a bruised right knee since July 5. The Royals said their team physician, Dr. Steve Joyce, recommended a rehabilitation at Haines City.
Beltran makes $350,000 this season and each day of the suspension his would cost him $1,923. He is hitting .247 this year with six homers, 32 RBIs and 10 steals in 10 attempts.
Last year, Beltran batted .293 with 22 homers, 108 RBIs, 112 runs and 27 steals in 35 attempts. He became the third Kansas City player voted Rookie of the Year, following Lou Piniella in 1969 and Bob Hamelin in 1994.
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Bumping an old thread, sorry. Using a Motorola amp now but having issues with my upstream power is too high on my cable modem (56 or 57). Any ideas?
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There could be too much splitter loss in the distribution system. You're compensating for it in the forward path by using that Motorola, but the return path doesn't get touched (amplification-wise, anyway). If possible, configure your system so that the first thing cable sees when it comes in is a 2-way splitter, with one leg going to your cable modem and the other leg going to your amp. From your amp to the TV distribution system.
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Return path is generally in the 5MHZ to 42MHZ range so attenuation from the coax it's self is generally not a factor , 1dB or less of loss per 100ft in RG6 or RG11. So you are either having to transmit through too much splitter attenuation, or if your amp doesn't have an active return path you will get a high attenuation through that. And there may be a line problem that requires a technician.
post #34 of 37 Old 03-27-2014, 06:55 PM
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The fact that you're using an amp at all points to there probably being a problem unless you have dozens of outlets. I have 14dB of splitters between my HDHR Prime tuners and the pole and I'm still seeing around -10dB. 14dB is approximately the loss you'd see through a 16 way splitter.
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Geez, Where do i begin. I have 7 TV's. I have Verizon Fios coming into the house which goes to a signal booster (SV-A15PRS), then to a 1x8 splitter. so, the signal is boosted before the splitter. 6 output ports go directly to 6 TV's and all work fine. The 7th port goes to my Ceton Infinitv Eth6. This is a network tuner which connects to my home theater pc via gigabit ethernet. my issue: 10% of the time my HTPC does not get enough signal and drops the recording (infuriates my wife!). i read in a different place that this was solved by putting an amplifier literally right in front of the Ceton Infinitv Eth6. So, my idea is the following. buy a 1x4 signal amplifier, toss the 1x8 splitter (gold plated mind you ), use 3 of the 4 ports and distribute the signal using 1x2 splitters (6 tv's) and the 4th port directly to the Ceton Infinitv Eth6. if this doesn't improve my problem, i'll move the SV-A15PRS to be literally right in front of the Ceton Infinitv Eth6 (like in the other post i read) think this is a good idea? and which dang amplifier do i buy? i've seen most of them on ebay and amazon but don't know which one to buy. Motorla, antroix, electroline, Holland, etc?
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Throwing a second amp at your problem probably won't help. Modern CATV design should allow up to 8 outlets without an amp. In your case it's probably worth having Verizon in to get it straightened out. I don't know if the Ceton has diagnostic info available. My HDHomeRun has a webpage that shows me levels and signal quality. If Ceton does that's a useful tool to help troubleshoot your problem. Have you tried the Ceton at one of the other outlet locations? Have you tried bypassing the splitter?
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Illinois Public Media News
In-depth reporting from WILL, NPR, the Associated Press, and other sources
Contact WILL News at email@example.com
August 09, 2013
(David Goldman/AP)
August 08, 2013
Can Congress Figure Out How To Rescue The Post Office?
(Amanda Vinicky/IPR)
August 08, 2013
Former Illinois Department of Public Health Chief Of Staff Indicted
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Billy Keane: Making up is hard to do but Delaney and Keane did it for Ireland's good
Published 18/11/2013 | 02:00
It was only a matter of time before Yahweh asked me to do him a turn. I have been in waiting. For a sign. It wasn't in any way as dramatic like as in a burning bush or a plague of locusts.
What with all the sense I've been making here every Monday, it was only matter of time before I became a vessel. That's how all prophets start out and technically, in a parable sort of way, I have also performed a miracle this very weekend, which goes to show I am indeed the chosen one.
The miracle occurred on Saturday in the bar where I work as a missionary, helping people with their problems and giving advice and refreshments for a modest fee.
The lady who asked me for the bottle of sparkling Kerry Spring was a messenger too, even though she didn't know she was as a messenger. I was just pouring the bottle of the lovely sparkling water when she called out: "Can you swap that fizzy water for a red wine?"
My policy is the customer is always wrong. Think about it. If the customer is right, she's right and if she's wrong, she's wrong.
What was I to do? Pour the water back into the bottle and sell as it as pre-owned to the next punter? It was then her words hit home. The sign. I should have got it straight away.
You become addled as a barman from listening to all kinds of shite. That's why so many of us turn to the drink. I read somewhere about some report that says doctors and dentists have the highest rate of alcoholism. Beats me, that stat. The dentists' customers can't talk, what with stuff like mirrors, drills and cement being stuck in their mouths most of the time. We have to listen to some desperate drivel, which is why so many of us take to the booze.
Now, we have to say unequivocally that 99pc of our clients are wonderfully entertaining, and it has always been the case that we have the best-looking women in Ireland coming into the pub, as well as fine men with minds like Einstein, but the one bore can wreck your head. There's no escape. You can't get the nurse to say 'next, please' like the doctors do. I call it repeat business when the same old story gets told time after time after time.
I was a bit cranky on Saturday night. I put it down to the full moon. I don't be well on nights of the full moon. If the full moon can pull the tides of huge oceans hither and thither, what does it do to the fluid in our brains? Normally, I would take my beating and drink the water myself as it's good for you. I was going to ask her for the price of it but then I recognised the handy maiden was merely a conduit for a greater power.
So it was that the prophet performed his second miracle. The first? Keeping a pub open in the worst recession ever.
The miracle wasn't as dramatic as the wedding feast of Cana, but I did change her water into wine. Now around here Keane is often pronounced Kane. Cana and Kane are much the same name. Obviously Cana was the land of Kane just as Kenya was the land of Keane. The signs are everywhere if you know where to look.
I was instructed to kill a fatted calf. Not in so many words. It was more of a feeling. I tried everywhere for a fatted calf. There are few, if any, calves born this time of the year. And anyway, how would we fit the calf into an oven that can only just about take a big turkey. It gives me all I can do to take a cooked chicken out of the silver lined bag. That's just a logistical thing anyway. It can be sorted. Like feeding all the people fish sandwiches at the Sea of Galilee. Visionaries leave details to functionaries.
The fatted calf will be killed for Keano. For Roy. My estranged cousin. He's come home at last and all is forgiven. I always felt he was wrong to leave Saipan, but he was young and it was a long time ago.
It will be a low-key affair. A family sit down. I'm pretty sure Roy is a cousin. I have no definite proof, but you sort of know, don't you? The skills, the power, the brooding good looks and the temper. John Delaney, with whom I have broken bread on many occasions, says we should draw a line under the past. He is so right. Martin O'Neill is an inspired choice as manager. The two will have us playing with fire and skill. Not that Trap was a bad boss. He was marvellously honest and got us to the Euro finals. But for Thierry Henri's cheating in Paris, we would have been at a World Cup when his team were still in their prime.
The making up by Delaney and Keane for the good of the country is an example to all of us who are stuck in the morass of the past. Too many of us are black with family and friends. How many brothers and sisters, best friends, husbands and wives have fallen out forever over issues that can be sorted out over a chat and a little bit of love and forgiveness. Then someone dies and it's too late to make the peace.
So it is, in the words of the prophet, that in the year of Our Lord 2013, the making up endeth the falling out.
Irish Independent


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"I pledge allegiance to the flag of the United States of America and to the republic for which it stands, one nation, under God, with Liberty and Justice for all. (Unless it might offend somebody.)"
Last Thursday a three-judge panel of the famously liberal 9th U.S. Circuit Court of Appeals ruled unanimously that administrators at Live Oak High School in the town of Morgan Hill, south of San Francisco, acted properly when five students wearing T-shirts that displayed the U.S. flag were ordered to take them off, wear them inside out, or go home.
The incident occurred nearly four years ago, on "Cinco de Mayo," a holiday celebrated in Mexico in observance of a 19th century victory over an occupying French army. That it took so long for this case to be heard on appeal says something about how overworked the federal court system is. Or, more likely, how inefficiently it performs its stated duty.
Lawyers representing students offended by the school's action want a hearing before the entire 11-member Court. If the panel's ruling is upheld, they plan to take their case to the U.S. Supreme Court.
One of the lawyers in the case, William Becker, said, "It's pretty incredible that the First Amendment rights of students to express their patriotic views has to take the backseat to the rights of students who want to celebrate another nation."
The student body at Live Oak High School is reportedly about 40 percent Hispanic. School administrators said there had been near altercations between rival gangs and that to forestall possible violence it was considered necessary not to offend Hispanic students by displaying the U.S. flag on Cinco de Mayo.
Judge Margaret McKeown, a member of the 9th Circuit panel, wrote that "given the history of prior events at the school, including an altercation on campus, it was reasonable for school officials to proceed as though the threat of a potentially violent disturbance was real."
It apparently didn't occur to school officials or the 9th Circuit that in the face of a "potentially violent disturbance" less radical measures might have been taken to forestall it, rather than the absurdity of forbidding display of the U.S. flag at an American school on a Mexican holiday.
Was there no authority the school could have appealed to? No extra security available to prevent the outbreak of a "potentially violent disturbance"?
For now, the law has come down on the side of those who would answer "no" to the foregoing.
But as Charles Dickens' Mr. Bumble said, "If the law supposes that, the law is a ass - a idiot."
As, unfortunately, it frequently is in the increasingly supine bureaucracies running, into the ground, the nation's schools and courts.


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Jonathon Blum D MIN 1 year ago
Blum was recalled from AHL Iowa on Tuesday, Michael Russo of the Minneapolis Tribune reports.
With the AHL club's season coming to a close over the previous weekend, Blum will be one of 11 players to join the Wild during their playoff run. Blum previously appeared in four games with the Wild during the regular season, but likely won't be anything more than a practice player during the postseason.
Jonathon Blum D MIN 2 years ago
Blum has been assigned to AHL Iowa.
Blum, who recorded one assist in three games during his latest stint with the Wild, heads back to Iowa, where he has tallied 16 points in 29 AHL games to date.
Jonathon Blum D MIN 2 years ago
The Wild recalled Blum from AHL Iowa Thursday.
Blum will provide some depth on the blue line until either Marco Scandella (head) or Nate Prosser (illness) is able to resume playing. Blum has tallied four goals and 12 assists in 29 games with Iowa this season.
Jonathon Blum D MIN 2 years ago
Blum was reassigned to AHL Iowa on Wednesday, Michael Russo of the Minneapolis Star Tribune reports.
Blum was recalled Nov. 1 following a shoulder injury that send Jared Spurgeon to injured reserve. He played in one game with the Wild over the span, finishing with a minus-one rating, a shot on goal and two minutes in the penalty box.
Jonathon Blum D MIN 2 years ago
Blum was recalled from AHL Iowa on Saturday, Michael Russo of the Minneapolis Star Tribune reports.
Blum will serve as an extra defenseman with the Wild as insurance in the event Jonas Brodin (general soreness) is unable to play Saturday against the Stars. The 25-year-old has tallied a goal and four assists in seven games for Iowa.
Jonathon Blum D MIN 2 years ago
Blum was assigned to AHL Iowa on Friday, Chad Graff of the St. Paul Pioneer Press reports.
Blum was recalled by the Wild on Wednesday after the team waived him early in the week, but that was only to provide an extra body on defense for Thursday's preseason loss to the Blues. He's expected to remain at the AHL level for the bulk of the campaign.
Jonathon Blum D MIN 2 years ago
Blum was recalled from AHL Iowa on Wednesday, Michael Russo of the Minneapolis Star Tribune reports.
Blum was among three players the team placed on waivers earlier in the week, but he'll return to provide depth for Thursday's preseason game against the Blues. Chances are, Blum will head right back down afterward, but he did play in 15 games with Minnesota last season and figures to get another chance at some point in 2014-15.
Jonathon Blum D MIN 2 years ago
Blum is one of three players the Wild have placed on waivers.
Blum being reassigned is a bit of a surprise as many had penciled him into the seventh d-man spot for the Wild. It'd be a surprise if he didn't find his way to St. Paul at some point this season though, it's just not clear if he'll be able to make it stick. For fantasy, it's probably best to steer clear of the previously touted defenseman.
Jonathon Blum D MIN 2 years ago
The Minnesota Wild has agreed to terms with defenseman Jonathon Blum on a one-year contract.
Blum, 25, recorded one assist in 15 games with Minnesota last season and tallied 29 points (7-22=29) in 54 contests with the Iowa Wild in the American Hockey League (AHL). He was named Iowa's Man of the Year for his outstanding contributions to the Des Moines community during the 2013-14 season. The 6-foot-1, 188-pound native of Long Beach, Calif., has notched 23 points (7-16=23) and 20 PIM in 106 career NHL matches with the Nashville Predators and Minnesota. Blum has produced 142 points (30-112=142) and 127 PIM in 290 career AHL contests. He was selected by Nashville in the first-round (23rd overall) of the 2007 NHL Entry Draft.
Jonathon Blum D MIN 3 years ago
The Minnesota Wild brought up Jonathon Blum.
He was called up after Clayton Stoner was injured in Saturday's loss to Detroit. Blum has skated in four games with the Wild this season.


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The Cherry Tree3
33 High Street , Steventon,, Oxford, OX13 6RZ
Price FromView Rooms
- Very Good
- 24 guest reviews
"Friendly service, clean room with everything you need for a short stay, reasonably priced and superb food. What more could you ask for. Will..."
"The Cherry Tree is a lovely inn, housed in a beautiful old building in a pleasant village. The room we booked was spacious, clean and comfor..."
"very friendly welcome, excellent room, good selection of real ales and quality food..."
"Food was good, staff were friendly and the room was nice, expect for ceilings being really low, and it was right next to quite a busy road,..."
"The Cherry Tree is extremely welcoming and comfortable, with excellent food and service. We met the Managers who were friendly and chatty. T..."
About the hotel
Whether you are popping in for a quiet drink, a great lunch or looking for somewhere to stay, The Cherry Tree offers a warm, homely welcome. A superb place to spend your time whilst in the Medieval village of Steventon. The Cherry Tree is a beautiful 18th Century building and is still run as a traditional village pub, serving as the heart of its community.
The low ceilings, oak beams and 3 open fireplaces are cosy in the winter whilst the large courtyard with giant umbrellas and heaters are perfect for those warm summer evenings. We are well known in the village and surrounding areas for our diverse selection of real ales, featuring 6 full time Wadworth brews and a further rotating guest ales. Come and join our regulars for a relaxing drink or bite to eat, or for a more lively visit pop along to our ever popular pub quiz each Monday night. The Cherry Tree is also a B&B and has 7 comfortable en-suite bedrooms, convenient for The Milton Business Park or Harwell Science Park
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- Car parking available onsite , Airport Shuttle
- Business
- Meeting Facilities , Wi-Fi Available In Public Areas
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- Restaurant , Bar
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- From 15:00 hours
- Until 10:00 hours
- The price shown is based on the occupancy and dates you have searched for. Prices and availability are subject to change based on the arrival date, number of nights and occupancy searched for. All prices are inclusive of all local taxes.
- Pets are not allowed
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Very Good
92% would recommend it to a friend
Customer service
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Cherry Tree
It was difficult to know where to go to check in on arrival, as there were no signs or available staff.
The bathroom was not up to standard as the toilet seat was broken; the sink plug hole was broken; and the shower did not drain away effectively, resulting in you standing in water for most of the shower. The bedroom itself was comfortable. There was a considerable amount of noise from the patrons in the bar and from the nearby A34, and as it was hot weather the need for open windows meant that this noise level could not be reduced. Finally, the staff were helpful, but we considered the place to be understaffed, as whenever we wanted someone we had to look for a member of staff, rather than being able to ring for attention or easily see someone available.
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Lovely Stay
Friendly service, clean room with everything you need for a short stay, reasonably priced and superb food.
What more could you ask for. Will definitely be returning.
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14 years of experience
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Medstar Georgetown University Hospital
3800 Reservoir Rd NW
Washington, DC 20007 Phone number & directions
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Was a patient of his for 6 months. First visit was okay but after that his bedside manner, amount of time that he spent with me, etc. all went down hill. Did not feel like this Dr cared at all about me as a patient or even wanted to help me out. If I called his office because I needed his attention or had a question he would take days to get back to me (by the way he told me to call when I had trouble but I am not sure why because it was obvious he was not going to help out). In general, my experience with this Dr and clinic have been negligible. Unfortunate for us who live in Yakima that this is our only option. Even though I am very sick if I want to receive care deserving of any patient I am probably going to have go out of town to get it.
Respect his professional opinion and value him as a doctor. Couldn't ask for a better person than him to help in healthcare.


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IDF Jeep Hit, Soldiers Injured, IDF Hits Back at Gaza City (Updated)
The IDF reports is reporting that Gazans hit an IDF jeep that was patrolling along the Gaza border with an anti-tank missile on Saturday night. The jeep went up in flames. Four IDF soldiers were injured in the attack.
In response, Israel launched either artillery or tank fire at the Zeitun neighborhood in Gaza City.
Palestinians medical sources are reporting 20 injured, and 3 dead, but it is not clear how reliable their reports are, as different Gazans organizations have been the reporting exaggerated numbers of dead and injured.
Abu Ahmad, the spokesman for Islamic Jihad threatens escalation within hours.
There has been a serious escalation in Gazan attacks against the IDF over the past few weeks.Jewish Press News Briefs
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Two similar minds come together, two personalities and two different professional experiences with one unique and precise entrepreneurial idea. And that is how was born Vetreria Bazzanese.
The founding partners, were able to transform a small artisanal workshop into one of the most important flat glass working companies in Italy. It has undergone constant evolution, which only a great passion for this sublime material could have made possible. It is so much more than a job: a real mission for glass art and quality
The main value of VB Vetreria Bazzanese is customer satisfaction . Our staff follows a rigorous and precise procedure for each client, whether it is a company or a private customer.
The observance of delivery dates is another essential value that makes the company credible and serious in the eyes of the market and a guarantee for the customer.
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There is an underlying thought that drives us, an essential leitmotiv: to satisfy each and every client. Whether it is a large company or a private customer, their satisfaction has always been our goal.


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