text:
Michelle opened her eyes. She felt more rested than she had in a long time. Still dizzy from deep sleep, she frowned, recognizing the ceiling but not able to place it. She glanced around the room, surprised to find it wasn't her own bedroom.
"Mom?" she whispered.
As if in a daze, Michelle folded back the covers and slid out of her mother's bed. She found she was wearing her own pyjamas. Without warning, the memory of her nightmare flooded her mind and she almost fainted from the pain it caused.
Michelle ran out of the room to find her mother eating toast in the kitchen. "Where is he?" Michelle wanted to grip her mother's thin shoulders and shake her.
Her mother stood. "Calm down, Michelle. Brendan is fine. The police found him two blocks from the house. They think he was being chased by a dog when he tripped and hit his head on the sidewalk, falling unconscious. He doesn't remember it happening. He has a concussion and a few scrapes and bruises, but he is just fine."
Michelle slumped into a chair, numbly. "Where is he now?"
"The hospital wanted to keep him overnight."
"For a concussion?"
"Just a precaution, dear."
"Is he there alone? Why aren't you with him?" Michelle's voice shook.
"Your father is with him. Have some breakfast Michelle, you look exhausted."
Too numb to argue, Michelle found a box of cereal and a spoon. Her mother produced a bowl from the cupboard. Michelle's mind immediately flew to the strange letter. Had that really happened?
"Michelle, I think I should look after Brendan for a while."
Michelle snapped out of her daydream. "What? No. Mom, no. I'm fine."
"You are not fine."
"I promise, I will never let him leave my sight again."
"You had a severe nervous breakdown."
"Mom, don't do this to me. You can't take him away."
"You are too busy mourning for Sarah to see what you are doing to your son."
"I'm doing the best that I can. Brendan-"
"She's gone, Michelle. Grieve as long as you need to, but you have to get some closure. She's not coming back."
Michelle had no words. They had had this argument before and there was nothing new to say. Silence descended on the kitchen, tension thick in the air. She could see the picture of her daughter in her mind, Sarah's blue eyes gazing into the distance. She was alive. She was coming back.
Michelle stood and left the kitchen.
"Where are you going?"
"I'm going to pick up my son." Michelle took the car keys from their usual place on the hook.
"If Brendan is taken away by Child and Family Services, he might as well be kidnapped too." Her mother's voice was loud and harsh.
That stopped Michelle in her tracks. Her mom stood and put her arm around Michelle, whispering in her ear. "You have gone through things that no mother should ever have to face. You can't do this on your own. I can't just stand back and let you. We are going to push through this together. My friend knows an excellent psychiatrist-"
Michelle shrugged out of the embrace. "I don't need a shrink to tell me what's wrong. My daughter has been gone for three years," her voice shook with fury. "That is what's wrong. No amount of psychoanalysis will bring her back."
Her mother opened her mouth to speak, but Michelle wasn't finished. "I know everybody thinks she's dead. I know and I don't care because you're all wrong! My daughter is alive. She is ten years old and her nose looks just like Karl's and I have a picture to prove it. So take good care of my son, Mom, because I want him to still be here when I bring her home." Michelle's voice broke on the last word. She would have left and slammed the door behind her, but realised in time that she was still wearing pyjamas. She meekly dropped the car keys onto the counter.
Her mother, having no more argument to make, put the dishes in the sink and found a sweater. Michelle just stood there, staring at the floor, dumbly. Being with her mom always made her feel young and foolish and she hated it.
"Well, you are welcome to stay here as long as you need to. Your clothes," her mother picked up the keys as she spoke, "and other items are in a bag on the sofa. I'll be back in an hour."
She took one last mournful glance at her daughter before she shut the door behind her. They both knew that Michelle would not be there when she got back.


text:
Tunbridge Wells firm Cripps Harries Hall has overhauled its longstanding compulsory sabbatical scheme for partners, which has proved both popular and divisive.
Since the sabbatical policy was introduced in the mid-1970s, every equity partner has taken three months off work for every 10 years of service at the firm.
The time periods have now been reduced, meaning equity partners will only have to take off six weeks every five years.
The idea of the scheme was originally to give partners time to recharge and to encourage teamwork by showing that life at the firm goes on, even without the partner, explained Cripps managing partner Jonathan Denny.
However, there grew a feeling within the partnership that being forced to take three months off at a stretch could have a negative impact on clients and make returning to work increasingly difficult.
Shorter but more frequent enforced breaks were felt to be more beneficial.
A similar scheme currently also exists for salaried partners, associates and heads of support groups, who take six weeks out every 10 years.

subset: commoncrawl


text:
Who Let the Dog In? ´2015
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- Genres: Comedy
- Duration: 30 min
- Country: USA
- Writers: Cedric the Entertainer, Suzanne Martin
- Stars: Cedric the Entertainer , John Beasley , Niecy Nash , Wesley Jonathan
When Nikki brings a dog to the office, Boyce feels she is undermining his authority. Barton's regular barbershop goes out of business so he makes Lolli's salon his new hangout. Stamps' new job isn't as much fun as it sounds.
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text:
From Fan History Wiki
- AdultFanFiction.Net
- FanDomination.Net
- FanFiction.Net
- FanWorks.Org
- FicWad
FanWorks.Org is an archive that hosts fan- as well as original fiction.
The Archivists
This section needs more information.
Archive Policies
This section needs more information.
Archive History
In May 2007, the site had problems with plagiarism associated with the Panic! At the Disco fandom.
Archive Coding
The site is custom coded, using closed source code. As a result, they've never been hacked.
Archive Funding
The site is hosted for free by another fansite who wanted to have a fan fiction archive on their server. As such, Joe does not have to pay for costs associated with the server space and bandwidth.
Legal Issues
The site has never recieved a legal threat. They were warned by one professional author's family that they would be sued if they ever added a category based on the author.
External Links
See also
Below is a partial list of articles and academic sources to help you continue to learn about this fan fiction archive.
This section needs more information.


text:
- Magazine
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Wickham Laboratories Limited
Hoeford Point
Barwell Lane
Hampshire PO13 0AU
United Kingdom
Tel: +44 01329 226600
Website: http://www.wickhamlabs.co.uk
Email: [email protected]
Microbiology & Toxicology Testing Expertise
As a GMP/GLP compliant laboratory with over 50 years of global experience, Wickham Laboratories Ltd is an established name in the fields of pharmaceutical and medical device testing, research and consultancy. We conduct business with clients worldwide and the combined expertise of our laboratory technicians and managers enables us to be fully conversant with global regulatory expectations.
We are committed to providing a quality testing service, combining high levels of client satisfaction together with the maintenance of appropriate accreditation. This and the continual pursuit of delivering excellence remain central to our business. We are routinely inspected by the MHRA, FDA and Home Office, and regularly host client audits.
We are a distinctive company, with customer relationship skills that set us apart. Whether we are assisting a start-up company demonstrating proof of concept, or working with a global pharmaceutical client, we recognise the importance of understanding individual client requirements. We provide rapid turnaround for both routine testing and projects, while maintaining our high standards of quality at all stages.
Our Pharmaceutical and Medical Device Testing Services include:
- Abnormal toxicity testing
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- Microbial identification, both traditional and rapid methods (MALDI-ToF)
- Microbial Ingress Testing
- Monocyte Activation Test (in vitro pyrogenicity assessment)
- Preservative efficacy and log reduction testing
- Rabbit pyrogen testing
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For more information about Wickham Laboratories Limited and our services, visit our website or please contact us directly at +44 (0)1329 226600 / [email protected].
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- Wickham Laboratories announces upcoming webinar on microbial limits testing
- Wickham Laboratories Announces Renewal of FDA Accreditation
- Wickham Labs to Exhibit at Pharmig 2016
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- Wickham Laboratories case study on the bioburden of the new £5 polymer note
- Wickham Labs to exhibit at Making Pharmaceuticals 2017
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- Wickham Labs to exhibit at Making Pharmaceuticals 2017
- Wickham Laboratories announces upcoming webinar on In-Vitro Alternatives


text:
Cash-rich Portsmouth have already lodged one bid for the 36-year-old although as yet the Fratton Park outfit have yet to meet City's valuation.
However, James, whose fiance lives in the south of England, has told Pearce he would like to go. "David James has expressed a wish to leave," said Pearce.
"It all depends on whether Portsmouth reach our valuation but in some ways I have to be prepared for the fact he will leave," he added.
"I spoke with him when we were away in China. It is not an issue about Manchester City, there are other reasons why he wants to be in the south."
James is about to enter the final year of his contract and City are thought to be unwilling to match the three-year deal Portsmouth are thought to be offering.
Pearce has already been heavily linked with Rennes' Swedish keeper Andreas Isaksson, and he confirmed a replacement would be required if James were to go.
The City boss also admitted Ajax defender Hatem Trabelsi was in the final stages of his medical and the Tunisian could sign..
"He has a couple of medical tests still remaining but we should have permanent news on him later on," said Pearce.Reuse content


text:
Luxury Sydney Apartment with Sea Views
お部屋の大きさ0 m²
Floor No.7(with elevator)
- キッチン
- テレビ
- プール
- 建物内にエレベーター有り
- タオル
Accommodation summary
This property accepts bookings starting within the next 180 Days.
Located on the top level of the security building 'Oxford Towers' this elegantly renovated, fully furnished apartment has been designed to reflect the functionality and charm of Paris living. Far reaching views across the district to the harbour, natural light and an ultra-convenient Paddington address characterise this 7th floor studio apartment.
With a wide open outlook and enviable northern aspect this studio boasts a separate kitchen, Murphy queen bed, built-in robes, bathroom with shower. There is a communal laundry in the basement. Enjoy the rooftop terrace with pool ideal for relaxed barbecues.
The building has secure access and a security intercom system. The apartment is accessed by a lift and is only footsteps from bus transport, cafés and designer boutiques. Minutes to Centennial Parklands and the Entertainment Quarter. The bus routes take you to the city, Bondi Junction and Bondi Beach.
ハウスルールAll bookings & tenancies incur a departure cleaning fee of $132
Please note that there is a minimum booking period from 23rd December to 2nd January. We cannot accept bookings with arrival or departure inside these dates.
|Check-in before
Fabulous apartment, very spacious and clean, with a gorgeous view of the bridge and cityscape, lovely little touches by the host made us feel at home, very secure building and parking made all the difference I will definitely be booking this apartment again in the future
Appartment is very good located and has space enough for 4 to 5 people (one bedroom for adults, the other bedroom rather for 2-3 kids). Great is tennis-court and pool on the rooftop with amazing few.
The price was rather high and for this, in our opinion all details shoud be perfect (like dishwashing machine must work correctly, all lights should work, no broken chairs).
Very nice spacious apartment with a fantastic view of Sydney. Great location. We really enjoyed our stay.
We stayed at the apartment in April 2015 (2 adults and 2 children) and found it to be excellent. Great location (handy to transport and also easy to walk into town and around), great facilities, spacious, very comfortable and very clean and tidy. The one negative was dealing with Peter and his office staff. When asking for clarification or assistance, they were very defensive and their general communication was not great. Once they sort that out, I would have no hesitation in recommending the apartment as a great place to stay.
A perfect apartment with a perfect location.
The location is very good. you can walk to most sightseeging points. But the appartment is very small ald old.
when we arrived the phone lay down on the floor amd the kitchen was dirty. the room is also very dark there is no possibilitiy for sunlight to come in. so you dont est at home because its really not nice. There is no possibilty for wireless. Also the owner wasn't really kind. we ask if you could check out a little bit later or if could
place our
baggage somewere. they just wrote back: "no", like in alot other situation. for that the price is really to hight also the cleaningfee of AUD 130 is way to
much for that little room.
The stay was comfortable & the location was very convenient. Thanks Peter :)
The apartment is in a good position, near the metro station, on bus routes, just a few minutes walk from Circular Quay, Darling Harbour, The Botanic Gardens and Central Station. Comfortable and well equipped though a bit dated. The weather was cold and the heating took a long time to warm the apartment up. The weather also meant we weren't able to take advantage of the large balcony. During our stay the hotel pool area was being refurbished but I'm sure it will be a great asset. There was nowhere to leave luggage after checking out, the hotel staff were friendly but we weren't treated as guests. There is a Thai restaurant on the ground floor which was very good.
The host cancelled the booking, this review is automated.
Communication was fine but didn't confirm until the last minute that we could collect the key at the apartment. To be honest if you want to do this, which I would recommend, then sort it at time of booking as recommended. Although apartment is small you will not get a better location than this. Perfect for staying downtown and reasonably quiet and felt very safe. Overall very enjoyable stay and would stay again.
- すべてのお部屋はチェック済み
- どのホストともお電話で直接お話いただけます


text:
Picture: Joan Rivers Opening Night of the Broadway musical 'Title of Show' at the Lyceum Theatre - Arrivals New York City, USA - 17.07.08
Comedienne Joan Rivers has taken aim at Hollywood beauty Angelina Jolie - branding the sexy actress "stupid".
The outspoken funnywoman used the Tomb Raider star as the centrepiece for her gags while being interviewed on U.K. TV show GMTV.
And Rivers didn't hold back.
She told reporters, ""Well, I've worked with stupid actresses - I've worked with Angelina Jolie - she saw a sign that said 'WET FLOOR' one time, and she did!"
"I mean she's attractive, but not a bright girl. Stunningly beautiful but stupid she would have asked Stevie Wonder, 'What's your favourite colour?'"
It's not the first time Rivers has attacked celebrities on British TV - in June (08) she was asked to leave an interview on U.K. show Loose Women after she called actor Russell Crowe a "f**king s**t".
Standing three apples high, the tiny Smurfs live happily and peacefully in their medieval Smurfs...
Filmmakers Stern and Sundberg, better known for punchy political films like The Devil Came on...
Set in an absurd, patronizing fantasy world in which flag-waving citizens line the streets to...


text:
Turnbull won't be spooked by rebels
A defiant Malcolm Turnbull says he will not run scared from climate change sceptics within his party and is confident he will remain Liberal leader.
The party is in crisis after mass resignations on Wednesday in protest against Mr Turnbull's decision to back the Government's emissions trading scheme (ETS).
Speaking on ABC1's 7:30 Report last night, Mr Turnbull said the party would meet on Tuesday morning at 9:00am (AEDT) to consider a spill motion.
And the embattled leader said there was "no way" he would be stepping down.
"There is no question that I will be standing if there's a spill," he said.
"There are some people like Senator Minchin, perhaps, who would like to spook me into standing down. I won't.
"The fact is the Liberal Party has elected me leader. I believe that I will be retained or endorsed as leader, but it's up to the party room."
Mr Turnbull denies Deputy Leader Julie Bishop has asked him to quit.
"Nobody has told me to stand down - literally nobody," he said.
"We had a vote on the leadership two days ago, on Wednesay, and my leadership was confirmed."
Mr Turnbull said it was possible the Government's ETS might pass the Senate on Monday, before Tuesday's leadership meeting.
Rough ride ahead
But Liberal Senator Nick Minchin says the leadership meeting should be held on Monday morning.
And he admits the Coalition will find it difficult to move on from the leadership crisis.
""It won't be easy to recover. I wouldn't want to mislead you," he said.
"This is a difficult period for our party and for the Parliament in terms of dealing with extraordinarily far-reaching agreements."
He says the decision to vote against Mr Turnbull was an extremely difficult one.
"Nobody likes leadership changes, but this is a serious matter of policy," he said.
"For me I've been in Parliament 16 and a half years - not once have I ever found myself in a situation of crossing the floor.
"It is with a heavy heart I went to Malcolm Turnbull yesterday. I never though I'd have to do it."
Senator Minchin says having a third new leader in two years would not be a satisfactory situation, but stressed the issue was about policy rather than leadership.
And he says there are many Labor Party members who also do not support the ETS, though he declined to name them.
'Honour the agreement'
The Senate will sit on Monday but still has about 250 amendments to debate.
The Nationals and some Liberals have already said they cannot vote for the ETS.
But Deputy Prime Minister Julia Gillard has urged the Opposition to honour the agreement Mr Turnbull made with the Government.
""If they fail to honour the agreement then that will tell you that they have been conquered by the sceptics and deniers in their ranks," he said.
"Mr Turnbull has shown great courage and great determination to deliver this change in the nation's interests."
But Ms Gillard would not speculate on whether today's lengthy debate or a Coalition move to defer the legislation to a committee would give the Government a double dissolution trigger.
"We are not focused on anything other than delivering the Carbon Pollution Reduction Scheme through the Parliament," she said.
She also refused to be drawn on whether the Government would move to gag debate and bring on a vote on Monday.
Mr Turnbull has warned that if his party does not pass the scheme, it would face being wiped out at the next election.
If Mr Turnbull is deposed it is unlikely the ETS will clear the Senate this year.
Topics: climate-change, government-and-politics, federal-government, liberals, turnbull-malcolm, australia
First posted


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cape op pls nerf
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Special education encompasses a broad range of techniques and tools for a catering to children with unique educational needs. Children in need of additional learning support, including children on the autism spectrum, benefit from continued research in emerging educational tools and pedagogies for best catering to their needs. Supporting the Education of Children with Autism Spectrum Disorders focuses on a well-rounded approach to special education, including perspectives on administration and leadership, course development, psychological and counseling support, educational technologies, and classroom management strategies. Emphasizing timely research focused on creating opportune learning environments for children on the autism spectrum, this publication is an essential reference source for educators, school administrators, graduate-level students, and researchers in the field of education.
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Between the Sea and Sky
Now, years forward, our little town is drawing near. The buildings are marked with date by their materials. The first year, we did not know how to build, and the oldest are packed of pitiful earth. The newer buildings show improvement, made of bricks. The closer to shore you go, the more beautiful the buildings become.
It takes a while to walk from home to the edge of the sea, through town with its sparse bustle. A proud building stands with its toes in the sea, a beacon to outsiders. A well-chiseled sign next to the door reads, "Port House."
Inside, I find Koso, at work with pen to paper. His face and body still ripple with youth, but his eyes, hair, and heart have lost their newness. He glances up as I walk in.
"Morning, Tomas," he says, eyes back to his work. I glance at the document, upside-down from me. It's filled with numbers, a tally of our progress. There is a pause, then, "You won't be happy."
"Why?" Koso is one to get bad news over with as soon as possible, but this early in the day it must be significant.
"I saw a ship this morning. It's not far now, just around the outer rim of shore. It's good sized, too. We have to move quickly."
I sigh. The porthouse boys are delivery boys. We hold all incoming goods in storage, and periodically transport them across town, a day of hard labor to break up the days of counting and monotony. Of course, we also retrieve goods from incoming ships and place them in our storehouse. These jobs occasionally fall on the same day, meaning twice as much labor for all involved.
"Benson has already gone with the deliveries, so you and I will oversee the unloading of the ship. Actually, while I'm finishing up, why don't you go down and see how close they are."
This is not really a suggestion. I go, cinching my pants up to the ankle and letting down my pushed up sleeves. I am almost a ship myself, adjusting my sails.


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Judge Tosses Bid to Revive Reparation Suit
"CHICAGO -- An effort by slave descendants to gain reparations from corporations that allegedly benefited from slavery was dismissed Wednesday by a federal judge.
Judge Charles R. Norgle characterized the issue as basically political, and said it should be decided by the legislative or executive branch.
He added that the plaintiffs have failed to show a link between themselves and the 17 corporations named as defendants, and that the statute of limitations rules out damages for wrongs committed before slavery was abolished in 1868."
It's about time!
No Reparations - "Suit Politically Motivated"Posted by Jack Moss
Judge Tosses Bid to Revive Reparation Suit
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text: Solution for Windows 7 (32-bit, will try the same with 64-bit later) Required (I found these on the manufacturers' CD):- Driver Date: 15/05/2003 Driver Version: 1.63.515.2003 (or 1.63.0515.2003) Driver details ... WS01UPH.BIN & ZD1201U.sys Steps a) do not install the driver via supplier CD Installation program. If it's already been installed, it won't work with Wimndows 7, so uninstall it. b) insert the supplier CD, select "Open folder to view files" c) browse to the lowest-level folder that contains the actual driver (in my case it was called ...EW-7117U\WinXP. Reason? W7 doesn't (yet) seem to work properly with searching for drivers in sub-directories - or at least it didn't work for me and I spent hours on this. d) Note the name of the folder e) Start Device Manager f) in Network Adapters right-click on the problem device, then Properties g) in the Driver tab click on Update Driver h) Click on Browse my computer for driver software i) Type in the name of the folder containing the driver (...EW-7117U\WinXP) j) follow the on-screen prompts. HTH, Ray


text:
All reader reviews by Anonymous
Scoffers Kitchen
Last night I went to the restaurant with some friends and we we all loved it!
There is a tree in the conservatory which make the place very cosy and unique. The food was lovely and the service friendly and efficient. I am surprise to see that some people did not enjoy Scoffers.
I will definitely go back.
Thursday, January 26, 2006
Overall rating
Food 8 | Service 8 | Atmosphere 9 | Value for money 8


text:
Because it is handmade for you, this tank requires ï»10 Business Days before it is shipped.
Embark on a trippy journey with this colorful shroom print tank! You'll love the psychedelic hues and patterns throughout the garment.
Our all over designs are printed on ultra-soft fabric and then individually sewn together to ensure a flawless graphic and a comfortable fit.


text:
Chanel Cambon Bucket Authentic Pre Owned
Product Details
Authenticity code: Chanel 9230485This guaranteed authentic preowned Chanel Pochette Cambon is a gorgeous classic Chanel bag. It has a zip top closure and is lined with black CC interior and has one pocket. The hardware is silver and consists of the zipper and the connectors to the black leather handle.
Authentic: Pre Owned
Exterior: Gently used
Interior: Gently used
Measurements: 14.6"L x 9.8"H x 5.9"D. Handle drop: 9 (Approx.)
Product Code: 151206
All photos are of actual item being sold. This Chanel® item is guaranteed to be authentic. Chanel is a registered trademark of Chanel. LuxeDH is not affiliated with or represents Chanel in any way or form.
New Arrivals


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Two gymnasiums, caring youth programming, swimming and child care are among the reasons our community loves the New Haven YMCA Youth Center. We offer full day preschool for 3 and 4 year olds which is supported by the school readiness program and accredited by NAEYC. In addition, we have a wonderful walk-in open gym program for youth ages 12 to 23 years old that runs afterschool Monday through Friday from 2:30pm to 6:00pm. During July and August, the walk-in gym is open 1-5pm, Monday through Friday.
Our Summer Care Program runs during the week when school is out and operates right out of our own facility. With plenty of field trips, fellowship and fun, it's the place to spend summer in New Haven!
Well known for our Youth leadership programs and swim lessons for youth – at the New Haven YMCA Youth Center you can also plan swim birthday parties or swim rentals for any group function. Contact us to inquire!
Amenities at the New Haven YMCA Youth Center:
- Swimming pool
- Game room
- 2 full size gymnasiums
- 4 preschool classrooms
- School Age summer care program for youth 5-12 years old
- Open Swimming for youth
- Social and recreational opportunities year round
- Youth leadership programming and training
- Youth Community Service opportunities
How to Participate
Why do so many people feel like they belong at the Y? One reason is that no other single membership provides so many ways to exercise spirit, mind and body as the YMCA. So, whether your life is about shaping up, studying up, meeting up or growing up, it all begins with signing up at the YMCA.
We have a wonderful community of people here at the New Haven Y Youth Center! It's a positive, supportive environment where community youth can feel comfortable while pursuing the activities that interest them most.
The New Haven YMCA Youth Center is not a full facility branch. We encourage adults to explore membership opportunities at other branches in the Central Connecticut Coast YMCA family. Financial assistance is available for youth and families with a demonstrated need. Financial Assistance Application
Click here for a list of all YMCA locations that are part of the Central Connecticut Coast branch network.


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Stillbirth differences according to regions of origin: an analysis of the German perinatal database, 2004-2007
Stillbirth is a sensitive indicator for access to, and quality of health care and social services in a society. If a particular population group e.g. migrants experiences higher rates of stillbirth, this might be an indication of social deprivation or barriers to health care. This study examines differences in risk of stillbirth for women of different regions of origin compared to women from Germany in order to identify high risk groups/target groups for prevention strategies.
We used the BQS dataset routinely compiled to examine perinatal outcomes in Germany nationwide. Participation of hospitals and completeness of data has been about 98% in recent years. Data on all live births and stillbirths were obtained for the period 2004 to 2007 (N = 2,670,048). We calculated crude and stratified mortality rates as well as corresponding relative mortality risks.
A significantly elevated stillbirth rate was found for women from the Middle East and North Africa (incl. Turkey) (RR 1.34, CI 1.22-1.55). The risk was slightly attenuated for low SES. An elevated risk was also found for women from Asia (RR 1.18, CI 1.02-1.65) and from Mediterranean countries (RR 1.14, CI 0.93-1.28). No considerable differences either in use and timing of antenatal care or preterm birth and low birthweight were observed between migrant and non-migrant women. After stratification for light for gestational age, the relative risk of stillbirth for women from the Middle East/North Africa increased to 1.63 (95% CI 1.25-2.13). When adjusted for preterm births with low birthweight, women from Eastern Europe and the Middle East/North Africa experienced a 26% (43%) higher risk compared with women from Germany.
We found differences in risk of stillbirth among women from Middle East/North Africa, especially in association with low SES and low birthweight for gestational age. Our findings suggest a need for developing and evaluating socially and culturally sensitive health promotion and prevention programmes for this group. The findings should also stimulate discussion about the quality and appropriateness of antenatal and perinatal care of pregnant women and newborns with migrant backgrounds.
Although stillbirth occurs rather rarely it is one of the more devastating events in obstetrics and a sensitive indicator for the quality of health care, living conditions and inequity in a society. If a particular population group, such as migrants experiences higher rates of stillbirth than the non-migrant population, this might be an indication of social deprivation or access to health care barriers.
Migrants tend to be more vulnerable in terms of morbidity and mortality patterns compared to non-migrant populations, influenced e.g. by socioeconomic factors, barriers to prevention and health care offers, as well as migration and cultural related factors
Recent published worldwide estimates of stillbirth rates showed a decline from 22.1 stillbirths per 1000 births in 1995 to 18.9 in 2009, with the highest rates being observed in south Asia and sub-Saharan Africa
In Germany, nationwide analyses on differences in stillbirth among migrants and non-migrants are lacking. Despite a positive trend in recent decades, there are indications that infant mortality among non-Germans is still higher than among Germans,
We compared the risk of stillbirth among women of different regions of origin with that of women without migrant backgrounds. Our aim was to identify high risk groups/target groups for prevention strategies in order to reduce inequalities in stillbirth and associated factors. The present study is the first in Germany to use nationwide perinatal data for the investigation of variations in the risk of stillbirth in relation to maternal migrant background.
We used anonymous data from the nationwide perinatal database maintained by the German National Agency for Performance Measurement in Health Care [Bundesgeschäftsstelle Qualitätssicherung gGmbH (BQS), since 2010: BQS Institute for Quality and Patient Safety]. From 2001-2009, the BQS was responsible for the development and implementation of comparative quality assurance in German hospitals. For this purpose, the BQS collected basic data and quality indicators from all hospitals in Germany. Participation in the quality assurance program is compulsory for all hospitals by law. Hence, the BQS database contains complete data concerning hospital-related processes of medical and nursing care. Participation of hospitals and completeness of data was about 98% in recent years
Ethical approval was not needed for our study as we fulfilled the criteria of the "Good Practice in Secondary Data Analysis" (GPS) of the German epidemiological societies. According to this guideline we observed all data protection provisions for secondary data analysis. Only anonymised data were used. Hence a re-identification of persons was not possible and no informed consent of participants was necessary.
Quality assessment in the field of obstetrics is based on a nationally standardized electronic data entry form which contains items concerning socio-demographic data of the mother, course of current pregnancy, delivery and birth outcomes, and health of the newborn. The perinatal database includes only live births and stillbirths born in a hospital, but no spontaneous abortions and home deliveries.
The perinatal data entry form is filled in by the staff of the labour room. Pregnancy-related information is obtained from the maternity care records each mother is supposed to carry during pregnancy, and birth-related information is obtained from the hospital records. Afterwards, data is submitted electronically to the Agency for Performance Measurement in Health Care (Landesgeschäftsstelle für Qualitätssicherung [LQS]) in the federal state in which the hospital is located. The LQSs ensure anonymization and internal validation of the data and submits them to the BQS.
We obtained pregnancy and birth-related data for all live- and stillbirths during the time period 2004 to 2007 (N = 2,670,048).
The main outcome measure was the relative risk of stillbirth for women from different regions of origin compared with women without migrant backgrounds. In Germany, the definition of stillbirth is a birth without vital signs after delivery and with a birthweight of at least 500 g. Births with a birthweight of less than 500 g were excluded from the analyses. Stillbirth rate was defined as the number of stillbirths during the period from 2004 to 2007 per 1,000 live- and stillbirths during the same period. An external validation procedure with population data of the Federal Statistical Office revealed that completeness of reporting of stillbirths was about 90%. Differential recording of stillbirths is improbable because stillbirths are recorded directly after delivery.
Region of origin
In the German perinatal database, migrant background is assessed by the mother's region of origin, grouped in six bands: (1) Germany, (2) Middle and Northern Europe, North America, (3) Mediterranean countries, (4) Eastern Europe, (5) the Middle East and (6) Asia. An overview of countries in the different bands can be found in the Additional file
Additional file 1
Table S1 - Overview of countries in the different regions of origin, according to BQS Institute. This table gives an overview of countries that are included in the variable "regions of origin", according to BQS Institute.
Click here for file
Stratification factors
Socio-demographic and lifestyle-related factors
The socioeconomic status of mothers is insufficiently measured in the database. The variable "mother's occupation" was the only one available as proxy for her socioeconomic status. We classified "housewife" and "un-/skilled worker" into low SES, "low-level office worker" and "currently being a trainee/student" into middle SES and "middle/high-level office worker" into high level SES. Nevertheless, it is a rather insufficient indicator for the SES, because subsidiary details concerning the occupation and income of the newborn's father are not included in the database. We assessed "being single (yes/no)" as a further available proxy for an unfavourable socioeconomic situation. Maternal age was classified in five groups (< 18, 18-29, 30-34, 35-39, > 39) and parity in three groups (0, 1, ≥ 2). The variable "smoking after awareness of pregnancy" was grouped in three categories (yes/no/missing information).
Obstetric factors
Concerning obstetric determinants, the following information was included: low birthweight (< 2500 g, ≥ 2500 g), gestational age in weeks (< 28, 28-31, 32-36, ≥ 37) and congenital anomalies (yes/no). Preterm delivery is often associated with low birthweight. In order to explore interaction effects of gestational age & birthweight on the stillbirth risk among women with and without migrant background, we defined an interaction variable grouped in four categories:
(1) preterm delivery (< 37 gestational weeks) combined with low birthweight (< 2500 g),
(2) preterm delivery (< 37 gestational weeks) combined with normal birthweight (≥ 2500 g), (3) term delivery (≥ 37 gestational weeks) combined with low birthweight (< 2500 g),
(4) term delivery (≥ 37 gestational weeks) combined with normal birthweight (≥ 2500 g).
Antenatal care
Use of antenatal care was assessed on the basis of number of antenatal care visits and the timing of the first visit during pregnancy. According to the BQS definition, number of antenatal care visits was classified in (1) 0-4 visits (considered "insufficient care"), (2) 5-7 visits, (3) 8-11 visits, (4) > 11 visits (considered "above-average care"). The timing of first antenatal visit in gestational weeks was grouped in four categories: (1) < 9 gestational weeks, (2) 9-12 weeks, (3) 13-16 weeks, (4) > 16 weeks. Furthermore, the number of ultrasounds and the timing of first ultrasound during pregnancy was also assessed according to the BQS definition. The number of ultrasounds was classified into (1) 0-2, (2) 3-4 (according to the German maternity guideline considered as standard for low risk pregnancies), (3) > 4. The timing of first ultrasound in gestational weeks was grouped into (1) 0-8, (2) 9-12, (3) 13-16 and (4) > 16 weeks.
Maternal co-morbidities
Maternal co-morbidities during pregnancy are assessed as pregnancy risk factors. We included pre-eclampsia, eclampsia, placenta praevia (antenatal) and placenta praevia (during birth) as important risk factors for stillbirth, classified into binary variables (yes/no).
Statistical analysis
Firstly, we tested differences in socioeconomic, pregnancy and delivery related characteristics between the migrant groups and the German reference group using chi-square tests.
Secondly, we calculated crude stillbirth rates for each group by region of origin. Stillbirth rates were calculated as all stillbirths in a group divided by all live- and stillbirths in the same group. We also performed a stratified analysis by each afore mentioned factor to assess its influence on differences in stillbirth rates between women of different region of origin and women without migrant backgrounds.
Thirdly, we calculated crude and stratified relative mortality risks and 95% confidence intervals. These expressed the relative risk of stillbirth for women from each foreign region of origin compared with women without migrant backgrounds (reference group).
All statistical analyses were performed using the Statistical Package of Social Science version 16.0 (SPSS Inc., Chicago, IL, USA).
During the period 2004-2007 there were 2,623,064 livebirths and stillbirths in Germany of which 504.043 (18.9%) were to women from foreign regions of origin. Of the mothers, 37,854 originated from Middle and Northern Europe or North America, 85,874 from Mediterranean countries, 138,217 from Eastern Europe, 164,341 from the Middle East or North Africa (incl. Turkey) and 30,773 from Asia. Migrants grouped in the category "other countries" were excluded from the analysis (n = 46,984). Table
Table 1
Characteristics of study population by mother's region of origin (in %), 2004-2007, (N = 2,623,064)
Middle and Northern Europe,
Eastern Europe
Middle East,
p value*
North America
North Africa
Number of births
Single status
< 0.0001
Social status
< 0.0001
Maternal age (years)
< 18
< 0.0001
≥ 40
Maternal smoking (during pregnancy)
< 0.0001
< 0.0001
≥ 2
Multiple births
< 0.0001
Twins or more
Gestational age (weeks) & birth weight (g)
< 37 & < 2500
< 0.0001
≥ 37 & < 2500
< 37 & ≥ 2500
≥ 37 & ≥ 2500
Number of antenatal visits
< 0.0001
≥ 12
First antenatal visit (gestational week)
< 9.
< 0.0001
≥ 17.
Congenital anomalies
< 0.001
* p value for a chi-square test
Additional file 2
Table S2 - Further characteristics of study population by mother's region of origin (in %), 2004-2007, (N = 2,623,064). Further characteristics of study population by mother's region of origin that are not shown in Table 1. Table S3 - Crude and stratified stillbirth rates and appropriate relative mortality risks according to mother's region of origin. This table shows stillbirth rates and relative mortality risks stratified for mother's region of origin as well as further socio-demographic, lifestyle-related and obstetric factors.
Click here for file
Compared with women without migrant backgrounds, women with migrant backgrounds were of younger age at delivery, more often multiparous, and less often single. The proportion of single women was lowest among women from the Middle East and North Africa. They also showed the highest proportion of mothers with a low social status (71.4%).
In our sample, women with and without migrant backgrounds showed no substantial differences in the number and timing of antenatal care visits. In all groups about 40% of pregnant women made sufficient use of antenatal care (8-11 visits). The proportion of women with insufficient care (0-7 visits) was low (under 3%). About 80% of pregnant women attended their first visit prior to gestational week 13, and nearly half of them attended before gestational week 9. Only women from Eastern Europe and Asia showed a higher prevalence of having their first visit rather late in pregnancy (after gestational week 12) and receiving only 0-4 visits (3.1 and 3.3 respectively, p < 0.0001).
The same applied to the number and timing of ultrasound examinations. About 50% of migrant mothers had an appropriate number of ultrasound scans (3-4 scans) and about 70% had their first ultrasound within the first trimester, compared to 49.9% and 84%, respectively, among German mothers.
We could not find relevant differences between women with and without migrant backgrounds for preterm delivery, low birthweight, smallness for gestational age (SGA), congenital anomalies and eclampsia during delivery. Pre-eclampsia was more prevalent among mothers from Germany (2.5%, p < 0.0001) compared to 1.3% among mothers from the Middle East and North Africa and 1.2% among Asian mothers. Although the proportion was rather low, compared to the other groups Asian women experienced a higher risk of placenta praevia during pregnancy or birth (Additional file
Additional file
Stratified analyses
In stratified analyses, we examined the effect of the previously described factors on the relative differences in the relative risk of stillbirth for women with migrant backgrounds compared with women without migrant backgrounds (Additional File
The relative risk of stillbirth was modified after adjustment for social status in all migrant groups. A significantly increased relative risk was only obvious among women from Middle East and North Africa with a low social status (RR 1.29, 95% CI 1.17-1.42). Amongst those with high social status, the relative risk was also elevated, but did not reach statistical significance. The number of stillbirths in this group was small.
Prior to gestational week 28, the risk of stillbirth for women with migrant backgrounds was mostly lower compared to women from Germany. In the time period 28 to 31 gestational weeks however it was significantly increased for Middle East and North African women (RR 1.34, 95% CI 1.13-1.59) and between 32 and 36 gestational weeks it was significantly increased for all migrant women compared to the German population, except for women from Middle and Northern Europe and North America (statistically significant at 5% level). The risk for women from the Middle East and North Africa was 70% higher during this period.
Adjusting for birthweight increased the relative risk in the birthweight groups under 2,500 g (low birthweight) significantly among women from Eastern Europe and those from the Middle East and North Africa.
Concerning the interaction of preterm birth and low birthweight, the risk of stillbirth for women from the Middle East and North Africa compared with the majority population was highest after 37 gestational weeks combined with low birthweight (RR 1.63, 95% CI 1.25-2.13). Women from Eastern Europe and from the Middle East and North Africa respectively experienced a 26% and 43% higher risk of stillbirth before 37 gestational weeks combined with low birthweight (both statistical significant at a 5% level).
Among women who attended antenatal care before week 9 of their pregnancy, the relative risk of stillbirth was significantly higher for migrants from the Middle East and North Africa, for Mediterranean countries and for Asia compared to women from Germany (RR 1.40, 1.37 and 1.48 respectively), but it was lower among those who attended late. The trend was similar when the number of antenatal visits was analyzed: amongst women with a substandard number of visits, women with migrant backgrounds showed a lower relative risk of stillbirth compared with women without migrant backgrounds. However, amongst women attending more than 11 visits, women from the Middle East and North Africa showed a 41% higher risk compared with women without migrant backgrounds. The relative risks of stillbirth adjusted for congenital anomalies remained stable (Additional file
Interpretation of differences in stillbirth risk
The present study is the first in Germany to use nationwide perinatal data for the investigation of variations in the risk of stillbirth in relation to maternal migrant background.
Using the German perinatal database, we found relative differences in the risk of stillbirth for women of different regions of origin compared with women from Germany. Women from the Middle East and North Africa (including immigrant women from Turkey) showed the highest risk. After adjustment for maternal characteristics and obstetric factors, the higher risk of stillbirth among women from the Middle East and North Africa was partly attenuated for example when stratified for mother's occupation. However the overall risk remained stable for other characteristics. In contrast to prior studies we did not find any considerable differences between women originating from foreign regions of origin compared to women from Germany in terms of obstetric factors that might explain the higher stillbirth rates in some migrants groups, e.g. in timing and number of antenatal care visits as well as preterm birth and low birthweight. As the factors analysed did not confound or modify the association between migrant background and increased risk of stillbirth in the majority of stratified analyses, migrant status may have an independent effect on the risk of stillbirth. As migrant background might be a proxy for other underlying factors such as cultural factors, social deprivation, access barriers etc., further studies should focus on these factors.
The increased relative risk of stillbirth among women with migrant background was slightly mitigated after stratification for socio-demographic factors, such as single status, low social status, young age of mother and high parity (Tables 2) but it was still elevated compared with women from Germany. These results are in line with a Danish study, where a higher risk of stillbirth for Turkish and Pakistani women was not associated with their higher parity, lower educational level and lower household income compared to the Danish women
As the variables available for SES were insufficient in this study we have to interpret our results very carefully. In addition, the population groups in each band are very heterogeneous e.g. in terms of socioeconomic status, making it difficult to examine associations between migrant background, SES and risk of stillbirth. Compared to other regions the Middle East and North Africa had the highest proportion of women with low SES. These women also experienced a higher risk of stillbirth. This might point to the importance of socioeconomic factors e.g. education and income as well as socioeconomic-related factors e.g. integration level and working possibilities of migrants when looking at stillbirth risks. This is in line with a study from the Netherlands, where higher infant mortality rates among Turkish migrants compared to women from the Netherlands were partly explained by socioeconomic and demographic factors
Several studies have reported an insufficient and late use of antenatal care among migrant women compared to non-migrant women
In contrast, previous studies based on regional data of the German perinatal database found a less frequent use of antenatal care, in particular for single women with migrant backgrounds
In our study, women with migrant background with only a few or no antenatal visits, or who attended very late, showed a lower risk of stillbirth compared with women without migrant background with similar utilization patterns. Women with migrant background give birth in younger years and have a higher parity compared with women without migrant background (Table
Several studies from Europe and the USA showed a higher maternal risk of preterm birth and low birthweight for migrant women
Higher risks of stillbirth in some migrant groups might be associated with a more unfavourable use of antenatal care compared to women without migrant background, but it might also be assumed that there are differences in the quality of antenatal care. In this context, studies found that 25-30% of perinatal deaths are due to factors of suboptimal care
Stillbirth and low birthweight relative to the gestational age can also be associated with congenital anomalies. We were not able to show considerable differences in the rate of congenital anomalies or modifications of risk of stillbirth adjusted for anomalies. However, several studies showed a higher perinatal mortality among newborns of women from non-western countries in the Netherlands and among Pakistani women in Great Britain, associated with a higher rate of congenital anomalies in these migrant groups
Strengths and Limitations
The strengths of this study are the large number of cases, its representativeness, the topicality and the completeness of data. We used population based and Germany-wide data. The data used were collected in a systematic way so we could confidently rule out selection bias. Furthermore, the study is the first to analyse relative differences in stillbirth rate and risk of stillbirth between several migrant groups in Germany.
The study, however, has its limitations. Although completeness of data is very high, the quality of some data items is sub-optimal. Jahn and Berle
One of the major limitations in the conduction of migration- and socioeconomic-sensitive research in the field of obstetrics in Germany is the lack of appropriate variables of migrant status and socioeconomic status collected in the perinatal databases. As there is no clear definition of "region of origin" in the instructions for completing the perinatal sheet in German hospitals, we cannot be sure about how the variable is collected in hospitals. Hence, our data set might include more than one migrant generation without opportunity for differentiation. Further, the combination of several countries in one group is unsatisfactory. Each group includes different national, ethnic and cultural populations that are not at all homogenous. This makes the interpretation of our results more difficult. While it can be assumed that women of Turkish origin represent the largest proportion in the group "Middle East/North Africa", we cannot rule out that our conclusions do not apply to the other migrant groups included. In addition, the group "Asia" is not further defined, making it difficult to draw conclusions about this group from the results presented in this paper. There might be huge differences in the group of Asian migrants especially regarding stillbirth rates as Asia includes some of the most deprived areas of the world such as Central Asia with high stillbirth rates, and some of the lowest stillbirth rates, e.g. in Japan. Furthermore, the indicator of socioeconomic status in the database is not optimal as it only provides information about the mother's occupation. Further information, e.g. concerning the maternal education level as well as the father's education level and occupation, would be necessary to describe and study the effect of SES on birth outcomes among migrants in a more appropriate manner. As the perinatal database is the only available routine database for perinatal research in Germany, the implementation of appropriate variables for migrant status (at least country of birth of father and mother as well as country of birth of mother's parents and nationality) and the socioeconomic status comprises a major challenge for the future. The perinatal database was mainly developed for, and is still an instrument for quality control in German hospitals. Hence its use for routine health reporting or health research is limited. A change of data collection and implementation of new variables is highly dependent on the backup from politics in each federal state in Germany, and would thus take a very long time. Nevertheless, there are already successfully working birth registries implemented in single regions in Germany, e.g. the Mainz birth defect monitoring system (called the ''Mainz Model"), which is based on an expanded perinatal sheet focussing mainly on anomalies. These kind of approaches should be promoted and expanded to other federal states in Germany.
This study is the first in Germany to use a large nationwide perinatal dataset for the investigation of variations in the risk of stillbirth in relation to maternal migration background. It shows differences in relative risk of stillbirth among women of different regions of origin compared with women originating from Germany, with a significantly higher risk among women from the Middle East and North Africa (which includes Turkey). This migrant group also showed by far the highest proportion of low social status mothers. Our findings lend support to planned efforts to develop and evaluate culturally sensitive health promotion and prevention programmes for pregnant women with low education and a Turkish migrant background in Germany. Considerable differences concerning obstetric risk factors, e.g. preterm birth, low birthweight as well as number and timing of antenatal care visits, could not be observed.
Our findings suggest a higher risk of stillbirth among women with migrant background due to intrauterine growth retardation. Differences in the quality of provision of antenatal care and/or the management of conditions identified cannot be ruled out. Migrant women with an early uptake and a sufficient number of antenatal visits experienced a higher risk of stillbirth. This indicates a particular need to closely monitor risk pregnancies among these women. Further studies should investigate whether the higher risk of stillbirths among migrant women is due to a lower sensitivity of antenatal screening for intrauterine growth retardation and insufficient follow-up interventions.
Competing interests
Funding for these analyses was granted by the Federal Association of Local Health Insurance Funds [AOK-Bundesverband]. AR was financed from this grant during the study period. The AOK-Bundesverband had no influence on the data analysis and interpretation.
Authors' contributions
AR, OR and JS conceived the study. AR performed the data analysis and wrote the first draft. MK gave statistical advice and coordinated the data analysis at BQS. JS participated in the data analysis. JS and OR supported the interpretation of results. All authors helped to draft the manuscript and read and approved it in its final form.
Acknowledgements and Funding
We thank the BQS (now: BQS-Institute) for providing the data and hosting AR and JS during the data analyses in Düsseldorf. Further, we thank Kai Kolpatzik from the Federal Association of Local Health Insurance Funds [AOK-Bundesverband] for his support.
The data analyses were part of a project concerning health of pregnant women with migration background, which was funded by the Federal Association of Local Health Insurance Funds [AOK-Bundesverband]. AR was financed from this grant during the study period. The AOK-Bundesverband had no influence on the data analysis and interpretation.
Prevention among immigrants: the example of Germany
National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995: a systematic analysis
Addressing the complexity of disparities in stillbirths
Maternal care and birth outcomes among ethnic minority women in Finland
Ethnic disparity in stillbirth and infant mortality in Denmark 1981-2003
Ethnic differences in perinatal mortality. A perinatal audit on the role of substandard care
The effect of age at immigration and generational status of the mother on infant mortality in ethnic minority populations in The Netherlands
Influences of ethnicity on perinatal and child mortality in the Netherlands
Adverse pregnancy outcomes: differences between US- and foreign-born women in major US racial and ethnic groups
Birth outcomes of immigrant women in the United States, France, and Belgium
Stillbirths and infant deaths among migrants in industrialized countries
Ethnic differences in preterm birth and its subtypes: the effect of a cumulative risk profile
The risk of preterm delivery in women from different ethnic groups
Preterm birth and maternal country of birth in a French district with a multiethnic population
Why does birthweight vary among ethnic groups in the UK? Findings from the Millennium Cohort Study
Explaining differences in birthweight between ethnic populations. The Generation R Study
Lack of change in birthweights of infants by generational status among Indian, Pakistani, Bangladeshi, Black Caribbean, and Black African mothers in a British cohort study
Complaints and complications in pregnancy: a study of ethnic Norwegian and ethnic Pakistani women in Oslo
Birth defects and parental consanguinity in Norway
Late start of antenatal care among ethnic minorities in a large cohort of pregnant women
Utilisation of antenatal care by country of birth in a multi-ethnic population: a four-year community-based study in Malmo, Sweden
Social class, ethnicity and attendance for antenatal care in the United Kingdom: a systematic review
Small Area Analysis of Infant Mortality in Bielefeld with Special Consideration of the Migration Status of Parents, 2000-2006 [article in German]
Ausländische Neugeborene in Deutschland: Analysen zur Säuglingssterblichkeit
Cross-country variation in stillbirth and neonatal mortality in offspring of Turkish migrants in northern Europe
Soziale Unterschiede bei der Inanspruchnahme der Schwangerschafts-Vorsorgeuntersuchungen, beim Rauchen der Mutter während der Schwangerschaft und beim Geburtsgewicht des Neugeborenen. Empirische Analyse auf Basis der Bayerischen Perinatal-Studie
The role of mediating factors in the association between social deprivation and low birth weight in Germany
Perinatal outcome in Berlin (Germany) among immigrants from Turkey
Gesundheit von Zuwanderern in Nordrhein-Westfalen
Datenübermittlung und -import
Ethnic differences in total and cause-specific infant mortality in The Netherlands
Racial and ethnic disparities in the discordance between women's assessment of the timing of their prenatal care entry and the first trimester standard
Inanspruchnahme der Schwangerschaftsvorsorge - ein Spiegel gesellschaftlicher Entwicklungen und Aspekte der Effizienz. Untersuchung auf Basis der Perinatalerhebung Baden-Württemberg 1998-2001
Questionable Effectiveness of Routine Ultrasound Screening in Antenatal Care in Germany: An Observational Study [article in German]
Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services?
Potentially avoidable perinatal deaths in Denmark and Sweden 1991
Influence of obstetric and perinatal care on perinatal mortality
Differences in perinatal mortality and suboptimal care between 10 European regions: results of an international audit
'They're more like ordinary stroppy British women': attitudes and expectations of maternity care professionals to UK-born ethnic minority women
How well do doctors document their findings in antenatal care - and are there differences between women of German and non-German nationality?
Investigating variations in infant mortality in England and Wales by mother's country of birth, 1983-2001
Consanguinity and reproductive health among Arabs
Reproductive behavior and health in consanguineous marriages
The Quality of Data in the Hessian Perinatal Registry Comparison with Antenatal Records and Results of Interviews with Pregnant Women [article in German]
Hypertensive Erkrankungen in der Schwangerschaft
Eklampsie und HELLP-Syndrom
Pre-publication history
The pre-publication history for this paper can be accessed here:


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- Castelvecchio (0.8 mi / 1.2 km)
- Stadio Marcantonio Bentegodi (0.8 mi / 1.3 km)
- Basilica of San Zeno Maggiore (0.9 mi / 1.4 km)
- Ponte Scaligero (0.9 mi / 1.5 km)
Hotel Martini, Verona
Hotel Info: 866-539-8117from $78
- Economy Double Room (Breakfast Excluded)
- Double Room (Breakfast Excluded)
- Small Double Room
- Double or Twin Room
- Triple Room
More great choices
At a glance
Key facts
Hotel size
- This hotel has 40 rooms
- This hotel is arranged over 4 floors
- Check-in time starts at 2 PM
- Check-out time is 11 AM
- Express check-in/out
Required at check in
- Credit card or cash deposit required
- Government-issued photo ID required
Travelling with others
- Children (3 years old and younger) stay free when occupying the parent or guardian's room, using existing bedding
- Pets allowed
- Free WiFi in public areas
- Free WiFi in rooms
- Self parking *
- Free nearby parking
Other information
- Smoke-free property
In the hotel
- Buffet breakfast daily (surcharge)
- Restaurant
- Room service (during limited hours)
- Coffee/tea in a common area
- Fitness facilities
- Spa treatment room(s)
- Sauna
- Bicycle rentals on site
- Number of meeting rooms - 2
- Meeting rooms
- 24-hour front desk
- Concierge services
- Tours/ticket assistance
- Free newspapers in lobby
- Luggage storage
- Multilingual staff
- Porter/bellhop
- Year Built 1992
- Elevator/lift
- Rooftop terrace
- Garden
In the room
- In-room climate control (air conditioning)
- Air conditioning
- Private bathroom
- Shower only
- Bidet
- Free toiletries
- Hair dryer
- Satellite TV channels
- Desk
- Free WiFi
- Phone
- Refrigerator
- In-room safe
Also popular with travelers from the USA
Special features
DiningTrattoria ai Bastioni - This family restaurant serves lunch and dinner. Guests can enjoy drinks at the bar.
Hotel Martini, Verona's small print
Also known as
- Hotel Martini Verona
- Martini Hotel
- Martini Verona
- Hotel Martini
- Martini Hotel Verona
All guests, including children, must be present at check-in and show their government-issued photo ID card or passport.
Cash transactions at this property cannot exceed EUR 2999.99, due to national regulations. For further details, please contact the property using information in the booking confirmation.
Reservations are required for massage services and can be made by contacting the property before arrival at the number on the booking confirmation.
Mandatory fees
You'll be asked to pay the following charges at check in or check out:
- A tax is imposed by the city: EUR 1.50 per person, per night, up to 5 nights. This tax does not apply to children under 15 years of age.
Optional extras
Self parking costs EUR 8 per day
Rollaway beds are available for EUR 30 per night
Buffet breakfast is offered for an extra charge of EUR 8.00 for adults and EUR 8.00 for children (approximately)
Cribs/Infant beds are available for EUR 13 per night
We have included all charges provided to us by this hotel. However, charges can vary, for example, based on length of stay or the room you book.
Recent reviews
Good 3.9 /5 from 110 reviews
walkable from train station to hotel and to those sightseeing spots
Spent 2 nights here with my daughter looking at the local university. Front desk staff was very helpful with directions and recommendations. They rented us bikes so we could get around the city and helped us find a laundry. Wifi was excellent, air conditioning was good, and the room had been recently upgraded.
Very comfortable. Staff was very friendly.
We selected this room because we wanted something close to the train station. The hotel was 4 long blocks from the station, but very walkable. The distance to the attractions was longer but accessible from the train station by bus. Having the Verona pass meant free bus service. The breakfast was very good, cold meats, hard boiled eggs and pastries that the made on site. The hotel was a moderate priced hotel that met all expectations.
I stopped in Verona for one night to catch an opera performance. I booked this room mere hours before I arrived, and check-in went smoothly and hassle-free. The room was in great shape and everything worked well. The front desk personnel were helpful in meeting my needs, including allowing me to store my bag the next day for several hours before catching my next train. The location was a short taxi-ride to the train station, though someone with luggage on wheels could walk if needed.
Is the description of this hotel not correct? Tell us


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Rs. 19,999.00 Rs. 21,990.00 Is our price too high?You save: Rs. 1,991
The award- winning Beyerdynamic DT 880 Edition premium headphones boast of a dual technology system of the open and closed design, and reproduce music in succinct and crisp detail.
Clear highs, analytical mid ranges and bass that makes you forget the highs and the mids, these headphones are truly high-end. With a rich frequency response of 5Hz to 35kHz, they make even average sound appear beautiful and engrossing. These 32 Ohm version of the DT 880 Edition and can be driven easily without amplifiers.
Appropriate for long listening sessions, these headphones provide you with the ultimate comfort of their replaceable soft earpads, a generously padded headband and a single sided cable. These lovely comfort features only add to the stellar look of these headphones.The grilles are made of high quality steel add that extra aesthetically pleasant touch.
The package comes included with a nifty zip-up hard carry case. The well padded cushioned carry case keep your headphones safe inside it, while the handle lets conveniently carry it wherever you go.
Features such as a semi open back design, a tough and innovating bass reflex system make these headphones a real sonic heartthrob.
Semi-Open Back DesignThe DT 880 Edition's semi-open, over-the-ear design offers slightly increased sound isolation and reduced noise leakage, while retaining the high fidelity normally associated with open-back headphones. The semi open back also lets the headphones breathe which make the sound reproduced natural sounding and enhance it to a great extent.
Adjustable Headband and Velour EarpadsLuxury of the user has been kept in mind while designing these headphones. Mindfully designed, the DT880 Edition comes with an adjustable headband, whose little notch is on the side. Move it to adjust the headband so that it firmly and comfortably cradles your head. The headband created with high end strap on leather, will only increase the comfort. The velour earpads are synonymous to bespoke luxury, and speak volumes of the comfort they provide hence. The build quality of the headphones has also been improved.
Detailed Sound
Soundstage experience
Single Sided cableThe single sided straight cable avoids getting tangled so that your music experience is compromised in no way.
Rapid trebleAmong other unignorable features, one of the most noticeable features of these headphones is the treble they produce. Rapid and energetic, these over ear headphones strive to achieve a high standard with higher frequencies, and do so with great elan. Mid range that is clear and fine, and bespoke bass, these headphones make you feel closer to music. Solo voices and instruments appear highly defined and close to the listener.
32 Ohm ImpedanceThese circum-aural headphones that have a 32 Ohm impedance allows you to use the headphones easily without the necessity of an amplifier to drive the sound well.
What's in the box:


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Thalassa Shima Hotel and Resort is located at 1826-1 Uramura-cho, Toba. It provides a warm personal welcome, a hospitable atmosphere and rooms that have all modern conveniences. It offers excellent opportunities for inspiring meetings, management training, motivational events, training courses, sym...
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Calculating Sales Tax
You know how it goes: Your child begs for you to buy the coolest new toy, saying it only costs 20 bucks. But how much does it really cost? If he needs a quick lesson in sales tax, give him this worksheet. He'll learn how sales tax works and practice with some fun kids' products.
Click to find similar content by grade, subject, or standard.


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What is fear?
An unpleasant emotion caused by the belief that someone or something is dangerous, likely to cause pain, or a threat
Often, fear tells us there is something wrong that needs to be addressed or corrected. For example, I feared if I didn't change my eating habits, my cholesterol, triglyceride, and blood glucose levels would continue to increase and I'd develop diabetes. Then I'd end up like my dad, who had a stroke and ultimately passed away. The message? Cut down on the processed foods and sugar, and exercise regularly. I did exactly that, and the fear I had that my poor health habits would threaten my health led to me making better choices and becoming healthier and stronger.
But often, we look at Fear as something to be conquered, something to be overcome. We look at Fear as something that can paralyze us. We fear not being good enough. We fear the past. We fear the future. We fear failure. And these fears can seem to be very real, especially if we play around with them in our minds.
I've done this. I've feared the past. I feared that my husband would be just like the men I allowed hurt me in my past, because, of course, all men are the same. And because of this fear, I treated him like he would hurt me as others did in my past by being defensive toward him.
I wanted to rid myself of Fear. After all, the most frequently stated admonition in the Bible is, "Do not fear."
I found this to be a monumental task, and that if I spent time thinking about it, even imagining how I could rid myself of it, Fear became bigger.
But what if we looked at Fear as "an amazing act of the imagination," instead of something that we conquer, says fiction writer Karen Thompson Walker in a TED Talk entitled "What Fear Can Teach Us". What if we looked at our fears as stories?
Yes, stories. Stories with character, setting, and plot, with a beginning, middle, and ending.
According to Walker,
"…fears are…a kind of unintentional storytelling we're all born knowing how to do."
And don't we tell the stories? In my own story, I'm the main character, of course. I see how stories have run their course in the past, and I've told my stories in ways consistent with how they've progressed in the past. In doing so, I've used my imagination as a breeding ground for my fears. I've wasted a lot of time doing that. And I can't get the time back.
So why don't I use my fears to tell different stories? I can come up with a different plot, definitely a different ending. My story doesn't have to end up the way it's always ended up. I can make different choices in my story. I can actually choose my actions and plot based on how I want my story to end.
So if I have a fear of not being good enough that, in the past, caused me to behave in ways that sabotaged my relationship, why not tell my story differently than in the past so that it ends well? In my narrative, I can imagine that I am worthy of having a great relationship. In the process of me using my imagination to tell a different story of my worth, I believe it. And then I make choices that contribute to that better relationship. I don't sabotage my relationship the way I've done in the past because of the false story I've told about my worth in the past. I've now used my imagination in a positive way. According to Ed Finn in his article "The Spark of Imagination,"
"Imagination is a powerful tool for changing the world because it can simply rewrite reality as we perceive it."
I can simply rewrite what I want my reality to be and change my own internal world, leading to a change in my external world, my relationship (or any other aspect of my life).
But essential to being able to tell better stories is to be able to read our fears. Is the fear real? Is the fear justified? If the fear is real, if it is justified, then I must take steps to address it.
But if, after reading or examining the fear, we determine that the "narrative" is "false evidence appearing real," then we can rewrite our plot.
Prior to seeing Karen Thompson Walker's TED talk, through much prayer and reflection, I've been able to change what I've imagined concerning my husband. I see my husband as the gift God gave me, instead of seeing him in the context of past relationships. As a result, our relationship has improved greatly.
But since I've begun writing this post, I've had the opportunity to address certain fears, and it really has been helpful to view them as narratives. Instead of reacting and operating on auto-pilot, I was intentional to think about how I wanted my story to end. I behaved differently, and situations didn't escalate. It works!
What do you think about viewing your fears as stories? How would your situations resulting from fear turn out if you used your imagination to generate narratives that turned out well?


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For 11 weeks, from one part of the Vermont to the other, youth baseball and softball teams had the chance to "Meet the Monsters". But one team got to take the summer segment to a new level.
The Wallingford Sluggers were chosen by a random drawing to be the guest of the Lake Monsters Monday at Centennial Field. Players from both teams met on the field and watched the Sluggers week two "Meet the Monsters" segment on the video board in left field. Since some time had passed since the Sluggers "Meet the Monsters" segment, both sides had an in-person question and answer period.
An afternoon well worth the trip and a Wallingford Sluggers team that happy to have been along for the ride.
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Bread-and-Butter Pudding with Strawberries
Allowing bread to soak in custard batter for a full hour is the secret to a good bread-and-butter pudding.
- Servings: 6
Photography: Victoria Pearson
Source: Martha Stewart Living, March 2001
- 4 large eggs
- 3/4 cup milk
- 3/4 cup heavy cream
- 7 tablespoons sugar
- 2 tablespoons dark rum
- 8 slices white bread
- 4 tablespoons unsalted butter, very soft
- 1 pint fresh strawberries, hulled and cut in half
Whisk together eggs, milk, heavy cream, 3 tablespoons sugar, and rum. Set aside.
Spread top of each slice of bread with generous amount of butter. Cut slices in half diagonally. In a 9-inch-round baking dish or cake pan, fan overlapping slices in one layer. It is also fine for bread to overlap randomly. Pour egg mixture over bread, and let stand 1 hour.
Heat oven to 400 degrees. Sprinkle pudding with 2 tablespoons sugar. Bake until puffed and golden brown, and pudding has set, about 20 minutes.
Meanwhile, combine strawberries with remaining 2 tablespoons sugar. Let stand while pudding bakes. Serve strawberries with baked pudding.


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Young Adult
Monday, May 25, 2015
Book Review: The Sacred Lies of Minnow Bly
By: Stephanie Oakes
Published By: HarperCollins Australia - Dial (US)
Publication Date: July 1, 2015 (Australia) - June 9, 2015 (US)
Page Count: 400
Buy it at Amazon, Barnes & Noble, or IndieBound
Source: ARC Kindly Provided by Australian Publisher
Young Adult
Young Adult
Seventeen year old Minnow has escaped from the Kevinian cult where she spent most of her life, and now she's headed to a juvenile detention centre. The book follows Minnow as she begins to learn about the real world and work through the events that led to the fall of the cult and her stint in detention.
Minnow is an extraordinary character. She has had her hands taken from her in the most horrific of ways, has seen people she loves brutalized and has gone from one form of incarceration to another, but she still has a fiery spirit and a fierce curiosity about the world.
I loved Minnow and her unbreakable spirit. I loved Angel, her cell mate, who manages to have hope despite her hopeless circumstances.
Everything about this book was fascinating – life in the cult, how the cult started, how it ended, what happened to the members, how Minnow came to be arrested, how and why she lost her hands, what happened to the boy she loved, and what will happen at her parole hearing.
I'm loathe to give much more in the way of detail, because I think the less you know about this book the better, but it deals with love, loss, violence, the danger and beauty of faith, friendship, loyalty, and so many other themes. Ultimately this is a book about the human condition and it's beautifully told.
This is one of my favourite books of the year so far. It's beautiful, tragic, uplifting. It's a must read.
The Kevinian cult has taken everything from seventeen-year-old Minnow: twelve years of her life, her family, and her ability to trust.
And when Minnow rebelled, they took away her hands, too.
Now the Kevinian Prophet has been murdered and the camp set aflame and it's clear Minnow knows something. But she's not talking. As she adjusts to a life behind bars in juvenile detention, Minnow struggles to make sense of all she has been taught to believe, particularly as she dwells on the events that led up to her incarceration. But when an FBI detective approaches her about making a deal, Minnow sees she can have the freedom she always dreamed of; if she is willing to part with the terrible secrets of her past.
Powerful and compelling. this remarkable and brave debut novel reveals the terrible dangers of blind faith. And the importance of having faith in yourself.
From the Dazzling Mind of Reading Lark at 8:00 AM
Categories: 5 Birdies, Book Review, Dial, HarperCollins Australia, Nicole, Stephanie Oakes, The Sacred Lies of Minnow Bly
7 comments:
I'm glad to see that you really enjoyed this one! I've been seeing it around a bit and I may just have to buy a copy. It sounds pretty good. Great review!ReplyDelete
Krystianna @ Downright Dystopian
Oh how I want to read this book! This looks like SUCH a lovely book. Thanks for sharing :DReplyDelete
Jackie @ No Bent Spines
Fantastic review. Sounds like a great cult thriller! Adding to my GR!ReplyDelete
I'm so glad you loved this book! It looks so interesting!ReplyDelete
Her hands? They took away HER HANDS? I'm already freaked out.ReplyDelete
Sounds intense! I'd like to find out how she reconciles everything.ReplyDelete
I don't think I've ever actually read a book with a cult, which is weird now that I think about it but I guess it's never too late to read one and this one sounds like a good start.ReplyDelete
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It only takes a minute to get started. Fill out our uncomplicated sign up form and login to the site.
This step is noncompulsory but will greatly raise your chances of getting interest from other members on the website. Write a little something about yourself, your hobbies and upload any nice photographs of yourself.
Use our website's advanced search to find members who match your requirements. Or just flip through listings and find daters that take your fancy.
Discovered someone who could be a good match? Send an email to them or just a wink and let it develop from there. With a little luck you'll be on your way to true love.
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The problems in Euro Zone like Greece cause weak euro
European & US sessions forecast levels: 1.3910/1.4105
Trend Sessions: European: Neutral/Downward
US: Neutral/Downward
Market Focus: 8:30 AM Chain Deflator-Adv, Employment Cost Index, GDP-Adv, 9:45 AM Chicago PMI, 9:55 AM Michigan Sentiment.
Daily Strategy: The Euro Zone budget crisis is one of the reasons for the dollar rises these days. The Greece fiscal situation is very big problem for the Euro Zone but the main concern come by the situation in Spain the fourth biggest economy in the Euro Zone. The dollar will continue rise these days, as the trading strategy is to open short positions on any upward correction.


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The three ran quickly to see what was going on.
A grassy area of the mountains was ahead, thick with leafy trees and shrubs.
Keir, James and Sienna ventured in, hiding
behind a large bush to see what was going on.
Most of the field as far as the eye could see,
was divided into earthy squares, a sliver of grass dividing them, weeds growing
out of most of the further away ones. The nearest ones were square pits in the
ground yet to be filled.
A young boy of about thirteen, scrawny, and
dirty with green-grey eyes full of fear and a white-grey tear-stained face
emerged from the bushes, dragging the body of a young girl emerged from another
clump of bushes.
His hands were stained with her blood and he
looked scared and sick.
He dropped her into one of the earthy, square
pits. Tears were running down his face. He mourned this girl he'd never known.
A man in white, blood-stained ceremonial robes
also emerged from the bushes.
"Stop your snivelling, Braeden! These are evil
people, the filth beneath the feet of the holy people of Virtue! You will not
mourn for Satan's people!"
The man in the white robes said forcefully.
Then he wandered back into the bushes.
When he re-emerged he was dragging a struggling
sixteen year-old by the hair with one hand, and holding a short sword in the
"Let me go, you murderous bas-"
Desiree was silenced by the knife being held to
her throat but only momentarily.
"You don't scare me."
She whispered.
Keir, Sienna and James, crouched behind the
bushes, were frozen with fear.
Keir seemed to sense from Sienna's shock that
it was Desiree.
His fingers tightened around the diamond
encrusted weapon until his knuckles went white.
He was just about to shoot when Desiree's
throat was slit.
The young boy, Braeden, had to hold her limp
body until she stopped shaking and her eyes closed. Then her body began
twitching. Blood was still pouring all over Braeden.
Keir tried to escape from the fear that was
freezing him. He lifted the revolver and fired a bullet at the man in the robes
just as Braeden dropped Desiree into the last grave.
There was a stone in front of each grave, with
a number chalked on each one.
Desiree was number 666.


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137 Pinegrove Avenue, Chetek, WI 54728
About the Listing
6 Chain of Lakes-this property connects to over 3800 Acres of water to roam on! Original 1905 Charm but completely redone in 1994. Lower bank waterfront with fabulous views! Walking distance to downtown. Spacious eat-in kitchen, formal dining, large living room, 3 bedrooms on one level. Main floor master suite. Original open stair case. Major updates: windows, siding, central air, heating system. Property could be converted back to commercial for a bed & breakfast.
Share Listing
Property Details for 137 Pinegrove Avenue, Chetek, WI 54728
Bedrooms: 4
Bathrooms: 2 Full | 1 Half
Lot Size: 0.53 Acres
Lot Dimensions: 180x125
Year Built: 1905
Garage Dimensions: 3 car
Garage: Detached Garage, Driveway - Asphalt
Style: (SF) Two Stories
Water: Well
Sewer: Private
Square Feet: 2000
Above Ground Sq Ft: 2000
Room Information for 137 Pinegrove Avenue, Chetek, WI 54728
Main Floor
Living Room: 16x20
Dining Room: 14x17
Kitchen: 15x18
Bedroom 1: 15x16
Laundry: 9x11
Upper Floor
Bedroom 2: 16x14
Bedroom 3: 17x16
Bedroom 4: 12x16
Other: 5x5
No Information Available.
School Information for 137 Pinegrove Avenue, Chetek, WI 54728
School District: Chetek-Weyerhaeuser
School District Phone: 715-924-2226
Interior Features for 137 Pinegrove Avenue, Chetek, WI 54728
Appliances: Range, Microwave, Refrigerator, Washer, Dryer
Air Cond: Central
Heating: Forced Air
Fireplaces: No
Basement: Full
Exterior Features for 137 Pinegrove Avenue, Chetek, WI 54728
Lot Dimensions: 180x125
Zoning: Residential-Single, Shoreline
Financial Considerations for 137 Pinegrove Avenue, Chetek, WI 54728
Tax Amount: $2,801
Taxes w/Assessments: $2,698
Tax/Property ID: 211164815000
Tax Year: 2016
Monthly Payment = $0
INRIX Drive Time
Calculate Your Drive Time From This Property
Similar Listings For Sale
The data relating to real estate for sale on this web site comes in part from the Broker Reciprocity Program of the Regional Multiple Listing Service of Minnesota, Inc. Real estate listings held by brokerage firms other than the owner of this website are marked with the Broker Reciprocity logo or the Broker Reciprocity thumbnail logo and detailed information about them includes the name of the listing brokers.


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Buyers guide to VPS v/s Dedicated Servers
Before you decide to buy VPS or dedicated servers, there is the need to know some of the main details they have or come with. When you are able to understand the various servers and hosting servers, you can then know which one will be best for you. A dedicated server is its very own computer processor in an isolated site which is where you can save all kinds of documents or files that you want and also run whatever apps you require while allowing you as well as others you approve to access those specific documents or files as well as apps no matter where they are from.
This is contrast to what is known to as "shared" hosting because; this type of hosting has only one remote server that runs on an individual operating system and permits you to save all of your files as well as programs in a part of the disk space even s other individuals save their files on the other parts. Naturally, dedicated servers cost more to preserve than shared servers however; they all offer some of the best services and uses happy mediums and this medium is known as VPS.
The method by which it works
Virtual private servers are hosted on a division of a remote central processing unit. This has two implications it brings for you with the first being that, your server is being hosted technically on the very same physical personal computer with other people. Due to this, your bandwidth will not be very high compared to being on dedicated servers and also, your accessible disk space will also be low. This does not mean you will not be able to operate on your personal operating system. Therefore, setting up your server in a specific method to provide all the apps of your company the needed space can be done. This way, all hosting needs will be catered for with no issues whatsoever.
Some other comparisons
Adding to the very high cost for maintaining dedicated servers, they afford or offer you much more authority than you get with virtual private servers. For instance; you can reboot your dedicated server whenever you want however; that cannot be done with a virtual private server. You can also install any software not already available on the server of your virtual private server with your dedicated server which cannot be done easily with a VPS. If you also know you will have to deal with so much traffic then, you will be better off with a dedicated server because; a virtual private server will not give you all you need.
Deciding or knowing which server will be best for you
It is always important to have a server that will offer you more hosting space. This is because; it will save you so much stress when your website starts to grow and gain more traffic. If you are however a small or medium scale business, the virtual private server will work just fine or even the shared hosting sever. However; for larger businesses, dedicated servers always offer the best.
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KONICHIWA! Free SE from Japan http://taira-komori.jpn.org/freesounden.html
glasses clinking
Corkscrew winding down into cork. Pop of cork as it's pulled out. Sound of pour into wine glass, liquid rushing ...
long, thick heavy chain clinking against each other - recorded on a Roland 26 - heavy chains clinking, ratteling
I recorded the sound at my door when it was windy and the wind houls in the door.
a horse neighs /un caballo relincha
Vocals in an imaginary language, processed and distorted.
Stereo .wav 44.1k sampling rate Yet another alteration of Large Spaceship Pass file.
Someone writing with a pencil
Deep whoosh/swosh transition-type sound. Made by effects applied to a vocalised sound (recorded by me). This sound is not in ...
A windy transition created by using FM synthesis. Recorded with Sony Sound Forge Audio 10.
Sound design; A transitional or impact effect.
An engine sound effect created using "Crystal", a freeware and extremely powerful synthesizer (that unfortunately consumes a lot of processing ...
Moderation state: Deferred
Me singing a small tune, messed with in audacity. Feel free to use without crediting! If you want, you can ...