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Changing practice as a quality indicator for primary care: analysis of data on voluntary disenrollment from the English GP Patient Survey
Service organization, utilization, and delivery of care
Changing family practice (voluntary disenrollment) without changing address may indicate dissatisfaction with care. We investigate the potential to use voluntary disenrollment as a quality indicator for primary care.
Data from the English national GP Patient Survey (2,169,718 respondents), the number of voluntary disenrollments without change of address, data relating to practice characteristics (ethnicity, deprivation, gender of patients, practice size and practice density) and doctor characteristics were obtained for all family practices in England (n = 8450). Poisson regression analyses examined associations between rates of voluntary disenrollment, patient experience, and practice and doctor characteristics.
Mean and median rates of annual voluntary disenrollment were 11.2 and 7.3 per 1000 patients respectively. Strongest associations with high rates of disenrollment were low practice scores for doctor-patient communication and confidence and trust in the doctor (rate ratios 4.63 and 4.85). In a fully adjusted model, overall satisfaction encompassed other measures of patient experience (rate ratio 3.46). Patients were more likely to move from small practices (single-handed doctors had 2.75 times the disenrollment rate of practices with 6–9 doctors) and where there were other local practices. After allowing for these, substantial unexplained variation remained in practice rates of voluntary disenrollment.
Family practices with low levels of patient satisfaction, especially for doctor patient communication, are more likely to experience high rates of disenrollment. However substantial variation in disenrollment rates remains among practices with similar levels of patient satisfaction, limiting the utility of voluntary disenrollment as a performance indicator for primary care in England.
In some countries such as the US, disenrollment rates from health plans are published routinely and are publically available as indicators of the quality of medical care. Although voluntary disenrollment rates have been used as a marker of patient satisfaction, the relationship between voluntary disenrollment and patient satisfaction is complex and multi-factorial
In this study, we use the term voluntary disenrollment without change of address to signify patients who voluntarily leave their primary care practice. The percentage of patients leaving their family practice without change of address ranges from 0.4%
The aims of this study were to determine whether rates of voluntary disenrollment in England were associated with i) poor patient experience, ii) practice and doctor characteristics or iii) the availability of other family practices in the locality. We also considered whether rates of voluntary disenrollment should be used as a quality indicator to inform health policy.
Data relating to patients changing family practice
The numbers of patients changing practice without change of address between 1st March 2009 and 28th February 2010 (inclusive) were provided by the UK Department of Health. 8,450 family practices in England had at least one patient who changed practice without changing address. Registered practice list size was also provided by the Department of Health for March 2009 and February 2010 for each practice. All analyses were carried out with the practice as the unit of analysis.
Patient experience and overall satisfaction
Measures of patient experience and overall satisfaction were taken from the 2009/10 General Practice Patient Survey (2,169,718 respondents from 8,362 family practices, response rate 39%)
Case-mix adjusted estimates of practice level scores were calculated for items addressing four components of patient experience: i) communication with doctors and nurses (four questions); ii) access to care (three questions); iii) continuity of care (one question); and iv) overall satisfaction with care (one question). In the case of two communication questions with multiple items, a composite score was calculated as the mean of up to seven sub-items for those patients who answered at least four of the seven. The case-mix adjusted scores were calculated from mixed-effect linear regression models adjusting for patient reported gender, age, ethnicity, deprivation and self-rated health and predict the scores a practice would have received if its case-mix was the same as that of all responders. Full details of the survey and its development have been reported elsewhere
Practice and doctor characteristics
For each practice, registered patient numbers (broken down by sex and age group) were provided by the NHS Information Centre. In addition, data for 2009 for each practice were provided to calculate the number of family practitioners (FP) excluding trainees, the number of patients per full time equivalent FP, the mean number of years since qualification of the FPs in each practice, the proportion of male FPs, and the proportion of FPs trained in the UK for their primary medical qualification. A score for socio-economic deprivation for each practice was calculated by applying the 2007 Lower Super Output Area Index of Multiple Deprivation proportionately to the practice population
Availability of nearby family practices
The geographic location of each practice was determined by matching the practice postcode to data obtained from UK Borders
Practice-level scores calculated directly from the GP Patient Survey contain measurement error. Using simple scores in regression models may underestimate true effect sizes, and we therefore used shrunken case-mix adjusted estimates of GP Patient Survey scores. This reduced the effects of measurement error and improves the accuracy of estimated effect sizes
In order to compare the strength of association between disenrollment rates and the measures of patient experience, satisfaction, and other patient and practice characteristics, continuous variables (including proportions) were normalised such that the difference between the 5th and 95th percentile of practices was equal to one
Models were run in three stages. First, a series of models including a single fixed effect and the random practice effect were run using single measures of patient experience, patient satisfaction, and practice or doctor characteristics. These models (model set 1) were used to assess the crude association between voluntary disenrollment and each of the factors separately. This shows, for example, how much higher the disenrollment rate typically was in a practice on the 5th centile of overall satisfaction compared to a practice on the 95th centile.
A second model included fixed effects for all measures of patient experience, patient satisfaction, practice case-mix, and doctor characteristics, with a random effect to control for practice (model 2). Model 2 was used to assess the same associations as model set 1, but when adjusting for all other variables; for example, to show how much the disenrollment rate typically increased beyond the variations associated with other factors when comparing practices on the 5th and 95th centiles of overall satisfaction.
A final regression model (model 3) was constructed to assess the suitability of using voluntary disenrollment rate as a quality indicator. This model augmented model 2 with log(capitation), log2(capitation) and co-located surgery included in order to explain as much variation as possible. Model 3 was used to assess the variation in disenrollment rates that was not explained by measured characteristics (the random effect).
All analyses were performed in using Stata v11.2 (StataCorp, College Station, Texas, USA) and SAS v9.2 (SAS Institute, Cary, NC, USA).
Descriptive Statistics
The mean and median rates of annual voluntary disenrollments were 11.2 and 7.3 per 1000 patients respectively (standard deviation 12.0; inter-quartile range 3.7 to 14.4). The mean and median number of voluntary disenrollments was 56 and 42 patients per practice per year respectively (standard deviation 58; inter-quartile range 24 to 72).
Regression analyses
The results of the unadjusted regression analyses using a single fixed effect (model set 1) and the model adjusted for practice and patient factors (model 2) are shown in Table
Patient experience items
Lower patient experience and satisfaction scores were associated with higher rates of disenrollment in the unadjusted model. In particular, doctor-patient communication and confidence and trust in the doctor (rate ratios up to 4.85) show the strongest associations with disenrollment. When adjusted for the other patient experience items as well as patient and practice factors, most of these associations become weak, the main exception being overall satisfaction (rate ratio = 3.46), which then appears to encompass other markers of patient experience.
Doctor characteristics
The unadjusted analysis (model set 1) shows that practices with older FPs (increased years since qualification), more male FPs, and more overseas qualified FPs, all had higher rates of disenrollment (rate ratios 3.58, 2.21 and 3.52 respectively). After adjusting for patient survey and other factors (model 2), these rate ratios decrease to levels of little practical significance, suggesting that the high disenrollment rate from these practices can be explained by low scores on patient experience and satisfaction.
Practice characteristics
Patients were more likely to disenroll from practices with small numbers of doctors and practices where there were other primary care practices nearby (rate ratio of 2.75 for a single handed FP compared to 6–9 FPs in the practice, and rate ratios up to 1.36 for 6–9 surgeries within 1km compared to none) in the adjusted model. These are illustrated in Figure
Figure 1
Variation in mean disenrollment rates for different numbers of FPs, numbers of nearby practices and patient satisfaction scores
Variation in mean disenrollment rates for different numbers of FPs, numbers of nearby practices and patient satisfaction scores.
The suitability of voluntary disenrollment rate as an indicator of quality
Although we find significant associations between disenrollment and survey and practice characteristics, there is far greater variation between practices due to factors that we have not measured which is captured by the random effect of model 3. Comparing the 95th percentile of this random effect with the 5th percentile produces a rate ratio of 6.22, i.e. the rate of patients leaving a practice without changing address after adjusting for all the factors in our model still varies by over 6 times for the central 90% of practices.
Figure 2
Variation in adjusted rates of disenrollment for different levels of patient satisfaction
Variation in adjusted rates of disenrollment for different levels of patient satisfaction. This figure shows the mean (white line) and the typical ranges of adjusted disenrollment rates (shaded areas) for practices at different levels of patient satisfaction scores. The different levels of shading indicate the fraction of practices which lie within that range. An adjusted disenrollment rate of 10 per 1000 patients per year is within the expected reasonable range for any levels of satisfaction. Disenrollment rates have been adjusted for GP Patient survey items, doctor and practice characteristics.
Voluntary disenrollment, patient experience and patient satisfaction
It has been suggested that voluntary disenrollment could be used as an indicator of patient satisfaction and experience with care
This study highlights aspects of patient experience that were associated with patients changing their family practice. The largest simple associations were with doctor-patient communication, confidence and trust in the doctor, and overall patient satisfaction. A good relationship with the primary care doctor has also been shown in the US to be linked to patient loyalty, and it has been suggested that cultivation of positive interpersonal relationships by the doctor and developing patient trust may be effective strategies to differentiate doctor practices and prevent voluntary disenrollment
In the fully adjusted regression model for all factors which may influence disenrollment rates, patient experience factors were encompassed by a single measure of overall patient satisfaction. If patient experience is viewed as a process, and patient satisfaction an outcome of that process, our results suggest that the various facets of patient experience feed into overall satisfaction with care, the most important of which were doctor-patient communication. This finding is consistent with studies from the USA
Although we have demonstrated an association between voluntary disenrollment and both patient satisfaction and reported experience, there is considerable unexplained variation in rates of voluntary disenrollment between practices. This unexplained variation is much larger than that associated with overall satisfaction (illustrated in Figure
Patient choice
After patient experience, we found that practice factors were the next strongest predictors of voluntary disenrollment, and in particular the number of other doctors in the practice (disenrollment was commoner in small practices) and the availability of other nearby practices. Both these factors effectively give patients greater choice, one giving more choice of doctor within a practice, the other more choice outside of the practice. However, the size of the effect of these variables was less than the effect of overall patient satisfaction.
Low overall rates of voluntary disenrollment in England may indicate that satisfaction with care which is generally very high
Strengths and limitations of this study
The strength of this study lies in the use of a large data set, and the use of a validated, widely distributed patient questionnaire. To our knowledge, data comparing patient satisfaction with voluntary disenrollment have not previously been reported in England. Limitations of this study include the lack of patient-level data on disenrollment, which would allow more in-depth study of individual patient movements between practices. Our models also assume that individuals act autonomously when leaving their practice whereas it is likely that patients sometimes leave as a family group or with their partner. Other limitations include the limited nature of our measures of patient choice and the 39% response rate of the GP Patient Survey questionnaire in the year 2009–2010, which although comparable with other large public sector surveys, may not be fully representative of the population. The survey is population based and does not depend on a recently practice visit. However, fewer than 1% of respondents had not visited their practice and many of these gave non-informative responses which were excluded from the analysis. Inclusion of this group of patients is therefore unlikely to have influenced the results in any significant way.
Family practices with low levels of patient satisfaction, especially for doctor patient communication, are more likely to experience high rates of disenrollment. However substantial variation in disenrollment rates among practices with similar levels of patient satisfaction limits the utility of voluntary disenrollment as a performance indicator for primary care in England.
Ethical permission was not required for these analyses.
Competing interests
The research described here was funded in part by a grant from Ipsos-MORI who developed and delivered the GP Patient Survey for the Department of Health in England. Professor Roland and Professor Campbell contributed to the development of the survey as academic advisors, and their universities received payment for this advice from 2009–2011.All authors declare that they no competing interests.
Authors' contributions
All authors contributed to the conception and design of the study. The analyses were carried out principally by SN, GA and ME. All authors contributed to drafting and revising the paper. All authors read and approved the final manuscript.
Data from the GP Patient Survey were provided by Ipsos-MORI. Data on practice characteristics and disenrollment were provided by the Department of Health. The study was funded in part with a grant from Ipsos-MORI. SN was funded by an Academic Clinical Fellowship from the National institute of Health Research (NIHR) in England. Neither Ipsos MORI nor NIHR had any role in the design or conduct of the study. Other authors were funded by a range of university sources unrelated to this study.
No exit? The effect of health status on dissatisfaction and disenrollment from health plans
Switching physicians: predictors of voluntary disenrollment from a primary physician's practice
A qualitative investigation into why patients change their GPs
Patient choice. A randomized controlled trial of provider selection
The value of choice: a qualitative study
How do patients use information on providers?
How do people choose their doctor?
Why do patients change their general practitioner? A postal questionnaire study of patients in Avon
Reliability of patient responses in pay for performance schemes: analysis of national General Practitioner Patient Survey data in England
The GP Patient Survey for use in primary care in the National Health Service in the UK - development and psychometric characteristics
Physician cost profiling reliability and risk of misclassification
Effects of survey mode, patient mix, and no response on CAHPS hospital survey scores
How patients' sociodemographic characteristics affect comparisons of competing health plans in California on HEDIS quality measures
Patient dissatisfaction as a determinant of voluntary disenrollment in a managed care organization
Patient satisfaction and change in medical care provider: a longitudinal study
Behavioural consequences of consumer dissatisfaction with medical care
Beneficiary reported experience and voluntary disenrollment in Medicare managed care
When do older patients change primary care physicians?
Understanding patient satisfaction, trust, and loyalty to primary care physicians
Relationships of patient satisfaction with experience of system performance and health status
Out of Plan use and disenrollment: outgrowths of dissatisfaction with a prepaid group plan
Disenrollment of Medicare beneficiaries from HMOs
What benefits will choice bring to patients? Literature review and assessment of implications
Do patients want choice and does it work?
Pre-publication history
The pre-publication history for this paper can be accessed here:


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Archives (Click on title to see article)
Club Members Rank Nationally
I thought this news item should be of interest to the membership, it shows the competence of some of our members in the archery world. The national ranking for FITA and Target was recently published and names of some of our members appeared on that list. On top of the list as number one in Canada is no other than Dr. Andrew Fagan. Mrs. Pascale Payne is in a very respectable 5th position closely followed by Mr. Alex Mozhar in 6th position. Others are ranked a bit further back with a recent addition to our membership Zibby Scibor in 11th, place. Ann Kwok is in 16th, Daniel Ng in 17th, Ning Dong in 19th, Morgan McLean in 26th and Kevin Head in 64th position. Congratulations to all for their achievements and representing our club.

subset: commoncrawl


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Large Fused Glass Soap Dish in Silver and Aqua
Elegant fused glass soap dish in streaky aqua glass topped by royal silver glass. The silver glass has a feathery pattern on it that allows the aqua glass to peek through! Perfect for your bars of beautiful soap, this dish has 2 raised bars down the center to keep your soap dry. This is a stock photo and due to variation in the silver glass, your actual soap dish, while very, very similar, may not be exactly as shown in the photos.
This soap dish measures about 3.5" by 5.5". Soap bar shown here from A Slice of Delight - find them here.
You could also use this dish as a serving piece since it is food safe. I recommend hand washing for all of my glass pieces.
Price listed includes the cost of USPS shipping within the US. NO additional shipping charges will be added at checkout for domestic orders. International customers please see my shipping policy here.


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MLS Roundup: D.C. United thrashes Sporting KC, Thierry Henry sparkles in New York win
Sporting Kansas City 0 – D.C. United 3
D.C. United reinforced its Supporters' Shield credentials with a stunning victory at Sporting Park. United exploited Sporting's inability to hold a coherent line and ran rampant during a seven-minute spell in the first half. Fabian Espindola cut inside from the left and tucked his low effort inside the far post to start the deluge after 24 minutes. Chris Rolfe and Perry Kitchen followed suit with darting runs through the ramshackle Sporting line and tidy finishes to exacerbate the damage. The final result left United — the worst team in the league a year ago — perched atop the Eastern Conference.
New York 4 – Montréal 2
Bradley Wright-Phillips grabbed the Red Bulls' single-season goals record, but Thierry Henry once again stole the show in Harrison. Dilly Duka dealt the Red Bulls a blow by collecting Calum Mallace's sumptuous throughball and slotting home the opener eight minutes before halftime. Henry mustered the response with his angled header and sent the home side into the lead with a curling effort inside the far post. The former French international then played Wright-Phillips through for the eventual winner after 74 minutes. Andrés Romero produced a reply five minutes later, but Wright-Phillips guaranteed the points with his 20th goal of the season in second-half stoppage time.
LA Galaxy 2 – Vancouver 0
Robbie Keane inspired the Galaxy to a comfortable win over the Whitecaps at the StubHub Center. Keane played an integral role in both goals with a telling pass on Landon Donovan's fourth-minute opener and an unusual deflection in the buildup to Marcelo Sarvas' goal just after the half-hour. The Ireland captain also hit the bar in the late stages as the Galaxy secured a second consecutive victory after the stirring midweek comeback against Colorado.
Columbus 3 – Houston 0
The home side exploited the Dynamo's lingering defensive issues to post a second consecutive victory. Justin Meram pounced on a sloppy touch in the back and thumped the opener past the stranded Tally Hall 10 minutes before halftime. Adam Bedell and Aaron Schoenfeld extended the lead within five second-half minutes to ensure the Crew ended the night inside the Eastern Conference playoff places.
Toronto FC 2 – Chicago 2
Quincy Amarikwa pounced in second half stoppage time to lift the Fire to a point at BMO Field. TFC took the lead after just three minutes when Bakary Soumaré turned Justin Morrow's cross into his own net. Robert Earnshaw marked his Fire debut by nodding home the equalizer against his former side after 70 minutes, but Gilberto stormed through the line to restore the Reds' advantage nine minutes later. Amarikwa broke TFC's hearts and claimed yet another draw for the visitors by thumping home at the far post in the waning seconds.
New England 1 – Chivas USA 0
Lee Nguyen produced the only goal of the game shortly after halftime to give the Revs a precious three points at Gillette Stadium. New England enjoyed much of the possession as Chivas USA relied on its shape to frustrate the Revolution. The resistance broke in the 56th minute after a neat series of touches allowed Nguyen to curl his shot inside the far post and secure a necessary victory to keep pace with Columbus and New York.
FC Dallas 2 – Real Salt Lake 1
FCD overcame Blas Perez's first-half dismissal to extend its unbeaten run to 10 matches. Perez procured a controversial second yellow card after tumbling to the ground after a Chris Schuler push, but his teammates responded after the interval to secure the points. Je-Vaughn Watson chested home the opener from a Michel corner kick five minutes into the second half. Fabian Castillo completed a sweeping team move with a fine finish inside the far post in the 74th minute. Olmes Garcia pulled a goal back with his acrobatic finish in stoppage time, but FCD held out to move level with RSL on points.
FOX Sports Go


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Option for migrating logs to HDFS ---------------------------------- Key: HADOOP-3210 URL: https://issues.apache.org/jira/browse/HADOOP-3210 Project: Hadoop Core Issue Type: New Feature Components: dfs Reporter: Robert Chansler There should be an option to migrate server logs to HDFS for space and durability. This add another option for improving performance with a multi-tiered storage solution. In addition, durability and availability of the logs for analysis could be improved. (1761414) -- This message is automatically generated by JIRA. - You can reply to this email to add a comment to the issue online.
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ROSEN, Minn. — Richard "Ricky" Karels, 47, Rosen, died Thursday, May 16, 2013, in a hospital at Rochester.
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What's your dog called? And what names do you have for future ones?(96 Posts)
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Premier Oil provides an update in relation to two previously announced asset sales which have now completed. The combined cash consideration of the two transactions is $147.5 million.
Premier has completed the sale of its non-operated interests in the producing Scott, Telford and Rochelle fields to MOL Group for a cash consideration of $130 million before interim period adjustments. MOL has assumed the liabilities for future abandonment costs.
Premier has also completed the sale of its 30 per cent stake in PL359, which contains the Luno II discovery, offshore Norway, to Lundin for $17.5 million plus working capital adjustments.
MOL Group,
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Simplicity 8760; ©1978; One Size. Chair Pads, Napkins and Reversible Place Mats.... A Yes I Can® Learn To Sew Pattern. V1, V2 and V3 reversible place mats with reverse side of contrasting or coordinating fabric can be made with matching hemmed napkins. Rectangular place mat V1 with rounded corners is encased in bias tape. Rectangular place mat V2 with tulip applique is trimmed with rick rack. Oval place mat V3 features purchased piping. Chair pad V4 has self fabric ties. V5 is encased in fold over braid, forming ties.
Featured in Simplicity Fashion News, November, 1978


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What about the new "Assassin's Creed 4 Suggestions" theme? I have my list of places where it can be set (NO Italy, Palestine or America), tell me what you think. Protagonist's names are random names with eagle theme in the native language.
1. French Empire (1812, Jean Aigler)
2. Russian Empire (Around 1888, Nikolai Orelov)
3. Deuchland (1939, Hans Adlerman)
4. Japan (1603, Akuomi Datsui-San)
5. JOKE Italy (2012, Silvio Berluscony)


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Probe Specification: FUS Distal Probe 16p11.2 Green
The FUS Distal Probe, labeled in green, is 502kb in size and covers the region including markers SHGC-58827 and D16S2660.
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text: It hasn't been officially announced, but as of 11 June 2013, the original iPhone officially becomes vintage technology. Or at least, it becomes obsolete in an Apple retail store.That's according to internal documents that have come to light, which claims various pieces of Apple kit will be listed as 'vintage and obsolete products'. It means you can't walk into an Apple store to get your handset repaired, as the phone will be 'obsolete'. However, you might be able to get your 'vintage' iPhone repaired with AppleCare or authorised service providers if you call them directly. So not a complete dead end.Why you would want to keep an original iPhone going after all these years isn't clear. This is a phone with Edge (2G) connectivity and 128MB RAM. A stark contrast to the cutting edge technology six years on in the iPhone 5.Perhaps some people see the smartphones as future collectables and if you want to make top money, you'll probably want a working model (not to mention all the packaging).Source: 9 to 5 Mac


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Running Time: 85 minutes
Released: 01/2005
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How Many Cake Boards Do I Use?
Decorating By melissa0902 Updated 5 Jun 2009 , 1:19am by Rylan
I am making several 11X15 sheet cakes this weekend. I use the Wilton cake boards wrapped in fancy foil. I know the cake might crack if I only use 1. I have been stacking 3 since it looks nice, but would 2 be enough to guarantee the cake wont crack in the middle?
I wouldn't trust it. I would rather use something solid and stable such as wood.
Quote by @%username% on %date%


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Pierre Balmain
Website: www.pierrebalmain.com
Address: #01-11, Scotts Square, 6 Scotts Road Singapore 228209
Getting there:
Take the MRT to Orchard MRT Station (NS22). Take Exit A.
Contact: Opening Soon
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Daily from 10am to 10pm.
Infused with the powerful DNA of the original brand, Pierre Balmain, the sister line of Balmain, flaunts a younger and rockstar attitude. Be mesmerized with its downtown-cool vibe with the same rock'n'roll sensibility - at a wallet-friendly price. Its first flagship store in Singapore is located at Scotts Square. View Fullscreen Map
Search ComeSingapore for articles, events and directories matching your keywords.


text: PCMag Staff Sony Cyber-shot DSC-QX10 Reviews/ Consumer Electronics/ Digital Cameras/ Sony Cyber-shot DSC-QX10 View As: One PageSlides Back to Review 1 Share Tweet Pin Email Attached to iPhone The Sony Cyber-shot DSC-QX10 is one of two lens-style cameras that the company is marketing for use as add-on lenses for Android and iOS phones. 2 Share Tweet Pin Email Front The QX10 is remarkably compact. It measures just 1.2 by 2.5 inches (HD) and weighs a mere 3.2 ounces. 3 Share Tweet Pin Email Top The lens is a 10x design, covering a 25-250mm (35mm equivalent) field of view. 4 Share Tweet Pin Email Left The only controls of note are a zoom rocker and shutter release button, both on the side of the lens barrel. 5 Share Tweet Pin Email Right Even though it's slimmer than the QX100, I still had issues with the QX10's form factor. It doesn't lend itself well to quick, candid shots. 6 Share Tweet Pin Email Smartphone Mount A removable bayonet mount features clips that attach to a smartphone—there's a larger accessory available for tablets, if you're a fan of taking pictures with an iPad. 7 Share Tweet Pin Email Studio Scene I shot the PCMag studio test scene using the QX10. 8 Share Tweet Pin Email Studio Scene (Crop) This center crop from a wide-angle shot of the test scene shows off the detail that the QX10 can capture. 9 Share Tweet Pin Email ISO 100 (Crop) At the lowest ISO setting the QX10 captures detailed images with about 1.4 percent noise. 10 Share Tweet Pin Email ISO 400 (Crop) Noise is 1.7 percent at ISO 400, but there's still a good amount of detail in shots. 11 Share Tweet Pin Email ISO 3200 (Crop) Detail disappears quickly as the ISO is increased; it's mush at ISO 3200.


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Cheesy Broccoli and Cauliflower
READY IN: 23mins
Recipe by sydsmama
Great way to dress up veggies!
Top Review by pdxfoodie53
I brought this dish to a friends house for dinner, because she has a veggie picky son and a veggie picky husband. I left out the hot sauce to make it more kid friendly. We were all happy with the result - very tasty!
See Discussion:3 Reviews
Ingredients Nutrition
- 2 large head broccoli (about 3 to 3 1/2 pounds total)
- 1 medium head cauliflower (about 2 pounds)
Cheese Sauce
- 3 tablespoons unsalted butter
- 3 tablespoons all-purpose flour
- 1 3⁄4 cups milk
- 2 cups shredded sharp cheddar cheese
- 1 tablespoon Dijon mustard
- 1 (4 1/4 ounce) can diced green chilies, drained (to taste, I use 1/3 can)
- 1⁄4 teaspoon hot pepper sauce
- 1⁄8 teaspoon salt
- additional milk, if needed, to thin sauce
Directions See How It's Made
- Cut broccoli and cauliflower into florets, discarding outer leaves and stems.
- You should have about 8 cups broccoli florets and 4 cups cauliflower.
- In a large pot, bring 8 cups of lightly salted water to a boil.
- Add cauliflower; cook 2 minutes.
- Add broccoli; cook an additional 6 minutes or until vegetables are crisp tender. Drain.
- While vegetables are cooking, make Cheese Sauce:.
- In a medium-size saucepan, melt butter over medium heat. Whisk in flour and cook 1 minute.
- Gradually whisk in the milk; continue to whisk until smooth. Bring to a boil.
- Remove from heat and stir in cheese, mustard, chiles, hot-pepper sauce and salt.
- Stir until smooth. If a thinner sauce is desired, stir in a few more tablespoons of milk.
- To serve, place vegetables in large serving dish and pour cheese sauce over the top. Serve immediately.
- Do Ahead: Cook vegetables, rinse under cold water to stop cooking. Drain and refrigerate. Prepare sauce; let cool, then cover and refrigerate up to a day ahead.
- To serve, uncover; remove from refrigerator and let stand 30 minutes.
- Reheat separately in microwave oven (adding more milk to sauce as needed).


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While the consumer staples and consumer staple sectors both rely on spending habits, consumer related exchange traded funds act differently in a shifting economy.
Typically, investors can look at the two consumer sectors as discretionary "wants" and staple "needs."
Discretionary goods include nonessential items that consumers would splurge on during the good times but are willing to cut back during tougher times. These types of items and services include retailers, media, durables, apparel and automobiles.
So far this year, the Consumer Discretionary Select Sector SPDR (NYSEARCA:XLY) has gained 24.3%, outperforming the S&P 500.
Top holdings include Walt Disney 6.4%, Home Depot 6.4%, Comcast 6.2%, Amazon 5.9% and McDonald's 5.9%. Top sectors include Media 30.0%, Specialty Retail 19.1%, Hotel Restaurants & Leisure 14.5%, Internet & Catalog Retail 9.9% and Multiline Retail 6.8%.
"Investors should take note that the Consumer Discretionary Select Sector SPDR is a cyclical play tied to consumer spending," according to Morningstar analyst Robert Goldsborough. "At the same time, cyclical firms usually do rally before the economy fully emerges from a slump."
Consumer confidence is rising, along with the improving U.S. economy and a rising employment rate.
However, during any economic situation, people will still need basic goods or consumer staples, like food, beverages, tobacco and other household items, that many are unwilling to live without regardless of financial hardship.
The Consumer Staples Select Sector SPDR (NYSEARCA:XLP) has gained 18.2% year-to-date.
Top holdings include Procter & Gamble 14.1%, Coca-Cola 10.1%, Philip Morris 9.3%, Wal-Mart Stores 8.1% and CVS Caremark. Top sectors include Food & Staples Retailing 24.0%, Household Products 21.0%, Beverages 19.9%, Food Products 17.1% and Tobacco 16.0%.
"Staples companies typically deal with narrow margins, which can make it difficult to rapidly increase profitability and thus support swift growth in stock prices," writes Brad Sorensen, Director of market Sector Analysis, Schwab Center for Financial research. "So while staples have done well since the beginning of the year, we think their recent positive run probably has a limited time horizon."
Moreover, during times of improving economic growth, defensive, non-cyclical sectors like consumer staples typically fall out of favor as more investors take on riskier cyclical stocks.
"Staples stocks may have been driven up by investors who'd been out of the market for some time and tip-toed back in by starting with more defensive areas," Sorensen added. "If this is the case, then investment money may move toward cyclical sectors as investor confidence improves."
Max Chen contributed to this article.
Disclosure: I have no positions in any stocks mentioned, and no plans to initiate any positions within the next 72 hours. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it. I have no business relationship with any company whose stock is mentioned in this article.


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Do you have a childbirth story to share?
I'd love for my readers to post their childbirth stories here for everyone to read.
I'd love to hear from you!
How to Cope With Pain During Childbirth ~ My Childbirth Story
My name is Lisa and I am "Mom" to 4 awesome children ages 27, 25, 23 and 12. I gave birth to all 4 "naturally" without drugs – better known as "natural childbirth". While I was pregnant with my first child I read a book – Thank You, Dr. Lamaze. I read it twice. It is an EXCELLENT book. I also read a book titled Painless Childbirth – The Lamaze Method. My labor with my [Read more...]


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Technology convergence, folks, that's why it's an economic possibility for companies like Acer, Asus and now ViewSonic to make phones.
Visual display manufacturer ViewSonic has just announced that it will launch a smartphone line, initially in China followed by Europe and America. Why not - you're doing things on your phone that only used to be possible on TVs and computers after all.
ViewSonic is known for its LCD monitors and TVs, projectors and smaller-scale screens as well, so we can probably expect some nifty looking smartphones. At least let's just hope they jazz their products up more than say, Acer's rather staid-looking launch line (right).


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What Are Stomach Parasites?
If you are new to Betta fish protecting, feeding them may present a challenge at first. Treating seeds with these seed remedy chemical substances is the easiest way to guard it from bugs and pests thus increasing the stand quality, yield and return on investment. Not only are our pets at risk stick insects pets at home, but in addition your self and your loved ones, when we talk about ticks. Mosquito nets may be attached to nearly any service, and do an important job of protecting mosquitoes away, particularly when you are sleeping.
Normally the females are larger than the males and all stick bugs are herbivores, living off the vegetation they eat. Mosquito misting is without doubt one of the simplest methods to eradicate the threat of these bugs from a house, yard, or neighborhood. Residual spray merchandise labeled for control of crawling bugs packaged in aerosol bombs are hazardous if sprayed into the air even though stick insects as pets australia home windows and doorways are open. If you've got an infestation of basement bugs, one of the simplest ways to rid your basement of these bugs is thru the usage of pesticides or bug sprays. However, there are adequate cons and drawbacks of proudly owning wild animals as pets.
Factors equivalent to body heat and pheromones will guide bedbugs to areas where pets congregate and relax. Manufacturers declare that such pesticides are as effective at exterminating adult bugs, larvae and eggs, as chemical pesticides like Hydroprene or Diatomaceous Earth, while being absolutely non-toxic for pets. Regularly change outside water dishes for pets, water in fountains, child's swimming swimming pools and even preserving potted plant dishes empty. Believe it or not, aluminum foil can successfully can insects be pets hold hungry insects and slugs away out of your vegetable backyard. If you've pets you then already know that cat and dog food have a tendency to attract ants and other crawly creatures. Simply buy totally totally different kinds of cat nip out of your native pet retailer and try it out in your cat.
Although it is capable of carrying 850 times its own body weight in a laboratory experiment, Rob Knell from Queen Mary, University of London and Leigh Simmons from the University of Western Australia discovered insects as pets australia that the dung beetle is stronger.
If you prefer to keep the insects alive, contemplate transferring them to a brand new surroundings. Be certain to stay to one mannequin of cat nip because of your our cat my not react to others. This manner insects as pets, your property is freed from insects and other animals and you will not need to be involved about evacuating your house because of harmful fumes or harmful foggers.
Author: Dilan BeliThis author has published 2445 articles so far. More info about the author is coming soon.


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Today I'm not thinking about anyone specifically, but I've had this subject on my mind for a very long time. It hurts when other don't acknowledge our success because it might not be an obvious success. For instance, when I self-published there were some people who never said a word about it or seemed to care. I've wondered a thousand times that if that book had come out from a large New York publisher if those people would have cared then. Now that I'm with a small publisher, my mind goes in the same direction. If there are some people close to me that don't seem to care, would they care if I had a larger publisher, if I made the New York Times Bestseller list? If I did things a more conventional way?
More than likely, these people I care about will never truly care about these successes of mine. I've finally come to the conclusion that this doesn't mean they don't care about me.
Much of this might have to do with content. Your grandma might not wish to read the violence or love scenes you put in your book. Much of it might have to do with hobbies. Maybe your cousin simply doesn't like to read, and even though you did everything together as children, he'd rather pat you on the back for making a hole-in-one at the golf course than finishing that novel and getting an agent. He simply "doesn't get it." Then again, maybe you don't get something that means a lot to him. Imagine that.
So what do you do at this point? Do you zip your mouth shut around friends and family members who obviously don't care about what you do? Do you talk about your hobbies – your job – anyway? What if it's your spouse? I have one friend who writes. It's her passion, but her husband has never read any of her work. That depresses me. I need the support of my husband, but I figure I'd keep writing anyway if he didn't care. After all, I think it's best if we don't write for the approval of specific people. I've done that before, and it's no fun when it collapses at your feet.
Maybe this is all because we know that if we were to reach these people who don't care, that would be the ultimate success. Maybe.


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Secretary of Homeland Security Janet Napolitano, who has served in President Obama's Cabinet since Day One of his administration, announced Friday that she would step down to become president of the University of California system.
Napolitano's departure has been in the works for several months, and she plans to leave her post in early September, according to two administration officials. Napolitano, a former governor of Arizona who had been seen as a potential Democratic presidential candidate, will exit the political stage to run one of the nation's largest public university systems.
As homeland security chief, Napolitano has been a central figure in the immigration debate as well as the government's counterterrorism policies and responses to natural disasters. Her resignation comes at a critical time for the Obama administration, as the House debates a bill to overhaul the nation's immigration laws.
In a statement released Friday morning, Napolitano said that serving in the Obama administration has been a "privilege."
"The opportunity to work with the dedicated men and women of the Department of Homeland Security, who serve on the front lines of our nation's efforts to protect our communities and families from harm, has been the highlight of my professional career," Napolitano said.
An early political backer of Obama who joined his administration in 2009, Napolitano was among the first-term Cabinet officials to remain in their posts into Obama's second term.
Napolitano had given no indication publicly that she would leave, although she was seen as a possible successor to Attorney General Eric H. Holder Jr. should he depart. Administration officials said Napolitano, who had extensive law enforcement experience in Arizona, did not hide her desire to be attorney general and grew discouraged about her prospects as Holder stayed well into Obama's second term.
One administration official familiar with Napolitano's thinking cautioned that she simply seized what she considered to be a great career opportunity, calculating that after serving longer than any other homeland security secretary, it was time for a new challenge.
"The process was underway for some time, but it didn't formalize until recently, and she informed the president when she made her decision," said the official, who requested anonymity to speak about the process.
Obama thanked Napolitano for her more than four years of service, saying, "Janet's portfolio has included some of the toughest challenges facing our country."
"The American people are safer and more secure thanks to Janet's leadership in protecting our homeland against terrorist attacks," Obama said in a statement. "I've come to rely on Janet's judgment and advice, but I've also come to value her friendship. And as she begins a new chapter in a remarkable career of public service, I wish her the best of luck."
Napolitano has been at the front lines in the politically charged immigration debate, given her department's role in securing the nation's border with Mexico. She also helped lead the responses to deadly tornadoes in the Midwest and Hurricane Sandy, which ravaged the Northeast last year, as well as the 2010 BP oil spill in the Gulf of Mexico.
via Homeland Security Secretary Janet Napolitano stepping down to run UC system – The Washington Post.
Homeland Security Secretary Janet Napolitano stepping down to run UC system
Posted on 12 Jul 2013


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Hotel Cozumel
July 29 - August 5, 2017
Cozumel is known in the scuba diving industry as one of the best scuba diving locations in the world. Every dive is a scuba divers dream. Teaming with schools of fish and boasting amazing view, Cozumel offers the avid scuba diver a vast playground. Cozumel is the Mexican Caribbean's largest island, just 12 miles off the coast of the Yucatan Peninsula. Located near Cancun; Cozumel is an island destination for scuba divers and non-scuba divers alike. Although it is a diver's mecca, even after decades as a popular vacation resort, it remains a serene, quiet and undiscovered piece of paradise.
Package Includes:
- 7 Night accommodation at Hotel Cozumel in a Standard Room
- Breakfast, Lunch and Dinner Daily
- Alcoholic & non-alcoholic beverages (top shelf beverages extra)
- 5 days of 2-tank morning boat diving
- Hotel taxes and bellman/maid fees
- 1-Hour welcome cocktail with hot snacks and domestic drinks, in a private room at the beach club.
Your Package Excludes:
- International Air
- Round-trip airport/hotel transfers
- Marine Park Fee of $3.00 per person/day
- Personal Dive Equipment
- Dive Crew Gratuities
- Insurance (Dive & Cancellation)
$1,085 Per Person Double Occupancy
$1,405 Per Person Single Occupancy
$682 Non-Diver Double Occupancy
To insure your space a $250 non-refundable deposit payable to Aquatic Adventures is required.
Pre-Trip meeting is Thursday, July 13th @ 6pm. Please bring your certification cards, passport and flight itinerary to the meeting.
Additional Trip Information:
Final Payment: 60 days prior to departure date for trip, Friday May 26, 2017. Full payment must be made if any traveler signs up for trip under 60 days prior to departure.
Payments are to be made by check to Aquatic Adventures Ohio:
Aquatic Adventures Ohio
3940 Lyman Drive
Hilliard, OH43026
Payments made by credit card will be subject to a 3% processing fee.
Late Payment: Late payments will result in a $25/day late fee and will be subject to the fees/penalties associated by the respective operators.
Cancellations: Aquatic Adventures Ohio incurs unrecoverable charges preparing for your trip; therefore monies cannot be refunded if cancellations occur less than 60 days before departure. Cancellations more than 60 days prior to departure can be refunded with the exception of the non-refundable deposit. Travel Insurance is strongly recommended.
Changes to airline schedules and routing are at the sole discretion of the airline; Aquatic Adventures Ohio cannot be held accountable for these changes. Any cost incurred that is not covered by the airlines would be the responsibility of the traveler. Travel Insurance is strongly recommended.
Cancellation Note: Unfortunately, we cannot vary from our stated cancellation policy regardless of your situation. We recommend that you buy trip cancellation insurance immediately upon booking your trip.
We strongly recommend the use of travel insurance for any of your trips.


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There may not be an Apple iPhone 5 - white or otherwise - launching this summer after all. If rumours and anonymous tipsters are to be believed (and after all, they're the fuel that keeps the wheels of the internet going), there will not be iPad, iPhone or Mac hardware announced at Apple's Worldwide Developers Conference in June.
The annual event is traditionally where new iPhones have been unveiled. According to Wired, this year's conference will focus entirely on software news. In other words, we're likely to see a new iPhone OS, iOS5, as well as the next-gen Mac OS, OS X Lion - but not a new iPhone.
So when will that new iPhone launch then? After all, this is around the time when people start deciding not to buy one because of a guaranteed summer next-gen launch from Apple. Well, according to Tech Crunch, iOS5 is set to launch in autumn, so it's likely that the NFC-packing, better-antenna'd iPhone 5 would launch with the new OS at the same time.
As to what Apple will feed the hungry hordes, well, maybe that white iPhone 4 - supposedly set for a spring availability - will be the gadget of the season instead.


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Area participants open at state meet Thursday: State Tennis
MINNEAPOLIS -- Benson/KMS seniors Ben Murphy and Luke Widseth are in the doubles consolation semifinals of the Class A state individual tournament after splitting two matches Thursday.
Murphy-Widseth fell 6-4, 4-6, 6-4 to Charle Velie and Will Hawkins of Blake in the opening round before bouncing back to beat the Montevideo duo of Charlie Landmark and Dakota Frazier 2-6, 6-1, 11-9 in the consolation quarterfinals. Murphy-Widseth will play Logan Engelstad and Micah Rodahl of Thief River Falls today at 8 a.m. at the Reed-Sweatt Family Tennis Center. The consolation final follows at 11:30 a.m.
Landmark-Frazier lost 6-1, 6-1 to Felix Mettke and Andrew Engel of Breck in their opening match. Ben Peters and Dylan Hoffman of Minnewaska were also 0-2 and eliminated from the tournament, losing 6-1, 6-0 to Connor Rust and Brian Utz of Rochester Lourdes and 6-0, 6-0 to Beezer Skime and Connor Hutton of Thief River Falls.
In singles, Jack Hansen of Lac qui Parle Valley/Dawson-Boyd was eliminated after falling 6-2, 6-0 to Daniel Carpenter of Breck and 6-4, 6-4 to George Humphrey of Blake.


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You must Sign In to post a response.
- Category: Movies & Actors
- #5179Hello sir,
I too feel that the serial is the worst of all the serials in Tamil channels it has been simply dragged like anything and my mom spends most of her time in watching this serials. Almost all the serials are being dragged and the mega serials are made to run for some thousands of days which should run only for some 300 days. I feel instead of watching these serials they can watch some live programs that are run on the television channels.
Sudhan A
"All men who have achieved great things have been great dreamers"
- #5501Hello sir,
as per my view goes, the tamil serial thangam is only a entertainment serial and more concerned about the tamil rituals. I quote this because the comedy is given prior or more important than the rituals in this serial.
For example one day the man and vanthana both of them applied chillly powder on amman's face. After this very much expected incident, nothing happens to both the clients. So this seriale may not direct the people to the old rituals.
The serial goes on with more of comedies and entertainments. The character played by elavanchi is a remarkable one. According to me watching of serial is waste of time. Rather than watching the serials the people can do something to improve their life.
Defeat the defeat, before the defeat defeats you
- #5519Men also watching serials!!!
Suresh Kumar R.
Engal Vazhvum Engal Valamum Mangaadha Tamizh Endru Sangae Muzhanku
- #5526Hello mr. Suresh kumar,
it is not that men are watching serials. When we are at home the serial is watched by the members of the family. It is occasionally we here the dialogues from the serials while passing by. Or just sit with our households when they discuss about the serial. With that knowledge only i have commented on the serial. Giving opinion about a serial does not mean that we are watching.
Defeat the defeat, before the defeat defeats you
- #5533Dear Friends,
I feel that not only the Thangan serial in Sun TV is worst. Most of the serials in today's Tamil channel are worst. The Private TV channels is working in money motive basis. They are getting lakhs and crores of money by advertisement. This kind of serials are helping them to increase their revenue. They are not worry about the quality of serials that they are broadcasting and their aim is only to generate more income. In order to regulate this serial broadcasting in private channels, The government should take necessary action by incorporating the following conditions.
* The serials must avoid to have illegal scenes and give some good message to the people.
* They should get approval from the sensor board as like flim
* The time limitations and quality should be tested
* The restrictions among the ads should be implemented
with regards,
- #5564Yes, it is totally absurd.Such kind of serials have no meaning at all.But the serial directors simply make the housewives to watch it by creating a suspense scene at the end of day.
Return to Return to Discussion Forum


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Attracting and retaining the best talent in the marketplace to sustain our high growth and deliver an exceptional product to our customers is our talent mission.
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Symphony Advanced Media is a tech startup within the $2.7B Symphony Technology Group (STG). STG is a private equity firm that sets companies on the path to success by providing strong technology foundation, stable financial resources and deep marketplace insight. Using a powerful mix of capital, hands-on management and innovation expertise, STG propels its companies toward long-term success.
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Please send us your resume at firstname.lastname@example.com with a short cover indicating your area of interest.


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PEKING PRINCE can make the marathon trip north of the border pay off in the opener, while Firebet may prove next best in a competitive event. Andrew Balding sends Peking Prince all the way from Kingsclere and with David Probert claiming a good 3lbs he looks an attractive proposition. He stayed on strongly when scoring at Newbury last time, after taking a while to come to hand this season, and the manner of his success suggested that he can probably now go on and defy an 8lb rise. Firebet concedes 16lbs to the selection, and that may just prove beyond him. He is 6lbs higher than when scoring at Nottingham last week, and he goes well at this trip and on fast ground, so he is given due respect. Beautiful Breeze looked in the grip of the handicapper at Sandown but this extra furlong might help him find a bit extra, while African Art won a Haydock maiden and was then out of his depth at Newmarket, but this is easier and he may well figure. Tiger Reigns might benefit from the drop back in trip but he was well beaten last time and Peking Prince is preferred.
Firebet (IRE) 15-8fav (9-3) Tracked leaders, ridden over 2f out, led inside final furlong, stayed on, won at Nottingham 1m 3yo hcp 0-95 (3) gd beating Mull Of Killough (9-0) by 3/4l, 9 ran.
African Art (USA) 13-2 (8-12) Raced centre, held up, joined main group over 3f out, ridden over 2f out, headway and one pace from over 1f out, 4th of 7, 7l behind Four Winds (8-12) at Newmarket 1m 3yo stk (3) gf in May.
Big Apple Boy (IRE) 11-2 (9-4) In touch, ridden and weakened over 2f out, 6th of 8, 7l behind Silver Games (9-3) at Newcastle 1m 3yo hcp 0-90 (4) gf in May.
Green Agenda 7-2 (8-0) Stumbled start, tracked leaders, ridden and every chance over 1f out, kept on same pace final furlong, 3rd of 7, 4l behind Dream Lodge (9-9) at Redcar 1m hcp 0-95 (3) gd.
Come And Go (UAE) 20-1 (8-11) Reared at start, slow into stride, held up towards rear, ridden along halfway, headway over 1f out, stayed on final furlong, 5th of 9, 5l behind Roman Republic (9-0) at Doncaster 1m 3yo hcp 0-100 (2) gs.
Peking Prince 10-1 (9-2) Held up in mid-divison, headway travelling well 2f out, shaken up to lead 1f out, ran on well, in command when edged left final 50 yards, won at Newbury 1m 3yo hcp 0-75 (5) gf beating Carbon Hoofprint (9-3) by 1 1/2l, 15 ran.
Tiger Reigns 7-2 (9-0) Held up behind leaders, ridden along over 2f out, one pace final furlong, 4th of 7, 7l behind Geneva Geyser (8-9) at Redcar 1m 2f 3yo hcp 0-85 (4) gf in May.
Beautiful Breeze (IRE) 10-1 (9-4) Pushed along 3f out, always towards rear, 8th of 10, 10l behind Cyflymder (9-6) at Sandown 7f 3yo hcp 0-85 (4) gf.
Spinners End (IRE) 7-2 (9-1) Made all, ridden over 1f out, stayed on strongly final furlong, won at Musselburgh 1m 3yo hcp 0-80 (4) gf beating Sir Isaac (9-2) by 3 1/2l, 5 ran.


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|Message view
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|"Raghavendra Datt" <raghavendrad...@gmail.com>
|Re: Default error page generation logic in tomcat
|Wed, 13 Aug 2008 20:10:55 GMT
Ok... I just figured out a work around for this to make work. I modified ServerInfo.properties from catalina.jar and re-jarred it and overrode the original catalina.jar. This seems to work. but, I am just curious whether this has any side effects? Earlier, I tried doing the same thing but, was not actually overriding catalina.jar proprely. Thanks, Raghu On Wed, Aug 13, 2008 at 1:02 PM, Caldarale, Charles R < email@example.com> wrote: > > From: Raghavendra Datt [mailto:email@example.com] > > Subject: Re: Default error page generation logic in tomcat > > > > I have this tomcat running on linux and I don't find > > catalina.properties any where in the tomcat folders. > > A red flag just went up. Are you using a real Tomcat, or a 3rd-party > repackaged version? If the latter, it probably has scattered Tomcat files > all over the place, and will be prone to numerous errors and stability > issues. Suggest removing the Tomcat you have and downloading a real one > from http://tomcat.apache.org. > > - Chuck > > > THIS COMMUNICATION MAY CONTAIN CONFIDENTIAL AND/OR OTHERWISE PROPRIETARY > MATERIAL and is thus for use only by the intended recipient. If you received > this in error, please contact the sender and delete the e-mail and its > attachments from all computers. > > --------------------------------------------------------------------- > To start a new topic, e-mail: email@example.com > To unsubscribe, e-mail: email@example.com > For additional commands, e-mail: email@example.com > >
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According to research, how frequently do teachers ask questions?
Every 72 seconds
Every 5 minutes
Every 10 minutes
What percentage of the questions teachers ask are answered by themselves?
What is the average wait time provided by teachers when they ask a question?
Less than one second
Two seconds
Three seconds
Select all possible correct answers. The purpose of asking questions is to:
Inform planning for future teaching
Extend and deepen learning
Identify where students currently are in their learning
Effective questions are:
Mainly closed
Mainly open
All asked by the teacher


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House Sitter in Chardon
I am a recent college graduate from Ohio University and I currently have little obligations, so I have free time to housesit while you are on summer vacations, trips for work, etc. I will keep your house neat and clean while you are away. Also, I love animals and can care for your pets according to your instructions. Lastly, I have experience with gardening and can care for the indoor and/or outdoor plants.
House Sitter Details
|Email Address
|Phone Number
|440-725-... Confirmed
|Provider Type
Collect Mail
Feed Pets
Care For Plants
Take Out Trash/Recycling
Snow Clearing
Notes made here will only be seen by you. If you want to message the owner of this listing
Rebecca Curry's Other Listings
More in Chardon, Ohio
Looking for House Sitting jobs in Chardon, OH?
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16 September 2012 -midday to 4 pm Gilwell Park will be open to all Scouting members and their families.
The new facilities at Gilwell Park will be featured including the High Ropes Course, Flying Fox, Low Challenge Course, Abseiling Wall, and Bouldering Wall to name just a few, we have other activities planned and will announce them over the next few weeks. The best news is it's free!
So come along with your Group and your family, make a day of it have a picnic in the grounds and have a look at what we have been doing at Gilwell Park since you were there last. You will notice some amazing activities and improvements.
Members need to book to take part in the High Ropes Course, expect to be there for 30 minutes so please click here to indicate your interest and book your place.
Please note the Adult Recognition Awards are scheduled between 10 - 11 am, members are welcome to join in and celebrate this prestigious event with the awardees.


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Ask a Lawyer and Get Answers to Your Legal Questions
I am sorry to hear this; a Notice to Appear is authorized by Rule 3.125:
RULE 3.125. NOTICE TO APPEAR (a) Definition. Unless indicated otherwise, notice to appear means a written order issued by a law enforcement officer in lieu of physical arrest requiring a person accused of violating the law to appear in a designated court or governmental office at a specified date and time.
Here is the statute at issue:
It is important to contact an attorney to have them meet you at the court. For first offenders, the attorney can help negotiate a pre trial diversion program so that there is no conviction. Many prosecutors are willing to negotiate but it is best to have an attorney negotiate for the defendant.
The attorney will meet with the prosecutor and attempt to plea bargain the case to either a lesser charge, or they will examine the evidence and determine if the charge can be defeated at trial.
An attorney can be located here:
Further questions? Please post here to continue the chat.
Satisfied? Kindly rate positively so I receive credit for assisting you. I hope that you feel I have earned
5 stars *****
as I strive to provide my customers with great service.
(no additional charges are incurred).
Information provided is for educational purposes only. Consultation with a personal attorney is always recommended so your particular facts may be considered. Thank you and take care.
Hi- just checking in to see if you needed clarification on any of the above information. If so please post here (there is no additional charge for this) and I will do my best to get you the requested information.
Thank you!


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Summer 2017
- Independence Day
The Fourth of July is always celebrated in Mansfield, Missouri. Parades have been a tradition here since the days of Horses pulling Decorated Wagons and Buggies. Today we all celebrate Independence Day in Mansfield with a Parade, Festival and Fireworks.
- "Laura's Memories" – An Outdoor Pageant
Check Listings: The Ozarks Mountain Players present"Laura's Memories", an annual outdoor pageant in Mansfield City Park.
- Traveling Panel Display
Laura Ingalls Wilder – The Journey of a Pioneer Family Traveling Panel Display.
Fall 2017
- Wilder Day
Mansfield, Missouri, commemorating Laura Ingalls Wilder. Join us September 16th 2017 for our annual celebration commemorating Laura Ingalls Wilder, America's favorite pioneer girl, and her cherished "Little House" books. Hear Pa's fiddle, take a tour of the home, the upstair of the historic house will be open for touring this day only, enjoy the grounds of Rocky Ridge Farm. We hope to see you here! We will have our 4th Annual Fiddle Off on this day as well. This has become an exciting and entertaining event. Please come out and enjoy the festivities.
Winter 2016
- Christmas at Laura's
Chistmas Tradition here on Rocky Ridge Farm. Free admission to the historic home featuring vintage decorations. Tunes on Pa's fiddle. Bring YOUR camera or cell phone for pictures with Santa by Laura's fireplace. Tastings from Laura's own recipes. Laura's Christmas is scheduled for December 3rd from 6:00 – 8:00 P.M. Weather Permitting. (NOTE*) If the parade is canceled for bad weather Laura's Christmas will be canceled as well. Come celebrate Christmas with us in a most special way!
Click Here for all the information to plan your trip today!


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I've been doing my homework for 2 years now, and I've finally decided to improve the dimply and flat appearance of this butt. I have considered Miami doctors, but I've finally decided that Dr. Hughes in California is the best for me. I love the work he's done on the ladies here and on his site! Plus, I won't have to fly far, as I live in the next state.
That Girl Thinks She Needs a BBL
I've been doing my homework for 2 years now, and...
BBL Simulator App
More Before Photos
I've got legs that will set that new thick butt off
Buying Fajas Without Trying Them On?
Posing vs. Being Real
How to Make The Most of Your Pre and Post BBL Booty
New Boobs Needed
Lab Results
I got my labs back and they are A1 green light! I keep having these second thoughts, wondering if I'm doing the right thing. The worst is to have your teen daughter be so supportive while you're not telling her that one of your fears is... Well you all know what I'm thinking. I've only told her that I know my body is amazing just as it is and I fear I'll ruin it instead of making it better. She tells me how much I'll regret passing up the chance to change what I'm unhappy with, and to just do it. And I will.
I'm not going this to draw more attention to myself. I get plenty of that and more than I want. I'm doing this because I've always wanted a prettier rear view. I'm not going for much more in size, more than anything I'd like a shape and appearance change to round and smooth.
2 more weeks and I'll be transformed. How are your nerves? Are you close in time and biting your nails?
No More Posing
Wanted: Much A$$!
Thank You Beautiful Body
Today Is The Day
I'm a new woman
Feeling Fine
How Surgery Day Went
Juicy Booty!
Apple Bottom, Hips, Lats, Tiny Waist
Infection on My New Booty, BBL Mystery
The area is one that I've been puzzling about because from minute 1, it's been the biggest hardest location on my butt. It's on the right cheek.
Now the opposite cheek is nearly fully softened except for the top shelf area, while the infected butt cheek is hard in the center and soft everywhere else including the shelf.
This bbl process is such a mystery. I don't think enough dolls share their less positive experiences on here. I intend to keep my RS sisters informed and thank you all for continually updating your progress ups and downs.
I've done everything by the docs instructions and cannot figure out why this is happening to me. I started the antibiotics, which is my second course because doc prescribed them post surgery for 7 days too.
I'm praying my butt heals and does not need draining (I'm not flying back to L.A. for drainage!) and that I don't lose volume or suffer fat death.
Pray for me sisters. I really wanna cry about this because there's not enough info here or on the web about this situation, but what little info I've found is not good!
Gonna Get My BBL Drained
My butt isn't as round in profile views as it was the first week, but it's definitely better than it was before. I just need to eat more. My appetite has been down since getting this red area. My stomach and back are healing smoothly and nicely. Inner thighs are still swollen and so are my arms. Thighs aren't as slim as usual yet and I like them thicker! Arms are slimmer than usual even though they are swollen. After surgery I was up 12 pounds of water weight. Now on day 19 I'm only 3 pounds up from normal.
I'm gonna be fine and this booty is only gonna get bigger and better after I'm done dealing with this red spot!
No Infection! BBL Mystery Solved
The Doc has never seen this before and asked me all kinds of questions bout my activities. He said all he could think would cause this trapped blood was trauma to the area. There was one other hard spot on tge other cheek that actually felt a bit painful without touching meanwhile the original red area was only painful if you touched it. Doc tapped into that other spot too and got about 20 cc of blood from it.
He asked about my supplements too, which I knew not to take vitamins E or fish oil, etc because they could cause bleeding, and on fact I never take that stuff though I know it's supposed to be good for you except before and after surgery. And I wasn't taking any herbals either, I never take any of that. I wasn't taking aspirin or ibuprofen either. Wasn't having sex, wasn't working out, was being just plain lazy, following all orders because I didn't go through this to end up with a bad bad a$$! All I want is a good bad a$$!
I did recall that during week one on about the 8th day, my friends daughter was playing with a tennis ball in he living room. The ball hit my butt and omg it hurt for about 20 mins. I don't recall which cheek, but now I bet it was the biggest bleeding one with the red area. I remember playing it off not saying a thing so as not to traumatize that beautiful 10 year old for accidentally hitting my new booty.
What about the other cheek though? It only had 20 ish cc's of blood. So Doc Hughes thinks I incurred this based on my own body at this stage. He told me if ever I plan on surgery in the future be sure and let that doc know. He said it doesn't mean it will happen again but it should be brought to attention. What else could the Doc conclude when I'm telling him I've been a model well behaved rule abiding patient?
Right now I'm feeling grand! All that poking hurt a bit, but I was in awe of Doc Hughes' and Sandra's expertise, professionalism, sense of humor, and warm personalities which put me at ease and made me confirmed again that I'm with the "A" team.
Best part besides discovering my butt ain't infected is that I didn't have to get it cut open and scarred up!
Thanks for your prayers and support sisters!! Our prayers were answered, my booyty is healthy and thriving! Im including side by side pics of day 5, day 17, and day 19. There really hasn't been much booyty shrinkage!
BBL and Melatonin Don't Go Together!!
Doctor Hughes kept asking me what supplements I'm taking. I finally realized I'd left one out - melatonin. To help me sleep, I've been taking 3 of the trader joes chewable peppermint melatonin pills per night since 1 week after my surgery, and up until the day before yesterday. Before telling Hughes this, I researched the supplement and discovered it can cause increased bleeding! So whatever I had done that caused injury in those 2 areas on my butt, well instead of bleeding a little and clotting normally, they bled and bled and bled! I told the doc bout the melatonin and he said stop taking it. Amazing how the very thing I used to get good sleep ended up robbing me of sleep once I'd injured my butt.
I still believe that I injured my butt by squeezing myself into that faja! It would hurt so badly in those 2 areas after I forced the garment over them. Mind you I did cut the butt area out but that didn't matter because it didn't prevent the garment from being difficult to get past my hips and big butt.
During my research I found that melatonin is one of many supplements that surgeons put on their do not take 2 weeks before and 2 weeks after list!
So ladies, no melatonin! I actually got the idea to use it from one of the RS posts I saw here before my surgery. I don't think it's a well known fact that it can cause increased bleeding because the way it's discussed online is do not take with blood thinners or it can cause increased bleeding. Well duh! Aspirin can cause increased bleeding and that bleeding can increase even more if you use blood thinners. So annoying how the internet info isn't specific enough.
I'm now officially afraid of melatonin. Keep in mind I took 3 pills per night when the bottle said to take 1. I had read on the internet you could take up to 5. So done with supplements!
I'm feeling fine now and in no pain after flying back to L.A. and having Doctor Hughes drain a ton of blood outta my butt cheek just like he did a week ago on the opposite cheek!
My New Butt is on Doc Hughes' Instagram
The Doc put me on his Instagram, and I remember thinking when I took that photo on the 3rd post surgical day that my butt was too big! Of course the booty greed is kicking in! But no worries, though I've lost some fullness and size, it's still improved over what I had and I know some if the loss is because my appetite has been terrible during this ordeal. I've lost weight and weigh only 145, but weeks before surgery I steadily weighed 148-150. I'll get some pounds back on these cakes.
Don't think I haven't been down about my situation. I have but I've kept it to myself and shared with a couple of you who've emailed or texted me. Thank you so much, all of you, even my sisters who've steadily posted and shared their ups and downs here. You get me through my darkest moments.
Not posting pics right now of the state of my cakes just yet as they are healing. The latest and biggest hematoma area is dark and hard, but the first area has lightened up and softened to nearly unnoticeable levels. I'm optimistic! Love you dolls!
Real Projection - No More Posing Needed
I'm finally healing. My butt seems stable in fat retention, shape, and size. I'm very pleased with it, even though that last hematoma left a lil dent. I may have Platelet Rich Plasma injections there, depending on what Hughes says. I've read that can rejuvenate the area and bring it new life.
I'm so happy that I don't have to pose anymore to get my butt to look shapely. Hughes is the man!
Doc Hughes and his staff are the "A" team. I can't express to you how choosy and particular and detail oriented I am. I am a friendly but tough customer and I joined and studied this RS site intending to find the West Coast doctor who could fulfill my expectations. Dr. Hughes is that expert this community and my research made me choose. He proved himself worthy of consideration from the start when I first emailed my photos and wish pics. He responded that same day within a couple of hours. We emailed back and forth about 15 times that Saturday, and then Sunday morning, as he promptly answered my questions. He told me my wish pics were achievable. I simply wanted to look better, more rounded, and totally natural. I love the ladies here who've gone in the bombshell direction, and have nothing but admiration for them going for what they want. Before my surgery I was in constant contact with Dr. Hughes via additional emails, which he still responded to promptly same day and often within minutes. He was truly committed to answering all my questions and keeping it real about what's possible. Fortunately the look I wanted was attainable. He told me that and set out to deliver, giving me the body I wanted but even better than I imagined it would be. All along this journey to my transformation, he made me confident in choosing him, and at ease about following through with my decision. I felt safe, cared for, and I knew that the doctor was excited to work on me, to give me what I wanted. After surgery care and attention is consistent with what I received before he was ever paid proving to me that he never stops working for his patient even after surgery day.


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Calling All Businesses: The New Jersey Economic Opportunity Act Is Signed into LawSeptember 2013 – Articles In the Zone
On September 18, 2013, Governor Christie signed the New Jersey Economic Opportunity Act into law after nearly nine months of consideration, wrangling and negotiation between both houses of the New Jersey legislature. With the passage of this bipartisan bill, the State of New Jersey has crystallized its existing array of economic development programs into two surviving programs: the Grow New Jersey Assistance Program (Grow NJ) and the Economic Redevelopment and Growth Grant Program (ERGG). In contrast to their earlier versions, Grow NJ and ERGG have wider applicability and a lower cost to entry and should be considered by any business that is undertaking a capital investment in a real estate project located in New Jersey. This article provides a general overview of Grow NJ will be the first in a series of articles addressing the Economic Opportunity Act's potential benefits to you and your business.
Grow NJ provides a tax credit to businesses (other than point-of-sale retail) that create or retain jobs in New Jersey and make a qualified capital investment at a qualified business facility. Grow NJ reflects the state's smart growth policies by adjusting the amount of tax credits available to be awarded based on the geographic location of a project and by lowering the threshold of required capital investment for projects involving the redevelopment of an existing facility. Additionally, Grow NJ reflects New Jersey's strong push to attract certain targeted industries by providing bonus tax credits for such businesses.
Capital Investment
To qualify under the Grow NJ program, a business is required to make a capital investment in the following amounts:
- For the rehabilitation of an existing industrial project: $20 per square foot
- For the new construction of an industrial project: $60 per square foot
- For the rehabilitation of an office project: $40 per square foot
- For the new construction of a non-industrial project: $120 per square foot
The capital investment threshold can be met through expenses used for site acquisition (if purchased within 24 months of the application), site preparation and construction, repair, renovation, improvement, equipping and furnishing real property as well as the cost of obtaining and installing furnishings and machinery, apparatus and equipment.
Job Requirement
A business is also required to either employ new employees or retain jobs that are at risk of leaving the state in the following minimum amounts:
- For technology startups or manufacturing businesses: 10 new or 25 retained
- For targeted industries including transportation, defense, energy, logistics, life sciences, technology, health and finance: 25 new or 35 retained
- For all other business and industries: 35 new or 50 retained
Minimum Environmental Standards and Net Benefits
Additionally, Grow NJ requires a business to construct a project in accordance with minimum environmental and sustainability standards and further establish that the award of the tax credits will result in a net positive benefit to the state.
Tax Credit Award
Upon meeting the threshold requirements, a business may be entitled to a tax credit applicable to New Jersey state corporate business tax, insurance company tax and franchise tax. In the event that a qualifying business does not have sufficient tax liability to make use of the credits, Grow NJ allows the business to sell the credits for an amount not less than 75 percent of the transferred credit amount pursuant to procedures established in the statute.
The tax credits are calculated on a per job/per year basis in the following base amounts based upon the geographic location of the qualifying business facility:
- Category 1: Urban Transit Hub Municipality or Garden State Growth Zone (Camden, Trenton, Passaic, Patterson, Newark, Elizabeth, East Orange, Hoboken, Jersey City and New Brunswick) - $5,000 per job/per year
- Category 2: Distressed Municipality (approximately 50 municipalities) - $4,000 per job/per year
- Category 3: Priority Area (including metropolitan and suburban areas) - $3,000 per job/per year
- Category 4: Other Eligible Areas - $500 per job/per year
Bonus tax credits may also be awarded for businesses that fall into the following categories:
- Businesses that result in job creation or retention of 250 or more jobs
- Businesses that pay average salaries that are 35 percent higher than the surrounding county average
- Business that are located near public transit are considered "Mega Projects"
- Businesses that develop workforce housing for employees located in the qualifying business facility
- Businesses that achieve a certain level of LEED certification
- Businesses that undertake environmental remediation in conjunction with the development or redevelopment of a qualifying business facility
Grow NJ also provides additional incentives and a lower jobs and capital investment threshold for businesses located in Camden, Trenton, Paterson and Passaic, and businesses located in the following eight Southern New Jersey Counties: Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Ocean and Salem.
If your business is considering a capital improvement project in the state of New Jersey, and you meet the requirements referenced in this article, we urge you to contact us.


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Adelaide Strikers vs Brisbane Heat Big Bash Live Score Match Highlights 18, Jan, 2014. Both teams have good bating line up so game is very tough from both sides, Adelaide Strikers and Brisbane Heat teams are head to head as per scheudle at Adelaide Oval cricket stadium while game will be decide to start at 02:45 GMT | 13:15 local | 07:45 PKT timings. This is the big sports platform where we will provide the all new latest cricket matches updates so bookmark our site for daily new latest updates.
Adelaide Strikers vs Brisbane Heat Big Bash live game will be broadcasting at ESPN Star Cricket & Willow TV and Sky Sports, Star Cricket HD, PTV Sports, Fox Sports & Geo Super provide the live match coverage. Big Bash t20 2013,14 will be going to the final matches so every team try best to win his game so match victory is very important and top four teams qualifying for the semi finals matches, now let see who will be qualified for more further latest cricket and sports updates, in below we will provide the both teams player list which will be performed in today game.
Adelaide vs Brisbane Big Bash Live Score Match Highlights 18, Jan, 2014
Match: Adelaide Strikers vs Brisbane Heat
Date: 17, 01, 2014
Time: 02:45 GMT | 13:15 local
Venue: Oval cricket stadium
Here we discuss about the both teams performance, Adelaide Strikers team after the five matches now ready for six clash on 18, Jan, 2014 and they got two matches victory while defeat in two while one game will be drawn and took the 5 points on table. Brisbane Heat t20 team team will be going to played his next seven game they won two while defeat in 4 matches and took the 4 points on table.
Match Prediction:
Now here we discuss about the both teams performance our prediction is Adelaide Strikers bbl twenty20 team favorite for winning points of view now let see what happened in this big game for more further sports or Big Bash t20 updates please keep in touch with Asportsnews.com


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Summary of Season 1 (2003) - 7 discs
In the futuristic land depicted in this fantastical anime adventure, two pilots, Claus and Lavie, botch a delivery and wind up in the midst of two warring factions that battle it out in the skies for supremacy under the watchful eyes of the Guild. As battleships scour outer space for enemies and steely generals call the shots, the duo must find their way to safety -- no matter what it takes.
Show Details
- This show is
- Suspenseful


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Introducing Belgium-based dream-pop duo, Float Fall. Comprised of Rozanne Descheemaeker and Ruben Lefever, Float Fall are simply blossoming with ambient feel-good vibes. Destined for great things, the pair are reminiscent of Australian indie lads The Panics blended with a nice dose of The XX. Killer combo in our books.
Check out first release 'Someday':
Float Fall will be releasing the single on a limited 7" at this year's Record Store Day, backed with b-side track 'Snow.'
OneSheet.com/FloatFall | Facebook.com/FloatFallMusic | SoundCloud.com/Float-Fall