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Educational inequalities in quantity, duration and type of tobacco consumption among lung cancer patients in Asturias: Epidemiological analyses
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1 Psicothema Vol. 22, nº 4, pp ISSN CODEN PSOTEG Copyright 2010 Psicothema Educational inequalities in quantity, duration and type of tobacco consumption among lung cancer patients in Asturias: Epidemiological analyses Alexandra Leader*,**,***, Ana Fernández-Somoano*,**, María Felicitas López-Cima*,**, Patricia González-Arriaga*,**, Teresa Pascual****, Manuel G. Marrón**** and Adonina Tardón*,** * Universidad de Oviedo, ** CIBER Epidemiología y Salud Pública (CIBERESP), *** Mount Sinai School of Medicine (New York) and **** Hospital de Cabueñes (Gijón) Socioeconomic inequalities cause different tobacco consumption patterns. The purpose of this study was to examine the relationship between educational level and smoking behaviour, including type of tobacco consumption, in lung cancer patients. To this end, epidemiological analyses of 801 lung cancer patients recruited for a case-control study in four public hospitals in Asturias, Spain, between October 2000 and April 2006 were carried out. Smoking behaviour and educational level data were obtained through personal interview. Analyses indicated that the probability of heavy smoking among low educational-level patients was approximately twice as high as for high educational-level patients (RRR>31.2packs/years = 2.04; CI 95%= ; RRR>52packs/years= 2.14; CI 95%= ). -educated patients were more than three times as likely to be long-time smokers (RRR>40years= 3.30; CI 95%= ). The probability of smoking exclusively black tobacco was almost four times greater in low educational-level patients (RRRblack only= 3.72; CI 95%= ). The results show that there are broad educational inequalities with regard to the quantity, duration and type of tobacco consumption among lung cancer patients in Northern Spain. Desigualdades educativas según la cantidad, duración y tipo de tabaco consumido en pacientes con cáncer de pulmón en Asturias: análisis epidemiológicos. Las desigualdades socioeconómicas causan diferentes patrones de consumo tabáquico. El objetivo de este estudio fue examinar la relación entre el nivel educativo y el hábito tabáquico en pacientes con cáncer de pulmón. Para ello se llevaron a cabo análisis epidemiológicos en 801 casos de cáncer de pulmón reclutados en un estudio caso-control de Asturias, entre octubre de 2000 y abril de Los datos relativos al hábito tabáquico y al nivel educativo fueron obtenidos mediante entrevista personal. La probabilidad de ser gran fumador entre pacientes de bajo nivel educativo es aproximadamente dos veces mayor que en pacientes con nivel educativo alto (RRR>31,2paquetes-año = 2,04; IC95% = 1,15-3,62; RRR>52paquetes-año= 2,14; IC95%= ). Los pacientes con bajo nivel educativo fumaban durante más tiempo (RRR>40años= 3,30; IC95%= 1,43-7,62) y tenían cuatro veces más probabilidades de fumar exclusivamente tabaco negro (RRRsolo tabaco negro= 3,72; IC95%= 1,23-11,19). Los resultados indican que existen grandes desigualdades educativas en relación a la cantidad, duración y tipo de tabaco consumido entre los pacientes de cáncer de pulmón en Asturias. Fecha recepción: Fecha aceptación: Correspondencia: Adonina Tardón Facultad de Medicina Universidad de Oviedo Oviedo (Spain) Smoking and smoking-related diseases are crucial determinants of socioeconomic inequalities in health (Cavelaars et al., 2000; Huisman, Kunst, & Mackenbach, 2005a; Mackenbach et al., 2004). Among men in Western Europe specifically, lung cancer was found to be the second largest contributor to educational inequalities in mortality (Huisman et al., 2005). The patterns of the tobacco smoking epidemic and the consequent rise of socioeconomic inequalities in lung cancer mortality in developed countries worldwide have been well-characterised (López, Collishaw, & Piha, 1994; Peto, López, Boreham, Thun, & Heath, 1994). The tobacco epidemic is classically presented as a habit that initially diffuses through the most educated groups of society before progressively migrating and becoming established amidst the less educated population. However, while the general patterns of the smoking epidemic occur globally, specific smoking behaviours and their effect on societal health inequalities tend to develop uniquely in different national settings (Giskes et al., 2005; Kunst, Groenhof, Mackenbach, & Health, 1998). For this reason, public interventions meant to prevent the growth of socioeconomic disparities in lung cancer mortality should reflect the specific timing and nature of smoking behaviour within the population in question. Spain and its Southern European neighbours provide compelling national settings in which to actively anticipate the rise of such
2 EDUCATIONAL INEQUALITIES IN QUANTITY, DURATION AND TYPE OF TOBACCO COMSUMPTION AMONG LUNG CANCER PATIENTS IN ASTURIAS: EPIDEMIOLOGICAL ANALYSES 635 health inequalities. In Spain, as in Italy, Portugal and Greece, the smoking epidemic has been shown to be less advanced than in other Western European countries (Giskes et al., 2005; Huisman, Kunst, & Mackenbach, 2005a). Recent studies specifically locate Spain within the 3rd stage of the classically-described smoking epidemic (Cavelaars et al., 2000; Graham, 1996; Schiaffino et al., 2003), a stage during which smoking prevalence in the male population generally decreases disproportionately among those of higher socioeconomic status, whereas women of all socioeconomic levels of society reach their peak prevalence rate of smoking before a decrease in prevalence occurs exclusively among higher educated women. These trends typically precede the progressive transformation of smoking into a habit of the lower educated groups of society, a transformation which can only serve to amplify socioeconomic health inequalities within the society in question. Currently, however, while overall lung cancer mortality is rising in Spain, recent investigation suggests that less educated men and women are still generally benefiting from lower lung cancer mortality rates (Mackenbach et al., 2004). It is thus an opportune moment to analyse specific smoking tendencies in relation to educational level within this population vulnerable to an impending shift and growth of socioeconomic inequalities in mortality. A number of international, national and regional studies have described educational gradients in smoking tendencies largely smoking initiation and cessation among the general population in Spain in recent years. These investigations suggest that there are educational inequalities in the prevalence and duration of tobacco consumption in this population In Spain, there is an additional variable in smoking behaviour that must be considered. There are two types of tobacco used in manufactured cigarettes in European countries: black and blond. Blond tobacco is usually either air-cured or flue-cured and is not typically fermented, whereas black tobacco grown mainly in Central and South America, Cuba, Spain and France undergoes a necessary process of air-curing and fermentation before resulting in a tobacco adequate for consumption («Physicians for a Smoke- Free Canada», 2009). Higher socioeconomic status has been linked to greater blond tobacco consumption as opposed to black tobacco in Spain (Shafey et al., 2004); blond tobacco is similarly the type of tobacco historically favoured by Spanish women (Shafey et al., 2004), although much more investigation of this smoking variable is needed to reinforce the socioeconomic and gender-based links to consumption of specific tobacco type. The purpose of this study, therefore, was to evaluate in a geographically-based sample of lung cancer patients the association between educational level and quantity, duration and type of tobacco consumption. Participants Method The subjects for this epidemiological study were recruited for the Cáncer de Pulmón en Asturias (CAPUA) study, a hospital-based case-control study conducted in the «Unidad de Epidemiología Molecular del Cáncer, Instituto Universitario de Oncología» of the University of Oviedo. The detailed methods of recruiting participants for this study have been described elsewhere (Fernández-Rubio et al., 2008; González-Arriaga et al., 2008; López-Cima et al., 2007; Marín et al., 2004). Briefly, a total of 801 cases were recruited in four main hospitals of Asturias, Spain following an identical protocol from October 2000 to April Eligible cases were incident cases of histological confirmed lung cancer between 30 and 85 years of age and residents in the geographical area of each participating hospital for at least six months before diagnosis. Patients with primary cancer other than lung cancer occurring in the previous five years were excluded. The hospitals ethical committees approved the study and written consent was obtained from each participant. Procedure Data collection Information on participants smoking behaviour and education was collected personally by trained interviewers using computerassisted questionnaires during the first hospital admission for lung cancer diagnosis. A total of 976 eligible cases consented to study participation. Of these cases, 91.4% of the participants (892 cases) were interviewed, so 84 individuals without interview were excluded from analyses. Ninety-one cases with missing information in the questionnaires were also excluded from analyses. Thus, the final study population available for this investigation included 801 cases. Tobacco smoking behaviour Participants were defined as never smokers if they had not smoked more than 100 cigarettes in their lifetime and were defined as ever smokers otherwise. Ever smokers were further classified as current smokers if they had smoked at least one cigarette per day for the previous six months or longer. Individuals who had smoked regularly but had stopped smoking at least one year before the interview were defined as former smokers; those who had stopped smoking less than one year before the interview were defined as current smokers. Ever smokers were asked the duration in years that they had smoked at least one cigarette daily and how many cigarettes they normally consumed daily. Smoking intensity was further characterized in pack-years (PY), defined as the number of packs of cigarettes smoked per day multiplied by the number of years smoking. Subjects were categorized as light (<31.2 PY) or heavy ( 31.2 PY) smokers, based on median cumulative tobacco consumption in the control group. Subjects were also categorized in four categories of smoking quantity based on quartiles of the quantity of smoking in the control group. Duration of smoking was categorized according to scientific literature (Samanic et al., 2006) in order to compare our findings with the results in other studies. The type of tobacco consumed by subjects was ascertained by asking ever smokers which type of tobacco they normally smoked, with response options being «black tobacco», «blond tobacco» or «both». Education was chosen as an indicator of socioeconomic status because educational level appears to be more closely related to smoking habits than income in most European countries, and specifically in Spain (Huisman, Kunst, & Mackenbach, 2005b). Three educational levels were formed according to national
3 636 ALEXANDRA LEADER, ANA FERNÁNDEZ-SOMOANO, MARÍA FELICITAS LÓPEZ-CIMA, PATRICIA GONZÁLEZ-ARRIAGA, TERESA PASCUAL, MANUEL G. MARRÓN AND ADONINA TARDÓN classification schemes and using guidelines from the International Standard Classification of Education (UNESCO, 1997): (1) early primary education (first six years of compulsory education) or less; (2) completion of primary and lower secondary education; and (3) completion of upper secondary and tertiary education, which included all vocational and university education. These categories were respectively designated as «low», «medium» and «high» educational groups for the purpose of our analyses. This variable was used as response variable. Data analysis To assess the independence of two categorical variables the chisquare test was applied. Multinomial logistic regression (Hosmer & Lemeshow, 2009) with adjustment for age (continuous) and gender (male/female) was performed to evaluate the association between tobacco and educational level. Adjusted Relative Risk Ratios (RRRs) («Stata Services», 2009) and their 95% confidence intervals (95% CI) were calculated for the variables of interest. P-value for trend was also calculated for each risk factor. P-values less than 0.05 were considered statistically significant. All statistical analyses were performed with STATA/SE version 8.2 software. Subject characteristics Results The analysis included 801 lung cancer cases from the population of Asturias in Northern Spain. Table 1 presents the distributions of gender, age, educational level, family cancer history, smoking status, and specific smoking behaviour data for study subjects. and smoking tendencies There were various significant differences in tobacco consumption trends in relation to the educational level of our subjects. Table 2 presents the association between smoking characteristics and educational level. Using the high-educated subjects as the comparison group and adjusting for age and gender, the probability of being a heavy smoker, defined in this study as >31.2 pack-year or >52 pack-year smoking history, was approximately two times higher for low educational level subjects than for subjects in the high education group (adjusted RRR >31.2pack-years : 2.04; CI 95% and adjusted RRR >52pack-years : 2.14; CI 95% (P-trend), respectively). Similarly, low educational level subjects were twice as likely to smoke any quantity of cigarettes/ day (adjusted RRR 11-20cig/day : 2.11; CI 95% , adjusted RRR 21-30cig/day : 1.72; CI 95% , and adjusted RRR >30cig/day : 1.99; CI 95% ) and more than three times as likely to be long-time smokers (>40 years smoking history) than subjects in the high educational group (adjusted RRR >40years : 3.30; CI 95% , P-trend). This trend was also observed in the analysis of men alone (table 3). Our data showed a clear association between educational level and type of tobacco smoked by our study subjects. -educated patients smoke fundamentally black tobacco only (82%). 16% of high-educated patients smoke blond tobacco only. -educated patients were almost 4 times more likely to smoke exclusively black tobacco than their high-educated counterparts (adjusted RRR black only: 3.72; 95% CI , P-trend). When stratifying these results by gender, this educational gradient in black tobacco consumption was observed in both men and women, although these results did not reach statistical significance (adjusted RRR black only (Men): 4.03; 95% CI ; adjusted RRR black only (Women) : 5.35; 95% CI ). The adjusted relative risk ratio (RRR) was slightly lower for ever smoking vs. never smoking than for current smoking vs. never smoking when using the high education group as the Table 1 Characteristics of lung cancer cases Cases (n= 801) N % Gender Male Female Age (Median, p25; p75) ; High Family history of cancer No Yes Ever smokers Never Ever Tobacco status Never Former Currrent Smoking quantity (cig/day) (Median, p25; p75) ; 40 Smoking quantity (cig/day) Never > Smoking duration (years) (Median, p25; p75) ; 53 Pack-year (Median, p25; p75) ; 82 Pack-year Non-smoker > Type of cigarette tobacco smoked Non-smoker Black only Blond only Both
4 EDUCATIONAL INEQUALITIES IN QUANTITY, DURATION AND TYPE OF TOBACCO COMSUMPTION AMONG LUNG CANCER PATIENTS IN ASTURIAS: EPIDEMIOLOGICAL ANALYSES 637 reference in comparison to the low education group (adjusted RRR: 2.41; 95% CI and adjusted RRR: 2.56; 95% CI , respectively), suggesting that high-educated lung cancer patients in our study have a higher rate of quitting smoking than their low-educated counterparts. This trend was maintained when stratifying for gender but was no longer statistically significant (Men: adjusted RRR: 3.06; 95% CI and adjusted RRR: 3.23; 95% CI ; Women: adjusted RRR: 3.87; 95% CI and adjusted RRR: 5.27; 95% CI ). Summary of fi ndings Discussion and conclusion Our results reflect prominent educational inequalities with respect to the quantity, duration and specific type of tobacco consumption among lung cancer patients in Asturias, Spain. Subjects of low educational level smoked more, longer and more often exclusively black tobacco than their high-educated counterparts. All of these associations were statistically significant. Table 2 Association between smoking and educational level RRRb [95%CI] (n =238 ) (n = 367) High (n = 185) p-value a N % N % N % Smoker Never Ever [ ] 1.14 [ ] Tobacco status Never Former [ ] 1.28 [ ] Current [ ] 1.02 [ ] p-trend p-trend Pack-year (2 categories) Never or 31.2 PY >31.2 PY [ ] 1.29 [ ] Pack-year (4 categories) Never or 15 PY PY [ ] 1.33 [ ] PY [ ] 1.78 [ ] >52 PY [ ] 1.36 [ ] p-trend p-trend Smoking quantity (Cig/Day) Never or 10 cig/day [ ] 1.66 [ ] [ ] 1.10 [ ] > [ ] 1.45 [ ] p-trend p-trend Smoking duration (Years) Never or 20 years [ ] 1.30 [ ] > [ ] 1.51 [ ] p-trend p-trend Type of cigarette tobacco smoked Non-smoker Black only [ ] 1.52 [ ] Blond only [ ] 0.61 [ ] Both [ ] 0.99 [ ] p-trend p-trend a Two -sided Chi-squared b Relative Risk Ratio adjusted by age and gender (High= comparison group)
5 638 ALEXANDRA LEADER, ANA FERNÁNDEZ-SOMOANO, MARÍA FELICITAS LÓPEZ-CIMA, PATRICIA GONZÁLEZ-ARRIAGA, TERESA PASCUAL, MANUEL G. MARRÓN AND ADONINA TARDÓN The marked educational inequalities in smoking tendencies were found in similar measure in the male and female population when stratifying results by gender. Comparison of the adjusted relative risk ratios for ever smoking vs. never smoking and current smoking vs. never smoking between the high and low educational groups additionally suggests that subjects of low educational level quit smoking less than high-educated subjects. Several studies have described educational gradients in smoking tendencies largely smoking initiation and cessation among the general population in Spain in recent years. These investigations suggest that there are educational inequalities in the prevalence and duration of tobacco consumption in this population, according to our results. It has been observed that tobacco consumption is declining less among low educated smokers compared to their more educated counterparts (Fernández et al., 2001; Fernández, Schiaffino, García, & Borras, 2001; Giskes et al., 2005; Schiaffino et al., 2007) and that smoking initiation rates are now higher among less educated men and women (Schiaffino et al., 2003). In accordance with classically-observed patterns of the smoking epidemic, the relationship between low education level and increased tobacco consumption was first noted among male smokers and is subsequently being observed among the female Table 3 Association between smoking and educational level in male subjects RRRb [95%CI] (n =215 ) (n = 328) High (n = 166) p-value a N % N % N % Smoker Never Ever [ ] 2.23 [ ] Tobacco status Never Former [ ] 2.45 [ ] Current [ ] 2.03 [ ] p-trend p-trend Pack-year (2 categories) Never or 31.2 PY >31.2 PY [ ] 1.50 [ ] Pack-year (4 categories) Never or 15 PY PY [ ] 1.59 [ ] PY [ ] 2.36 [ ] >52 PY [ ] 1.80 [ ] p-trend p-trend Smoking quantity (Cig/Day) Never or 10 cig/day [ ] 2.16 [ ] [ ] 1.35 [ ] > [ ] 1.82 [ ] p-trend p-trend Smoking duration (Years) Never or 20 years [ ] 1.60 [ ] > [ ] 1.98 [ ] p-trend p-trend Type of cigarette tobacco smoked Non-smoker Black only [ ] 2.62 [ ] Blond only [ ] 0.92 [ ] Both [ ] 1.86 [ ] p-trend p-trend a Two -sided Chi-squared b Relative Risk Ratio adjusted by age and gender (High= comparison group)
6 EDUCATIONAL INEQUALITIES IN QUANTITY, DURATION AND TYPE OF TOBACCO COMSUMPTION AMONG LUNG CANCER PATIENTS IN ASTURIAS: EPIDEMIOLOGICAL ANALYSES 639 population of smokers in Spain (Fernández et al., 2001; Fernández, Schiaffino, García, & Borrás, 2001; Schiaffino et al., 2003; Schiaffino et al., 2007). One recent international study additionally cites strong cross-sectional evidence that lower educated smokers consume larger quantities of cigarettes than their more educated counterparts (Giskes et al., 2005). Less educated people carry out mainly manual jobs so, similarly, several studies have reported the same differential cigarette smoking patterns related to occupation: blue-collar workers (mainly manual workers and therefore less educated) were more likely to report current and daily smoking compared with white-collar workers (higher educated) (Hrubá et al., 2009; Lawrence, Fagan, Backinger, Gibson, & Hartman, 2007; Sorensen, Barbeau, Hunt, & Emmons, 2004). In relation to association found for type of tobacco smoked, it is remarkable that black tobacco is cheaper than blond tobacco, being therefore more accessible for less educated persons. In the case of our study, the described greater quantity and longer duration of tobacco consumption, the lower rates of smoking cessation and, perhaps most characteristically, the preferential use of black tobacco are all factors which may potentiate the connection between lower educational level and negative health trends in Northern Spain and similar populations. The causative relationship between increased tobacco consumption as well as decreased tobacco cessation and lung cancer mortality is well established (IARC, 1986). Furthermore, while there is not yet a consistent body of evidence describing the association of lung cancer risk with smoking black tobacco specifically, various international studies have linked the consumption of black vs. blond manufactured tobacco to elevated lung cancer risk (Armadans-Gil, Vaque-Rafart, Rossello, Olona, & Alseda, 1999; De Stefani et al., 2004). Therefore, the characteristic smoking tendencies exhibited in our study have the potential to escalate the magnitude of socioeconomic inequalities in lung cancer mortality if uncontrolled amidst the foretold progression of the smoking epidemic in this population, and should likewise be addressed as such. Study limitations The use of self-reported data on smoking could potentially lead to underestimation of smoking status and could particularly bias our results if underreporting were to occur more frequently in a specific educational group of the population. However, analysis of the validity of self-reported smoking data has found self-reporting to be an accurate method of obtaining information about tobacco in the case of interviewer-administered questionnaires (Patrick et al., 1994). Additionally, two U.S.-based studies reported only inconsistent associations between underreporting of smoking and socioeconomic status (Wagenknecht, Burke, Perkins, Haley, & Friedman, 1992; Wewers et al., 1995), whereas a past European study found no effect of socioeconomic status on underreporting of tobacco use (Suadicani, Hein, & Gyntelberg, 1994). While the possibility of such an association cannot be dismissed, it is unlikely to account for the pronounced educational gradients observed in relation to smoking tendencies among our study subjects. Over reporting of former smokers is also a potential problem related to the fact that smokers who quit immediately prior to the interview may subsequently resume smoking. To prevent this type of bias from affecting our results, we considered former smokers only those who had quit smoking at least one year before the interview. Conclusion The educational inequalities in smoking tendencies among Northern Spanish lung cancer patients, as reflected in these analyses, highlight behavioural patterns which merit further investigation and which may serve as potential and novel targets for populationspecific interventions to address socioeconomic inequalities in a population health. Previous research has underscored the notion that improving health disparities is a nationally- and culturallyspecific task, dependent upon recognition of the circumstances and mechanisms that reinforce the link between low educational level and poor health (Kunst, Groenhof, Mackenbach, & Health, 1998) in a given population. Tobacco control policies employed in Northern Spain, and within populations of similar cultural and regional circumstances, may benefit from addressing these specific high-risk health behaviours associated with lower educational level for men and women. Further research is justified to reinforce the link between low educational level and the exclusive consumption of black tobacco, as well as to examine the design and effect of future policy interventions in this context. Acknowledgements We are indebted to the patients who participated in the study. We should also like to thank our technical colleagues, Cristina Arias and Avelino Menéndez (Unidad de Epidemiología Molecular, IUOPA) for collecting the data. This work was supported by Obra Social Cajastur-Asturias, FISS 01/310, and FICYT PB02/67. References Armadans-Gil, L., Vaque-Rafart, J., Rossello, J., Olona, M., & Alseda, M. (1999). Cigarette smoking and male lung cancer risk with special regard to type of tobacco. 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text:
In today's Catholic Daily Roundup, top stories include the removal of the Confederate battle flag from the South Carolina state capital, ongoing nuclear talks with Iran, and the pope continues his trip to South America.
"God wants a Christian society, one in which we share the good things that God has given for all of us." (Blessed Óscar Romero)
Today's Reading: "Behold, I am sending you like sheep in the midst of wolves; so be shrewd as serpents and simple as doves." (Matthew 10:16)
In the News:
- Closing a chapter on a symbol of the Deep South and its history of resistance and racial animus, South Carolina on Friday lowered the Confederate battle flag from outside its State House, where it had flown for more than 50 years.
- Iran nuclear talks are likely to stretch into the weekend, the Iranian foreign minister said Friday, suggesting that gaps still remain following two weeks of intensive negotiations.
- After years of declining violent crime, several major American cities experienced a dramatic surge in homicides during the first half of this year.
Pope Francis and church news:
- A crucifix sculpted in the shape of a hammer and sickle presented to Pope Francis in Bolivia has caused a stir among Catholic commentators.
- Pope Francis offered a direct apology on Thursday for the complicity of the Roman Catholic Church in the oppression of Latin America during the colonial era.
- Addressing the World Meeting of Popular Movements in Santa Cruz, Pope Francis acknowledged he did not have a "recipe" for a perfect economic-social-political system, but he said the problems with the current system are obvious and the Gospel contains principles that can help.
CACG would like to equip lay Catholics with the resources necessary to promote the common good in their communities. That's why we have the Catholic daily roundup. You can sign up for this short and digestible daily e-mail here.
We always appreciate your support to continue our work into 2015. Please invest in us today.

subset: commoncrawl


text:
2010 Honda Accord Coupe - Consumer Review
Build Quality
Reliability Value
Build Quality
Reliability Value
2 of 2 people found this review helpful
Great Car
By Tom M on
Vehicle2010 Honda Accord EX-L V-6 2dr Coupe w/Navigation (3.5L 6cyl 5A)
ReviewJust rolled over 3000 miles and everything is just right. Went with an Accord for the bulletproof reliability and was pleasantly surprised by the speed, handling, and overall size of the thing. It's a big car, and getting into the back seats is a challenge, but it is very comfortable. The trunk is huge! The gearbox is lazy sometimes and the cylinder deactivation can get really annoying when trying to quickly overtake. Rapidly reengaging all 6 pots to light back up feels like the car is kicking down 3 gears and there is a delay, but only briefly. I recorded 5.6 seconds to 60, which for a relatively heavy and front wheel drive car, is amazing. MPG is about 27 highway, 20 city with a light foot.
Best Featuresv6 power, smooth ride, huge trunk, above average mpg, very intuitive (if at first hard to use) sat/nav. great stock sound system. overall a great car
Worst FeaturesA few things: it's a heavy car, and when you drive aggressively and corner hard, the back lumbers around unwillingly and you realize why RWD exists. this is a great commuting car and one to drive quickly occasionally. not like a vw gti in that respect. also, no gate/paddles for shifting. why Honda?
Recommend (2) (0)
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text:
Microsoft Internet Explorer
Often abbreviated as IE or MSIE, Microsoft Internet Explorer is an Internet browser, allowing computer users to view web pages. Users can also use Internet Explorer to listen to and watch streaming content, access online banking, make purchases over the Internet, and much more.
Internet Explorer was first introduced in August 1995 by Microsoft as Internet Explorer 1.0 and included with Microsoft Windows 95. Internet Explorer has been included with all versions of Windows since then. As of October 2016, the latest version of Internet Explorer is IE 11.
Note: With the release of Windows 10, Microsoft introduced the Microsoft Edge browser, with hopes it will replace Internet Explorer in the future.
Internet Explorer is a strong competitor with other Internet browsers, including Google Chrome, Firefox, Opera, and Safari. Today, it is still one of the most widely used Internet browsers. The picture above is an example of what Internet Explorer 7.0 looks like with the Computer Hope homepage.


text:
|This article is about a subject in the real world.
Information in this article is about real-life people, companies, and objects, and does not relate to the in-universe Sonic series.
Terry Austin is an inker at Archie Comics who has done various works for the Sonic the Hedgehog comic series and its spin-offs. He currently does the inking for the main Sonic the Hedgehog comic series, taking Jim Amash's place, who does the inking for Sonic Universe.
- Various issues of Sonic the Hedgehog
- Sonic Super Digest Special Edition #9


text:
Flawless Transatlantic: Queen Mary 2 (QM2) Cruise Review by Gilllizzie
Overall Member Rating
Flawless Transatlantic
Destination: Transatlantic
Embarkation: New York (Manhattan)
Every mouthful of every single dinner in the Britannia was excellent! The portions here are quite small, but that suits me fine as I can enjoy a five course meal without feeling uncomfortable. The sommelier was among the most attentive I have met, More the table waiters looked after us superbly, striking the perfect balance between being friendly without intruding. We tried all the breakfast options, room service, self service and full service, and all were equally good. For lunch we ate either in the Britannia or the Red Lion, where the fish and chip lunch was delicious. We didn't try the Todd English, as we couldn't see the need to pay when the quality was already so good.
The onboard activities presented some tough choices! There always seemed to be at least two things we wanted to do at the same time. The quizzes in the Red Lion each afternoon were superbly presented by the charming and intelligent Gun. The lectures were good, Rada productions likewise, and the unadvertised galley tour was another unexpected highlight. Facilities in the gym are excellent, and again kept clean and well maintained. I had artificial nails applied in the beauty salon, and they were done with exceptional care and looked perfect.
Our son was entertained well by the teen club staff on board. I glimpsed him only occasionally over the six days! We returned home sad that it was over. The only cure for the mild depression that ensued was to book another T/A for August, and both families can't wait to get back aboard the lovely QM2! Less
Published 05/09/09
Cabin review: DA8057
Sold as restricted view, but does have quite a good view between lifeboats. Good sized balcony.
Read Cruise Critic's Queen Mary 2 (QM2) Review >>
Sirena Transatlantic cruise - ...
Change is not always a good th...
Second time on Sirena
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Singer-Songwriter and Recovering Addict Spreads His Faithful Message
Six years ago, Steph Macleod found himself in rehab for homeless men with addiction problems. According to StornowayGazette.com, the singer/songwriter is now clean and sober, and has begun to share his experiences with others, where his personal faith transformed his life.
He has been asked to share his story at Martin's Memorial Church, in hopes to inspire others through his words. Steph was a classical guitar student at the royal Scottish Academy of Music and Drama before he began using drugs and alcohol. He began using, seeking an escape from problems tracing back to his teenage years. He ended up homeless in the streets of Edinburgh, begging for money to fund his habits. Eventually, he entered a treatment center for homeless men suffering from addiction.
Eight months into treatment, in 2006, Steph picked up a guitar for the first time in years. Songs describing his experiences of addiction and homelessness began pouring out of him. After treatment, he continued writing music and began performing locally. In the following year, he got married and started a family, and his writing became influenced by that, as well.
Steph has continued recording, as well as performing around the UK. He has played at festivals like The Retrofest, The Belladrum Festival, The Wizard Festival, and The Spratton Folk Festival. He competed in the 2009 Troubadour Singer Songwriter competition, where he won. For the last two years, he has been performing with his band, The Whitney Shuffle.
Steph's music and life has been greatly influenced by his faith. In 2009, with the help of Origin Scotland's Exile Band, he wrote and recorded a 12-track Christian album, detailing his faith and the impact it had on his recovery.
If you know a faithful Christian struggling with addiction, click here for more information about faith-based treatment options.
- Item Tag: faith-based recovery, Steph Macleod


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Dear Smiley: Your recent stories about seeing pennies on the floor in businesses reminded me of an event that occurred quite a few years ago.
Standing in line at a neighborhood grocery store, an elderly man in front of me slowly and awkwardly stooped down and picked up a dusty penny from under the candy rack near the register.
As I saw that this was a tough task for him, I asked, "Now, what are you going to do with that one old penny that you worked so hard for?"
He looked at me with a smile and said, "All I need is 99 more and I'll have a dollar!"
That made me smile, too, but then his face turned serious and he said, "You know the real reason I pick up pennies? I don't like to see something with the name of God being dropped and stepped on."
Now approaching "elderly" myself, I still pick up pennies when I see them on the floor.
Thank you, sir, for teaching me an important lesson.
Word of warning
Dear Smiley: I texted my daughter Aimee, who happens to work for the Alabama Athletic Department, and whose new motto appears to be "Roll Tide."
I said, "Be careful Saturday night, darling. As you nervously pace the sidelines, you might get ROLLED over by a "Blue" "Ford" driven by "General Lee."
St. James
Band memories
Dear Smiley: The recent article on the new LSU band hall brought back precious memories of when I played in the band 71 years ago.
In the summer of 1940 I was thrilled to be auditioned to play drums by the great LSU band leader Castro Carazo.
My audition consisted of playing a snare drum to a recording of John Philip Sousa marches — a piece of cake!
The band, of approximately 150 members, male only, was housed in the northeast bend of the stadium, six to a room, and was part of the ROTC cadet corps.
The band hall was a dilapidated wooden building far out in the northwest area of the campus.
Halftime band formations were done in complete darkness, with little lights on our caps.
Big city, big hearts
Dear Smiley: Noted your mention of the good reputation New Orleans has with visitors.
I was in New Orleans last month, but it was a very different experience from my time as a resident there.
I was in a wheelchair due to a bout of spinal stenosis.
I discovered the sidewalks in the French Quarter are tough to navigate in a wheelchair.
But every time I got stuck, someone stepped up and said, "Do you need a push?"
Once, when I was waiting to cross a street, a taxi driver stopped his vehicle, pushed me across and then waved, got back in the taxi and drove away.
The actions of my several helpers was greatly appreciated.
There were some big hearts in the big city.
Ban the bulk
Dear Smiley: You've printed some comments recently about the U.S. Postal Service.
You stated that if Saturday service was discontinued, we would have one less day to receive those political campaign flyers.
Well, if the USPS would like to keep Saturday service AND get out of the red, then they should eliminate the bulk mailing rate for those flyers and charge them what normal citizens have to pay.
They would surely be in the black in no time!
Baton Rouge
Hey, Jude!
Dear Smiley: You mentioned a mule named "Missouri" in a recent column.
That would be correct, since Missouri (my home state) was famous for its mules.
Our athletic coach from a northwestern Missouri state teachers college brought the name with him, and our teams were called Mules.
Daddy had two mules, one named Jude and the other Joshua, and when I was about 7 years old, he would let me ride Jude to school.
Baton Rouge
Time well spent
Dear Smiley: My answer to the comment "I always see you in Smiley, and only a person with time on their hands would write to him," is that some of us need less time to think and write than others.
This reply took only three minutes out of my busy day.


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Shioda was a monk adivsor of the Brotherhood of Shinsei.
Otosan Uchi Edit
Shioda was a quiet and unassuming monk who had lived in the Temple to the Kami at Otosan Uchi for more than twenty years. He was its caretaker prior to the Scorpion Coup. Nobody had seen him speaking for more than two decades, and tended the temple with an expression of guilt. His former clan and old deeds were unknown. [1]
Shioda's story Edit
Shioda had been a bushi who found the ghostly figure of a sickly boy, named Ukairo, in the Shinomen Forest. The spirit told he was a candidate to Acolyte of Air in the Temple to the Kami, but suffered a rare skin ailment. He had attempted to pass a test within the temple, confronting the five elements, but his illness was overcoming him when he was in the Tower of Void. He projected his spirit to find the root that would temporarily slow the disease. Shioda took the root and moved to the Imperial City, to find he had arrived too late to save Ukairo's life. The kami of the temple were enraged, and blocked the exit from the building to Shioda. He had to pay the debt he owed for his failure, and the kami would bind him to the temple, serving there until his debt was paid. [2]
Siege of Sleeping Mountain Edit
In 1132 Shioda was one of the members of the Brotherhood who joined the Naga army in the Siege of Sleeping Mountain. [3] He believed hitomi was tainted. [4]
See also Edit
External Links Edit
- Shioda (Scorpion Clan Coup, Scroll 1)
- ↑ Otosan Uchi:Book 2, p. 57
- ↑ Otosan Uchi:Book 2, pp. 57-58
- ↑ Rulebook story (Siege of Sleeping Mountain)
- ↑ Shioda (Siege of Sleeping Mountain flavor)
|This Brotherhood of Shinsei related article is a stub. That means that it has been started, but is incomplete. You can help by adding to the information here.


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Educación Popular y Nuevas Tecnologías: ¿una relación posible?
Algunas experiencias de articulación entre Educación Popular y Nuevas Tecnologías en Argentina
La Vicky Paseroon 6 December 2011
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Cesar Sanchez 7 Years For Burglary
December 3, 2011 by staff
Cesar Sanchez 7 Years For Burglary, A prison inmate who escaped from a moving van near Lockport while in transit from a court appearance was captured six hours later south of Joliet after police dogs caught his scent in a yard storing portable toilets and a helicopter crew using infrared technology located him in one of the toilets, authorities said.
Cesar Sanchez, 37, who state records show is serving a 7-year sentence for burglary, escaped about 2:15 p.m. near 159th Street and Farrell Road, a commercial strip not far from Lockport Township High School's East Campus.
Sanchez was believed to have gotten onto the back of a delivery truck after his escape, said Paul Kaupas, the Will County Sheriff. The truck was tracked to a business in Rockdale, southwest of Joliet, and video surveillance showed Sanchez getting off the truck in the 2000 block of Moen Avenue.
Joliet District State Police confirmed that Sanchez was captured about 8:15 p.m. in the same block as the business.
Joining the search were police dogs, including from Cook County Sheriff's Police, and a helicopter that's shared between the sheriff's office and Chicago Police, said Frank Bilecki, a spokesman for the Sheriff's office.
Melanie, a Cook County Sheriff's bloodhound, was with her handler, Officer Jim Pacetti, when she picked up a scent Sanchez left on a crutch in the corrections bus in a Waste Management yard on Moen Avenue that's used to store portable toilets, Bilecki said. Police at first couldn't find anyone in a nearby portable toilet.
But a corrections officer then noticed a footprint in the yard that matched the type of booty used by state inmates, and another dog caught the scent, confirming that Sanchez was somewhere in the area. Soon after, the joint Chicago-Cook County helicopter's infrared sensors found someone in one of the portable toilets, Bilecki said.
Officers checked a portable toilet and saw movement in the toilet's chemical tank, Bilecki said. Will County and Rockdale police were then able to capture him, authorities said.
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Human Trafficking is rapidly becoming one of the biggest crimes around the world. Though the media has highlighted certain countries where it is extremely prevalent, there are also some countries which you may not know are also facing a human trafficking problem. Such cases of human trafficking have emerged right here in the Kingdom of Saudi Arabia. It was reported that in the 2012 alone around 72 cases of human trafficking were discovered in Saudi Arabia alone. This news was published in a report by the Ministry of Justice in Saudi Arabia. This only amounts to about 0.11 percent of the total criminal cases in Saudi Arabia on which the Criminal and General courts have given their rulings. However, Saudi Police has taken very strict action against these cases and now they have been reduced significantly.
In the year 2012 the Saudi Courts gave their ruling on around 65,669 cases. Around 71 percent or 46,751 cases were filed which involved one or many Saudi Nationals, while around 29 percent or 18,918 cases were those which involved non Saudi citizens. In accordance to the annual statistical report, it was stated that the city of Riyadh had the highest recorded number of human trafficking cases which amounted to a total of 48 cases, on which the courts gave their ruling. Out of these cases found in Riyadh around 35 cases were those which involved one or more Saudi citizens while around 13 cases were those cases which involved non Saudi citizens.
In the Holy city of Makkah an astonishing 21 cases of Human Trafficking were reported and filed and out of these 2 cases were those which involved Saudi Nationals. Additionally two rulings were issued in cases found in the Holy city of Madinah while only one case of human trafficking was registered against a Saudi National in the Northern Borders Province region.
The report on the human trafficking laid great stress on the fact that the committee which has been appointed the human trafficking issues should also follow up closely with all of the victims and the conditions that they might be in. it was also recommended that the committee should also coordinate with other authorities to deport or rather depart the victims back to their home countries or whatever country their place of residence is. The committee has also recommended the retaining of the victims in Saudi Arabia after their status has been legalized.
Amongst the most important features of this system being implemented against these human trafficking crimes is the complete ban on trafficking of human beings in any form and under any disguise. The new system has also banned the use of any threat, fraud, and force or even kidnapping. The new system has also prohibited anyone from exploiting their job or influence to facilitate the necessary operations of the Human Trafficking crimes or any other forms of sexual abuse or enslavement. Anyone who has been found guilty of the human trafficking crimes will have to face upwards of 15 years in prison time or a monetary fine of SAR 1 million or even both.
Source: Arab News
Security Conditions in Saudi Arabia
- Features of Newly Introduced Smart Police Cars in Kingdom
- Women Safety Tips in Saudi Arabia
- Security Conditions in Saudi Arabia for Western Expats
- How Safe is Saudi Arabia?
- Crime Rate in Saudi Arabia


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Category:Baring family
From Wikipedia, the free encyclopedia
|Wikimedia Commons has media related to Baring family.
The Baring family has been influential in English finance, politics and the arts since the late 18th century. Originally from Germany, Johann Baring emigrated to England in 1717, took the name John Baring and became a prosperous wool merchant in Exeter. His sons John and Francis Baring founded the London merchant house "John and Francis Baring Company", which later became Baring Brothers & Co.
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JUST FEMALE | Mohair Knit-Salt & Pepper
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The combination of different elements to form compounds is governed by certain basic rules. These rules are referred to as laws of chemical combination. There are five basic laws of chemical combination that govern the chemical combinations of elements:
Law of Conservation of Mass
It states that matter is neither created nor destroyed during a chemical reaction, though it may change from one form to another. Total mass of products is equal to total mass of reactants. It was given by Antoine Lavoisier in the year 1789 based on the data he obtained after carefully studying numerous combustion reactions. The balancing of chemical equation follows the law of conservation of mass. The law does not hold good for nuclear reactions.
Law of Constant Proportion
A chemical compound always contains the same elements combined together in the fixed ratio of their masses whatever be its method of preparation. This observation was first made by the French chemist Joseph Proust, based on several experiments conducted between 1798 and 1804.note This law does not hold good for non-stoichiometric compound. For example, Wusitite Fe0.95O. It was given Proust.
Law of Multiple Proportion
When two elements A and B combine to form more than one chemical compounds then different weights of A, which combine with fixed weights of B, are in a simple whole number ratio. It is sometimes called Dalton's Law after its discoverer, the British chemist, John Dalton.
Law of Reciprocal Proportion
When two elements combine separately with a fixed mass of third element then the ratio in which they do so is either the same or whole number multiple of the ratio in which they combine with each other. The law of reciprocal proportions was proposed in essence by Richter, following his determination of neutralisation ratios of metals with acids.
Gay Lussac's Law
At a given temperature and pressure when gases combine, they do so in volumes, which bear a simple ratio to each other and also to the gaseous product formed.


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Get The Look
Sweet Suspense: "We Look Forward To Recording & Touring"Read More » »
Celeb Twitpics
Olivia Holt: Holiday Cheer In NYCRead More » »
Use Your Social Media Moxie to Win a Trip to the World's Most Epic Comic and Entertainment Event in San DiegoRead More » »
One Direction
Zayn Malik Is GQ's Best DressedRead More » »
Top stories
The girls of Sweet Suspense are continuing their journey to becoming a successful pop group. Summer Reign, Celine Polenghi, and Millie Thrasher finished in 12th place on season 3 of The X Factor USA.Read More
Up and coming actor Mason Dye stars in his debut role in Flowers in the Attic, a Lifetime Original Movie adapted from the classic novel written by V.Read More
Young Hollywood celebs arrived ready to get hyphy at Coco Jones' Sweet Sixteen Celebration, hosted by Pastry Shoes and Ford Driving Skills, on Saturday, January 11th.Read More
Recent posts
Jennifer Lawrence Makes Waves At GLAAD Media Awards
Jennifer Lawrence showed off her new shorter hairstyle at the GLADD Media Awards held at the JW Marriott in Los Angeles, Calif. on Saturday (April 20). Her locks are noticeably lighter than photos taken when she was filming Hunger Games: Catching Fire.
GLAAD posted a couple of photos via Instagram of the 22-year-old actress – one of them with Harvey Weinstein.
View Slideshow »»
Filed under: Jennifer Lawrence1 Comment
Justin Bieber Gets Cozy With Selena Gomez
On Saturday (April 20) Justin Bieber published a photo of himself with Selena Gomez – showing that they're back together. TMZ reports soon after he posted it – he deleted it!
Selena visited Justin in Oslo, Norway on Thursday (April 18). A source told People the pair were, "holding hands, hugging, and they kissed on the lips."
Filed under: Featured,Instagram,Justin Bieber,Selena Gomez
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Lea Michele Wrapped Up With 'Glee' This Week
Lea Michele posted a few photos from the set of Glee this week. Friday (April 19) was the last day of filming. Fortunately the series has been renewed for seasons 5 and 6.
Lea tweeted: "And thank you to all our amazing Gleeks who watched this season… I'm already excited for next year!!!"
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Filed under: Glee,Lea Michele,Twitter
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Harry Styles: Game Playa
What do mega-popstars do on the weekends? If you're Harry Styles, you might just be bowling with friends. Or playing Scrabble. With your mom.
The One Direction singer posted the pic above on Saturday (April 20) and wrote, "BOWLING!! I won." On Sunday he shared a shot of a Scrabble board and tweeted, "Just lost scrabble by 5 points. To my mother." Adorable!
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Giveaway: Go Contemporary Chic With InStyle Modern, $50 Giftcard
You spend a good amount of your time there in high school and in college. Whether you're studying or entertaining friends, your bedroom or dorm room is the hub of your late teen years. Shouldn't it reflect your growing maturity in style? And, shouldn't you begin acquiring quality, yet budget-friendly, pieces that can turn your room into your haven?
InStyle Modern has the answer with their fun and minimalist furnishings! You can easily add a contemporary piece or two to your room for comfort and style. You'll turn your bedroom or dorm room into a homey place for you and your friends!
Whether your friends need a place to crash or if you need to pull together your study area, these pieces are sure to add a bit of flare to your space:
- Taupe Micro Twill Modern Sofa Bed
- Romano Convertible Sofa Chair In Red Fabric
- Elegant Conference Office Chair
- Studio Office Chair
- Arco Coster Lamp
- Arne Jacobsen Egg Ottoman In Wool
We are giving away a $50 gift certificate to InStyle Modern to 1 lucky reader!
Four easy ways to enter:
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One winner will be chosen at random at the end of the contest.
This contest ends Monday, April 29th at 7:00 pm EST. This contest is open to contiguous US residents (48 states) only! Good luck!View Slideshow »»
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Miley Cyrus: Sunday Kisses
Miley Cyrus puckered up and posted this pic for her fans on Sunday (April 21). The singer – who seems to be bouncing back after recent rumors of a breakup with fiancé Liam Hemsworth – wrote this cheerful message:
"Happy Sunday ❤❤❤"
Filed under: Miley Cyrus,Twitter
Photo credit: TwitterNo Comments


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Use the Winco CDP-1Q Insert for Condiment Dispenser 1 Qt. for holding lemons, pickles, and other dressings at your salad bar. A must-have in any foodservice establishment, this insert can be used as a replacement for a worn out condiment holder or for holding refills. Crafted from durable plastic, this condiment insert is easy to clean and will withstand the rigors of a busy kitchen. Condiment Insert 1 Qt., Durable plastic construction, Fits CDP-4/5/6
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While most of London slept, a royal wedding rehearsal took place starting at 4:30 a.m. this morning and lasting until about 8 a.m. Clarence House tweeted this photo of it.
No, Prince William and Kate Middleton were not up at that hour going through their nuptial motions. But it was a full dress rehearsal for all the military and police groups involved and for the carriages that will carry the bridal party from the Abbey to Buckingham Palace. By all accounts, everything went off without a hitch. As one reporter for British morning show Daybreak said, "It's all starting to feel very real now."
And today it will feel especially real. According to British press reports, Kate and her sister Pippa were spotting driving from Bucklebury to London yesterday. They are in town now for final preparations, and they are expected at Westminster Abbey today for a dress rehearsal that will include Prince William.


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SOBEWFF: Saturday's New Times Best Bite on the Beach Winner
Fun at the village.
Laine Doss
Saturday's Grand Tasting Village at the South Beach Wine & Food Festival saw thousands of people flock to Miami Beach's white sands to sip wine, mingle with the likes of Martha Stewart, Emeril Lagasse, and Rachael Ray, and chow down on some of the best bites they've ever had from 40 of the finest restaurants in town -- each outdoing each other to compete for the coveted Miami New Times Short Order's Best Bite on the Beach award.
See also: SOBEWFF: The Top Ten Things to Do at the Grand Tasting Village Besides Swirl Wine
The award is chosen by GTV attendees, who vote for their favorite food via text.
The votes have been tabulated and Saturday's winning restaurant is American Social. The Fort Lauderdale restaurant is well known for its good food and extensive craft beer offerings.
If you're heading out to the Grand Tasting Village today, be sure to vote for your favorite restaurant and read Short Order to find out which restaurant earned Sunday's Best Bite on the Beach title.
Follow Laine Doss on Twitter @LaineDoss and Facebook.
Follow Short Order on Facebook, on Twitter @Short_Order, and Instagram @ShortOrder.
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Become a Corporate Partner
Hope for Henry welcomes corporate and nonprofit partners to help us serve even more children.
- Consumer electronics manufacturers can donate portable electronics to entertain and distract kids during painful medical procedures.
- Party stores can donate birthday supplies.
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If you or someone you know has access to products that make kids happy, please think of Hope for Henry. If you are looking to invest your money in a nonprofit that makes a significant difference every day, think of Hope for Henry. All donations are tax deductible and are guaranteed to bring a smile to a sick child's face.
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$ 112.99
Nice edges or nice pinches depending on the orientation. But always nice. On vertical terrain you'd find holds like these in the 5.9 and up range. And that's with good footholds. Positive enough to still hold onto though for your super steep and stellar sick V6.
...sculpted by Terry Moller
...sculpted by Terry Moller
- 9 holds
- pictured here in purple with an orange SoftBack
- SoftBack is recommended
- these holds have HollowBacks