text:
When I bought my first car, my budget was a little . . . strained. After doing the research and test-driving a few models, I made my choice. The car was simple, reliable, and affordable. A hundred thousand miles later, my modest investment had delivered on its promise to get me where I wanted to go. I still think about that car with a fair amount of nostalgia because it proved a better buy than those I purchased later. It was also my first introduction to the cost-value paradox where what you pay and what you get in return can be markedly different.
Vanguard investors know this paradox well. It's why many of our clients come to Vanguard, and it's why even more of them stay for the long term. They understand that when you pay less for an investment, you get to keep more of its return. The research bears this out: Fees are the most consistent and effective predictor of long-term performance.
Lower costs have meant higher net returns
10-year annualized return by quartile: As of 12/31/2015
Source: Vanguard, using data from Morningstar. Past performance is no guarantee of future returns.
But low cost doesn't always mean better value. If I think of all the low-cost cars I could have purchased, many of them wouldn't have made it to my college graduation. They were cheap for a reason—some had high mileage, some had reliability issues, and some were bare bones when it came to amenities. The melding of low expenses and high quality is the key to the cost-value paradox.
When evaluating the value of active investments, I tell clients to consider two factors: cost and outperformance. It's a straightforward formula that requires considerable effort to get right because long-term outperformance is often elusive. Beating the benchmark over the course of one or two years could be the product of skill or luck, depending on the circumstances. When we talk about a winning active strategy at Vanguard, the time horizon is much longer. Over the past ten years, 92% of our funds have outperformed their peer-group averages, which is a testament to the expertise, skill, and judgment of our teams.
Long-term outperformance
For the one-year period ended December 31, 2015, 81% of Vanguard funds outperformed their peer-group averages. For the three-year period ended December 31, 2015, 88% of Vanguard funds outperformed their peer-group averages. For the five-year period ended December 31, 2015, 87% of Vanguard funds outperformed their peer-group averages. For the ten-year period ended December 31, 2015, 92% of Vanguard funds outperformed their peer-group averages. Results will vary for other time periods. Only funds with a minimum one-, three-, five-, or ten-year history, respectively, were included in the comparison. (Source: Lipper, a Thomson Reuters company.) Note that the competitive performance data shown represent past performance, which is not a guarantee of future results, and that all investments are subject to risks. For the most recent performance, visit our website at www.vanguard.com/performance
Indexing requires just as much skill, but value is measured in a different way. Portfolio managers must tightly track their fund's benchmark while managing tax efficiency, cash flow, and changes to the index. On the surface, indexing may seem simple. Look closely and you'll get a sense of the sophistication and talent needed to approximate a benchmark return with minimal tracking error while keeping costs low. It's not easy, yet our teams consistently meet the challenge year in and year out.
Underlying this work are the benchmarks themselves, which deserve just as much consideration. In 2012, we made the decision to transition more than 20 of our funds and ETFs to new benchmark providers. It was a decision that invited scrutiny, but it was the right one for continuing to drive down costs for our investors and the industry at large. While we may be known for our passive investing products like indexing, we'll never be passive in our approach to giving clients the best chance for investing success.
Economies of scale and strategic investments continue to propel us forward. As more clients entrust us with their assets, we're able to invest in the talent, technology, and research that keep our funds consistently competitive. At the same time, we're able to return savings back to our clients in the form of lower expense ratios. It's the cost-value paradox at its best.
Vanguard is known as a low-cost provider, and we wear that title proudly. Keeping costs low can help generate higher returns for investors. But don't let low costs be the only factor driving your decision about which funds to include in your lineup. Look under the hood and determine what exactly you're getting for every basis point.
Note: All investing is subject to risk, including the possible loss of the money you invest. Diversification does not ensure a profit or protect against a loss.


text:
. Warm-up Questions: 1.Explain your motto in life. 2. Do you find life sometimes paradoxical? Why or why not?? Text Explanations This essay discusses one of the paradoxes in life: ?to let something go\" and ?to hold something fast.\" The author tries to explain in the importance of cherishing beauty when it is offered and to let it go when it is inevitable. Thus ?to let it go\" is as important as ?to hold fast\" in our lives..
Related searches for Unit 10 Two Truths to Live By
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

subset: commoncrawl


text:
Leadership Muskingum 2013-2014 kicked off Friday at the OUZ/Zane State College campus center.
16 leaders from all over the county spent the day learning to become better leaders, and they'll spend the next nine months honing their skills and learning all about Muskingum County.
"We have business and industry days where they'll go into different businesses within the county, history and diversity day; learning about the history of Muskingum county," said Chair of the Leadership Alumni Committee Dan Kieffer. "Social services day, education day. Just so many things that they'll learn about Muskingum County."
The 16 participants started the morning off with breakfast and took notes and advice from keynote speakers. Kieffer said the group will also learn about the four different types of leadership styles.
"Some might believe that you're a born leader. I don't believe that, I believe you make leaders. That's why were here. Certainly different personalities have more ability to be forth coming with their leadership. But it doesn't mean that the person who's quiet doesn't also have leadership capabilities within them."
The group will also learn about networking during their nine month course.


text:
|Message view
|« Date » · « Thread »
|« Date » · « Thread »
|" Raman Ganesh (JIRA)" <j...@apache.org>
|[jira] [Commented] (GEARPUMP-218) Documentation bug for WordCount example
|Wed, 12 Oct 2016 11:20:20 GMT
[ https://issues.apache.org/jira/browse/GEARPUMP-218?page=com.atlassian.jira.plugin.system.issuetabpanels:comment-tabpanel&focusedCommentId=15568440#comment-15568440 ] Raman Ganesh commented on GEARPUMP-218: ---------------------------------------- i've found it working from master .. do we close this given shaded lib is part of the dependency? Or do complete the daemon merge onto core under this itself? > Documentation bug for WordCount example > ---------------------------------------- > > Key: GEARPUMP-218 > URL: https://issues.apache.org/jira/browse/GEARPUMP-218 > Project: Apache Gearpump > Issue Type: Bug > Components: doc > Affects Versions: 0.8.1 > Reporter: Raman Ganesh > Assignee: Huafeng Wang > Priority: Minor > > The sbt and maven should include a few more dependencies for the example to work as the example has dependencies on : > Starting with the example as is gives : > Exception in thread "main" java.lang.NoClassDefFoundError: org/apache/gearpump/codahale/metrics/MetricRegistry > After adding "gearpump-shaded-metrics-graphite_2.11" to dependency it doesn't the service location for the JarStore and ends with the same issue as :https://issues.apache.org/jira/browse/GEARPUMP-19 > After adding daemon and excluding gearpump-experimental-cgroup_2.11 it ends with another exception as Caused by: java.lang.ClassNotFoundException: org.apache.gearpump.google.common.io.BaseEncoding > The documentation needs to fix the sbt/maven library dependencies. > Finally adding guava collections assembly shaded jar full-fills all class path requirements however doesn't run the application .via Embedded cluster -- This message was sent by Atlassian JIRA (v6.3.4#6332)
|View raw message


text:
Archive for the 'My voice' Category
Because we care about you
If I photographed you during New York Fashion Week SS16 and you've not seen your picture yet, please revisit Qui style also checkout our instagram page @quistyle. I am working with hundreds of images.
See you on the street.
Mangue Banzima
Just like that, NYFW is a wrap!
Looking back through the week, it was fashion over comfort. The cold never bothered these fashionistas anyway. The women offered an eclectic range of styles- from avant garde masterpieces to athletic goth. Winter white paired with camel was a popular, classic look among the ladies. Some even dared to dream of spring with refreshing pastels. any played it safe with neutrals, a little texture, and over the top heels to stand out.
2015 is the year of the MAN. I'm sorry ladies, but the men stole the spotlight of NYFW. Beards, three-piece suits, loafers, and classic fedoras galore… Need we say more? The dapper gents pieced together a perfect winter attire with neutral coats and sharp accessories. Dressed all in a similar style, each man brought their own element making every ensemble invigorating to study. From bow ties to fur, these men did not disappoint.
Fringe and Fur are in.
When forced to face subzero temps, many embraced fur. Fashion blogger from The Haute Pursuit was seen throughout the week with this divine chartreuse fur stole that paired magnificently with her blonde bombshell hair. Actually, a lot of dyed fur was on the scene adding texture and warmth, quite literally.
Fringe is no longer just a biker's accessory. Jackets and fringe skirts made an appearance. With a little wind and the right catwalk, fringe can cause quite a spectacle. Black leather fringe was the most popular, which is no surprise. After all, this is New York.
Spotted during New York Fashion Week F/W 15…
If I photographed you during New York Fashion Week and you've not seen your picture yet, please revisit Qui style also checkout our instagram page @quistyle. I am working with hundreds of images. See you on the street. Mangue Banzima
QuiStyle on Instagram
Do you want to develop your eye for street style Photography ?
Introducing "Qui Style in Practice," a bi-weekly photographer's meet up that will improve your response to the fast-moving, ever-changing styles of New York City's streets. Our first session is on October 18th!
Here's what you should expect to take away from Qui Style in Practice:
- How to ready your camera to capture moving subjects with speed and style
- How to position yourself to achieve more visually interesting compositions
- How to develop a narrative through successive imaging and editing
And here's what we expect from you:
- A commitment to evolving your practice and developing your own point of view regarding style
Please come prepared with a fully charged camera, enough storage space to accommodate a vast number of images, a computer ( optional ) to import your images onto, and a well-nourished body to endure your exploration of the city.
Sessions will be held on every other Saturday, for 2 hours at a time. There will be a 30-minute break to recharge (lunch on me!) and discuss any challenges or difficulties you may have faced. This will also be a great time to import your images onto your computer if you have reached your memory card's capacity.
We will also offer individual sessions to discuss your work and practice in greater detail. These will be held every Monday, Wednesday, and Friday of each week.
Bi-Weekly Sessions – $100/per session
Individual Sessions – $300/per session
The Monday following our session you will have the opportunity to see your work posted on Qui Style with full credit.
To apply, please email firstname.lastname@example.com with the following information ( please indicate in the subject line if you are applying for the Bi-Weekly or individual Session):
- Name
- Address
- Profession
- A brief paragraph explaining your interest in Qui Style in Practice
- Any relevant experience or links to your work
- If interested in the Individual Session, please provide a date and time that works best for you
An email will be sent confirming receipt of your application, along with a PayPal invoice for the amount of the session. Payment is due within two days of this confirmation.
There will only be 4 spots available per bi-weekly session, so apply now!
Spotted during AfroPunk Fest 2014
If I photographed you during AfroPunk Fest 2014 and you've not seen your picture yet, please revisit Qui style. I am working with hundreds of images. Feel free to follow my Instagram at @Quistyle for more photos.
Spotted at Spike Lee block party
If I photographed you during Spike Lee block party and you've not seen your picture yet, please revisit Qui style. I am working with hundreds of images.
Spotted at Frieze Art Fair
If I photographed you during Frieze Art Fair and you've not seen your picture yet, please revisit Qui style. I am working with hundreds of images.
Easter Sunday Street style
If I photographed you during Easter parade and you've not seen your picture yet, please revisit Qui style. I am working with hundreds of images
Mangue Banzima
Thank you all and a special thanks to my family and those who have consistently believed in me.
As we leave 2013 behind and usher in 2014, I wanted to reflect and give gratitude. To all those whom I have pictured through my view finder: thank you for showing me your world, your ideas, your joy and your style. Your displays of self- expression made me appreciate my every moment on the street. Going forward, you will continue to see different images, different compositions, different cities, and the vast array of different people and cultures that make our world amazing.
May 2014 be a year filled with joy, prosperity and peace for us all.
Lets keep expressing ourselves out there in the world.
See you on the streets.
Mangue Banzima


text:
Peter Marigold
Cedar wood steel nails, 81 x 38 x 23 cm
Cedar wood steel nails, 206 x 74 x 49 cm
Cedar wood, steels nails and glass shelves, 103 x 73 x 49 cm
Cedar wood steel nails, 85 x 110 x 58 cm
Hiba Japanese Cypress and Igusa woven grass, 220 x 38 x 42 cm
Wood and Kvadrat wool, Approx dims 45 x 35 x 35 cm (stools) and 45 x 35 x 70 cm (bench)
Wood and Kvadrat wool, Approx dims 45 x 35 x 35 cm (stools) and 45 x 35 x 70 cm (bench)
Dodai, 2012
Peter Marigold's "Dodai" benches were created for an exhibition with the theme 'Simple Vision' coordinated by Japan Creative, shown at the Milan Salone di Mobili, 2012. They were realised by the respected Japanese furniture company Hinoki Kogei following visits to their factory in Japan.
The benches are created from a log split into two pieces and set opposing each other. This is similar to Marigold's 'Palindrome' work and also echoes the 'Split' series that he has worked on for some time. The covering is created from woven grass (igusa) and wooden rods. This can be rolled back so that the interior space can be used for storage. It is held in place with coloured elastic chord stretched over dark hardwood turned knobs. The wood used is 'hiba', a type of Japanese Cypress. Both the igusa and hiba have fantastic natural odours. In fact, at the first exhibition of the piece the 'igusa' grass surface was still fresh, and the show was full of the incredible natural aroma.
Bleed, 2014
Peter Marigold's most recent design project 'Bleed' is a series of contemporary cedar wood cabinets. Although simple forms, the surface patina is painterly and complex and incorporates a form of 'localised ebonising' created through an entirely innovative process. On the cabinets the strategically placed steel hardware is stripped of its protective zinc coating using acid, which reacts overtime with the tannin in the cedar. This produces an intricate bleeding pattern on the wood that in turn emphasises and adds to the warm tones and natural grain of the organic material.
In 2004 Marigold joined the M.A. Design Products course at the Royal College of Art, London under esteemed designer Ron Arad. He was awarded an Esmee Fairbairn bursary following his graduate exhibition at the Design Museum, London and his show with the British Council as one of the 'Great Brits' at the Milan Furniture Fair 2007 was followed by an invitation to create an entire installation for Paul Smith in Milan and then further work with Paul Smith in London. Working with both galleries and manufacturers, Marigold's work continues to be exhibited in the UK and abroad, including the Pavilion of Art Design, London; Milan Furniture Fair, Italy; Design Miami, USA; Stavanger 2008, Norway; and MoMA and Moss New York. In 2009 he was awarded one of the four 'Designer of the Future' awards by Design Miami, followed by a significant installation at Art Basel. Recently Marigold has shown at 21_21 Design Sight in Tokyo, the Victoria & Albert Museum, London, and Design Museum Holon, Israel.
Works by Aneta Regel, Eleanor Lakelin, Ernst Gamperl, Gareth Neal, Helen Carnac and David Gates, Jim Partridge, Joseph Walsh, Liam Flynn, Marc Ricourt, Michael Peterson, Nic Webb, Peter Marigold, Wycliffe Stutchbury.
The gallery will present new works by Maisie Broadhead, Christopher Duffy, Liam Flynn, Ernst Gamperl, Peter Marigold, Gareth Neal, Michael Peterson, Marc Ricourt and Joseph Walsh.
The gallery will show new works by Christopher Duffy, Liam Flynn, Sung-Jae Han, Ernst Gamperl, Michael Geertsen, Peter Marigold, Michael Peterson, Marc Ricourt, Joseph Walsh and the collaborative vessels by the late Zaha Hadid and Gareth Neal.
Featuring works by Thomas Bohle, Christopher Duffy, Michael Geersten, Zaha Hadid and Gareth Neal, Liam Flynn, Peter Marigold, Philip Moulthrop, Michael Peterson, Marc Ricourt, Nic Webb.
Sarah Myerscough presents designers and makers whose works explore innovative conceptual and technical trends in contemporary woodworking. The museum-quality designers and makers investigate the relationship between function and form using traditional techniques as well as new technologies to create sculptural pieces.
For Design Miami/Basel 2015, Sarah Myerscough Gallery has selected artists whose works explore innovative conceptual and technical trends in contemporary woodworking, while engaging with the gallery's multidisciplinary approach to art and design.
A selection of new works by our contemporary makers and designers.
SARAH MYERSCOUGH GALLERY is delighted to announce its exclusive representation of the collaborative sculpted oak vessels by architect Zaha Hadid and designer Gareth Neal, first exhibited at the Victoria and Albert Museum London as part of "The Wish List" during the London Design Festival 2014. The vessels will be shown at COLLECT 2015, alongside new works by Thomas Bohle, Friedemann Buehler, Christian Burchard, David Gates, Liam Flynn, Ernst Gamperl, Shelley James, Peter Marigold, Malcolm Martin and Gaynor Dowling, Pascal Oudet, Michael Peterson, Marc Ricourt and Nic Webb.


text:
The Liberation newspaper claimed to have papers showing L'Oreal heiress Liliane Bettencourt handed over 100,000 euros (£83,000) to an unnamed person in 2007.
They appeared to give weight to claims by an accountant who worked for Mrs Bettencourt that illegal payments were made to Nicolas Sarkozy's presidential campaign that year.
Claire Thibout, 52, has told detectives she personally collected some of the money from a cashpoint to hand to party figures.
The paper published a ledger showing several payments including one where the beneficiary of a 100,000 euro payment was marked as "Monsieur".
"It's necessary to go back to the month of January 2007 to find confirmation of the claims of the accountant, which refer to important withdrawals designated for political financing," said the paper. "On January 26, 100,000 euros were handed over to an unnamed man."
Mrs Thibout's lawyer, Antoine Gillot, said: "My client is categorical. When you take out 100,000 euros for Mrs Bettencourt, it's not because it's going to the hairdresser."
Much of the money is alleged to have come from undeclared Swiss accounts, which Mrs Bettencourt had not declared to the French tax authorities.
Mr Gillot said Mrs Thibout police had travelled to the South of France so as to bring her back to Paris for further interviews.
She is now likely to be given the official status of a witness in the criminal investigation being coordinated by Nanterre prosecutors.
Mrs Bettencourt's lawyer, Georges Kiejman, insisted that the accounting documents helped contradict Mrs Thibout's claims.
He said the ledger showed one 50,000 euro withdrawal taken from a Paris bank in March 2007 was clearly marked as having gone on "food shopping" and to a "bookbinder", said Mr Kiejman.
Mr Sarkozy has denounced the allegations against him as "libel that aims only to smear, without the slightest basis in reality".
Mrs Thibout has also pointed to Eric Woerth, a senior minister and treasurer of Mr Sarkozy's UMP party, as being at the centre of the alleged corruption.
Mr Woerth, whose wife was a financial adviser to Mrs Bettencourt until she resigned last month, has resisted opposition calls to stand down.
He also denies all wrongdoing or any conflict of interest when he held parallel offices as party treasurer and, until March, budget minister. 'I did not receive a single euro illegally,' said Mr Woerth.
A recent opinion poll found that nearly two-thirds of the French public believe their political leaders are corrupt.


text:
P- Reviewers Leitman IM, Milone M, Mazzocchi M, Tagaya N, Wang DR, Yin DP S- Editor Ma YJ L- Editor A E- Editor Wang CH
Published online Oct 15, 2013. doi: 10.4239/wjd.v4.i5.202
Revised: August 26, 2013
Accepted: September 14, 2013
Published online: October 15, 2013
AIM: To investigate whether or not bariatric surgery weight outcomes vary by ethnicity in a large, nationally representative sample of adolescents.
METHODS: The Bariatric Outcomes Longitudinal Database was used for analysis and contains data on surgeries performed on adolescents from 2004 to 2010 from 423 surgeons at 360 facilities across the United States Adolescents (n = 827) between 11 and 19 years old who underwent either gastric bypass or adjustable gastric banding surgery were included in the analysis. Outcome measures included changes in anthropometric measurements [weight (kg) and body mass index] from baseline to 3 (n = 739), 6 (n = 512), and 12 (n = 247) mo after surgery.
RESULTS: A year after patients underwent either gastric bypass (51%) or adjustable gastric banding (49%) surgery, mean estimated weight loss for all ethnic groups differed by a maximum of only 1.5 kg, being 34.3 kg (95%CI: 30.0-38.5 kg) for Hispanics, 33.8 kg (95%CI: 27.3-40.3 kg) for non-Hispanic blacks, and 32.8 kg (95%CI: 30.9-34.7 kg) for non-Hispanic whites. No overall pairwise group comparisons were significant, indicating that no ethnic group had better weight loss outcomes than did another.
CONCLUSION: Bariatric surgery substantially reduces the weight of severely obese adolescents at 1 year post-procedure with little variation by ethnicity and/or gender. These results suggest that bariatric surgery is a safe and reasonable treatment for all severely obese adolescents with the appropriate indications.
Core tip: Bariatric surgery is one of the few effective treatments for severe obesity. Among adults, outcomes of bariatric surgery differ by ethnicity. We tested whether this relationship is also true among adolescents. Outcome measures included changes in anthropometric measurements (weight and body mass index) from baseline (n = 827) to 1 year after surgery. Our results support the conclusion that bariatric surgery can substantially reduce weight in severely obese adolescents for at least 1 year, irrespective of their race or ethnicity. Ethnicity is a reasonable and safe treatment for all severely obese adolescents with the appropriate indications.
Citation: Messiah SE, Lopez-Mitnik G, Winegar D, Sherif B, Arheart KL, Reichard KW, Michalsky MP, Lipshultz SE, Miller TL, Livingstone AS, Cruz-Muñoz NDL. Effect of ethnicity on weight loss among adolescents 1 year after bariatric surgery. World J Diabetes 2013; 4(5): 202-209
The Centers for Disease Control and Prevention (CDC) recently reported that the prevalence of childhood obesity in the United States has stabilized over the past few years, although it remains high among all age, sex, and ethnic groups[1]. An estimated 12% of all United States children between 2 and 19 years old have a body mass index (BMI) ≥ 97th percentile for age and sex. Moreover, the prevalence of obesity differs significantly among racial and ethnic groups. In 2009-2010, 21% of Hispanic and 24% of non-Hispanic black children and adolescents were obese, whereas 14% of non-Hispanic white children and adolescents were obese.
Childhood obesity has several health-related consequences that, until recently, were documented only in adulthood, including hypertension, insulin resistance, glucose intolerance, and dyslipidemia[2]. In turn, these conditions are risk factors for type 2 diabetes and cardiovascular disease in both childhood and adulthood[3-5]. Weight-loss surgery among both adults and adolescents has become increasingly recognized as effective treatment for severe obesity and several of its related comorbidities[6-10]. Current studies suggest that neither pharmacologic nor dietary treatment can maintain weight loss in obese adolescents as effectively as can weight-loss surgery[11,12].
Several studies have shown that among adults, weight loss outcomes after bariatric surgery differ by ethnicity with some studies reporting better outcomes among non-Hispanic whites than among non-Hispanic blacks[13-16]. Although the literature on outcomes of bariatric surgery in adolescents has increased exponentially, many studies are small and usually from single institutional series[8]. As a result, patients are not geographically or ethnically diverse, despite the fact that obesity disproportionately affects ethnic minorities[1].
Accordingly, we analyzed data from the Bariatric Outcomes Longitudinal Database (BOLD), a large national database that tracks outcomes in patients from a wide geographical area who have undergone bariatric surgery. We report here the results of our analysis, which indicate that weight loss in a large cohort of severely obese adolescents 1 year after bariatric surgery did not differ by ethnicity.
Data for the BOLD database are collected prospectively from participants in the Bariatric Surgery Center of Excellence (BSCOE) program sponsored by the American Society for Metabolic and Bariatric Surgery (ASMBS)[17]. Participating centers enter data collected on all bariatric surgery patients during preoperative visits, the hospital stay, and all postoperative visits. These data are used to monitor adherence to the requirements of the BSCOE program and to support quality assessments for the surgical treatment of obesity and its associated conditions.
All BSCOE programs undergo a site inspection before approval and recertification every 3 years. During the site inspection, the accuracy of BOLD data is verified in an impartially selected sample of 10% of medical records. All data on complications and readmissions are also reviewed for accuracy. To ensure accurate data input, any discrepancies result in a mandatory review of all charts at that center.
The Copernicus Group Independent Review Board (Durham, NC) approved the use of BOLD data for research. The BOLD study has been registered with the National Institutes of Health (clinical trial #NCT01002352). Informed consent was obtained from all parents and assent was obtained from all patients.
About 65% (169000) of patients treated by surgeons participating in the BSCOE program have allowed their data to be analyzed for research purposes. Preliminary analyses show that the demographic characteristics of patients included in the database do not differ substantially from those who are not[17]. Data are currently entered into the database by more than 1000 surgeons from more than 600 facilities in the United States (all states are represented with the exception of Vermont and New Mexico), representing approximately 85% of all facilities nationwide performing at least 10 bariatric procedures per year.
We analyzed data from all patients 11 to 19 years old who had undergone bariatric surgery between April 2004 and October 2010 (the most current data available for analysis) who allowed their data to be used for research purposes. The data analyzed here came from 360 facilities and 423 surgeons participating in the BSCOE program. All patients had met the National Institutes of Health criteria for bariatric surgery[18]. Thus, all patients had a BMI > 35 kg/m2 and ≥ 1 co-morbidity (e.g., elevated blood pressure, hypercholesterolemia) or a BMI > 40 kg/m2.
We collected data on age, sex, race/ethnicity, weight (kg), BMI, and weight loss, calculated as the difference between the weight before surgery and the weight at each respective time point.
Intraoperative data used in the present analysis consisted of the procedure (gastric bypass or adjustable gastric band) and the date of surgery. The primary outcomes were weight loss measured by various anthropometric measures and consisted of age-and sex-adjusted BMI percentiles as well as crude BMI and weight (kg)[19]. Data were collected before surgery and at 3, 6 and 12 mo after surgery.
Because not all patients had their follow-up appointment exactly at these times, the 3-mo data collection point included data collected from 0 to 3 mo after surgery, the 6-mo time point consisted of data collected from 3 to 9 mo after surgery, and the 12-mo time point consisted of data collected 9 to 15 mo after surgery.
To assess changes in weight and BMI, separate repeated-measures, linear mixed-models were fit using the MIXED procedure in SAS version 9.2 (SAS Institute, Inc., Cary, NC, United States). A compound symmetric variance-covariance matrix was selected for each model to account for the correlation of within-patient repeated observations. Age at surgery, sex, surgery type (gastric bypass or adjustable gastric band), and time period of data collection were the fixed covariates considered for potential inclusion in each model; patients were considered to be a random variable. Because the sample was so skewed in terms of distribution of BMI percentile (the majority of patients had a BMI at or above the 99th percentile, the clinical definition of "severe obesity" before surgery) and because the literature consistently reports that comorbidities intensify and multiply with increased weight[4,5] we also analyzed the results for three categories defined by baseline BMI values: 35.0-49.0 kg/m2; 50.0-59.99 kg/m2; and greater than 60.0 kg/m2.
Patients may not have been eligible for follow-up analysis if they had surgery shortly before the analysis: 89% of eligible patients were seen at 3 mo (n = 739), 62% at 6 mo (n = 512), and 30% (n = 247) at 12 mo after surgery. Those identified as "other" are not included in the denominator or the follow-up analysis as a result of the small sample size.
Because of potential selection bias caused by losses to follow-up, we tested for any selection bias between the whole sample (n = 890) and those patients for which data from all four time-points were available (n = 247) using the mixed-model approach described below and by including an indicator variable for complete or incomplete data[20]. Results showed that the two samples did not differ on baseline BMI or weight outcomes or between the proportion of males and females. This finding supports the external validity of our overall conclusions.
In a mixed model, the particular levels of fixed-effects are of interest, and inferences are made for those specific levels; random-effects are considered to be random samples from the population, and inferences are not made to a specific sample but to the entire population. The interaction between time and ethnicity was also assessed. A planned-comparisons approach was used to evaluate changes between ethnic groups because mean baseline BMI values differed significantly. Contrasts were used to test for differences between groups at each time for mean values of weight and BMI. Alpha was set at 0.05.
Of the 890 eligible adolescents, 75% were females (mean age, 18.5 years 68% were white non-Hispanic, 15% were Hispanic, 11% were non-Hispanic black, and 6% were "other"' (Table 1). Gastric bypass surgery was performed in 51% of the patients, and gastric band surgery in 49%. At baseline, males were significantly heavier than females. Those undergoing gastric bypass surgery were significantly heavier than those undergoing adjustable gastric band surgery. Non-Hispanic whites were significantly lighter than their ethnic group counterparts (Table 1). Because of these significant baseline differences in sex and surgery type, all subsequent analyses are adjusted for these variables.
|n (%)
|Baseline BMI Z
|score, mean ± SD
|< 0.001
|225 (25.3)
|3.14 ± 0.24
|665 (74.7)
|2.41 ± 0.19
|Type of surgery
|< 0.001
|Gastric bypass
|454 (51.0)
|2.67 ± 0.38
|Adjustable gastric band
|436 (49.0)
|2.53 ± 0.36
|Non-hispanic white
|606 (68.1)
|2.57 ± 0.37
|129 (14.5)
|2.68 ± 0.40
|Non-hispanic black
|98 (11.0)
|2.67 ± 0.34
|57 (6.4)
|2.60 ± 0.42
All anthropometric measures significantly decreased in non-Hispanic whites and Hispanics throughout the 1 year follow-up period (Table 2). Among both non-Hispanic whites and Hispanics, mean BMI percentile decreased to just below non-obese levels 1 year after surgery (94.67th percentiles for both groups, respectively).
|Non-hispanic whites,
|Non-hispanic blacks,
|estimate (95%CI)
|estimate (95%CI)
|estimate (95%CI)
|estimate1 (95%CI)
|BMI (kg/m2)
|47.9 (47.3-48.4)
|51.7 (50.1-53.4)
|48.9 (47.7-50.2)
|48.5 (48.0-49.0)
|99.3 (99.2-99.4)
|99.5 (99.4-99.6)
|99.4 (99.3-99.5)
|99.4 (99.3-99.4)
|Weight (kg)
|136.8 (135.0-138.6)
|147.9 (142.5-153.3)
|137.7 (134.1-141.3)
|138.4 (136.8-140.0)
|3 mo after surgery
|BMI (kg/m2)
|43.9 (43.4-44.5)
|47.9 (46.4-49.4)
|44.5 (43.3-45.6)
|44.48 (43.98-44.97)
|99.0 (98.0-99.1)
|99.3 (99.2-99.4)
|99.1 (99.0-99.2)
|99.02 (98.96-99.08)
|Weight (kg)
|125.6 (123.9-127.4)
|137.0 (132.0-141.9)
|125.1 (121.7-128.4)
|126.84 (125.33-128.35)
|EWL (kg)
|10.7 (10.1-11.3)
|10.57 (9.11-12.04)
|12.3 (10.5-14.1)
|10.9 (10.4-11.5)
|7.8 (7.3-8.2)
|6.9 (6.0-7.8)
|8.6 (7.4-9.7)
|7.8 (7.4-8.2)
|6 mo after surgery
|BMI (kg/m2)
|39.0 (38.3-39.7)
|44.1 (42.4-45.7)
|39.9 (38.5-41.2)
|39.70 (39.1-40.3)
|97.0 (96.5-97.5)
|98.9 (98.6-99.1)
|97.8 (97.3-98.3)
|97.3 (96.9-97.7)
|Weight (kg)
|111.7 (109.7-113.7)
|125.7 (120.4-131.0)
|111.9 (108.2-115.6)
|113.3 (111.6-115.0)
|EWL (kg)
|25.1 (24.1-26.0)
|22.3 (19.7-25.0)
|25.4 (22.8-28.0)
|24.8 (23.9-25.7)
|18.3 (17.66-19.0)
|14.5 (12.9-16.1)
|18.1 (16.2-19.9)
|17.8 (17.2-18.4)
|12 mo after surgery
|BMI (kg/m2)
|36.6 (35.7-37.4)
|40.3 (37.5-43.0)
|36.7 (34.7-38.8)
|37.0 (36.3-37.8)
|94.7 (93.6-95.7)
|96.8 (94.3-99.2)
|94.7 (92.2-97.2)
|94.9 (94.0-95.8)
|Weight (kg)
|104.6 (102.1-107.0)
|114.7 (106.4-123.0)
|103.1 (97.3-109.0)
|105.6 (103.4-107.8)
|EWL (kg)
|32.8 (30.9-34.7)
|33.8 (27.3-40.3)
|34.3 (30.0-38.5)
|33.1 (31.4-34.82)
|23.6 (22.3-24.9)
|21.6 (17.4-25.7)
|24.7 (21.8-27.7)
|23.5 (22.4-24.7)
When the sample was stratified by sex the variation among ethnic groups was only 3.7 kg for girls and 10 kg for boys (Tables 3 and 4). Further analysis revealed no significant differences between pairwise ethnic group comparisons for all anthropometric measures (Table 5).
|Non-hispanic whites,
|Non-hispanic blacks,
|estimate (95%CI)
|estimate (95%CI)
|estimate (95%CI)
|estimate1 (95%CI)
|Before surgery
|BMI (kg/m2)
|51.2 (49.8-52.7)
|52.3 (49.0-55.5)
|52.8 (50.8-54.9)
|51.68 (50.53-52.84)
|99.9 (99.6-100.0)
|99.9 (99.8-100.0)
|99.9 (99.8-100.0)
|99.9 (99.8-100..0)
|Weight (kg)2
|162.4 (158.0-166.7)
|166.7 (155.3-178.2)
|161.8 (155.8-167.8)
|162.8 (159.3-166.3)
|3 mo after surgery
|BMI (kg/m2)
|46.9 (45.5-48.3)
|47.5 (44.8-50.2)
|47.1 (45.2-48.9)
|46.9 (45.9-48.1)
|99.7 (99.6-99.8)
|99.9 (99.7-99.9)
|99.8 (99.7-99.9)
|99.8 (99.7-99.9)
|Weight (kg)2
|148.5 (144.1-152.8)
|151.7 (141.7-161.7)
|144.3 (138.6-149.9)
|148.0 (144.5-151.4)
|EWL (kg)2
|13.2 (11.7-14.6)
|14.4 (10.9-17.9)
|17.3 (13.3-21.3)
|14.1 (12.8-15.4)
|8.1 (7.3-8.9)
|8.5 (6.6-10.3)
|10.4 (8.2-12.6)
|8.6 (7.9-9.4)
|6 mo after surgery
|BMI (kg/m2)
|41.9 (40.3-43.9)
|43.4 (40.9-45.9)
|41.8 (39.9-43.6)
|42.0 (40.8-43.2)
|98.7 (98.1-99.3)
|99.6 (99.4-99.8)
|99.6 (99.4-99.7)
|98.9 (98.6-99.4)
|Weight (kg)2
|132.7 (127.8-137.6)
|138.5 (129.8-147.1)
|128.1 (122.4-133.8)
|132.4 (128.7-136.1)
|EWL (kg)2
|29.7 (27.4-31.9)
|28.1 (22.8-33.5)
|34.0 (29.6-38.4)
|30.3 (28.4-32.1)
|18.3 (16.8-19.8)
|16.2 (13.9-18.6)
|20.5 (18.2-22.8)
|18.4 (17.3-19.6)
|12 mo after surgery23
|BMI (kg/m2)
|39.6 (37.8-41.5)
|40.2 (35.5-44.8)
|37.0 (34.0-40.0)
|39.3 (37.8-40.9)
|97.5 (95.8-99.1)
|98.6 (96.9-100.4)
|98.2 (96.8-99.7)
|97.7 (96.5-98.9)
|Weight (kg)2
|125.3 (119.6-130.9)
|127.9 (113.3-142.5)
|113.7 (104.6-122.9)
|128.7 (118.9-128.5)
|EWL (kg)2
|37.9 (33.7-42.1)
|40.4 (26.8-54.0)
|47.9 (41.2-54.6)
|40.1 (36.5-43.7)
|22.9 (20.4-25.4)
|23.0 (16.0-30.0)
|29.4 (25.2-33.6)
|24.0 (21.9-26.2)
|Non-hispanic whites,
|Non-hispanic blacks,
|estimate (95%CI)
|estimate (95%CI)
|estimate (95%CI)
|Estimate1 (95%CI)
|Before Surgery
|BMI (kg/m2)
|46.8 (46.2-47.5)
|51.6 (49.6-53.6)
|47.0 (45.5-48.6)
|47.5 (46.9-48.1)
|99.1 (99.0-99.2)
|99.4 (99.3-99.5)
|99.2 (99.0-99.3)
|99.2 (99.1-99.3)
|Weight (kg)
|129.1 (127.18-131.1)
|141.6 (135.4-147.7)
|125.9 (121.5-130.4)
|130.3 (128.6-132.1)
|3 mo after surgery
|BMI (kg/m2)
|43.0 (42.4-43.6)
|48.0 (46.3-49.8)
|43.3 (41.8-44.7)
|43.7 (43.1-44.2)
|98.7 (98.6-98.8)
|99.1 (98.9-99.2)
|98.7 (98.5-98.9)
|98.8 (98.7-98.9)
|Weight (kg)
|118.7 (116.9-120.5)
|131.9 (126.3-137.6)
|116.0 (111.8-120.2)
|119.9 (118.2-121.6)
|EWL (kg)
|9.9 (9.3-10.7)
|9.2 (7.6-10.7)
|9.8 (8.0-11.6)
|9.8 (9.2-10.4)
|7.7 (7.1-8.2)
|6.3 (5.3-7.4)
|7.7 (6.3-9.1)
|7.5 (7.0-7.9)
|6 mo after surgery
|BMI (kg/m2)
|38.1 (37.4-38.8)
|44.4 (42.3-46.4)
|39.0 (37.1-40.8)
|38.9 (38.3-39.6)
|96.5 (95.9-97.1)
|98.6 (98.3-98.9)
|96.9 (96.2-97.7)
|96.8 (96.3-97.2)
|Weight (kg)
|105.3 (103.2-107.4)
|121.8 (115.4-128.3)
|104.2 (99.3-109.1)
|107.0 (105.1-108.8)
|EWL (kg)
|23.7 (22.6-24.8)
|20.0 (16.9-23.2)
|21.2 (17.9-24.5)
|22.9 (21.9-24.0)
|18.3 (17.5-19.1)
|13.8 (11.7-15.8)
|16.9 (14.4-19.5)
|17.6 (16.9-18.4)
|12 mo after surgery
|BMI (kg/m2)
|35.6 (34.7-36.6)
|40.32 (36.96-43.67)
|36.65 (34.15-39.16)
|36.28 (35.40-37.17)
|93.9 (92.6-95.1)
|96.10 (92.81-99.39)
|92.99 (89.48-96.51)
|93.99 (92.87-95.12)
|Weight (kg)
|98.3 (95.5-101.0)
|110.4 (100.5-120.2)
|98.0 (91.3-104.6)
|99.6 (97.1-102.1)
|EWL (kg)
|31.2 (29.1-33.4)
|31.4 (24.0-38.8)
|27.8 (22.9-32.6)
|30.9 (28.9-32.8)
|23.8 (22.3-25.2)
|21.1 (16.1-26.2)
|22.5 (18.7-26.3)
|23.4 (22.0-24.7)
|Estimated change 12 mo after surgery (mean ± SE)
|BMI (kg/m2)
|-11.4 ± 0.5
|-11.2 ± 1.6
|-12.7 ± 1.2
|-11.5 ± 0.4
|-4.7 ± 0.6
|-2.7 ± 1.3
|-4.9 ± 1.3
|-4.6 ± 0.5
|Weight (kg)
|-32.2 ± 1.3
|-32.3 ± 4.6
|-36 ± 3.5
|-32.6 ± 1.2
Changes in BMI varied somewhat by preoperative BMI category. For the entire sample, the highest BMI category lost the most BMI units when compared to lowest BMI category (17.8 kg/m2vs 9.9 kg/m2, respectively, P < 0.001). Only Hispanics showed no difference in weight loss between the three groups (11.7 kg/m2) (Table 6). Rate of change over the year for the three BMI categories did not vary much by ethnicity or sex, but they did by surgery type: in all three categories, BMI was reduced more among those who underwent gastric bypass surgeries than among those who had adjustable band surgeries (P < 0.001) (data not shown on tables).
Details about aggregate post-operative complications are published elsewhere[9]. Briefly, of the 120 complications reported (13.5%), 38 were with the gastrointestinal system and 26 were with nutritional deficiencies. Complication rates did not differ by ethnicity. Similarly, when readmissions (n = 55) were analyzed by ethnic group, no significant differences were found. (Data not reported). One death was reported from cardiac arrest 5 mo after (gastric bypass) surgery.
In a national sample of ethnically diverse, severely obese adolescents, 1 year after bariatric surgery, weight and other anthropometric measures had decreased by the same amount in all racial/ethnic groups and in both sexes. Mean estimated weight loss for all three groups at 1 year differed by a maximum of only 1.5 kg. Surgery resulted in an average weight loss of more than 30 kg per person, a loss that far exceeds those reported in non-surgical weight-management programs[21].
Among adults, ethnicity predicts better weight loss outcomes after bariatric surgery, with some studies reporting better outcomes among NHWs than among NHBs. There is little information about outcomes in Hispanics. Harvin et al[13] found that 2 years after undergoing bariatric surgery, NHW adults had lost significantly more weight than did their ethnic group counterparts. Similarly, Buffington et al[15] found that NHB adults had less-successful weight outcomes after gastric bypass than did NHW adults. Among adults, NHB women lost considerably less weight after surgery than did NHW women[13-16]. Additionally, in the Netherlands, Admiraal et al[22] found that African, South Asian, Turkish and Moroccan patients lost less weight at 1-year post-gastric bypass surgery versus their ethnic Dutch counterparts.
Conversely, most studies of adolescent bariatric surgery are case series from a single-institution, resulting in samples that are generally small and relatively homogeneous, which does not permit robust comparisons among ethnic groups[8]. Although race and ethnicity are independently associated with cardiometabolic disease risk[23,24], we found that weight loss was similar among all three ethnic groups and varied more among boys than among girls. However, no overall pairwise group comparisons were significant, indicating that no ethnic group had better weight loss outcomes than did another, unlike comparisons of adults, as described above. Parental influence over post-operative adherence to quality nutrition and physical activity recommendations may partially explain the lack of ethnic group differences.
Although the childhood obesity epidemic continues unabated in most developed countries, non-surgical approaches to the long-term (1 year or more) management and decrease of overweight in childhood have had limited success[21]. Despite standardized indications for bariatric surgery in adolescents[25], obese children are not simply younger versions of obese adults; they are still developing and growing, both physically and psychologically. Extreme obesity should be treated sooner rather than later[8], particularly in adolescents, who may have not yet developed full-blown, related comorbidities, such as diabetes or heart disease. Our analysis found that type of surgery significantly influences weight loss, however and thus must be a consideration for adolescents considering this alternative; gastric bypass surgery resulted in significantly more weight loss at 1-year versus adjustable gastric band surgery. Therefore, gastric bypass may be a viable option for those who are in need of more weight loss to resolve co-morbidities that have already developed. However, the optimal age in adolescence for bariatric surgery is as yet undetermined[24]. Our findings, and those of others[26,27] indicate that bariatric surgery before adulthood can substantially reduce weight[10,25] and resolve comorbidities[25]. Moreover, earlier treatment of obesity may prevent later costs. For example, children and adolescents with a primary or secondary diagnosis of overweight, obesity, or severe obesity require longer hospital stays than do children without these diagnoses[28].
Even as the emerging data on bariatric surgery-including those from randomized-controlled trials[26,29] -continue to show important long-term weight loss and improvement in most obesity-related comorbidities, many pediatric specialists still hesitate to refer patients for surgery[30]. A survey of several hundred pediatricians in the United States showed that, although they believed pediatric obesity to be a major problem, less than half would be somewhat or very likely to refer a severely obese adolescent for surgery[30]. Yet, the medical consequences of childhood obesity continue and suggest that overt disease beginning in early adulthood may become chronic[31].
Our findings and conclusions are limited by a substantial amount of missing follow-up data, a common problem in the bariatric literature among both adults and adolescents. Older adolescents in particular are difficult to follow because they may leave the geographic area for education or employment. More age-relevant tracking procedures, such as those based on social media or handheld or cellular telephone devices, may be able to decrease losses to follow-up.
Variations in practice management among BSCOE participants may delay data entry, potentially resulting in incomplete follow-up data. Additionally, pre-surgical information on nutritional deficiencies is not available to determine whether surgery is the cause of the few deficiencies we found or whether these deficiencies existed before surgery.
Our results support the conclusion that bariatric surgery can substantially reduce weight in severely obese adolescents for at least 1 year, irrespective of their race or ethnicity. Ethnicity should not be a contraindication for bariatric surgery in adolescents, which is a reasonable and safe treatment for all severely obese adolescents with the appropriate indications.
We thank all the surgeons and centers of excellence that have contributed their data to Bariatric Outcomes Longitudinal Database (BOLD). We also thank ASMBS for its continued efforts to support BOLD. Finally, we are grateful to all the bariatric patients who agreed to share their data for the current analyses.
Several studies have shown that among adults, weight loss outcomes after bariatric surgery differ by ethnicity. Although the literature on outcomes of bariatric surgery in adolescents has increased exponentially, many studies are small and usually from single institutional series. As a result, patients are not geographically or ethnically diverse, despite the fact that obesity disproportionately affects ethnic minorities.
Bariatric surgery is one of the few effective treatments for morbid obesity. Among adults, outcomes of bariatric surgery differ by ethnicity.
In a national sample of ethnically diverse, severely obese adolescents, 1 year after bariatric surgery, weight and other anthropometric measures had decreased by the same amount in all racial/ethnic groups and in both sexes. Mean estimated weight loss for all three groups at 1 year differed by a maximum of only 1.5 kg. Surgery resulted in an average weight loss of more than 30 kg per person, a loss that far exceeds those reported in non-surgical weight-management programs.
Bariatric surgery substantially reduces the weight of severely obese adolescents at 1 year post-procedure with little variation by ethnicity and/or gender. These results suggest that bariatric surgery is a safe and reasonable treatment for all severely obese adolescents with the appropriate indications.
Bariatric surgery is synonymous with weight loss surgery and in this analysis consisted of two specific types: gastric bypass surgery and adjustable gastric band surgery.
Attrition is one of the major challenges with this patient population and that is indeed apparent in the analysis here. As a result, the authors could not simultaneously dichotomize surgery type and ethnicity thus why surgeries are reported in aggregate. Instead, the purpose of this article was to focus on exploring ethnic group differences in weight loss 1 year after surgery.
|Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA. 2012;307:483-490. [PubMed] [DOI]
|Ford ES, Li C. Defining the metabolic syndrome in children and adolescents: will the real definition please stand up? J Pediatr. 2008;152:160-164. [PubMed] [DOI]
|Lee S, Bacha F, Gungor N, Arslanian S. Comparison of different definitions of pediatric metabolic syndrome: relation to abdominal adiposity, insulin resistance, adiponectin, and inflammatory biomarkers. J Pediatr. 2008;152:177-184. [PubMed] [DOI]
|Sun SS, Liang R, Huang TT, Daniels SR, Arslanian S, Liu K, Grave GD, Siervogel RM. Childhood obesity predicts adult metabolic syndrome: the Fels Longitudinal Study. J Pediatr. 2008;152:191-200. [PubMed] [DOI]
|Morrison JA, Friedman LA, Wang P, Glueck CJ. Metabolic syndrome in childhood predicts adult metabolic syndrome and type 2 diabetes mellitus 25 to 30 years later. J Pediatr. 2008;152:201-206. [PubMed] [DOI]
|Sugerman HJ, DeMaria EJ, Kellum JM, Sugerman EL, Meador JG, Wolfe LG. Effects of bariatric surgery in older patients. Ann Surg. 2004;240:243-247. [PubMed] [DOI]
|Inge TH, Jenkins TM, Zeller M, Dolan L, Daniels SR, Garcia VF, Brandt ML, Bean J, Gamm K, Xanthakos SA. Baseline BMI is a strong predictor of nadir BMI after adolescent gastric bypass. J Pediatr. 2010;156:103-108.e1. [PubMed] [DOI]
|Treadwell JR, Sun F, Schoelles K. Systematic review and meta-analysis of bariatric surgery for pediatric obesity. Ann Surg. 2008;248:763-776. [PubMed] [DOI]
|Messiah SE, Lopez-Mitnik G, Winegar D, Sherif B, Arheart KL, Reichard KW, Michalsky MP, Lipshultz SE, Miller TL, Livingstone AS. Changes in weight and co-morbidities among adolescents undergoing bariatric surgery: 1-year results from the Bariatric Outcomes Longitudinal Database. Surg Obes Relat Dis. 2013;9:503-513. [PubMed] [DOI]
|de la Cruz-Muñoz N, Messiah SE, Arheart KL, Lopez-Mitnik G, Lipshultz SE, Livingstone A. Bariatric surgery significantly decreases the prevalence of type 2 diabetes mellitus and pre-diabetes among morbidly obese multiethnic adults: long-term results. J Am Coll Surg. 2011;212:505-511; discussion 512-513. [PubMed] [DOI]
|Yermilov I, McGory ML, Shekelle PW, Ko CY, Maggard MA. Appropriateness criteria for bariatric surgery: beyond the NIH guidelines. Obesity (Silver Spring). 2009;17:1521-1527. [PubMed] [DOI]
|Hollenbeak CS, Rogers AM, Barrus B, Wadiwala I, Cooney RN. Surgical volume impacts bariatric surgery mortality: a case for centers of excellence. Surgery. 2008;144:736-743. [PubMed] [DOI]
|Harvin G, DeLegge M, Garrow DA. The impact of race on weight loss after Roux-en-Y gastric bypass surgery. Obes Surg. 2008;18:39-42. [PubMed] [DOI]
|Parikh M, Lo H, Chang C, Collings D, Fielding G, Ren C. Comparison of outcomes after laparoscopic adjustable gastric banding in African-Americans and whites. Surg Obes Relat Dis. 2006;2:607-610; discussion 610-612. [PubMed] [DOI]
|Buffington CK, Marema RT. Ethnic differences in obesity and surgical weight loss between African-American and Caucasian females. Obes Surg. 2006;16:159-165. [PubMed] [DOI]
|Anderson WA, Greene GW, Forse RA, Apovian CM, Istfan NW. Weight loss and health outcomes in African Americans and whites after gastric bypass surgery. Obesity (Silver Spring). 2007;15:1455-1463. [PubMed] [DOI]
|DeMaria EJ, Pate V, Warthen M, Winegar DA. Baseline data from American Society for Metabolic and Bariatric Surgery-designated Bariatric Surgery Centers of Excellence using the Bariatric Outcomes Longitudinal Database. Surg Obes Relat Dis. 2010;6:347-355. [PubMed] [DOI]
|Gastrointestinal surgery for severe obesity. NIH consensus development conference, March 25-27,1991. Nutrition. 1996;12:397-404. [PubMed]
|Centers for Disease Control and Prevention. BMI - Body Mass Index: BMI for Children and Teens: 2011. Available from: http: //www.cdc.gov/nccdphp/dnpa/bmi/bmi-for-age.htm.. [DOI]
|Chakraborty H, Gu H. A Mixed Model Approach for Intent-to-Treat Analysis in Longitudinal Clinical Trials with Missing Values. RTI Press publication No. MR-0009-0903, 2009. Research Triangle Park, NC: RTI International. Retrieved May 20; 2011; Available from: http: //www.rti.org/rtipress.
|Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, Summerbell CD. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009;CD001872. [PubMed] [DOI]
|Admiraal WM, Bouter K, Celik F, Gerdes VE, Klaassen RA, van Dielen FM, van Ramshorst B, van Wagensveld BA, Hoekstra JB, Holleman F. Ethnicity influences weight loss 1 year after bariatric surgery: a study in Turkish, Moroccan, South Asian, African and ethnic Dutch patients. Obes Surg. 2013;23:1497-1500. [PubMed] [DOI]
|Capella RF, Capella JF. Ethnicity, Type of Obesity Surgery and Weight Loss. Obes Surg. 1993;3:375-380. [PubMed] [DOI]
|Messiah SE, Carrillo-Iregui A, Garibay-Nieto G, Lopez-Mitnik G, Cossio S, Arheart KL. Inter- and intra-ethnic group comparison of metabolic syndrome components among morbidly obese adolescents. J Clin Hypertens (Greenwich). 2010;12:645-652. [PubMed] [DOI]
|Pratt JS, Lenders CM, Dionne EA, Hoppin AG, Hsu GL, Inge TH, Lawlor DF, Marino MF, Meyers AF, Rosenblum JL. Best practice updates for pediatric/adolescent weight loss surgery. Obesity (Silver Spring). 2009;17:901-910. [PubMed] [DOI]
|O'Brien PE, Sawyer SM, Laurie C, Brown WA, Skinner S, Veit F, Paul E, Burton PR, McGrice M, Anderson M. Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial. JAMA. 2010;303:519-526. [PubMed] [DOI]
|Inge TH, Miyano G, Bean J, Helmrath M, Courcoulas A, Harmon CM, Chen MK, Wilson K, Daniels SR, Garcia VF. Reversal of type 2 diabetes mellitus and improvements in cardiovascular risk factors after surgical weight loss in adolescents. Pediatrics. 2009;123:214-222. [PubMed] [DOI]
|Hlaing WM, Messiah SE, Lipshultz SE, Ludwig DA. Obesity and length of hospital stay in children: a retrospective review of Florida Agency for Health Care Administration data. Prog Ped Cardiol. 2011;31:66-72. [DOI]
|Keidar A, Hecht L, Weiss R. Bariatric surgery in obese adolescents. Curr Opin Clin Nutr Metab Care. 2011;14:286-290. [PubMed] [DOI]
|Iqbal CW, Kumar S, Iqbal AD, Ishitani MB. Perspectives on pediatric bariatric surgery: identifying barriers to referral. Surg Obes Relat Dis. 2009;5:88-93. [PubMed] [DOI]
|Lipshultz SE, Messiah SE, Miller TL, Editors . Pediatric Metabolic Syndrome: Comprehensive Clinical Review and Related Health Issues. London: Springer; 2012;. [DOI]


text:
DENVER -- After sitting out the first month of the season because of a broken right pinky, Chicago Bulls forward Carlos Boozer appears ready to rejoin his teammates on the practice floor.
"It felt good," he said before Friday night's 98-97 loss to the Nuggets. "Got a chance to work out again, worked out [Thursday] and worked out today. It's a little sore. Still not strong enough, but as long as it keeps getting stronger and stronger, it should be pretty soon."
Boozer participated in some shooting drills at the Pepsi Center and appears to be using the hand with more ease. Bulls head coach Tom Thibodeau was happy with what he saw.
"He actually looked good in the shootaround today," Thibodeau said with a chuckle. "He was making shots. He's been shooting, but he was actually making them today, so that was encouraging.
"He hasn't gone through contact yet. The shootaround this morning was basically shooting, running through offense and just going over the schemes. And he was fine. But it was the first practice he really went through. ... Once we get back [from the Circus Trip] I expect him to practice."
Boozer has been working out with a protective sleeve the team had made for him, but it doesn't sound as if he will continue to wear it in the coming weeks.
"It's not my favorite," he said. "I'd rather wear nothing. ... I don't know if I'm going to wear it too much. I'd rather just play without it, to be honest. But we'll see."
Boozer understands that no matter when he starts playing in games again, he will have to deal with soreness in the hand.
"When I go out there and work out, shoot. Do all my drills, play five on five with the guys. Let it get hit in practice, when it doesn't hurt," he said, when asked when he'll know he's ready. "To be truthful, I'll probably end up playing through, for the first couple weeks, probably playing through a lot of that pain, just because I'm anxious to get back out there."
Boozer signed a five-year deal worth close to $80 million in the offseason.
Nick Friedell covers the Bulls for ESPNChicago.com and ESPN 1000.


text:
Providence vs. Bryant - 12/12/15 College Basketball Pick, Odds, and Prediction
Bryant Bulldogs (2-8) at Providence Friars (9-1)
College Basketball: Saturday, December 12, 2015 at 12:00 pm (Dunkin Donuts Center)
The Line: Providence Friars -- Over/Under: See the Latest Odds
The Bryant Bulldogs and Providence Friars meet Saturday afternoon at the Dunkin Donuts Center.
The Bryant Bulldogs need a nice victory in order to snap a seven-game losing streak. The Bryant Bulldogs are averaging 58.6 points on 37.7 percent shooting and allowing 79.2 points on 47.4 percent shooting. Hunter Ware is averaging 13.7 points and three rebounds while Nisre Zouzoua is averaging 11 points and 1.3 rebounds. Shane McLaughlin is dishing four assists and Dan Garvin is grabbing 8.7 rebounds. The Bryant Bulldogs are shooting 27.1 percent from beyond the arc and 59 percent from the free throw line. Bryant has missed 64 free throws in 10 games and is allowing teams to shoot 36.5 percent from downtown. The Bryant Bulldogs have lost six straight road games.
USA TODAY Sports
The Providence Friars look to build on their impressive 9-1 start to the year. The Providence Friars are averaging 74.9 points on 45.8 percent shooting and allowing 66.7 points on 44 percent shooting. Ben Bentil is averaging 17.7 points and 7.2 rebounds while Kris Dunn is averaging 16.8 points and 6.9 assists. Rodney Bullock is the third double-digit scorer and Kyron Cartwright is dishing three assists. The Providence Friars are shooting 32 percent from beyond the arc and 73.6 percent from the free throw line. Providence is forcing 15 turnovers per game and is allowing 33.5 percent shooting from deep. The Providence Friars have won eight of their last 10 home games.
The Bulldogs are 2-5-1 ATS in their last 8 games vs. a team with a winning straight up record and 1-5 ATS in their last 6 games overall. The Friars are 4-0 ATS in their last 4 games vs. a team with a losing straight up record and 4-1 ATS in their last 5 games overall.
Providence is off to an impressive start and that's not going to change against a Byrant team that's stuggling at both ends of the court. Look for the Firars to in in a blowout even though there's no line on this game yet.


text:
Kim Cattrall Starring On 'Sex And The City' Spinoff Series?
Kim Cattrall is NOT starring on a "Sex and the City" spinoff series that would supposedly focus on her character Samantha Jones, despite a false tabloid report. Gossip Cop can exclusively debunk this claim. We're told it's not true.
According to Star, the actress is working with HBO to create a new show all about her "man-eating character." A so-called "source" tells the magazine, "It's certainly unusual to have a show about a woman in her 60's sleeping with younger men, but HBO is all about pushing limits." The outlet's dubious insider goes on to claim Sarah Jessica Parker also plans to appear on the series and is "eyeing this as her next project."
"Sarah knows people love the franchise so she's totally game," adds the questionable insider. "And Kim is in amazing shape and still beautiful. She's blown away that this project could happen and more than ready to be a cougar again." Unfortunately, "Sex and the City" fans shouldn't get their hopes up. Gossip Cop looked into the story, and sources close to Cattrall and at HBO tell us there's no such spinoff project in the works.
In fact, this isn't the first time Gossip Cop has had to bust a false rumor regarding the franchise. We previously corrected Star's sister publication, the National Enquirer, for wrongly reporting that Parker was demanding $50 million to star in Sex and the City 3. That story was completely inaccurate, and the same goes for this latest one.


text:
Updated: Women's Narrow Silver Sandals for Wedding Season
It's wedding season and guests, bridesmaids and maybe even a few brides will be looking for women's narrow silver sandals to wear with their lovely dresses. Here are our top 7 (up from 5) from Vaneli, David Tate and Stuart Weitzman:
1. We'll call this newly available Silver Vaneli Sandal our new #1 because we just found out about it and it's so pretty!
2. and we'll call this one #2 now because it's the same new Vaneli sandal in a multi-silver color:
Each of these lovely narrow silver sandals offers something you'll enjoy, be it a flexible sole, soft comfortable cushioning, elegant rhinestones, or all that glitters, you're sure to find a special pair this season.


text:
We recommend upgrading to the latest Internet Explorer, Google Chrome, or Firefox.
Learn More
If you are using IE 9 or later, make sure you turn off "Compatibility View".
Handpicked brands for you
Ponele onda a tu look nautico!
#totebags #sientobags #lifestyle
Stay logged in
Forgot Password?
Or use these networks
New to GoodPeople?Create an account here!


text:
We recommend upgrading to the latest Internet Explorer, Google Chrome, or Firefox.
If you are using IE 9 or later, make sure you turn off "Compatibility View".
Handpicked brands for you
Today we hail the beauty and purity of water, and pledge to help keep our oceans, rivers, waterfalls, and streams pollution free. Our #muse @mariannes.yoga.journey leads the way on this #WorldWaterDay. #getoutthere #water #everydropcounts #ecuador...


text:
Helping You Better Understand Time Management With These Simple To Follow Tips
Improving yourself begins with an ability to manage your time. The good news is that the article below has great tips to help you with better managing your time management.
Keep the deadlines in mind at all times.However, staying on track can make a world of difference, you will not get into the position where you have to abandon on task to attend to another.
Planning for disruptions can keep you stay on schedule.
Plan your day ahead of time if you're struggling with time management.You can choose to create a to-do list for the day ends. This reduces your mind and lets you sleep soundly.
Think about the things that are costing you find yourself running out of it. Make sure to use of your time to optimize results. Only look at emails or voice mail when time for them. Checking them when they come in takes away from the time you've allocated for other things.
You have got to learn how to say no. Many people get too stressed out due to the fact that they never say no when someone asks them to do things. Are there tasks that somebody else can delegate? Ask your family members to assist in areas that are appropriate.
Plan out your day when you wake up. Write down everything you plan to do and the things that you need to do and the amount of time each task will require. A schedule will get you feel less stressed.
Unless you need to, it's not good to answer the phone, texts, or instant message when you're doing something else. It can be hard to return to your train of thought you allow yourself to be interrupted. Return calls or texts after you get done with whatever task you are currently working on has been completed.
Stay focused and on what you are doing until it's done. Don't let yourself to become distracted by anything. People often hand you more to do before you to finish the new one first. Avoid allowing this happen. Complete one task before you begin a new one.
Tasks Early
Take on the toughest tasks early. The tasks should be done as early as possible. This puts you under less pressure as you move on to simpler tasks. If you finish your stressful tasks early, you can ensure that the rest of the day cruises by.
Stress is inevitable if you don't have enough time to accomplish everything that you need to. Reading this article is a good start towards slowing down and getting everything done that needs to be. Study and keep these tips close to easily see the benefits of proper time management.


text:
If you are hungry there are a few restaurants serving the area. For food stuffs and household goods there is a Grocery Store around to provide. Rest assured, there is at least one doctor in the area. There is at least one attorney nearby.
For advice with tax or credit there is a local accountant who can help. There is a new and used car dealer locally, offering deals on brand new or used automobiles. For a reliable, pre-owned vehicle there is a Used Motor Vehicle Dealer nearby.


text:
1. Pack light - which I did - I fit all three of us girls in this one duffle bag - including shoes...
I thought I was doing good. Even the boys only had a small sports bag for their things. Well all you really need is bathing suits, underwear a play outfit and a nice outfit - they wore the same thing every day. And again I didn't pack that much!!!
2. My mini van can hold way more than I ever gave it credit for - I don't know how we managed to have more than we came with because all we really brought home were the extra groceries and seashells but our van was on overload - and she can take it!!
3. NEVER and I mean NEVER go family grocery shopping.... David usually always runs to the grocery store while I unpack and get us settled, we have already planned a menu and he likes to go in and get out. He thought it might be fun if I went along too this time since I never usually go. IT WAS NOT FUN. We both learned a valuable lesson that day - if at all possible do not take 7 people to the grocery store together. We lost a whole day of vacation...or at least it felt like that :-)
4. We can count to 5 million - I am sure we did it- always in groups of five. You know 1, 2, 3, 4, 5 yep they are all here.
5. Reading material is no longer necessary on vacation - there is NO time for it. I once was able to read two or three books on vacation - for now that is a thing of the past I barely got a few chapters read.
All that aside - I would not trade our time or memories for anything. Even now that we are home I will just think of something funny and bust out laughing - that is what vacation is really all about - enjoying every moment - even the crazy ones!!
|So blessed - full heart!!


text: Last minute steez. That's how we do it. Wake up in the morning and your day is your day then somewhere along the line you're Audi five-thousand. I'm not saying it's the only way to do it. Just my favorite. It certainly ain't the best way—you know—not having a ticket for a music fest. If everyone went out like that it'd be chaotic. There'd be no festival because of low ticket sales. But you have to realize, son. If there's a music festival with ninety thousand tickets, there will be extras. There are a million reasons why someone won't make it. A million reasons! Someone gets sick. Someone's date sold them out. Someone has to work. It's the same thing in New York. I'm always tellin Diamonds when he wants to see a sold-out Yankees game, or Lee when he tries to peep a blockbuster play. You have to charge the venue like it's a new frontier. The only way to lay claim to an adventure is to go for yours. How do you think America even came into its own? Peeps went for theirs, took chances. It may not always work out, but when you let go, everything will be just fine. I'm not tryin to motivate anyone so much as I'm tryin to explain why some of us go on these missions. Listen. There are a lot of us. Okay? Almost too many characters for one story. There's a seven nation army of us—we-se deeper than you think. I'm tryin to tell a story from an insider's perspective. I'm not tryin to motivate anyone here. We're young. A lot of us are a little off. Heck, you need to be off if you want to be on. But whatevs, son. We are young. I'm one of the oldest kids here and I'm only twenty. We're young but we're still old enough to know this spirit is dangerous and contagious and powerful. What are we going to do with it? Hmm?


text:
04-23-2010 #1Administrator
- Join Date
- Apr 2005
- Posts
- 25,037
PS3 Firmware 3.30 Update Breaking PlayStation 3 Consoles?
As with nearly every PS3 Firmware revision, the recently released PS3 Firmware 3.30 update arrived with user reports of PlayStation 3 consoles breaking post-update.
To quote: "The main reported problems are that the systems no longer read any form of disc, thus making gaming and watching movies an impossibility - even the NetFlix disc is reported to no longer work in some cases.
One user report stated on the official PlayStation forums: "Are you kidding me! First (3.21) it freezes, and now with this one (3.30) it won't even read or recognize the disk, that means that I won't be able to play online or offline."
Although they may be isolated cases, has anyone here experienced these issues since updating to PS3 Firmware 3.30 this week? Feel free to reply in the comments below!
More PlayStation 3 News...
04-23-2010 #2spark32 Guest
Both of my PS3`s (slim and fat) had bluetooth and WiFi completely killed (so no wireless controllers, headsets, or Internet) until after like 5 resets.
04-23-2010 #3micro87 Guest
I updated to 3.30 from 3.15 yesterday and after that, Guitar Hero World Tour hung up on start saying that the downloaded content had changed and the game had to be restarted. Eventually I had to completely remove every data on the hard drive to be able to start it again. Now I've got to play through the carrier mode again to unlock the tracks.
04-23-2010 #4Neo Cyrus Guest
This post by littlemevcobear was the most interesting:
This is what the Technician that repaired my machine said happened, and by the way I went for a new Blue Ray drive not replacing the BR controller board and laser that had been burnt out, and I went with a local computer hacker shop.
This guy said the newer slims have a Blue Ray drive that is able to spin and read at a faster rate, more speed and faster reading because of the complaints to Sony about poor frame rates and lagging visuals for your games, Sony tweaked the Blue Ray for better performance unaware it would cause catastrophic over heating of the older Phat consoles causing the controller boards to burn out, most service shops just replace the controller board and the laser in a matching set, it has been noted that these repairs only last a short while (usually die shortly after the warranty expires) because it is still the same slower drive some will even try to replace the heat sinks but even this will not last, so I elected to replace the whole drive with a new one and I had them wipe my EPROM and install the firmware before 3.15, so now my PS3 is X Moded and I do not trust Sony with any further firmware updates if a game requires a update to play it I take it back to the store and get a refund, you can do this within 7 days at Game Stop, then I get the same game but in XBox 360 format.
No matter what Sony tells you this is their fault!
In a World filled with Lies and Deciet!
Telling the truth can be a Revolutionary Act!
04-23-2010 #5theirishman Guest
I have not had any issues as of yet with my fat ps3 with any of the updates.
04-23-2010 #6prins022 Guest
My point : how can $ony do a unique firmware that can fit 6 or 7 ps3 models, each with its own configuration (hdd, br player, bwc or not bwc...) ? when they perform test, they do it on 20, 30, 40 consoles not on millions...
I used to have fun with videogames... dommage
04-23-2010 #7rajkosladic Guest
no problem with my slim 120GB..
04-24-2010 #8Coolie4 Guest
If I remeber correctly, there is some kind of glitch with the blueray drive, where as with each firmware update there is a slight possbility of it no longer working. This happened to me a couple months ago, luckily i was able to ship it out to sony to be replaced a week before my warranty would have expired. I'll be on 3.15 for awhile... not agreeing to the new BigBrother ToS, and not giving up my linux box.
04-24-2010 #9Chivafighter Guest
I wonder...
Okay for those having the problem, did you update from 3.15 straight to 3.30 or 3.15 then 3.21 then 3.30?
04-24-2010 #10silencephaze Guest
Don't update!! Screw online for now till someone in the scene comes up with a plan!


text:
Read More
- Small-Group Halong Bay Day Cruise
- Small-Group Saigon Night Tour & Dinner Cruise
- Local Flavors Food Walking Tour
- Small-Group Full-Day Mekong Delta Cruise
- Small-Group Half-Day Tour of Cu Chi Tunnels
- Half-Day Cu Chi Tunnels Tour
- Mekong Delta, My Tho & Ben Tre Tour
- Halong Bay Full-Day Boat Cruise
- Cu Chi Tunnels Excursion
- Small-Group Half-Day Ho Chi Minh City Tour
The town of Ninh Binh is a good place to base yourself if you're visiting one of the neaby national parks. Nearby is Tam Coc, an inland "Halong Bay" - where Sampans gently glide upriver through grottoes and past rice fields. A short drive away lies the ancient capital of Hoa Lu. Cuc Phuong National park is also within easy reach -around 45km from Ninh Binh.
Quang Dung Hotel is situated in the very heart of Ninh Binh and offers guests great value accommodation for leisure and business travellers alike. The hotel offers an oasis of relaxation with easy access to all that the vibrant city has to offer. Some of the attractions guests can find in the close vicinity of the hotel include Tam Coc Cave, Ninh Binh Quay and Bich Dong Cave. The Quang Dung Hotel has 85 guest rooms, all of them featuring a variety of amenities, including complimentary bottled water, internet access – wireless, non...
Rate This Place: ( votes)
Enter your stay datesto see prices and availability


text:
Restaurant / BarFound: 4
Midway Bar
89281 County Hwy F
Butternut, WI 54514
89281 County Hwy F
Butternut, WI 54514
Full bar and restaurant serving Wisconsin favorites including a Friday night Fish Fry and a Saturday & Sunday steak special. Burgers, sandwiches, salads and cheese curds. Screened porch dining, open seasonaly. Closed Wednesday. Also closed on Sunday during the summer of 2016.


text:
Separate names with a comma.
Discussion in 'Off-Topic' started by Stewo, Apr 9, 2009.
Thank you.
You have an absolutely fabulous heiny. I want to be friends with it.
I wanna be on you! :laugh:
I'm Ron Burgundy?
LOUD NOISES :arghh:
I am Ron Burgundy?
Dang you beat me to it.
He reads everything exactly how it's written on the prompter.
I could SOOOO get this thread sent to the cave right now... :biglaugh::biglaugh::biglaugh:
I love lamp.
she pointed to her boobies!
Don't you do it!!!
I believe it's pronounced yogging, the j is silent. Apparently you just run for fun.
I'm proud of you fellas. You all kept your head on a swivel, and that's what you gotta do when you find yourself in a vicious **** fight.
I ate a whole bunch of fiberglass insulation. It wasn't cotton candy like that guy said. My stomach is itchy.
Whered u get that gernade?
They've done studies, you know. 60% of the time it works, every time
Skyyyyyyyy rockets in flight!
Afternoon delight!
60 percent of the time, it works every time.
beat me to it! I'm going to punch you right there, in the baby maker.
I don't know.


text:
28 Hotel Rooms Trailer (2012)
21 January 2012 Drama, Romance 82 mins
While traveling for work in a city far from their homes, a novelist and a corporate accountant find themselves in bed together. Although she's married, and he's seeing someone, their intense attraction turns a one-night stand into an unexpected relationship and a respite from the obligations of daily life. Through a series of moments – some profound, some silly, some intensely intimate – we see a portrait of an evolving relationship that could become the most significant one of their lives.
Watch the official 28 Hotel Rooms 2012 trailer in HD below or find more 28 Hotel Rooms videos on Vidimovie.


text:
There are hundreds of ways that you can help us raise funds to help us keep Frogmore Paper Mill open, active and available to all.
Staff, Vounteers and Supporters have undertaken lots of different activities to raise funds for particular projects or just to help cover the running costs.
Our Education Manager, Sue Woolnough, a noted arachnophobe, arranged herself a date with a Tarantula (accompanied by her, that is the tarantula's, keeper) and was sponsored for her courage. Her bravery raised funds to pay for the installation of Brown Tourist signs to help visitors find us.
Our Boat crew – Keith Jones and Colin Hambrook – together with their partners and helpers on another narrowboat, re-enacted the 'Dickinson Dash', travelling from Apsley to Paddington basin in just over 11 hours and raised funds towards a new canopy for our Bryan Donkin ferry boat which does such sterling service during the summer months.
If you have a good idea, we'd very much appreciate your support.
Donating to The Paper Trail's cause has never been easier. All donations are greatly appreciated and help preserve a valuable part of the world's history: Frogmore Paper Mill.
Golden Giving is a secure and simple way to donate money – thank you for your support!


text:
What year was my house built please?
Asked on Nov 29 2010, General in Grantham | Report content
Answers (3)
Sort by: Oldest | Recent | Highest rated
The date should be on the deeds, which you should have a copy of. Or you can go to the council and see when the building was signed of under the building regs. This will give you an indication of how old the property is.Answered on Dec 1 2010, Report content
Cornwall Close was built in the late 1940's / early 1950'sAnswered on Mar 4 2011, Report content
The only way to be sure of an area is to visit it. I would suggest visiting at the weekend, maybe a saturday afternoon/evening, then one evening during the week and then one day during the week (rush hour would be good.)Answered on Jan 9 2012, Report content
Didn't find what you were looking for? Ask a question
More General in Grantham questions on AskMe
Asked on Sep 19 2013, General in Grantham
1 answer - Answer this question
Asked on Mar 18 2012, General in Grantham
Be the first to answer this question
What are the management fees that home owners have to pay?
Asked on Jan 12 2009, General in Grantham
2 answers - Answer this question
What's it like to live in Grantham?
Asked on Aug 28 2007, General in Grantham
3 answers - Answer this question


text: I'm home today from my rocky mountain high after a trip to Utah (sorry John Denver, not Colorado) where I spent the weekend with Garrett visiting Salt Lake City and the Young Living Lavender farms in Mona, Utah. Y'all. There is TOTALLY NOT ENOUGH ALPHABET to describe the beauty we witnessed on this trip. It was just.... I mean. For real, y'all. I cannot even. Absolutely stunning views every single direction I turned. I won the free trip to Utah … [Read more...]


text:
Legal Agreement Template
A legal agreement includes all the parts of an authorized contract: tender, approval, and consideration (compensation or performance), on the basis of definite terms. A legal agreement template is the representation of that document that is required by any person or party to carry out any work related to legal issues. Basically a template of this form consists of all the major points except for those details which the users have to fill in to customise the document as per personal need and requirement.
These legal agreement templates are useful for also saving a lot of time for big organisations who regularly need legal documents for their transactions. This website shall offer you a number of legal agreement templates to suit your purpose and need.
One can find many such samples on this website on almost every kind of agreements.
"You can Download the Free Legal Agreement Template form, customize it according to your needs and Print. Legal Agreement Template is either in MS Word and Editable PDF.
Sample Legal Agreement Template
Download Editable Legal Agreement Template for only $4.99
[paiddownloads id="30″]
Category: Agreement Templates


text:
GraphicRiver Royal Mantle 5641002
Category: Stock Vector | Comment: ( 0 )
GraphicRiver Royal Mantle 5641002
Stock Vector \ Conceptual \ Miscellaneous
Medieval \ Ornament \ Mantling \ Mantle \ Heraldry \ King \ Pennant \ Royal \ Vector
Stock Vector - Royal Mantle 5641002 by seamartini @ GraphicRiver
Stock Vector \ Conceptual \ Miscellaneous
Graphics Files Included: JPG Image, Vector EPS; Layered: No; Minimum Adobe CS Version: CS.
Royal mantle with crown for heraldry design. Editable EPS8 and JPEG (can edit in any vector and graphic editor) files are included
Smiling Tooth with Tooth-Brush; Heraldic Wings Set; Cartoon Hurricane; Christmas Wreath with Holly and Berries; Spaceships and Rockets; Funny Santa Claus; Christmas Bell with Holly.
Keywords: antique, background, badge, banner, blazon, coat of arms, crown, decoration, design, emblem, engraving, frame, gold, graphic, heraldic, heraldry, king, mantle, mantling, medieval, old, ornament, pennant, royal, shield, sign, style, symbol, vector, vintage.
Download Link


text:
Jackson is the author of a series of retold fairytales, including SISTERS RED, SWEETLY, FATHOMLESS, and COLD SPELL, as well as three other novels, AS YOU WISH, PURITY, and the forthcoming middle grade novel THE DOUBLECROSS. As J. Nelle Patrick, she is the author of TSARINA. Her work has received multiple starred reviews and has been published in 17 international markets. Pearce lives in Atlanta, Georgia.
Photo Credit: Vania Stoyanova


text:
Banner, CIM and CMS Training
Banner (Star)
Please email OUR for training schedule and registration.
OUR and Ellucian Documentation
- Introduction to Banner Power Point
- Introduction to Banner Hand Out
- Getting Started Guide
- Banner Electronic Gradebook Instructions
- Adding and Removing Term Pin Instructions
Student Systems Management Documentation
Banner Document Management (BDM)
Catalog Management (CMS)
Download the Catalog Editing Manual and Style Guide.
Curriculum Inventory Management (CIM)
The CIM software system takes the course and program approval process online. Customized forms are used to streamline the process, workflow is pre-populated for effective approval routing, and users can track the progress of proposals in the system at anytime. Banner course data, the CIM system, and the academic catalogs work together to ensure all catalogs are updated with approved course and program data. Because all three systems are integrated, users can easily identify all impacted courses across a proposed change, and all changes are tracked in the system.
CIM Courses
CIM Courses instructions will provide information for faculty members submitting and/or reviewing the following:
- Propose new courses
- Make course alterations
- Make course changes
- Add a GEC, Writing, or Capstone attribute to a course
- Complete an audit for a GEC or Writing course
Download CIM Courses Initiator
Download CIM Coursers ReviewerLogin CIM Courses
CIM Programs
CIM Courses nstructions will provide information for faculty members submitting and/or reviewing the following:
- Propose a new major (associated with a new or existing degree designation and/or degree program)
- Propose a new minor
- Propose a new Area of Emphasis
- Make a change to an existing program
- Deactivate a program
Download CIM Programs InitiatorLogin CIM Programs


text:
Public Access Trailer (1993)
"Is it wise to talk to strangers?" 01 January 1993 Drama, Thriller 90 mins
Brewster seems to be an almost too perfect example of idyllic small-town America, with everyone living in peace and harmony. So when newcomer Whiley Pritcher starts up his own local cable TV show with the question "what's wrong with Brewster?", there surely can't be any deep dark secrets in the town that are just waiting to come to the surface - or can there? And when the question becomes "who's wrong with Brewster?" things start getting seriously nasty.
Watch the official Public Access 1993 trailer in HD below or find more Public Access videos on Vidimovie.


text:
GraphicRiver Halloween Landscape with Witch and Pumpkins 5761063
Stock Vector \ Conceptual \ Seasons \ Holidays \ Halloween
Vector \ Landscape \ Lantern \ Halloween \ Furnished \ Visibleearth \ Contains
Stock Vector - Halloween Landscape with Witch and Pumpkins 5761063 by OK-SANA @ GraphicRiver
Stock Vector \ Conceptual \ Seasons \ Holidays \ Halloween
Holiday Halloween landscape with pumpkins Jack O Lantern, witch, trees and bats. Element of this image furnished by NASA (www.visibleearth.nasa.gov).
Vector EPS 8 plus AI CS 5 plus high-quality Jpeg.
Editable vector file, containing only vector shapes.
Contains gradients. No transparencies.
Layered: No; Graphics Files Included: JPG Image, Vector EPS, AI Illustrator; Minimum Adobe CS Version: CS5.
Keywords: bat, black, cartoon, character, contour, dark, evening, forest, graphic, halloween, holiday, jack, landscape, lantern, moon, nature, night, october, outdoor, pumpkin, season, silhouette, sky, tree, vector, vegetable, witch, witchcraft, wizard, wood.


text:
Refine your results
Car maintenance prices for Sale ( Price from $1109.00 to $9000.00)
Sort by
Date (recent)
2007 Toyota Camry LE *Very Low Maintenance Car*
30+ days ago
Hantilly, VA 20152, USA
134,445 Miles
Hantilly, VA
Hantilly, VA
... emission ready, carefully selected, meticulously detailed, expertly and professionally serviced by ASE & DEQ certified technicians. For all qualified vehicles a complementary 3 month / 5000 miles powertrain Extended Warranty Service contract is offered at no cost. We Are a Ce...
- Mileage: 134,445 Miles
- Location: Hantilly, VA 20152
- Exterior: Silver
- Transmission: Automatic
- Seller: Motorcars Sales And Service LLC
great running car, tons of maintenance been done
30+ days ago
Rexburg, ID 83441, USA
Rexburg, ID
nothing is wrong with the car 04 Acura TL maintenance is up to date
30+ days ago
Brooklyn, NY 11248, USA
Brooklyn, NY
... I will consider any reasonable offers car has every option for its year and model car has on-star system in case of breaking down or an accident car comes equipped with front and side airbags as well as anti locking brakes premium factory upgraded...
- Location: Brooklyn, NY 11248
- Transmission: automatic
2003 Toyota Camry XLE low maintenance car with 69K mileage only
30+ days ago
Philadelphia, MS 19440, USA
69,000 Miles
Philadelphia, MS
Philadelphia, MS


text:
January, 2015
Moss Park at GCTC Falls Flat
Reviewed by Connie Meng
I've always been a fan of George F. Walker's plays with their dark humor, unusual characters and plot twists. Unfortunately I can't say that about "Moss Park," his two character 60 minute play currently running at GCTC. The two characters are pretty much stereotypes and the plot predictable. The fact that it's produced by Green Thumb Theatre of Vancouver which produces theatre for young audiences perhaps explains why "Moss Park" feels like a cautionary tale for pre-teens.
The two characters, Bobby (Graeme McComb) and Tina (Emma Slipp), have a baby and no money. They get together to try to figure out their future. At least Tina does but Bobby, obviously a few bricks short of a load asks, "The future? Like tonight?" Among the possible solutions considered is Bobby becoming a thief. His explanation of the ethics of stealing is mildly amusing. Another option is the Army and Bobby has some funny lines, but his total ignorance is just not believable. Both actors hail from Vancouver and do passable jobs with their predictable characters. (more…)
January 27, 2015 Tuesday at 11:55 am
Moss Park: George F. Walker's shining moment
Reviewed by Jamie Portman
It's not the freshest of dramatic situations — two troubled young people face another moment of crisis in their lives and are on the verge of taking a very wrong turn.
So why — we might ask ourselves — is it worth spending even an hour in their company? Surely, these will be recognizable types pursuing useless, self-destructive lives? Surely, we'll be able to predict what will happen: either the promise of redemption or else a further descent into the mire. No real surprises there.
So we're apt to give a sigh of resignation and figure we're in for another dose of "socially significant" theatre from playwright George F. Walker.
But then Walker confounds us. In the first place, his forthright but captivating play, Moss Park, is devoid of the quirky self-indulgence for which his more devoted admirers must sometimes make excuses: instead he has delivered one of his most disciplined and exhilarating pieces. Secondly, he has created two splendidly alive characters in Tina, the single, near destitute mother who has just discovered she's pregnant again, and Bobby, her shambling and feckless boyfriend. (more…)
January 27, 2015 Tuesday at 11:25 am
Moss Park: Keeping hope's door open
Reviewed by Iris Winston
When you have landed on the garbage dump of life, the only way to go is up. At least, that is how Tina, a single-mother with a toddler, thinks. Meanwhile, her on-again/off-again boyfriend, Bobby, dreams of better times but is seemingly incapable of dealing with reality or even holding a job for more than a single day.
Playwright George F. Walker introduced Tina and Bobby a decade ago in Tough. Then, she was pregnant and they were trying to deal with their future together or apart. In Moss Park, they are apparently three years older (judging from the age of their daughter) and they are drowning in present disasters.
Tina, her daughter and her mother are being evicted from their apartment because they are five months behind on the rent. She is pregnant again after a brief reunion with Bobby. Meanwhile, he has just been fired again and is considering a life of petty crime or discovering some talent — as a rapper, perhaps. (more…)
January 27, 2015 Tuesday at 11:12 am
Moss Park: Exaggeration kills credibility
Reviewed by Rajka Stefanovska
In George F. Walker's dark comedy "Moss Park," Tina (Emma Slipp) and Bobby (Graeme McComb) are a young couple who fell in love, made love and, consequently, became parents as teenagers. It's now three years later and, although they no longer live together, they still love each other. Now, they meet in Moss Park in Toronto to figure out whether there is a future in store for them, their three-year-old daughter, and – whoops- another one on the way. Yes, Emma is pregnant again, as a result of a night of passionate reconciliation between her and Bobby.
Walker puts all imaginable obstacles in their way. Not only are they as poor as church mice, but they also come from very problematic families. Emma is the third generation of immigrants whose dreams of a better life have been going to pieces ever since her grandfather came to the country. Bobby grew up with an alcoholic father, who recently replaced drinking with smoking weed. As if that weren't bad enough, it seems that at least half of his relations and friends have a criminal record. He is incapable of keeping any decent job more than a day, but has been proficient at committing petty crimes since his early teens. (more…)
January 24, 2015 Saturday at 6:03 pm
Two: The Performances Rise Above The Material
Reviewed by Jamie Portman
Mere silence on stage can sometimes be as arresting as an explosion. That's what happens at the Gladstone Theatre during the most memorable moments of its new production of Lancashire playwright Jim Cartwright's pub drama, Two. We have a woman sitting quietly at a table. There's a tentative smile on her face — she's relaxing into a moment of serenity. In the background there is the noise of other customers, but for the moment she's occupying her own, private secure world. But only for a moment. Reality intrudes, the smile vanishes. and those brief glimmerings of happiness yield to anguish bordering on despair. There's also fear.
Michelle LeBlanc is the actress here, her face and body language signalling an unsettling gamut of emotions. We start realizing that this is someone in deep trouble, and when her boyfriend shows up with the drinks, we know why. We have front-row seats for a glimpse into an abusive relationship. Her boyfriend, played with swaggering cruelty by Richard Gelinas, is as much an emotional tyrant as he is a physical menace — toying with her anxieties and fears, threatening her with the jealousies and possessiveness which hide his own insecurities. You know the scene will have a bad ending — and it does.
Director John P. Kelly has staged this sequence with the care and nuance this treacherous material deserves. He and his performers must do their best to disguise the fact that the two characters are stereotypes and that their sad little drama is playing out predictably. Gelinas, truly discomforting here, manages to bring out the awfulness of the boyfriend, getting beyond the elements of caricature in Cartwright's script. And it is LeBlanc's brilliantly modulated characterization that conveys the young woman's ultimate anguish of spirit. (more…)
January 21, 2015 Wednesday at 6:51 pm
Shaw's Saint Joan Still Relevant Today
Reviewed by Jane Baldwin
The Central Square Theatre in Cambridge Massachusetts has brought in Bedlam's unusual production of George Bernard Shaw's Saint Joan, written in 1923. The New York-based company, now in its second year, has specialized in performing large cast classics in meager spaces with a small number of actors, sparse scenery and minimal technical effects.
Few cuts have been made to the three-hour work written, in Shavian fashion, as a debate in which Joan has the last word. Shaw is true to the well-known tale of the medieval country girl, who by dint of religious belief, patriotism, and love of warfare, almost succeeds in driving the English out of France, is tried by the Inquisition for heresy, and burnt alive. However, his Joan is a female version of Shaw's übermensch, a person whose superior intellect entitles him/her to lead.
Joan is played by the extraordinary Andrus Nichols, co-founder of the company. Nichols, dressed in plain contemporary clothing in lieu of armor, her hair long, contrary to the script, plays with all facets of Joan's personality. She is warm, naïve, proud, playful, lucid, brave, as the text would have it. By turns, she elicits laughter and tears.
The twenty-three male roles – soldiers, plain folk, nobles, churchmen – are in the hands of three talented actors, Edmund Lewis, Tom O'Keefe, and actor/director Eric Tucker, the other co-founder. (more…)
January 21, 2015 Wednesday at 1:39 pm
Two: A solid production about human frailty
Reviewed by Iris Winston
Think of ordinary folk at a local pub in northern England in the vein of Coronation Street or The Eastenders.
As the (unnamed) landlord and landlady bicker between serving assorted regulars on a busy night, the audience meets the customers through a series of vignettes. As directed by John P. Kelly, who breaks down the fourth wall by having some audience members seated at cocktail tables on stage, the audience is pulled into a kaleidoscope of short character sketches about human frailty. Alongside the occasional happy thought, they are presented with a series of images of drudgery, disease, domestic abuse and loneliness, even a child left behind when his drunken father forgets him outside the pub.
All 14 characters in Two are played by the publicans, who find various excuses to leave the stage and return in a new guise for the next segment. (more…)
January 19, 2015 Monday at 11:30 am
Clybourne Park: A worthy production despite a shaky second act
Reviewed by Iris Winston
Racism, economic concerns and human tragedy sound unlikely themes for humour. Yet Bruce Norris's savage satire, Clybourne Park, frequently prompts laughter — perhaps partly because of audience discomfort with being forced to face uncomfortable truths.
The title is taken from the fictional white neighbourhood in Lorraine Hansberry's 1959 drama A Raisin in the Sun. The address of the house that has just been sold to a black family is the same. Even Karl, the smarmy head of the community association, who tries to block the sale, has the same name and official reason for his attitude. (It will bring the property values down, he says.)
From here, the multi-award-winning Clybourne Park draws back the curtains of any political correctness and goes into attack mode. Before the veil of politeness is ripped away — particularly in the first act — things move slowly. Inane chatter about the origin of the name of a type of ice cream or a discussion about capital cities take a disproportionate amount of time, until the antagonism and fear of "the other" is laid bare. (more…)
January 17, 2015 Saturday at 11:28 am
Karen MacDonald Gives a Helluva Performance in Red Hot Patriot: The Kick-Ass Wit of Molly Ivins
Reviewed by Jane Baldwin
Molly Ivins was a leftist journalist who wrote in and about the politically conservative state of Texas for most of her career. Her brash, biting, mocking, satirical columns ultimately brought her to the attention of American liberal ideologues. With the ascendancy to the oval office of George W. Bush, whom she nicknamed Shrub, Ivins reached the height of her notoriety. Her favorite Texas political chump had become big news.
Now at Boston's Lyric Stage, the one-woman show, Red Hot Patriot: The Kick-Ass Wit of Molly Ivins, assembled by first- time playwrights Margaret Engel and Allison Engel, is composed of political commentary, biography, and anecdotes. Since much of the material is taken directly from Ivins' writing, it is generally funny, intelligent, and thought provoking. (more…)
January 17, 2015 Saturday at 10:43 am


text: Human Rights Observatory Analysis: Concerns Rise About US Intel Capabilities on IS Concerns about the capabilities of U.S. intelligence agencies have been steadily rising, sparked in part by comments from President Barack Obama that they "underestimated" the rise of the group known as Islamic State. But far from an intelligence failure, insiders and analysts warn the furor is symptomatic of larger problems that could haunt the U.S. in years to come. For weeks, Islamic State militants have besieged Kobani, the majority-Kurd Syrian city at the doorstep of NATO partner...Read complete article© Voice of America - Thursday, October 23, 2014