text:
By Louise Walden, Director of Big Beach Marketing
Have you got a plan? Not a Marketing plan, a business plan. Why do I ask? Because it's fundamental to me – as a marketeer - that there is some kind of plan for your business. Marketing activity should support the agreed objectives of the business. If you don't know where you want your business to be, it is difficult for marketing to help you get there. Sometimes producing a marketing plan can help a business focus on what is important for its success.
I have a plan, what's next?
Working with a new client is very exciting as we have to quickly get 'under the skin' of the business in order to understand it, to deliver the best marketing advice. We do this by conducting a Marketing Audit; 50 questions about your business, designed to draw out the real picture and completed often though discussion. We prefer to talk through the questionnaire as it means we can quickly build trust, rapport and obviously ask further questions if necessary and involve other key members of the team.
The Marketing Audit, what kind of things do we ask?
We've usually had some communication prior to carrying out the audit so we're able to tailor it around unique concerns or common industry issues. The obvious and most direct questions are often the best; what's your historical and projected turnover? Do you have a company vision or mission? How do you segment your customers? What's the competition like? A good 'starter for 10' is...


text:
Any time the item best wishes your guide, there will probably be a new greeting or saying that is definitely individualized. It must contain a tremendously important statement during rewards, excellent controlled evidence through your body and a correct conclusion. A release is usually a brief one. A good launch is recommended to generate site reader interest. Look, you have to achieve fantastic introduction.
Because your arrival should certainly specific ones own fears, aspirations and dilemmas as a way to work. Make sure that every thing starting from these first appearance, correctly roughly the final outcome of this timeframe conventional paper is in the right way represented. Any release is required to be personalized in order to that men and women you're meeting. These rewards requires offer the issue that may delivering research is certainly about along with the motive you consider hiring who distinct subject. As a rule, the proper process may be to prepare the actual advent after you finish your system of your report. You'll want a really good introduction. The most recognized item for you to do in order to generate a good advantages will be to guarantee to comprehend the things you're writing relating to first.
For the contributor, a particular advent can function being a guide. This offers a review of this issue within hand. Some extra ordinary opening is significant not just for for you to include the reader's consideration, nevertheless to provide your reader your short and snappy examine in what is actually that will come. Simply just just as in alternative options publishing, a person wish it to have got a distinct arrival and then gentle changes in which encounter that that you are which includes a talk that has a pellucid scenario line. The opening also know as the prefatorial sentences can be a instead appropriate part from the seek a result of simple fact the idea claims the main reasoning behind any composition.
Great essay or dissertation arrives with 1 hour and even I had absolutely no hint as to best places begin. Posting these types of dissertation isn't a straightforward job. Whilst illustrative works are generally somewhat additional exposed to creative imagination, there's a chance you're taken aback to fnd out that will it demands a lot of corporation in order to appeal to her target market and so it is critical you're a chance to make this happen to assure exceptional work. The actual 1st deputize publishing some illustrative essay or dissertation could be to choose an individual's topic.
You should learn how to finish a powerful essay the proper way, for the purpose of highest effect. Penning some sort of article can be a great maddening, maddening procedure. It is deemed an range of brain together with ideas. The actual write off television screen or perhaps report before you even when drafting essay or dissertation is your most challenging segment of one's practice. If you are going to step by step grant writing pay students to do write arizona faculty legal university writing frame an intriguing, completely unique dissertation, you'll have to conduct research. The very first item you should carry out can be to think about what exactly you may well neutralize your main essay. You might also intend to read through any composition out loud to make sure you a particular person to know the things which these people think. Typically the composition must be accurately formatted using the guidelines. An amazing seek posting idea will be to guarantee they're notion agitative and attractive, apart from informative. Any time you organize your own article and additionally make note of the particular points that you are almost certainly to talk about on your draw up, you may currently have great number of specifics to make sure you discuss. Setting up your article is less complicated if you now have a term count. Before even thinking about, you can find a couple of stuff you have to know around publishing some sort of essay. Setting out a person's dissertation is a marvellous methods to set up your opinions plus skin your dissertation topic. If you are engaging in a private try or maybe having a debate about a little bit of materials, you will need to go for a main time which unfortunately you want to make. Accurately such as a written composition, yourrrll evaluate which you want to show you and also argue.
In case your dissertation is normally lengthy or perhaps it's a dissertation, you must prepare yourself smaller drafts involving sentences and then consider to concentrate regarding every different paragraph. In doing this, it might be quicker to consider the seek on a whole. A different handy essay or dissertation composing end is always to just remember to put in sufficient time investigating every one of the regions of your selected topic.
A planned out plan is known as designed for in some recoverable format an dissertation and it's critical that a contributor comprehends this issue altogether not to mention carry out the usual activities to do and keep the software more important or even more for the mark. Then simply sum up every location for you to create on every one of the essay's system paragraphs for a couple of sentences. The positive aspects of arranging some sort of life story essay or dissertation is definitely an accredited file, not just for on MLA style form, however in the option in the very easy firm belonging to the content.
Everything you finish up engaging in right considerably depends upon the amount of essay anyone are planning on writing. Greater unique you may be, the simpler it will possibly be to help establish it again in your own essay. A methodical plan is important so that you can make up a task essay.

subset: commoncrawl


text:
We hear all the time that being a geek is about how you love something–obsessively, passionately, and with an intense drive to consume. I've always been a fantasy, sci-fi, and comic fan…but I'm been branching out a bit lately, and I thought I would share a few new geeky categories that I've become interested in over the past several months to a year.
At the end of August, a friend of mine invited me to join a D&D group. I've always been a little curious about the games–my dad always likes to tell the story about how be played for a few weeks, but was a complete jerk so the rest of his group killed him off–so I tentatively agreed to join. And I have become obsessed.
I play as a tiefling warlock named Calamity, and my group is amazing and fun and pretty much the most perfect group you could ever have. She's bound to a Lovecraftian-like eldritch god named Xelyoath, and that's how she derived her powers (I even designed a symbol for him). I have a dragonkitty named Kyle, and I've managed to become pretty badass despite the fact that my dice often hate me. There are a few more pictures I'd like to share, but I need to get them back from my DM!
But that is just the beginning of my current obsession.
I've fallen into two totally awesome YouTube RPG series (one which was a limited run and one which was ongoing). Both are from Geek and Sundry .
Titan's Grave: The Ashes of Valkana is the RPG created by Wil Wheaton for Tabletop. It's a very unique world, played in the Pathfinder system, and it's amazing to experience it alongside Wheaton and his awesome players, particularly Hank Green and Laura Bailey. There are ten episodes, and they're over all too soon.
Critical Role is Geek and Sundry's Twitch channel's biggest show, and it's easy to see why. It's features a group of nine professional voice actors playing a D&D campaign. They've been playing together for years, so they have a rapport and friendship that really makes the game amazing. There's a lot of suspense and a lot of laughs–it's pretty much perfect. I have been binge watching it for the last few weeks–each episode is 3+ hours, and there are currently 17 episodes on YouTube. I'm on fifteen, and I really don't know what I'm going to do once I'm all caught up until they post more. You can also watch it at 7pm ET Thursday nights on Twitch.
Have you guys ever played an RPG? If so, what kind of character did you play? If not–what kind of character would you want to play?


text:
Our Lord's was a chequered history. Lights and shadows thickly blended in the marvelous picture of His life. The lights were but few; the shadows predominated. He did not come into the world to be joyful and happy, but to make others so. Hence the portrait, "He was despised and rejected, a man of sorrows, acquainted with bitterest grief." We have just looked upon one of the earthly lights thrown upon the picture; we are now to contemplate one of its dark shadows. From viewing Him as for the moment favored with the adulation of the multitude, we turn to behold Him the object of their bitter scorn and rejection.
Tag: cross
Looking At The World Through The Cross
Jesus could accomplish man's redemption in no other way than by crucifixion — He must die, and die the death of the cross. What light and glory beam around the cross! Of what prodigies of grace is it the instrument, of what glorious truths is it the symbol, of what mighty, magic power is it the source! Around it, gathers all the light of the Old Testament economy.
November 5: Passing From Death To Life
"Verily, verily, I say unto you, He that hears my word, and believes on him that sent me, has everlasting life, and shall not come into condemnation; but is passed from death unto life." John 5:24
Let us consider what this condition does not imply. It does not include deliverance from the indwelling of sin, nor exemption from Divine correction, nor the absence of self-accusation; still less does it suppose, that there is nothing for which the believer deserves to die. All this exists where yet no condemnation exists. The battle with indwelling evil is still waged, the loving chastisement of a Father is still experienced, the self-condemnation is still felt, and daily in the holiest life there is still transpiring that which, were God strict to mark iniquities, merits and would receive eternal woe; yet the declaration stands untouched and unimpeached—"No condemnation to those who are in Christ Jesus."
The freedom of the believer is just what it is declared to be—entire exemption from condemnation. From all which that word of significant and solemn import implies he is, by his relation to Christ, delivered. Sin does not condemn him, the law does not condemn him, the curse does not condemn him, hell does not condemn him, God does not condemn him. He is under no power from these, beneath whose accumulated and tremendous woe all others wither.
The pardon of sin necessarily includes the negation of its condemnatory power. There being no sin legally alleged, there can be no condemnation justly pronounced. Now, by the sacrifice of Christ, all the sins of the church are entirely put away. He, the sinless Lamb of God, took them up and bore them away into a land of oblivion, where even the Divine mind fails to recall them. "How forcible are right words!" Listen to those which declare this wondrous fact. "I, even I, am He that blots out your transgressions for mine own sake, and will not remember your sins." "You have cast all my sins behind Your back." "Having forgiven you all trespasses." Their sins and iniquities will I remember no more."
The revoking of the sentence of the law must equally annihilate its condemnatory force. The obedience and death of Christ met the claims of that law, both in its preceptive and punitive character. A single declaration of God's word throws a flood of light upon this truth: "Christ has redeemed us from the curse of the law, being made a curse for us." The sentence of the law thus falling upon Surety, who was "made under the law, that He might redeem those who were under the law," there can be no condemnation from it to those who have taken shelter in Him. Thus, then, it is evident that both sin and the law are utterly powerless to condemn a believer in the Lord Jesus Christ.
The perfection of Christ's satisfaction supplies the meritorious and procuring cause of our condemnation. No legal obedience—no personal merit or worthiness of the sinner whatever—is taken into the account of His discharge. This exalted position can only be reached by an expedient that harmonizes with the attributes of God, and thus upholds, in undimmed luster, the majesty and honor of the Divine government. God will pardon sin, and justify the sinner, but it must be by a process supremely glorifying to Himself.
How, then, could a creature-satisfaction, the most perfect that man, or the most peerless that angel could offer, secure this result? Impossible! But the case, strange and difficult though it is, is met, fully, adequately met, by the satisfaction of Jesus. The Son of God became the Son of man. He presents Himself to the Father in the character of the church's substitute. The Father, beholding in Him the Divinity that supplies the merit, and the humanity that yields the obedience and endures the suffering, accepts the Savior, and acquits the sinner.
Hence the freedom of the believer from condemnation: "There is, therefore, now no condemnation." It is the existence of a present condition. It is the enjoyment of a present immunity. It is the simple belief of this fact that brings instant peace to the bosom. A present discharge from condemnation must produce a present joy. Christian! there is now no condemnation for you. Be yours, then, a present and a full joy.
Study The Mystery Of Christ's Love To Sinners
Regard it as one of your chief mercies that your salvation depends not upon reason but upon faith: that you are not called upon fully to comprehend, but unquestioningly to believe and love: that you are not the less saved because your faith deals with obscurity, nor is your faith less real, precious, or saving, because it abjures the wisdom of the sage for the docile spirit of the child, and the learning of the philosopher for the humility of the disciple. Let your great study be the mystery of Christ's love to sinners–the mystery of Christ's love to you.
The apostle was content to leave all mysteries to the day of perfect knowledge, might he but attain unto love. "Though I know all mysteries, and have not love, I am nothing." Study that grand truth, "God is love," as embodied in the cross of Christ, and you can well afford to refer all that is obscure and hard to understand in revealed truth to the day when we shall know all, as we also are known. Cease to dispute, cavil, and speculate on the subject of religion and revealed truth, and receive the gospel and enter into the kingdom of Christ as a little child.
In the momentous matter of your future destiny, you have but to deal with two specific and distinct facts–your sinnership, and Christ's Saviorship. What if you solve all the problems of science, and fathom all the deeps of learning, and unravel all the mysteries of truth, and yet are lost! What will your speculations, and researches, and discoveries avail, if at last they be found ineffectual to distill one drop of the water of life upon the tongue, now caviling and profane, then fevered and tormented in the quenchless flame? Are you not, by your present persistent course of unbelief, pride, and rejection of truth, in danger of finding yourself there?
Oh, it is of infinite moment to you that you come as sinful to the blood, as condemned to the righteousness, as ignorant and unlearned to the feet of Christ. The great problem you have to work out is, your own salvation. The grand mystery you have to unravel is, the mystery of your union with Jesus. The momentous questions you have to decide are, the place, the society, and the employments of your endless future! Where, with whom, and how, you will spend your long eternity? Compared with these grave considerations, all your doctrinal hair-splitting and your religious speculations, your vain disputes and your dreamy hopes, are as the follies of drivelling idiocy, or the aberrations of a mind insane.
October 12: Flee To The Crucified
"Then Jesus spoke again unto them, saying, I am the light of the world: he that follows me shall not walk in darkness, but shall have the light of life." John 8:12
Are you, my reader, a searcher of this life? Are you breathing for it, panting after it, seeking it? Then be it known to you, that He who inspired that desire is Himself the life for which you seek.
That heaving of your heart, that yearning of your spirit, that "feeling after God, if haply you may find Him," is the first gentle pulsation of a life that shall never die. Feeble and fluctuating, faint and fluttering, as its throbbings may be, it is yet the life of God, the life of Christ, the life of glory in your soul. It is the seedling, the germ of immortal flower; it is the sunshine dawn of an eternal day.
The announcement with which we meet your case—and it is the only one that can meet it—is, "THIS MAN RECEIVES SINNERS." Oh joyful tidings! Oh blessed words! Yes, he receives sinners—the vilest—the meanest—the most despised! It was for this He relinquished the abodes of heavenly purity and bliss, to mingle amid the sinful and humiliating scenes of earth. For this He quitted His Father's bosom for a cross. For this He lived and labored, suffered and died. "He receives sinners!" He receives them of every name and condition—of every stature and character and climate.
There is no limit to His ability to pardon, as there is none to the sufficiency of His atonement, or to the melting pity of His heart. Flee, then, to Jesus the crucified. To Him repair with your sins, as scarlet and as crimson, and His blood will wash you whiter than snow. What though they may be as clouds for darkness, or as the sand on the sea-shore for multitude; His grace can take them all away. Come with the accusations and tortures of a guilty conscience, come with the sorrow and relentings of a broken heart, come with the grief of the backslider, and with the confession of the prodigal; Jesus still meets you with the hope-inspiring words—"Him that comes unto me, I will in no wise cast out."
Then, "return unto the Lord, and He will have mercy upon you; and to our God, for He will abundantly pardon!"
October 10: Many Backslidings
"Our backslidings are many; we have sinned against you." Jeremiah 14:7
All spiritual declension in the true believer necessarily implies the actual possession of grace. We must not lose sight of this truth. Never, in the lowest condition of the believer, does Christ deny His own work in the soul. "You have a little strength," are His heart-melting words to the backsliding church in Sardis. Oh, what a gracious, patience Savior is ours! But let us briefly trace this melancholy state to some of its causes, that we may be better able to point out its appropriate remedy.
The first cause undoubtedly is, the unguarded state of the soul. A Christian living in the daily neglect of self-examination must not marvel if, at a certain period of his religious course, he finds himself trembling upon the brink of gloomy despondency, his evidences gone, his hope obscured, and all the past of his Christian profession appearing to his view as a fearful delusion. But here let me suggest the cure.
Examine before God the real state of your soul. Ascertain where you have lost ground. Retrace your way. Look honestly and fairly at your condition. Discouraging and repelling as it may appear, look it fully in the face, and lay it open before God exactly as it is, in the spirit and language of the Psalmist: "Search me, O God, and know my heart; try me, and know my thoughts; and see if there be any wicked way in me, and lead me in the way everlasting."
The grieving of the Spirit of God is a most fruitful cause of spiritual relapse. We have yet much to learn of our entire dependence upon the Holy Spirit, and of our eternal obligation to Him for all the blessings of which He is the author and the conveyancer. What themes for grateful contemplation to the spiritual mind are the love of the Spirit—the faithfulness of the Spirit—the tenderness of the Spirit—the patience of the Spirit!
And yet in the long catalogue of the believer's backslidings, not the least is his grieving this Holy Spirit of God. But there is a remedy. Seek that Spirit whom you have driven from your presence; implore His return: beseech Him for Jesus' sake to revisit you, to breathe His reviving influence as of old upon your soul. Then will return the happy days of former years, the sweet seasons of your early history, and you shall "sing as in the days of your youth, and as in the day when you came up out of the land of Egypt."
"Return, O holy Dove, return,
Sweet messenger of rest;
I hate the sins that made You mourn,
And drove You from my breast."
Distance from the cross contributes greatly to a state of spiritual declension. Retiring from beneath its shelter and its shade, you have left the region of safety, light, and peace, and, wandering over the mountains of sin, worldliness, and unbelief, have lost yourself amid their darkness, solitude, and gloom. Turning away from the cross of Jesus, you have lost the view you once had of a sin-pardoning, reconciled Father; and judging of Him now by His providences and not by His promises, and contemplating Him through the gloomy medium of a fconscience unsprinkled with the blood of Christ, you are disposed to impeach the wisdom, the faithfulness, and the love of all His conduct towards you.
But listen to the remedy. Yield yourself afresh to the attractions of the cross. Return, return to it again. No burning cherubim nor flaming sword guards its avenue. The atoning blood there shed has opened the way of the sinner's approach, and the interceding High Priest in heaven keeps it open for every repentant prodigal. Return to the true cross. Come and sit down beneath its grateful shade.
Poor, weary wanderer! there is life and power, peace and repose, for you still in the cross of Christ. Mercy speaks from it, God smiles in it, Jesus stands by it, and the Holy Spirit, hovering above it, is prepared to reveal it to you afresh, in all its healing, restoring power.
September 29: Always Returning A Prodigal
"For if the blood of bulls and of goats, and the ashes of an heifer sprinkling the unclean, sanctifies to the purifying of the flesh: how much more shall the blood of Christ, who through the eternal Spirit offered himself without spot to God, purge your conscience from dead works to serve the living God?" Hebrews 9:13, 14
But for a crucified Savior, there could be no possible return to God; in no other way could He, consistently with the holiness and rectitude of the Divine government, with what He owes to Himself as a just and holy God, receive a poor, wandering, returning sinner. Mere repentance and humiliation for and confession of sin could entitle the soul to no act of pardon. The obedience and death of the Lord Jesus laid the foundation and opened the way for the exercise of this great and sovereign act of grace.
The cross of Jesus displays the most awful exhibition of God's hatred of sin, and at the same time the most august manifestation of His readiness to pardon it. Pardon, full and free, is written out in every drop of blood that is seen, is proclaimed in every groan that is heard, and shines in the very prodigy of mercy that closes the solemn scene upon the cross. Oh blessed door of return, open and never shut to the wanderer from God! how glorious, how free, how accessible!
Here the sinful, the vile, the guilty, the unworthy, the poor, the penniless may come. Here, too, the weary spirit may bring its burden, the broken spirit its sorrow, the guilty spirit its sin, the backsliding spirit its wandering. All are welcome here. The death of Jesus was the opening and the emptying of the full heart of God; it was the outgushing of that ocean of infinite mercy that heaved, and panted, and longed for an outlet; it was God showing how He could love a poor guilty sinner. What more could He have done than this? what stronger proof, what richer gift, what costlier boon could He have given in attestation of that love?
Now, it is the simple belief of this that brings the tide of joy down into the soul; it is faith's view of this that dissolves the adamant, rends asunder the flinty rock, smites down the pyramid of self-righteousness, lays the rebellious will in the dust, and enfolds the repenting, believing soul in the very arms of free, rich, and sovereign love.
Here, too, the believer is led to trace the sin of his backsliding in its darkest lines, and to mourn over it with his bitterest tears—
"Then beneath the cross adoring,
Sin does like itself appear;
When the wounds of Christ exploring,
I can read my pardon there."
If the Lord has restored your soul, dear reader, remember why He has done it—to make you hate your sins. He hates them, and He will make you to hate them too; and this He does by pardoning them, by sprinkling the atoning blood upon the conscience, and by restoring unto you the joys of His salvation. And never is sin so sincerely hated, never is it so deeply deplored, so bitterly mourned over, and so utterly forsaken, as when He speaks to the heart, and says, "Your sins are forgiven you, go in peace." As though He did say, "I have blotted out your transgressions, I have healed your backslidings, I have restored your soul; that you may remember and be confounded, and never open your mouth any more because of your shame, when I am pacified toward you for all that you have done, says the Lord God."
If your heavenly Father has restored your soul, not only has He done it from the spring of His own unchangeable love, but that which has prevailed with Him was the power of the sweet incense of the Redeemer's blood before the mercy-seat. Moment by moment does this fragrant cloud go up, bearing as it ascends all the circumstances of all the Israel of God. There is not only the blood already sprinkled on the mercy-seat, which has satisfied Divine justice, but there is the constant pleading of the blood, by Jesus, the Priest, before the throne.
Oh precious thought, oh comforting, encouraging truth, for a soul retreading its steps back to God! Of its own it has nothing to plead but its folly, its ingratitude, its wretchedness, and its sin; but faith can lay its trembling hand upon this blessed truth—faith can observe Jesus clothed in His priestly garments, standing between the soul and God, spreading forth His hands, and pleading on behalf of the returning believer the merits of His own precious obedience and death. And thus encouraged, he may draw near and touch the scepter: "If any man sin, we have an Advocate with the Father, Jesus Christ the righteous." "Christ is not entered into the holy places made with hands, which are the figures of the true; but into heaven itself, now to appear in the presence of God for us.
June 26: How Amazing This Love
"Jesus therefore, knowing all things that should come upon him, went forth, and said unto them, Whom seek you?" John 18:4
His voluntariness was not founded on ignorance. He well knew what the covenant of redemption involved- what stern justice demanded.
The entire scene of His humiliation was before Him, in all its dark and somber hues- the manger- the bloodthirsty king- the scorn and ridicule of His countrymen- the unbelief of His own kinsmen- the mental agony of Gethsemane- the bloody sweat- the bitter cup- the waywardness of His disciples- the betrayal of one, the denial of another, the forsaking of all- the mock trial- the purple robe- the crown of thorns- the infuriated cry, "Away with Him, away with Him! Crucify Him, crucify Him!"- the heavy cross- the painful crucifixion- the cruel taunts- the vinegar and the gall- the hidings of His Father's countenance- the concentrated horrors of the curse- the last cry of anguish- the falling of the head- the giving up the spirit; all, all was before the omniscient mind of the Son of God, with vividness equal to its reality, when He exclaimed, "Save him from going down to the pit: I have found a ransom."
And yet He willingly rushed to the rescue of ruined man. He voluntarily, though He knew the price of pardon was His blood, gave Himself up thus to the bitter, bitter agony. And did He regret that He had undertaken the work? Never! It is said that repented God that He had made man; but in no instance is it recorded that it repented Jesus that He had redeemed man. Not an action, not a word, not a look betrayed an emotion like this.
Every step He took from Bethlehem to Calvary did but unfold the willingness of Jesus to die. "I have a baptism to be baptized with, and how am I straitened until it be accomplished!"
Oh, how amazing was the love of Jesus! This, this was the secret why He loved not His own life unto the death. He loved sinners too well. He loved us better than Himself. With all our sinfulness, guilt, wretchedness, and poverty; He yet loved us so much as to give Himself an offering and sacrifice unto God for us. Here was the spring-head where flowed these streams of mercy. This was the gushing fountain that was opened when He died. And when they taunted Him and said, "If You are the King of the Jews, save Yourself," oh, what a reply did His silence give "I came not to save myself, but my people- I hang here, not for my own sins, but for theirs- I could save myself, but I came to give my life a ransom for many."
They thought the nails alone kept Him to the cross- He knew it was His own love that fastened Him there. Behold the strength of Immanuel's love. Come, fall prostrate, adore and worship Him. Oh, what love was His! Oh the depth!
Content not yourself with standing upon the shore of this ocean- enter into it, drink largely from it. It is for you, if you but feel your nothingness, your poverty, your vileness; this ocean is for you. It is not for angels, it is for men. It is not for the righteous, but for sinners. Then drink to the full from the love of Jesus.
Do not be satisfied with small supplies. Take a large vessel to the fountain. The larger the demand, the larger the supply. The more needy, the more welcome. The more vile, the more fit.
June 25: A Voluntary Offering
"Walk in love, as Christ also has loved us, and has given himself for us an offering and a sacrifice to God for a sweet-smelling savor. Ephesians 5:2
It was an entire sacrifice. It was Himself He offered up. More He could not give; less would not have sufficed. He gave Himself- all that He possessed in heaven, and all that belonged to Him on earth, He gave in behalf of His people. His life of obedience, His death of suffering, He gave as "an offering and is sacrifice to God." It was an entire surrender.
It was a voluntary offering. "He gave Himself." It was not by compulsion or by constraint that He surrendered Himself into the hands of Divine justice- He went not as a reluctant victim to the altar- they dragged Him not to the cross. He went voluntarily. It is true that there existed a solemn necessity, why Jesus should die in behalf of His people. It grew out of His covenant engagement with the Father. Into that engagement He voluntarily entered: His own ineffable love constrained Him: But after the compact had been made, the covenant of redemption ratified, and the bond given to justice, there was a necessity resting upon Jesus why He should finish the work.
His word, His honor, His truth, His glory, all were pledged to the entire fulfilment of His suretyship. He had freely given Himself into the power of justice; He was therefore, on His taking upon Him the form of a servant, under obligations to satisfy all its claims; He was legally bound to obey all its commands. And yet it was a voluntary surrender of Himself as a sacrifice for His people. It was a willing offering.
If there was a necessity, and we have shown that there was, it grew out of His own voluntary love to His Church. It was, so to speak, a voluntary necessity. See how this blessed view of the death of Jesus is sustained by the Divine word. "He was oppressed, and He was afflicted, yet He opened not His mouth: He is brought as a lamb to the slaughter, and as a sheep before her shearers is dumb, so He opens not His mouth." His own declaration confirms the truth. "Therefore does my Father love me, because I lay down my life, that I might take it again. No man takes it the following is from me, but I lay it down of myself. I have power to lay it down, and I have power to take it again."
March 20: Carried Up Into Heaven
"And it came to pass, while he blessed them, he was parted from them, and carried up into heaven." Luke 24:51
How touching and instructive was the parting interview! Oh, how worthy of Himself was this His final blessing! How harmonious with every previous act of His life was this its closing one! Blessing to the last, and while with outstretched hands that blessing was yet breathing from His lips, "received up into glory." Oh, how full of grace and love is our adorable Immanuel! What a heart of overflowing tenderness and blessing is His!
Knowing this, knowing it from observation and from experience, supported by the innumerable proofs which crowd every page of the New Testament, is it not a marvel that we should seek our blessing from any other source than Jesus, or that we should breathe our sighs, or pour our sorrows, or repose our aching head, on any other bosom than His? Ah! our acquaintance with Him- our best, our dearest, our most loving Friend- is so limited, we walk with Him so coldly, we follow Him so distantly, we believe in Him so feebly; the greatest wonder is; that in the midst of all, His patience forbearance, tender and unchangeable love, towards us should still be so unwearied and so great.
But who can describe the parting interview and the last blessing? Clustering around Him a lonely timid band, saddened as they must have been by the thought that they were about to separate forever on earth from Him whom they loved- as many of them afterwards proved- better than life itself- to whom they had been wont to look for guidance, on whom they had leaned for strength, and to the shelter of whose bosom they had fled in danger and in sorrow, they needed His blessing- they needed that which none but Jesus could give to them. They were oppressed, and He only could undertake for them. They were in sorrow, and He only could comfort them. They were tried and perplexed, and He only could sustain and counsel them.
And what, may we suppose, would that blessing contain, which He now breathed over them? The richer anointing of the Spirit to fit them for their work- a larger measure of grace to shield them in temptation, and to uphold them in trial- increased light in the understanding respecting the spiritual nature of His kingdom, and the meaning of the Holy Scriptures of truth; and- what to them, at that moment, would be of unspeakable preciousness- a deeper discovery of His own pardoning love, a fuller assurance of their personal acceptance in Himself, and a richer bestowment of the "peace of God, which passes all understanding." Thus blessing, He was "parted from them, and carried up into heaven," to intercede for them there; and thus blessed, "they worshiped Him, and returned to Jerusalem with great joy," to spread the fragrance and to manifest the power of His name through all the world.


text:
Artificial Intelligence driven Marketing Communications
Voyage CEO Oliver Cameron isn't in any hurry to conquer self-driving cars. The former Udacity vice president for engineering oversees a fleet of low-speed autonomous vehicles providing trips to residents of two retirement communities. His vehicles aren't fully driverless; they include safety drivers. He'll remove them when he's ready. And Cameron's not interested in tackling complex urban environments or fast-moving highways where split-second decisions can mean life or death… at least not yet.
"I think sometimes people think Voyage is all about just low speed, zero to 25 mile-an-hour autonomy," Cameron said in an interview with The Verge. "We're not. We're going to expand our capabilities over time, to zero to 35 [mph], to zero to 55 [mph], to zero to 65 [mph]. And one day we'll connect all the roadways in the US with a Level 4 self-driving car. But we're not going to say that'll be delivered next year. And we're not going to wait to build a business before that's ready."
Now Voyage has some runway to make that happen. The company announced Thursday that it has raised $31 million in a series B funding round led by Franklin Templeton with significant participation from Khosla Ventures, Jaguar Land-Rover's InMotion Ventures, and Chevron Technology Ventures. The San Francisco-based startup, which has raised $52 million in capital so far, also announced some key new hires. And Cameron outlined his company's plans to grow its fleet of second-generation self-driving cars, launch a commercial product, and eventually roll out a third generation vehicle that will have fully driverless capabilities.
Voyage is a spinoff from Udacity, an online learning service that offers courses in driverless technology. Cameron headed the startup's open-source self-driving project before launching his own venture. Sebastian Thrun, Udacity's chairman and one of the founders of Google's self-driving car project, was briefly chairman of Voyage before a conflict forced him to step down. (He is also the chief executive of Kitty Hawk, the flying car startup backed by Larry Page, chief executive of Alphabet, which owns Waymo.)
The company operates a fleet of self-driving cars in two retirement communities, one near San Jose, California, and the other north of Orlando, Florida, both called The Villages. Targeting retirees is what sets Voyage apart from its competitors. The startup gets to boast about providing a real service for people in need, while seniors get to lord over their grandchildren about being early adopters of an innovative new technology. They're also getting something a little more valuable: Voyage is giving the owners of the Florida-based Villages and the smaller San Jose development equity stakes of 0.3 percent and 0.2 percent, respectively.
But now Voyage is focused on growth, and that means bringing in revenue and trimming costs. The company is readying to launch its first commercial product, a subscription service that allows customers, for a monthly fee, to take a certain number of rides in its self-driving cars. Customers will use a "very simple" smartphone app to hail their vehicle, Cameron said.
Operating in retirement communities also allows Voyage to turn some of the disadvantages of autonomous vehicles — slow speeds, overly cautious driving maneuvers, simplistic routing — into an advantage. "If you talk to a senior, that's absolutely fine," Cameron said. "They're not in a rush."
Cameron wouldn't reveal too many details about Voyage's G3 self-driving car. It used Ford Focuses for its first-generation vehicle and Chrysler Pacifica minivans (a la Waymo) for its second-generation one. "That G3 vehicle will not just have the technical specs for driverless, but it will have a lot of the cost effectiveness necessary to scale built in," Cameron said.
Voyage recently nabbed two new big-name hires — Drew Gray (ex-Uber ATG, Otto, Cruise, Tesla) and Davide Bacchet (ex-NIO, Tesla) — as the company's CTO and director of autonomy, respectively. As for when Voyage anticipates pulling its safety drivers out of the vehicles and going fully driverless, Cameron declined to specify an exact date. "I'm not going to pull an Elon Musk here," he said


text:
White Wine/Onion Sauce
Heat a skillet over medium after coating with cooking spray. Saute 1/3 c. chopped onion for 2 minutes, stirring frequently. Stir in 1/2 c. broth, 1/4 c dry white wine, and 2 tb white wine vinegar. Bring to a boil. Cook until reduced greatly (5ish minutes). Remove from heat, stir in 2 tb butter and 2 tsp freshly chopped chives. Awesome on chicken!


text:
Time to Order Garden Furniture!by kathyregini | Comments Off on Time to Order Garden Furniture!
If you are thinking of buying new outdoor seating, table & chairs, a hammock, an awning, or anything else to enhance your summer outdoor experience, THIS is the time to get it ordered. Many items take 4-6 weeks to arrive after you've ordered them, so if you want to be enjoying the outdoors by June 1st…better get moving!


text:
2nd EDITION OF 'FERIA DE INNOVACIÓN AUTOMOTRIZ' IN COSTA RICA
During the last 8th, 9th and 10th November the 2nd edition of "Feria de Innovación Automotriz" was held in Alajuela (Costa Rica) by our official importer Comercializadora Automotriz 4Js in BesaCAM facilities. This event was attended by numerous professionals related to Automotive Industry from all over the country, showing great interest in our range of products; specially for the Bodyshop and Refinish applications. We would like to thank Mr. Heing Jonathan Rodríguez not only for the perfect organization of the event but for giving us the opportunity to take part on it.


text:
Find Trucking Jobs
Hazmat Status please help
Discussion in 'Questions From New Drivers' started by Gip321, Jan 17, 2020.
Page 2 of 3
Ubu Road Train Member
- 1,166
- Aug 25, 2012
Trucking Jobs in 30 seconds
Every month 400 people find a job with the help of TruckersReport.
What's on your background that you're worried about? Not trying to be nosy just curious to see if it's one of the disqualifying offenses
tscottme Road Train Member
- 9,317
- Jul 25, 2008
In my case it took the TSA 3 weeks after I gave fingerprints to start my background check. It took them 2 days to do the background check. And, it took about 6-10 days after that to receive my TSA letter in the mail.
If anyone also does TWIC when they do HazMat your TWIC card will usually arrive first and a few days later you receive your PIN number for your TWIC card in the mail.
The online status you posted is the exact wording I received before my "you are good to go" letter showed up.
I figure that
lovesthedrive Is here to help
- 31,956
- Nov 11, 2008
My hazmat took 4 months to be approved. I dont remember the particular.
Trucking Jobs in 30 seconds
Every month 400 people find a job with the help of TruckersReport.
Page 2 of 3


text:
Tuition and Funding
Tuition and fees vary from year to year and are determined by the Utah legislature. The following links will help you determine the costs associated with a degree at Utah State University:
- On campus fee schedule: Tuition and Fees (Registrar's Office). This includes information for undergraduate, graduate and regional campus students. Scroll down to see the Tuition and Fees Schedule for the current year (PDF).
- Online students have different rates from on-campus students. The current tuition-only rate for all 5000 level ITLS online courses is $473.06 per credit and for 6000 level classes is $488.70 per credit.
Research Presentation Funding for Students
Date of Policy: July 31, 2019
We are pleased to announce the availability of travel funds to support ITLS student travel to conferences. A graduate student may receive up to $900 and an undergraduate student (must be a declared ITLS major, minor, or working on an ITLS research grant) can receive up to $450 between July 2019-June 2020. Applications will be reviewed on a rolling monthly basis, with a maximum total allotment of $7,000 for fall semester, and the remainder allocated in spring and summer semesters (up to $14,000 total).
Students are encouraged to pay close attention to match opportunities and rules to maximize their sources of travel support. For the most up-to-date information refer to the graduate school website or the research website for undergraduate students. Please read carefully as undergraduate students have multiple opportunities.
To be eligible, the student must be presenting at a professional conference.
Email application and Travel Authorization (see below) must be submitted at least one month before the travel date. Students who do not meet this deadline will not be approved for travel funds.
To apply, please send the following information to Annalee (email@example.com):
- Student Name, A#
- Conference information: conference title, location, dates, and webpage
- Presentation information (author, title)
- Source of extra funds, if any (graduate school travel award or grant funds)
- Proof of conference acceptance
Departmental funds cannot be used for late registration, except with department head approval. Travel cannot be used to cover avoidable added expenses (such as flight mistakes) but can be used to pay for costs outside the traveler's control (flight for a canceled meeting). Coordinate any cash advances or pre-trip reimbursements with Jennifer Lyons a minimum of 2 weeks in advance of travel.
If awarded, the student will submit the completed Student ITLS Travel Form to Jennifer Lyons (firstname.lastname@example.com) at least one month before traveling. Students must submit a copy of all, itemized receipts, along with the Student ITLS Travel Form, to Jennifer within two weeks after they return in order to receive the award and reimbursement.
The Graduate Studies Financial Information Page lists scholarships, insurance information, assistantships, fellowships, tuition awards, travel support, and other financial assistance. Past ITLS students have received these scholarships:
- Wesley & Lucille Soulier Scholarship: Funding for married students who can demonstrate financial need.
- Byron R. & Shirley Burnham Scholarship: Funding for full-time graduate students who demonstrate financial need and have a minimum cumulative GPA of 3.50.
- ITLS Department Tuition Scholarships: Up to $1000 awarded in the spring semester. Recipients must be taking at least six credits in the next Summer and/or Fall semester.
- ITLS Department Research and Development Scholarships: Funding for research or project expenses.
Financial Aid and Loans
Federal Student Aid
Fill out the FAFSA (Free Application for Federal Student Aid).
Follow the steps on Utah State's financial aid page. See also: Graduate Studies Financial Aid page.
We encourage all students to complete the FAFSA, regardless of your status or funding. Many scholarships and assistantships require a FAFSA on file.
Assistantships and Doctoral Scholars Program
Interested in working alongside our faculty to get first hand experience in research and instruction? The department often has openings for research and teaching assistantships. We also guarantee four years of funding to standout PhD applicants!
See Graduate Studies Assistantships Page for more info about assistantships.
Tuition Waivers and Assistance
Check the requirements below for tuition waiver qualifications. Coverage is available for all types of students (non-resident, out-of-state, in-state, and differential). Fees are the responsibility of the student.
Tuition Waiver Qualifications
Research non-resident with assistantship
- domestic student – first year only
- international student – duration of program
- .50 FTE assistantship (20 hours/week)
- matriculated into ITLS program
- full-time (registered for 6 or more graduate credits)
University non-resident for excellence (criteria effective Fall 2017)
- first year only
- matriculated into ITLS program
- above the average of students admitted fall semester in the college – computed each October
- admission GPA > 3.66
- GRE verbal > 68.4%
- GRE quant > 77.2%
- MAT .. insufficient data from last year, not an option
College in-state and differential
- .50 FTE assistantship (20 hours/week)
- matriculated into ITLS program
- full-time (registered for 6 or more graduate credits)
- credits on Program of Study – < 70 credits
Do you work full or part time? Many ITLS students, especially our online students, receive funding through their employer!


text:
Debian in VPS Servers
You'll be able to pick the Debian Operating System with each and every VPS server solution that we provide. 32-bit and 64-bit releases of the OS are some of the options that you'll find on the order page, so you can pick the one that will be more suitable for the software that you would like to install and run later. A Debian-powered VPS can be set up either with no Control Panel or with our in-house made Hepsia Control Panel. In the first case, you have more freedom, due to the fact that you will have full root access and you will be able to take advantage of the advantages and the full functionality offered by Debian. In the second case, the root access will be restricted, yet you're able to manage your online content through a web interface, not a console. If you do not have a lot of time to control your Debian-powered server, or if you don't have substantial experience, you're able to add the Managed Services upgrade to your plan and our administrators will handle the regular OS updates.
Debian in Dedicated Servers
32-bit and 64-bit editions of Debian are available on our dedicated server order page and you can pick all of them with just a single click for your brand new server, depending on what software environment the apps which you wish to use require for top notch performance. You can also choose whether our Hepsia Control Panel should be installed on the server or if it should come without Control Panel at all. The first option is suitable for inexperienced users who want a Debian-powered server, yet would like to manage it like a shared website hosting account, while the second option is good for more experienced users who wish to have more control, because 'no Control Panel' stands for only Debian and the Apache web server software, but no other software set up on the server at all. We can also save your time and effort with the Managed Services upgrade, since it features regular Operating System updates, to ensure that you will have a safe and stable Debian installation.


text:
Busting Invoice Factoring Myths
Everyone loves a myth. From the Ancient Greeks to today's modern world we are inundated with myths and legends.
That's all well and good, but not what you want when it comes to financing your business.
So here we are, to settle once and for all, the myths surrounding invoice factoring.
Myth: Just for Flagging Businesses?
Thriving businesses choose invoice factoring to maintain their cash flow. It's a sensible finance facility that means businesses get paid, within 24hrs, on issued invoices.
Myth: Buried in Hidden Charges
Here at Calverton Finance, our range of invoice factoring options are completely transparent, with no hidden charges or additional fees.
Myth: Expensive?
A small fee (and at Calverton we have market-leading competitive rates) is charged on the invoice factoring you choose. This is normally in the form of a percentage of the invoice total you put through the facility.
Myth: My Customers Will be Harassed?
Our team at Calverton Finance use the utmost discretion and courtesy when calling your customers to chase payment. We consider ourselves an extension to your credit control department, and appreciate that any heavy demands on your customers would have a detrimental effect on your business.
Myth: I Have to Disclose I'm Using Invoice Factoring to My Customers
No, you don't have to disclose our financial arrangements. If you don't want your customers to know of our involvement, then simply opt for invoice discounting. This service offers the exact same benefits as invoice factoring but our involvement is totally confidential, with your customer paying into a personalised trust account.
Myth: All My Invoices Need Factoring
Not true. Many businesses are subject to seasonal peaks and troughs and therefore do not need a factoring facility all year long. This is when the selective invoice factoring service from Calverton Finance is the ideal choice. You choose which invoices you put through the facility, advancing 90% of their worth. Businesses use this facility to see them through seasonal lows, using it only when they need it.
Myth: I'll Get Locked into a Long Term Contract
Your invoice factoring contract will be tailored to best suit your needs. Here at Calverton we don't operate a 'one size fits all' mentality. Instead we look carefully at what will best suit your business.
Myth: Factoring Companies Will Interfere With My Business
We don't interfere in the day to day running of your business, nor do we get in the way of your logistics and operations. You're the expert at what you do, and we in our field. We simply want to provide you with a constant cash flow. This enables your business to grow and as such helps our business too. It's a win, win for both of us.
Myth: Factoring Companies Will Only Deal With Larger, Established Companies
At Calverton we specialise in SME invoice factoring, whether those businesses are established or new start ups. In fact, we've even won an award, being named as the 'Best Smaller Invoice Financier 2017' by Business Money magazine for our SME services.
We appreciate that start up businesses struggle to manage cash flow in the first few years of operation, especially when slow paying customers regularly exceed 60+ day payment terms. And that problem isn't unique to start ups; even established businesses need an injection of cash to manage working capital and accommodate seasonal ups and downs. Invoice factoring, paying 90% of each invoice value within 24 hours, helps all businesses handle overheads, growth and fluid cash flow.
Image courtesy of Warpaintcobra at FreeDigitalPhotos.net


text:
Brainerd Lakes Area
Stonehenge Remodeling & Construction
If you're thinking about remodeling your home, you can be sure that Stonehenge Remodeling of Brainerd, MN will remodel your home utilizing the highest quality materials.
From adding a garage or shed to your property to remodeling your kitchen and bathroom, you can be assured that we will do a good job because we have over 10 years of experience in the industry.
We can easily convert that extra space into your home into something beautiful quickly. From interior and exterior painting and drywall to tiling and plumbing, we're your one-stop shop for kitchen and bathroom remodeling.
Garages and sheds
Carpentry and decks
Roofing and siding
Doors and windows
Have your home looking its very best with our help: 218-839-7296


text:
Mousse 6 Items
Mousse - The all-round styling product for the hairMousse is more than just a styling product for the hair. A mousse makes the hair not only in shape, but nurtures and protects the hair as well. The foam for the hair is incredibly versatile and is able to emphasize curls and to give them tension, as well as to create more volume at the neck with fine hair, to define step cuts and to give short hair frictions the desired stability.
How to use mousseMousse is incorporated into towel dry hair. Depending on the length of the hair, a large amount of walnut-sized to tennis balls is placed on the palm of the hand and then kneaded in the damp hair. Subsequently, the hair can be air-dried or stylized as desired, for example by blow-drying it.
The benefits of mousseMousse can be used for all kinds of hairstyles. It is suitable for short hair cuts as well as for medium and long hair. It does not matter whether you have curls, waves or straight hair. The hairy hair is a particularly light styling product, which does not weigh the hair. The result is an airy hairstyle with hold. In addition, many mousses contain nourishing ingredients such as argan oil, which maintain and protect the hair. The blow-dry, for example, which can damage the hair under certain circumstances, is not a problem with mousse, since the mousse protects the hair from the hot air.
Hairstyles that can be done with mousseMousse can be used to define existing curls and waves when they are placed in the entire hair length. In addition, with smooth hair, it is easy to style curls and waves with the product. For this purpose, the almost dry hair with mousse is simply wrapped on curlers and then completely dried. The result are beautiful curls or waves with great jumping power. If you have fine hair and want more volume, simply add a bit of mousse to the hairline and then blow-dry it with a brush to achieve the desired volume effect. Long and medium-length hairs can be structured with mousse. Above all, step cuts get morw wow by the incorporation of the styling mousse. Short hair treatments are also no problem for the hair product. No matter if you want to put your hair up or make a fancy dress, the mousse makes it possible without the hair to complain.
For each type of hair the appropriate mousseAs with shampoo and other hair care products, there is, of course, the appropriate mousse for every type of hair. For example, there are e.g. Products that are designed for curly, dyed, gray or fine hair. In addition, there are special sudsers which protect the hair mousse external influences, e.g. The blow-dry and are particularly nourishing.
Buy the right mousse online
In our shop dambiro.de you have a wide selection of mousses that you can buy online easily. In our assortment we offer like products from brands such as Malizia, Intesa and Elidor.


text:
Article Text
Objectives Misuse of investigations, medications and hospital beds is costing the National Health Service (NHS) billions of pounds with little evidence that approaches centred on reducing overuse are sustainable. Our previous study demonstrated that twice-daily consultant ward rounds reduce inpatient length of stay and suggested a reduction in overuse of investigations and medications. This study aims to assess the impact of daily consultant ward rounds on the use of investigations and medications and estimate the potential cost benefit.
Settings The study was performed on two medical wards in a major city university teaching hospital in Liverpool, UK, receiving acute admissions from medical assessment and emergency departments.
Participants and intervention The total number of patients admitted, investigations performed and pharmacy costs incurred were collected for 2 years before and following a change in the working practice of consultants from twice-weekly to twice-daily consultant ward rounds on the two medical wards.
Outcome measures We performed a cost-benefit analysis to assess the net amount of money saved by reducing inappropriate investigations and pharmacy drug use following the intervention.
Results Despite a 70% increase in patient throughput (p<0.01) the investigations and pharmacy, costs per patient reduced by 50% over a 12-month period (p<0.01) and were sustained for the next 12 months. The reduction in investigations and medication use did not have any effect on the readmission or mortality rate (p=NS), whereas, the length of stay was almost halved (p<0.01). Daily senior clinician input resulted in a net cost saving of £336 528 per year following the intervention.
Conclusions Daily consultant input has a significant impact on reducing the inappropriate use of investigations and pharmacy costs saving the NHS more than £650K on the two wards over a 2-year period.
- Inappropriate investigations
- Cost-benefit
- Quality iimprovement
- Decision making
- Ward rounds
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Strengths and limitations of this study
Although daily consultant ward rounds have been reported in the USA and Canada, our paper reports for the first time the impact of daily senior clinician input on increasing patient throughput while significantly reducing investigation and pharmacy costs. In addition, the Academy of Medical Royal Colleges has recently reported a potential savings on £11.7 million from our model of care.
Our study demonstrates sustained cost savings over 2 years and the savings are reproducible on medical wards where twice-weekly consultant wards still persist.
We have shown that daily consultant ward rounds can be achieved by changing the way we work without incurring extra costs while reducing inappropriate investigations and medication use, which is demonstrated by the unchanged readmission and mortality rate despite almost doubling the patient throughput.
The study, however, only took into account the most common investigations, but given the significant reduction in investigations demonstrated, it is likely that we would have identified further cost savings if all investigations were included.
Although our study demonstrates a reduction in investigations, the net cost savings would also be dependent on bed base and staff reduction in the respective departments. It can be argued that in the absence of bed base or staff reduction, no actual money was saved but wide spread implementation of daily consultant ward rounds in the future would allow these departments to incorporate changes in the way they work.
The overuse of investigations in clinical medicine has been discussed over the past four decades1 and has been consistently increasing. There is little evidence that quality of care has proportionately improved,2 yet the burden on healthcare resources has substantially increased.3 More importantly, only 1% of haematological and less than 10% of other investigations were shown to contribute to a diagnosis suggesting investigations should be ordered responsibly.4 ,5 Furthermore, excessive and inappropriate investigations can lead to further tests and physicians treating the results rather than the patient.6 ,7
Various reasons including lack of training and supervision of junior staff have been suggested for the inappropriate use and duplication of investigations.2 ,3 ,7–14 The cost of investigations can range from £5 to few hundred pounds per test, with a substantial cost implication if used inappropriately in hospital settings with high patient throughput (PT). Cost containment strategies focused on clinician education, cost awareness, use of computer models, feedback and other aspects have led to wastage reduction but were either not sustainable or incurred an ongoing cost.15–17
Inappropriate use of medication is another source of resource wastage and has direct cost implications with cost savings demonstrated by implementing restriction or management policies,18–22 which again required extra resources and ongoing educational costs.
Delays in investigational procedures and inappropriate use of medication have been highlighted as factors leading to prolonged of length of stay (LoS).22–24 Senior clinician input has been shown to reduce LoS.23 It is proposed that the reduced LoS and bed days is associated with significant cost savings.25
The current study aims to look at the impact of twice-daily consultant ward rounds on the number of investigations performed and the pharmacy costs compared with the traditional twice-weekly ward rounds.
Hospital setting
The study was conducted on two general medical wards with a mixed case load of admissions from the acute admissions unit, A&E and the clinics at the Royal Liverpool University Teaching hospital. The two wards are covered by four consultants and their teams, described elsewhere.23
Cost-benefit analysis
We performed a cost-benefit analysis of the impact of twice-daily consultant wards on the use of investigations and medication on our two busy medical wards. The main outcome measure was the per patient annual financial cost benefit of twice-daily compared with the traditional twice-weekly consultant ward rounds over a 2-year period. Since the only intervention was a change in consultant working pattern with the same number of sessions, team structure and experience, same number of staff on the wards with no extra costs incurred and no change in overheads, we were able to estimate the net change in the use of investigations and its financial costs before and after the intervention.
Following detailed team discussions and job planning negotiations, the working pattern of the four consultants responsible for two general medical wards was completely changed from a traditional twice-weekly to twice-daily ward rounds and a week-on the ward and a week-off the ward job plan. This change provided daily consultant input in clinical decision-making as well as daily bedside teaching and supervision of junior staff and monitoring their investigation requesting and prescribing habits while keeping the staff costs neutral. The details of the changeover are described elsewhere.23
Data collection
The intervention was implemented on 1 November 2009. All data were collected by the hospital information department on a daily basis and reported on a monthly basis. To ensure sustainability of the intervention and reliability of the results, data were collected for the 2-year period following the intervention. LoS, readmission rates (RRs) and mortality rates (MRs) were obtained for the two wards. Their definitions are described elsewhere.23 RR and MR data were obtained to assess any adverse effects on the quality of patient care.15 PT was the patient intake and flow through both wards over the study period and was collected to calculate the investigation and pharmacy cost per patient. The same data were also collected for the 2-year period preceding the intervention to estimate the benefit of the intervention.
The investigations studied included biochemistry (urea and electrolytes and liver function tests), full blood count, chest X-ray (CXR), CT, MRI, ventilation/perfusion scan (V/Q), endoscopy (oesophogogastroduodenoscopy and colonoscopy). These represent the most commonly requested investigations by our wards from clinical chemistry, radiology, nuclear medicine and gastroenterology departments over the 4-year period. The total number of each investigation used between 1 November 2007 and 31 October 2011, and the cost of each investigation was provided by the respective departments. We also obtained the annual pharmacy costs for the same 4-year period from the pharmacy department. These figures were confirmed by the Royal Liverpool Hospital's finance department. Other investigations such as ECGs, C reactive proteins (CRPs), echocardiograms, etc, were not included as most of these were requested by the emergency and acute medical admission units prior to the patients' arrival on our wards.
Data analysis
The monthly mean for PT, LoS, RR, MR and investigations performed was calculated for the 2 years prior to and following the intervention. The annual mean PT was calculated to determine annual cost savings for the period following the intervention.
Per patient monthly mean investigations were then calculated by dividing the mean investigations by the mean PT for the 2 years prior to and following the intervention. Per patient mean monthly investigation was then multiplied with the unit cost of each investigation to obtain per patient mean monthly cost for each investigation. Per patient mean annual pharmacy cost was calculated by dividing the mean annual pharmacy cost by the mean annual PT for the two wards and reported as monthly mean for uniformity.
Cost saving benefit was then calculated by finding the difference between the mean per patient cost before and after the intervention. Finally, to calculate the total annual cost saving the mean per patient cost saving for each investigation and the pharmacy was multiplied with the mean annual PT number after the intervention. The results are reported as means±SD.
Since the working hours of staff and the number of clinics were unaffected, these costs remained neutral and therefore were not included. Similarly the cost for ward overheads was not included as the wards remained fully functional throughout the study period and were not affected by the intervention. The cost saving calculations and the potential savings from reduced bed days and LoS we reported in our previous paper23 was beyond the scope of this study.
Statistical analysis
Statistical analysis was performed using one-way analysis of variance, and where multiple comparisons were made, Tukey and Dunnett's C test was applied depending on equal or unequal variances, respectively. The p value <0.05 was considered significant. Results are expressed as means±SD.
The annual means±SD of PT, LoS, RR and MR are shown in table 1, which demonstrates a significant increase in PT and reduction in LoS following the intervention. Importantly, the RR and MR did not change significantly despite the increase in patient flow through the wards.
The monthly mean investigations, annual pharmacy costs, per patient investigation and pharmacy cost with annual cost savings are shown in table 2. Our report shows that despite the significant increase in patient flow, the daily consultant input led to a 50% reduction in the mean per patient investigations and pharmacy costs. The annual mean net cost saving benefit from reducing the investigations and pharmacy cost was £336 528 per year and a total of £673 056 over the 2-year study period.
This study shows that consultant ward rounds and decision-making significantly reduces the use of inappropriate investigations, pharmacy costs and LoS, resulting in a significant, sustainable year-on-year cost savings in excess of £300K. Our per patient investigation and pharmacy costs were halved and sustained over a 2-year period. More importantly, reducing the number of investigations and pharmacy use did not result in increased RRs or inpatient mortality. This study does not include the potential savings from reducing the LoS and inpatient bed days.
Overuse of investigations leading to resource wastage has been highlighted from as early as 1979.1 There is very little evidence that excessive testing improves diagnostic accuracy or patient care2 ,4 ,5 ,7 and indeed may be harmful to patients due to misinterpretations and lead to further inappropriate testing or even potentially harmful clinical interventions.7 Several reasons for the variation and continued increase in investigations have been offered including ease of access to tests, lack of training, uncertainty of diagnosis, defensive medicine, increased patient turnover and excessive monitoring.2 ,7–14 The clinical and educational inexperience of doctors is considered one of the important factors for inappropriate tests being ordered.17 ,26 ,27 The test ordering behaviour of doctors significantly changed by introducing guidance in the form of simple form and computer-based requests.14 ,15 Numerical rationing,2 notifying doctors of their test usage compared with their peers,28 informing physicians of the test costs,29 ,30 introducing investigation requesting protocols31 and education of clinical staff32 have all shown to reduce inappropriate investigations. However, senior clinician input in the form of auditing the intern's charts weekly led to a 50% reduction in investigations.33 Our study has similarly demonstrated that daily consultant input can lead to a 50% reduction in unnecessary testing without compromising patient safety.
Although the various strategies used to reduce overuse of investigations demonstrated cost benefits, their implementation has cost implications and are difficult to sustain.15–17 Developing paper-based or computer-based request forms or computer-based models in itself require funding but, furthermore, need ongoing educational programmes to cope with the rapid turnover of junior doctors to ensure proper use of these models on a consistent basis.13 Similarly, developing and running ongoing educational programmes to promote optimal use of investigations requires senior clinician time in addition to other cost implications, while there are some questions on the value of such programmes.17 ,34 Introducing investigation requesting protocols can be useful in reducing investigations but arguably can lead to unnecessary testing in patients who clinically may not need them.7 ,35 In our previous study,23 we compared the impact of daily consultant ward rounds on LoS between our and two other wards with similar case load and demonstrated halving of the LoS on our wards, whereas, the LoS essentially remained unchanged on those two wards practising the traditional twice-weekly consultant ward rounds. While most hospitals36 including ours have been reporting a year on year increase in the use of investigations, our model of consultant working pattern allowing daily senior clinician input into clinical decision-making led to a reduction in investigations without any extra costs and obviated the need for developing special requesting models or ongoing educational programmes requiring extra clinician teaching time. We were able to provide relevant and focused bedside teaching and supervision to the junior doctors on appropriate use of investigations and help them understand results interpretation. Our model has led to considerable cost savings while preventing patient discomfort or compromising quality of care.
It is debateable whether the reduced LoS we observed following twice-daily ward rounds was due to a reduction in unnecessary tests which caused delayed discharges, or if reducing LoS by better senior clinician's decision-making led to a decrease in unnecessary testing because of the considerably shorter stay of patients in the hospital. Evidence suggests that prolonged LoS leads to increased thromboembolic and hospital-acquired infection risk, which inevitably results in more investigations and treatment costs.37 ,38 Reducing the LoS has been shown to decrease infection risk,39 comorbidities and mortality37 and has an impact on clinical outcomes.40 Appropriate use of antibiotics helps reduce the LoS.41 These measures impact on pharmacy costs, which is another major resource wastage in hospital medical care. Doctors lack of understanding and knowledge plays a role in inappropriate use of antibiotics and education programmes, and restriction policies have shown to improve appropriate use of antibiotics.21 ,42 ,43 Similar to strategies employed in reducing investigations, the educational programmes required to implement these policies are labour intensive and time consuming with cost implications.21 The halving of LoS we achieved by daily consultant ward rounds may have contributed significantly in reducing the pharmacy costs by a combination of reducing hospital-acquired infections and appropriate use of antibiotics by providing daily supervision and guidance to junior doctors.
We anticipate that the savings reported in this study are an underestimation of the total potential savings since all the resources groups used on the wards, such as cardiology resources (eg, ECG, echocardiogram), microbiology or other blood tests (eg, thyroid function tests, CRP), were not included as they were either already ordered and performed in the admission units or by the specialist teams reviewing these patients on our request. In addition, societal costs, patient satisfaction, quality of life and the potentially reduced hospital-acquired morbidities because of the reduced LoS were beyond the scope of the study but may have highlighted further significant cost savings. The financial implications of reducing the number of bed days per patient have to be considered. It can be argued that in the absence of bed base or staff reduction, no actual money was saved. However, the recent report from the Academy of Medical Royal Colleges, based on our previous study,23 has suggested a potential saving of £11.7 million and a reduction of 1900 tonnes of carbon per year by reducing the LoS and bed days using our model.23 ,25 Although our model was implemented on only two medical wards, the case mix is similar to most medical wards in most hospitals.
Although various strategies used to reduce investigations and pharmacy costs demonstrated cost savings,14 ,15 ,27–31 they either had cost implications of developing and providing ongoing education to staff, lacked sustainability because of the rapid junior doctor turn over or were even detrimental to clinical decision-making.15–17 Almost all approaches are centred on reducing investigations whereas our study method is based on a change in consultant working pattern allowing senior clinical input and decision-making on a daily basis improving clinical diagnosis, which in turn has led to reduced investigations and reducing LoS. This is a more holistic approach allowing daily education of staff, supervising the use of tests and medications while improving clinical decision-making that has led to a 50% reduction in LoS, investigations and pharmacy laboratory costs saving in excess of £300K per year. This is not only sustainable and reproducible but has very little cost implications if properly implemented.
The authors would like to acknowledge our information and finance department for the help they provided in gathering and confirming the data and the unit costs of investigations. They are indebted to Dr Peter Williams, the Medical Director, for his support in bringing about these changes. They appreciate the help provided by the clinical chemistry, radiology, gastroenterology, nuclear medicine, pharmacy and all other departments during this change. They are grateful to Colette Turner, their directorate manager for helping them implement this model of change. Special thanks to Professor Munir Ahmad who helped them with the statistical analysis of the data.
Contributors AA, PJW, DS and TP conceived and designed the study. MA collated and analysed the data. AA analysed and interpreted the data. All authors drafted and revised the article and approved the final version.
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
Request Permissions
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center's RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


text:
Can Cannabis be Grown Legally in Bulgaria?
In recent months, the media has been saying about growing cannabis for medical purposes on the territory of the Republic of Bulgaria. One reason was that there are companies that have already obtained a license to grow and process cannabis for medical purposes in Bulgaria, writes money.bg
The cultivation and use of cannabis for medical purposes is one of the issues not regulated at the level of the European Union. Member States are given the autonomy to determine whether and under what conditions marijuana may be allowed for medical purposes, although the issue will be resolved at EU level in the near future. On 13 February this year, the European Parliament endorsed Resolution 2018/2775 (RSP) on the use of cannabis for medical purposes. It calls for a clear legal definition of the use of cannabis in medicine and differentiation from all other uses. MEPs insist on strengthening funding for medical research on cannabis, and cannabis-based medicines be covered by health insurance funds. To date, Member States apply different approaches to this. Some countries only allow the registration of drugs containing cannabis-derived substances, others allow the cultivation and processing of cannabis for medical purposes. The focus of this material is the conditions for its cultivation under the current legislation in the Republic of Bulgaria.
Cannabis or hemp is a term that denotes a genus of plants from some of the varieties of which marijuana can be harvested. Cannabinoids are chemical substances in marijuana that have an effect on the human psyche. Of these, the most important is delta-9-tetrahydrocannabinol (THC), ranging from 0.2% to 21%. Among other cannabinoids, cannabidiol (CBD) and cannabinol (CBN) have a significant effect. Hemp varieties in which the content of cannabinoids is less than 0.2% are qualified as industrial and therefore unsuitable for marijuana production. When establishing cannabis plantations for marijuana for medical purposes, it is considered whether final production can be realized on the local market or should only be used for exports to other countries.
The legal situation of cannabis in Bulgaria is regulated by the Narcotics and Precursors Control Act. It is noteworthy that the attitude of the law to the plant is as strict as other high-risk substances - opium poppy, cocaine shrub. The principle is that the cultivation of opium poppy, cocaine bushes and plants of the genus of hemp is forbidden. Moreover, the law explicitly places an obligation on owners or users of land for agricultural or other purposes to monitor the emergence of such plants and to ensure their timely destruction.
The law provides for the classification of narcotic substances and plants according to their danger to the life and health of humans (and animals). Cannabis and marijuana fall into List I - Plants and substances with a high risk to public health due to the harmful effect of their misuse prohibited in human and veterinary medicine. The remaining lists of classified drugs are: List II - Substances with high risk for use in human and veterinary medicine and List III - Risks. It is from this classification of marijuana / cannabis that we can conclude that it is forbidden for use in medical devices. Moreover, the production, processing, marketing, storage, import, export, re-export, transit, transport, supply, acquisition, use and possession of the plants, narcotic substances and their preparations listed in List I are prohibited under current legislation.
History recognizes a number of cases where hazardous substances treated as dangerous to the population subsequently enter human medicine, and vice versa.
The normative acts in the field take into account the possibility to reach new results from scientific researches and the Ordinance on the order of classification of plants provides for a special order in which the classification of a given plant or substance can be changed as well as the rules for its use. Such a change can be expressed in several ways - excluding a particular plant from the list of narcotic substances, including a new plant / substance on these lists or moving plants from one list to another.
Proposals to make changes to the lists are addressed to the chairperson of the National Narcotics Board, which instructs the expert council to prepare a reasoned opinion on each of the submitted proposals. It may be necessary to include, delete or displace a plant or substance from the lists from obligations of the Republic of Bulgaria under an international treaty. In these cases, the procedure is identical and an expert advice is required again.
In order for a substance to be listed in the narcotic drugs list, it must meet one of the following criteria: to have a proven psychoactive effect, to cause a state of dependence, to cause harmful effects similar to those of narcotics and psychotropic to be transformed into an anesthetic or psychotropic substance, to have abusive data from another country, be placed under control in another country. It is clear from the criteria set out that cannabis can not be excluded entirely from the narcotic lists, but there is no obstacle to be moved from list I to list II. The switching of cannabis into list II could open doors for cannabis use in human or veterinary medicine, but would not only allow cannabis cultivation (containing more than 0.2% by weight of tetrahydrocannabinol). It is the tetrahydrocannabinol (THC) that is the key active ingredient of cannabis, which is also used in the development of medical products. To this end, a change to the Narcotic Substances and Precursors Control Act, which contains an explicit ban, as well as other related acts, will be necessary. The more important part is to conceive this concept in society and only then introduce changes made by professionals familiar with local legislation, European acts and world practices.
As mentioned above, the principle is that cannabis cultivation on the territory of the Republic of Bulgaria is forbidden. An exception is permitted - where the hemp grown for cannabis (cannabis) is intended for fiber, for feed and forage and seed and has a content of less than 0,2% by weight of tetrahydrocannabinol, as determined by the leaf, the color and the fruit tips. Cannabis cultivation, even under these conditions, is not free - this activity is subject to control by the State Agency for National Security. Persons who grow cannabis intended for fiber, feed and food and seed crops must be licensed to carry out this activity. A non-public register is kept for the licenses issued.
In March 2018, Ordinance No 1 was adopted on the terms and procedure for issuing a plant breeding license for cannabis (cannabis) intended for fiber, for feed and food and seed for sowing, with a content of less than 0,2 the weight percent of tetrahydrocannabinol specified in the leaf, color and fruit tips for trade and control and Order No 3 on the conditions and procedure for issuing an import license for seed of hemp not intended for sowing. With the issue of these two regulations, the Ministry of Agriculture, Food and Forest has established clearer rules in the area. However, it is noteworthy that even with regard to hemp plants with a content of less than 0.2% by weight of tetrahydrocannabinol, which do not affect the human psyche, strict regulation is applied both in terms of cultivation and in terms of conversion of production.
Lastly, it should also be noted that the Narcotics and Precursors Control Act provides for the possibility for natural and legal persons to produce, acquire, import, export, store and use limited quantities of plants and substances in List I for medical, scientific and laboratory research, for educational purposes, as well as for maintaining the working condition of official dogs finding narcotic substances. Eligible quantities are set by an ordinance, and at present limited allowances for hemp and marijuana are 30,000 grams.
The comparative analysis of the legislation in the sphere of the different EU states implies the necessity of reforming our national legislation. The aim of such a reform would be to develop more modern rules on the cultivation, import, export and processing of plants such as hemp. The experience of some neighboring countries shows that, with adequate regulation of the sector, the emerging new business opportunities are substantial. Of course, the issue of the status of cannabis as a drug but also as a substance should undergo a profound public debate to anticipate possible legislative changes. Here, social attitudes will play a key role in striking a balance between society's fears and the desire to unveil new business.
We need your support so Novinite.com can keep delivering news and information about Bulgaria! Thank you!
- » Will There Be a Second Wave of Coronavirus Infections?
- » Russians Watch the American Protests as Clouds Gather at Home, Ilya Klishin
- » Emil Harsev: Volkswagen Has Not Given Up on Turkey
- » Opinion: Bulgaria Needs to Take a Position on Syria
- » Opinion: There Are Three Versions of the Turkish Operation in Northern Syria
- » Why Bulgarians Want to Conserve Communist Monuments


text:
This is a short story about a southerly front. Wellington is well known for its windy weather - and I recently found some graphic illustrations of how quickly and dramatically the conditions can change. From a northerly of less than 5 knots to a southerly of 50+ knots in less than 3 minutes! Years ago (20), when I was single and obsessed with windsurfing I was one of the keen windsurfers who used to park at the bottom of the harbour on the Petone foreshore and wait for the predicted 'southerly buster' to arrive. When it did there would be a black wall appear at the harbour entrance which would rapidly advance towards us over a period of a few minutes, and the only question was 'which sail should I rig, 3.5 or 3.0?'.
Recently, I happened to be checking out some weather stations positioned around Wellington Harbour when I noticed a dramatic change at Leading Head. This is located near the entrance (south) of the harbour.The first screen shot below shows the wind dials from both ends of the harbour. You can see that Leading Head has reached 40knot S (10 minute average) while Seaview, only a few km north is still registering 3knot N!
Within less than 10 minutes the Leading Head wind has settled a little to a modest 30knots, but Seaview has now reached 40knots and the wind has swung through 180 degrees from north to south. If you were out sailing in that how would you feel?
The next image shows how dramatically the change came through, it shows the maximum gust at Leading Head went from 4-5 knots to 50+knots in about 3 minutes!
Finally, the last graph shows the rapid change not only in wind speed but also direction as experienced at Leading Head.
If ever there was a salutary lesson on watching the weather while you are out sailing - this would be it!
Check out the animated wind models from Metservice - Animated wind models on Metconnect


text:
See the Pen Tribute site by Zeeshan Haider (@zeeshan72) on CodePen.
Hi! Saw that no one gave you any feedback so far so here goes. (Please keep in mind, I am still quite a beginner myself and do not have a background in design or whatnot. Not an expert here.)
I like the font you used for the gentleman's man at the top. Overall, the look is kind of stark, but I think it goes well with the subtitle of the subject being the "Richest Poor Man."
I think it would read easier if you kept the same format for your facts. Since you are using a bulleted list it would be easier on the eyes if the date and information order were consistent.
For example:
- 1928 - Born ...
- 1951 - Founded Eidhi Foundation
More padding or margin on the sides of your text areas would be nice. The final sentence at the bottom is the one that really comes to mind.
With regard to your code, I was able to understand what you did and predict how the page would look. You did a good job calling on Bootstrap's classes instead of having to write CSS for every style on the page.
I think you are missing a closing tag for your unordered list though. Looks like it would go on line 44 right before you close that
div element. Also, line 48 you used the
footer tag for citing your quote. I don't think that is semantically correct. You could have probably enclosed that text within the
cite tag instead and change that element's appearance in CSS, as desired.
Not a bad job though!
Thanks for your honest response. I already sent an email to you regarding the changes that I made after you pointed my mistakes. I think it looks better now. thanks for your time.