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Alderman, Amy K. M.D., M.P.H.; Bauer, Joseph M.D.; Fardo, Dean M.D.; Abrahamse, Paul Ph.D.; Pusic, Andrea M.D., M.S.
Atlanta, Ga.; Ann Arbor, Mich.; and New York, N.Y.
From private practice; University of Michigan; and Memorial Sloan-Kettering Cancer Center.
Received for publication June 25, 2013; accepted September 18, 2013.
Disclosure: Drs. Fardo and Abrahamse have no conflicts. Drs. Alderman and Bauer have consulting agreements with Mentor. Dr. Pusic is co-developer of the BREAST-Q, which is owned by Memorial Sloan-Kettering Cancer Center and the University of British Colombia. In accordance with the inventor-sharing policies of these institutions, she receives a portion of licensing revenues when the BREAST-Q is used in industry-sponsored clinical trials.This work was supported by Mentor.
Amy K. Alderman, M.D., M.P.H., 4165 Old Milton Parkway, Suite 200 East, Alpharetta, Ga. 30005, firstname.lastname@example.com
Background: The aim of this study was to prospectively evaluate patient satisfaction and quality of life with elective breast augmentation.
Methods: Patients with bilateral submuscular breast augmentations prospectively completed the BREAST-Q preoperatively and 6 weeks and 6 months postoperatively; t tests compared preoperative and postoperative scores at 6 weeks and 6 months, and standard indicators of effect sizes were calculated. Logistic regression was used to evaluate the association between patient and surgical factors on satisfaction outcomes.
Results: The study sample included 611 female patients with the following characteristics: (1) mean age of 33.5 years; (2) mean body mass index of 21.7; (3) and mean implant volume of 360; with (4) 73 percent having received a silicone implant. Significant improvements were found in patient satisfaction with breasts (p < 0.001), psychosocial well-being (p < 0.001), and sexual well-being (p < 0.001) at 6 weeks and 6 months postoperatively, and all were associated with a very large Kazis effect size of 3.66, 2.39, and 2.56 at 6 months, respectively. However, at both 6 weeks and 6 months postoperatively, physical well-being remained significantly below preoperative baseline scores. In addition, satisfaction with breasts and with the overall surgical experience was significantly lower among older patients (p = 0.01 and 0.02, respectively).
Conclusions: Breast augmentation is associated with high patient satisfaction and significant improvements in quality of life. However, physicians should inform patients that submuscular augmentations are associated with a delay in recovery of physical functioning and be aware that older patients may experience diminished satisfaction and should counsel accordingly.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Breast augmentation is one of the most commonly performed elective procedures in the United States, and breast implants are one of the most frequently placed medical devices in all of medicine, with nearly 300,000 procedures performed annually.1,2 However, many health policy leaders have concerns about the safety of breast implants that have heightened with the European Poly Implant Prothèse implant crisis and the potential link of implants to anaplastic large cell lymphoma.3,4 High-quality, clinical outcomes research can help mitigate concerns about the effect of breast augmentation on women's health, especially the safety and efficacy concerns expressed by the U.S. Food and Drug Administration.5 Furthermore, plastic surgeons need clinically meaningful, patient-centric outcomes data to optimize surgical outcomes.6
Traditional methods to evaluate surgical outcomes have included short- and long-term complications and aesthetic outcomes from the surgeon's perspective. However, as plastic surgeons advance surgical techniques, the ways in which outcomes are assessed must also advance. Surgical outcomes need to be evaluated from the perspective of both the surgeon and the patient, realizing that the two perspectives may be very different. In addition, much of the previous research on patient satisfaction with breast augmentation has methodological limitations, such as the use of ad hoc questionnaires, which have limited reliability and validity.7–11 Fortunately, plastic surgeons now have access to a sensitive and specific patient-reported outcome instrument for elective and reconstructive breast surgery—the BREAST-Q—that can provide objective, reliable, and valid data.12–14 Use of the BREAST-Q may advance our understanding of breast surgery outcomes from the patient's perspective that can be reproduced across different clinical settings and patient populations.
Our purpose was to prospectively evaluate patient-reported outcomes with elective breast augmentation using the previously validated BREAST-Q patient-reported outcome instrument. Specifically, we evaluated changes in patients' satisfaction with their breasts and quality of life after elective breast augmentation. We also evaluated clinical factors that may be associated with satisfaction with breasts and with the overall surgical experience.
We performed a prospective, single-center cohort study involving patients undergoing bilateral elective breast augmentation from January of 2011 to July of 2012. Before commencing our study, institutional review board approval was obtained. All consecutive female patients undergoing elective breast augmentation treated by one of three surgeons in our practice were offered study participation. All patients underwent breast augmentation using an inframammary incision and submuscular implant pocket. Patients with breast cancer or those with previous breast surgery were excluded.
Eligible patients were recruited for study participation at their preoperative visit and were asked to complete the self-administered breast augmentation module of the BREAST-Q survey. No incentive gifts were provided. A follow-up questionnaire about their surgical outcomes was administered to patients at the 6-week and 6-month postoperative visits. All patients agreed to participate in the study; however, 4 percent of patients were ineligible for study participation because of errors in survey administration (e.g., failure of the staff to administer the survey preoperatively or postoperatively). The number of patients who completed a preoperative questionnaire was 639; 90 percent (n = 576) of patients completed a postoperative survey at 6 weeks and 48.5 percent (n = 310) at 6 months.
The primary outcomes were patient satisfaction with breasts and quality of life measured with the BREAST-Q patient-reported outcome instrument.14 Development and validation of the BREAST-Q has been reported previously.12,14,15 In brief, the questionnaire was developed through a series of in-depth patient interviews, focus groups, expert panels, and literature review. Extensive field testing was performed for item reduction and final scale development across five centers in the United States and Canada. The BREAST-Q has a modular, procedure-specific structure for procedures involving breast reconstruction, augmentation, and mastopexy/reduction. The module for augmentation was used for this study. The scales of the BREAST-Q have proven reliability and validity. Reliability tests for internal consistency and test–retest reproducibility of the survey items. Internal consistency is measured using Cronbach's α and item-total correlation statistical tests (>0.70 is considered acceptable for both tests). Test–retest reproducibility is evaluated using intraclass correlation coefficients and tests the stability of a scale with repeated administration (>0.70 is considered acceptable). The Cronbach's α for the augmentation module ranges from 0.81 to 0.94, and the item-total correlations range from 0.55 to 0.82. Test–retest reliability, measured by intraclass correlation coefficients, ranges from 0.85 to 0.94.14
Satisfaction with breasts was assessed using a 17-item scale focusing on issues related to breast appearance, softness, amount of cleavage, size, scar appearance, and extent of implant rippling. Three quality-of-life subscales measured psychosocial well-being, sexual well-being, and physical well-being. The nine-item scale for psychosocial well-being addressed issues such as confidence in social settings, feeling attractive, and self-assurance. The five-item scale for sexual well-being addressed issues related to confidence with sexual activity and feelings of sexual attractiveness. The seven-item scale for physical functioning addressed issues related to pain in breasts, difficulty with lifting objects, and discomfort attributable to shifting of implants with physical activity. Satisfaction with the overall surgical experience was assessed using an eight-item scale addressing issues related to the overall experience, overall satisfaction, regrets, and extent that expectations were met. We also displayed some outcomes from the subset of questions that measured satisfaction with perioperative information, which was a 16-item scale that covered issues related to surgical risk, recovery, and outcomes. All questions were designed as a Likert scale response format. In accordance with the BREAST-Q Scoring Manual, patient scores were transformed into linearized, interval-level measurements using the Q-Score program and presented on a 0 to 100 scale, with higher values representing a more favorable outcome.16
The independent clinical variables obtained by chart review included patient age, height, weight, implant type (saline or silicone), implant volume, and surgeon. Age was analyzed as a four-level categorical variable (<30, 30 to 40, 40 to 50, and >50 years). Body mass index was calculated from the patient's height and weight and reported as a three-level categorical variable (<25, 25 to 30, and >30). All implants were smooth round Mentor implants that were analyzed as either saline or gel-filled devices. The implant volume was calculated for each patient, taking an average of the implant volume from each side, and analyzed as a three-level categorical variable (<300, 300 to 400, and >400 cc). Varying the cutoff ranges for the categorical variables did not substantively change the results.
Descriptive statistics were performed to understand the demographic and clinical characteristics of our patient sample. In all analyses, preoperative body mass index was used rather than bra cup size because it appeared to be a more objective and reliable measure of patients' preoperative body habitus size. t tests were used to compare preoperative and postoperative scores at 6 weeks and 6 months for satisfaction with breasts and quality-of-life subscales. To further assess outcomes related to physical functioning, an analysis of variance was performed to evaluate preoperative bivariate differences among the independent variables, and a logistic regression was used to assess physical functioning outcomes while controlling for patient and surgical factors. In the regression, a mean postoperative score of 70 or less indicated poor physical function (median score was 71). Varying the cutoff did not affect the results. We then calculated two standard indicators of effect size: (1) Kazis effect size17; and (2) standardized response mean.18 Larger effect sizes and standardized response means indicate greater responsiveness, and it is standard practice to interpret the magnitude using Cohen's arbitrary criteria (0.2 for small, 0.5 for moderate, and 0.8 for large).19–21 We then calculated the mean score for satisfaction with breasts and satisfaction with the overall surgical experience across each independent variable. Logistic regression was used to evaluate the association of patient and surgical factors on satisfaction scores, controlling for the surgeon who performed the procedure. In the regression model, a score of 75 was considered "highly satisfied," and varying the cutoff did not substantially change the results. Last, we described some specific information regarding individual questions within a scale. Questions within the satisfaction with the overall surgical experience used a three-point scale, and a t test was performed to show differences in responses by the independent patient or surgical variable. A p value less than 0.05 was considered statistically significant. All analyses were performed with STATA version 8.0 software (StataCorp, College Station, Texas).
Table 1 shows the study sample characteristics. The mean age was 33.5 years, and more than three-fourths of the patients were 40 years old or younger. The mean body mass index was 21.7, and 91 percent of patients had a body mass index less than 25. Nearly three-fourths of patients received a silicone gel–filled device, and the mean implant volume was 360 cc. More than two-thirds of patients had an implant fill volume between 300 and 400 cc.
Figure 1 displays changes in patient satisfaction with breasts and health-related quality of life with elective breast augmentation. Mean BREAST-Q scores ranged from 0 to 100, with higher scores indicating greater satisfaction or quality of life. Significant improvements are seen for all scales at both 6 weeks and 6 months postoperatively, except for physical functioning. Satisfaction with breasts improved from a mean preoperative score of 25.57 to 79.66 at 6 weeks (p < 0.001) and 84.10 at 6 months (p < 0.001), psychosocial well-being improved from a mean preoperative score of 51.86 to 85.40 at 6 weeks (p < 0.001) and 88.81 at 6 months (p < 0.001), and sexual well-being improved from a mean preoperative score of 38.45 to 82.54 at 6 weeks (p < 0.001) and 85.67 at 6 months (p < 0.001). However, physical functioning declined from a preoperative score of 94.83 to 71.04 at 6 weeks (p < 0.001) and 83.61 at 6 months (p < 0.001).
Table 2 shows the preoperative and postoperative 6-week physical functioning scores for the independent variables. In the bivariate analyses, advanced patient age, higher body mass index, and patients with saline-filled compared with silicone-filled breast implants had significantly worse preoperative physical functioning (p < 0.05). However, when preoperative physical functioning and patient-level factors were controlled for in the logistic regression model, postoperative physical functioning outcomes were not significantly correlated to the type of breast implant or fill volume.
Table 3 displays the magnitude of the effect of breast augmentation on patient satisfaction and health-related quality of life. Very large effect sizes are seen with all satisfaction and quality-of-life subscales. The Kazis effect size and standardized response mean are ways to measure how big of a difference a procedure has on a patient's satisfaction or quality of life. Standard practice is to interpret a Kazis effect size or standardized response mean of 0.2 as small, 0.5 as moderate, and 0.8 as large. At both 6 weeks and 6 months postoperatively, the positive effect is greater than 2.5 for satisfaction with breasts (Kazis = 3.18 and 3.66, respectively; standardized response mean = 3.18 and 2.66, respectively), greater than 1.5 for psychosocial well-being (Kazis = 1.55 and 2.39, respectively; standardized response mean = 1.55 and 1.55, respectively), and greater than 2.0 for sexual well-being (Kazis = 2.37 and 2.56, respectively; standardized response mean = 2.37 and 2.23, respectively). Surgery appeared to have a negative effect on physical functioning, with an effect size greater than 2.0 at 6 weeks (Kazis = 2.30; standardized response mean = 2.30). However, this negative effect diminished at 6 months postoperatively (Kazis = 0.81; standardized response mean = 0.75).
Table 4 shows patient-reported satisfaction with breasts after augmentation mammaplasty, controlling for patient and surgical factors. These questions focused on breast size, feel, shape, and other aspects of physical appearance. Patient age was significantly associated with breast satisfaction and appears to diminish with age. Compared with patients younger than 30 years of age who had a mean satisfaction score of 82.0, the mean score for patients 30 to 40 years old was 80.1 (OR = 0.76, 95% CI = 0.50 to 1.16), for patients 40 to 50 years old was 78.2 (OR = 0.76, 95% CI = 0.44 to 1.31), and for patients older than 50 years was 71.1 (OR = 0.29, 95% CI = 0.12 to 0.77). Patient body mass index, implant type (saline versus silicone), and implant volume did not appear to be associated with postoperative satisfaction with breasts.
Table 5 shows patient satisfaction with the overall surgical experience after breast augmentation. These questions focused on the surgical experience, whether expectations were met, regrets about surgery, and satisfaction with the results. Patient body mass index and implant volume were not significantly associated with overall satisfaction with the surgical experience. However, patient age was associated with satisfaction with the overall experience and appeared to diminish with increased age. Compared with those younger than 30 years old who had a mean satisfaction score of 89.9, the mean score for patients 30 to 40 years old was 85.9 (OR = 0.69, 95% CI = 0.45 to 1.05), for patients 40 to 50 years old was 81.9 (OR = 0.60, 95% CI = 0.35 to 1.06), and for patients older than 50 years was 77.3 (OR = 0.24, 95% CI = 0.08 to 0.66). Patients with silicone implants also appeared to have diminished satisfaction, with a mean score of 85.1 compared with 88.3 for those with saline implants (OR = 0.62, 95% CI = 0.40 to 0.97). In particular, patients with silicone implants compared with those with saline implants were less likely to report that the surgery overall was a good experience (mean score of 2.88 versus 2.93, respectively, on a three-point scale; p < 0.05) and were less likely to feel that the surgery changed their lives for the better (mean score of 2.78 versus 2.89, respectively, on a three-point scale; p < 0.01). We explored reasons for the difference in satisfaction outcomes by implant type and did not find any differences in satisfaction with perioperative knowledge between patients with saline versus silicone implants regarding possible surgical complications, potential for implant leakage, risks associated with the implants, or the potential for rippling of the implant.
In this large, prospective cohort study of patients undergoing elective breast augmentation, we found significant improvements in women's satisfaction with breasts, psychosocial well-being, and sexual well-being that persisted from the early postoperative period to 6 months afterward. Breast augmentation also has a very large magnitude of effect across all patient quality-of-life domains in both the early and later postoperative periods, except for physical functioning. Patients' physical functioning does appear to be negatively affected by submuscular breast augmentation, although the negative effect is diminished at 6 months compared with 6 weeks. The physical functioning outcomes do not appear to be correlated to the type of breast implant (saline versus silicone) or fill volume. Furthermore, patient satisfaction with breasts postoperatively and with the overall surgical experience varies by patient age and implant type, with older patients less satisfied with both the surgical outcome and the surgical experience, and those with silicone gel–filled devices less satisfied with the overall surgical experience. However, there does not appear to be any differences in patients' satisfaction regarding information about potential adverse events related to implant devices among those with saline versus silicone gel–filled devices.
Much of the quality-of-life research in breast surgery has focused on the improved quality-of-life changes associated with breast reconstruction or reduction mammaplasty and has been used to support health policy initiatives aimed at improving access to these procedures.22 Equally important is quality-of-life research with elective breast augmentation, especially given the heightened political concerns about the safety of these devices because of anaplastic large cell lymphoma awareness and the European Poly Implant Prothèse implant crisis.3,4 The U.S. Food and Drug Administration has stated that the efficacy of breast implants, not just the safety, must be documented in ongoing surveillance efforts.5 Validated measures such as the BREAST-Q can provide reliable and reproducible results addressing the efficacy and effectiveness of breast surgery. Our results, along with a recent report by Coriddi et al.,23 demonstrate that elective breast augmentation can significantly improve women's quality of life. The psychosocial benefits include greatly improved confidence in social settings, feelings of attractiveness, and self-assurance. Confidence with sexual activity and feelings of sexual attractiveness are significantly improved. Patients undergoing the procedure are also significantly more satisfied with their breast appearance, size, softness, and amount of cleavage.
Our results also support those by McCarthy et al.,15 who found that elective breast augmentation has a significant and profoundly positive effect on women's satisfaction with their breasts, along with their psychosocial and sexual well-being. Both our data and those of McCarthy et al. found very large (i.e., >0.80) effect sizes for each satisfaction and quality-of-life outcome. Other areas of surgery have evaluated the magnitude of effect a procedure can have on patients' health-related quality of life. Hip arthroplasty has a documented large effect size of 3.1 on symptom improvement,18 pectus excavatum has a medium effect size of 0.6 on cardiopulmonary function,19 and carpal tunnel surgery has a small effect size of 0.2 on grip strength.24 When comparing across procedures, it is remarkable how large an effect size breast augmentation (Kazis effect size = 3.66) has on patient's quality of life compared with those found for life-changing procedures, such as hip arthroplasty (Kazis effect size = 3.1) and pectus excavatum (Kazis effect size = 0.6). These results, along with those of McCarthy et al.,15 provide important data that can be used for both patient education and health policy initiatives regarding the positive effect of breast augmentation on women's breast-related quality of life.
It is important to note the decline in physical functioning in our patient cohort. All patients in the study had a submuscular, not subglandular, augmentation. At 6 months postoperatively, physical function improved compared with 6 weeks postoperatively but did not return to baseline preoperative measures. A longer follow-up period is needed to assess whether physical functioning returns to preoperative levels or remains diminished in the long term, and a comparison cohort with a subglandular implant pocket would further elucidate the effect of pocket location on physical functioning. One could hypothesize that patients with a larger breast implant fill volume could have worse physical functioning compared with those with smaller implants, especially among more petite women with a lower body mass index. However, we found that postoperative physical functioning was not significantly correlated to the size of breast implant in either the bivariate or multivariate analyses. Research in the postmastectomy breast reconstruction population has not demonstrated any negative correlation between implant-based reconstruction and physical function outcomes,25 but data on physical functioning with elective breast augmentation are limited. These data are important for patient education and should be included when surgeons discuss with patients the implications of pocket location on mammography screening, aesthetic outcomes, and complications.
We found patient age to be significantly associated with satisfaction outcomes, with diminished satisfaction with advanced age. However, those older than 50 years still have a high satisfaction score of 71 of 100 for satisfaction with the postoperative breast result and 77 of 100 for satisfaction with the overall surgical experience. The older patients seem less satisfied with their aesthetic result and less likely to have their expectations met. We can only speculate as to the association between advanced age and diminished satisfaction. Older women have lived longer with micromastia and have learned to cope with issues related to body image, sexuality, and more pragmatic problems related to clothing fit. Older women may also have diminished body image related to the normal aging process, which may influence satisfaction with surgical outcomes. Similar findings have been found in the breast cancer population because older patients are less likely to receive postmastectomy reconstruction as a result of diminished desire for the procedures compared with younger patients.26 These data are important for surgeons to consider when counseling the older patient about elective breast augmentation but should not be viewed as a reason to deny this procedure because satisfaction outcomes are still very high.
The type of implant, saline versus silicone gel–filled devices, is an important decision for patients undergoing elective breast augmentation. Interestingly, we did not find implant type to be associated with satisfaction with the postoperative breast outcome. McCarthy et al.15 did find an association in the postmastectomy reconstructive population, with higher patient satisfaction with the postoperative breast result among patients with silicone compared with saline implants.27 We can only speculate, but the amount of soft-tissue coverage in the setting of elective breast augmentation compared with a postmastectomy defect may be enough to minimize differences in outcomes by implant type. It is important to note that the analyses controlled for patient body mass index, because thinner patients in our practice are more likely to receive a silicone gel–filled device. The reason why patients with silicone implants had diminished satisfaction with the overall surgical experience is unclear. We speculated that it was as a result of concern about implant safety; however, we found no differences in satisfaction with information about the devices among patients with saline and silicone implants. It is important to note that patients were not randomized to implant type. Thus, there may be other patient or clinical factors influencing the outcome that was not controlled for in the analyses. However, the differences in satisfaction among patients with saline versus silicone devices (mean score of 88.3 versus 85.1 of 100, respectively) were very small and may be more of statistical than clinical significance.
Our findings should be interpreted in the context of some limitations. Some patients were lost to follow-up at 6 months, and the outcomes of those patients are unknown. However, in our experience, highly satisfied patients are more likely to be lost to follow-up than dissatisfied patients, which would lead to an underreporting of improved satisfaction and quality-of-life outcomes. Furthermore, 6 months may be too short a follow-up period, especially for physical functioning outcomes. However, the other outcomes appeared relatively stable between 6 weeks and 6 months, suggesting that 6 months is adequate to assess early outcomes. Future BREAST-Q studies with follow-up beyond 6 months can be expected to provide additional important patient-centric outcomes data for patient education and regulatory efforts. Last, it may not be valid to generalize the results of this single group practice to other patient populations. Regional differences in patients and different surgical incisions, pocket locations, and device choices may lead to different patient-reported outcomes.
Our results have important implications for patient care and policy. Breast implants are one of the most frequently placed medical devices in all of medicine.1 Five to 10 million women worldwide have breast implants, and approximately 350,000 women in the United States undergo a breast implant procedure annually.2 Breast implants have been under close scrutiny by health policy leaders for decades, dating back to the silicone implant crisis of the 1990s,28 and have returned to the forefront of attention with the recent anaplastic large cell lymphoma concerns and the European Poly Implant Prothèse implant crisis.3,4 Some health policy leaders have taken a very negative view of these devices, claiming that they worsen the quality of life of women and therefore should be removed from the market.29–31 Our data suggest the opposite. Women with elective breast augmentation show significant improvements in psychosocial well-being, sexual well-being, and satisfaction with their breasts. Outcomes research on elective breast augmentation has never been more needed to ensure the continued availability of these devices in the marketplace. In particular, patient-reported outcomes provide a unique perspective of surgical outcomes that is becoming increasingly important in our consumer-driven healthcare system. It is no longer sufficient for physicians to report that patients are satisfied with surgery. The surgical experience must be documented from the perspective of the patient. These data along with other research using the BREAST-Q can be used on the policy level to support the availability of breast implants to women in the United States and worldwide.
The authors give special thanks to Collin Joiner for data management.
©2014American Society of Plastic Surgeons
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|01 Sep 2011
windows xp
Tablet battery life- is there a software solution?
I'm in the market for a new tablet just with the following wish list-
6 hour+ battery life
Windows 7
...and thats about it.
I've had a chinese tablet in the past with windows 7(probably not a legit copy) and after tweeking and optimizing it, it could run like the wind with everything I threw at it.
Only issue was the battery, would last 2.5 hours max between charges, totally impractical.
80% i was using it to read ebooks/daily newspapers in work and generally browsing the web while sitting with my feet up watching tv. The other 20% of the time I'd be streaming tv or radio, the odd video call and some fiddling with work stuff in office. For most of what I needed it for, Android couldve done the job but there has been a few times where only a full on Windows 7 system could save the day, for me its a must.
So has anybody here got a tablet running windows that could last me a solid 6 plus hours?
If not, is there a software solution to stop power being destroyed? Would give me options.
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subset: commoncrawl


text:
And a dentist student dating a dentist is even worse… . I have floss in my key chain though, so my friends and I don't...
I don't dig that shit at all! I'd say: go fu*k yoself dental wife, don't put those filthy hands in my chew!
one day… hehehehe
Scope, lol


text:
Yesterday the New York Giants finally gave Osi Umenyiora his wish, a new contract. That new contract bumps Umenyiora's salary up to $7 million from just over $3.5 million. However the new contract does not add any years to the defensive end's deal. Is this contract more of a parting gift than a reward?
Umenyiora is happy with the deal and will report to OTAs on Monday, for the first time in several years. With the 2013 year of the contract voidable, this may be Umenyiora's last OTA in a Giant uniform. What the Giants guaranteed themselves is a motivated year from a star defensive end from start to finish. Umenyiora got his raise and the ability to cash in, or at least try to, next off-season. The Giants are still unlikely to shell out the big money, long term deal that Umenyiora is looking for next off-season, so Giants' fans should start saying their goodbyes.
Is Osi Umenyiora's New Contract Really a Goodbye?
6/2/12 in NFL | Anthony_Raia | 37 respect


text:
KXTX TV Tower Collapse Site
A 1,551-foot tall communications tower fell to the ground here in 1986. Three workers fell over 1,000 feet off the tower, and one worker was thrown 600 yards away by the force of the collapse. The tower once stood 50 feet taller than the Sears Tower in Chicago.
General Location:
Cedar Hill


text:
An Islamic State.
An Islamic State is a land ruled exclusively by Islamic rules. It must be a Khalifa (Caliphate) system. This ruling system was implemented by the Prophet (saw). The State functions as one state with a centralized ruling system. The head of the state, the Khalifa (Caliph) must be elected due to his piety.
Political Structure:
- The Khalifah.
- The Khalifa's Assistants, of which there are two types: Delegated Assistant and Executive Assistant.
- The Amir of Jihad.
- The Governors (Walis).
- The Judges.
- The Administrative System.
- A Consultative (Shura) Assembly
The Creed of the State:
is built upon the basis that there is No Deity but Allah (swt) and Muhammad (saw) is His Messenger.
Ruling Principles:
Sovereignty belongs to Allah (swt)- through the Shari'ah, and not the people. The authority of ruling belongs to the nation (Ummah). The installation into office of ONE Khalifah is an obligation upon all Muslims. Only the Khalifah has the right to adopt divine laws (Ahkam Shari'yah) for implementation by the State.
Citizens of the State:
All citizens of the State shall be treated equally regardless of religion, race, colour or any other consideration. The State in all matters, be it ruling, judiciary, or welfare, is forbidden to discriminate amongst citizens.
The State does not recognize the physical borders or the independence of one Muslim country from another. The Ummah is one, the State is one, the Army is one, the Flag is one, and the Budget is one. The outer boundaries are always expanding to encompass Dar-ul Islam. Travel between distant lands is open and no restriction or visa is required.
The State has two flags. White is the flag of the Islamic State and the Black flag is carried by the army of Islam.
The Hijra, or Islamic calendar is the official calendar.
The official language of the State is Arabic, the language of The Qur'an.
The Islamic state was established by the Messenger of Allah (saw) as soon as he set foot in Madinah, after he had taken the second pledge (Baya'a) of Al-Aqaba from the Ansar, a pledge of protection and war, and a pledge to hand the authority in Madinah to the Messenger of Allah (saw). The birth of the Islamic state was the result of a new Aqeeda and a host of new concepts adopted by those who believed in him (saw) these concepts generated in his followers a new viewpoint about life, which in turn changed their viewpoint towards relationships and interests. The Messenger of Allah (saw) built the Islamic state in Madinah on the basis of this Aqeeda, and on the concepts which emanated from it, despite the fact that the verses of legislation had not been revealed yet. She was therefore a new state, built on a new Aqeeda, and on a host of new thoughts and concepts. The Islamic state is unique in her nature, her structure, what she stands for and the basis on which she is built. She is completely different from the nature and the structure of all the existing states in the world.
Now judge for yourselves if there is an Islamic state present in the world today and judge for yourselves the importance of such a government and the impact it can have if the 1.6 Billion Muslims around the world were united on such an aqeeda today. No, it isn't a utopian state, it's real. it existed in the past and it can in the future as well. It's very real.
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text:
404 S Cherry Grove Ave has a Walk Score of 63 out of 100. This location is Somewhat Walkable so some errands can be accomplished on foot.
This location is in Annapolis. Nearby parks include Truxton Park and Navy-Marine Corps Memorial Stadium.
Nearby schools include St Martins Lutheran Church School, Aleph-bet Jewish Day School and Mills - Parole Elementary School.
The closest grocery stores are Anita Spanish Grocery Inc, Tax Service Sinai and Clock Tower Plaza Shopping Center.
Nearby coffee shops include Starbucks, Dunkin' Donuts and Ceremony Coffee Roasters. There are seven restaurants within a 15 minute walk including Five Guys Burgers & Fries, Matsu and Ledo Pizza - Annapolis.
404 S Cherry Grove Ave is near Truxton Park, Navy-Marine Corps Memorial Stadium and Colonial Annapolis Historic District.


text:
35.9172453 -94.9711451
215 West Morgan Street, Tahlequah, OK 74464, United States +1 918 456 3377
This bed and breakfast, located in a quiet residential neighborhood in Tahlequah, Oklahoma, has two units and provides a perfect setting for families, corporate housing, and romantic getaways. Your party of one to eight guests will enjoy a continental breakfast and other exceptional amenities at an affordable price.
Get Rates
Get Flight + Hotel
Star Ratings
|The Mary Geasland Guest House


text:
Those of you who've been following my recent by-election campaign may be interested to know that there's a Pirate Party meetup in Edinburgh next Wednesday (the 22nd September). Non members are welcome. Details on the Pirate Party website.
Join Pirate Party UK!
My Twitter
- @Sallyroberts @IsabelOakeshott True, shame it has nothing to do with EU. 7 months ago
- #lbcdebate EU needs common defence policy so if anyone invades a European country, they get a good kicking; Putin would be too scared to. 7 months ago
- #lbcdebate Farage says situation in Ukraine is EU's fault. This is only true to the extent that EU isn't integrated enough. 7 months ago
- @GuidoFawkes You think Farage is better? 7 months ago
- #lbcdebate Good question about trust and how neither Farage nor Clegg deserve any. 7 months ago
Recent Posts
Top Rated


text:
Topics: Supreme Court, Insurance, Marketplace, Medicaid, Politics, Health Reform
Mar 21, 2012
The high court is scheduled to hear three days of oral arguments related to the legal challenges to the health law. Amid the expected media attention, political posturing and spin contests, interested parties are finalizing their arguments and strategies.
Politico: Health Law Heads Back Into Spotlight
For those who support the health care reform law, the trick next week will be to get the public to see it as a bunch of pieces -- the parts everyone likes. For the opponents, the goal is to paint it as one big, scary law: "Obamacare" (Haberkorn, 3/20).
The Hill: Supreme Court Faces An Unprecedented Health Care Frenzy
The frenzy generated by the Supreme Court's arguments on the health care reform law next week is likely to dwarf anything the court has ever seen. Lawmakers and interest groups plan to stage protests and events outside the court nearly nonstop, creating a circus-like atmosphere for a case that could redefine the limits of federal power (Baker, 3/20).
NPR: White House Preps For Court's Health Care Ruling
Most of the president's speeches these days focus on jobs or gas prices. But the health care law is his signature achievement, and it always gets a mention at political events. … The law will be back in the spotlight next week when the U.S. Supreme Court hears oral arguments about the Affordable Care Act. The White House is gearing up to defend the policy, sending top administration officials out across the country to explain the law's benefits. The focus this week is on women, who are key health care consumers and an all-important demographic for the president's re-election bid (Liasson, 3/21).
The Hill: Obama Will Avoid Health Care Defense During Court Review
President Obama will not mark the two-year anniversary of his signing of the health care law -- which takes place days before the Supreme Court offers a decision on the constitutionality of his signature legislative achievement. Senior administration officials said on Tuesday that Obama will not be offering a vigorous public defense of the law, holding events or even making public remarks in the lead-up to the Supreme Court case (Parnes, 3/21).
The Associated Press/Washington Post: Summary Box: Supreme Court Has A Range Of Options In Ruling On Obama Health Care Law
The Supreme Court has several options in ruling on President Barack Obama's health care overhaul, from upholding the law to striking it down in its entirety (3/20).
Bloomberg: How The Historic Supreme Court Health Care Arguments Will Unfold
The U.S. Supreme Court review of President Barack Obama's health care law carries an unprecedented combination of economic, political and legal stakes. ... Its ruling, probably in late June, will shape the legacies of Obama, the driving force behind the 2010 law, and Chief Justice John Roberts, the Republican appointee whose views remain a mystery. The case may become a legal landmark, determining how much authority the Constitution gives Congress (Stohr, 3/21).
Some coverage examines specific arguments that could be in play --
Kaiser Health News: The New Jersey Experience: Do Insurance Reforms Unravel Without An Individual Mandate?
In this Kaiser Health News analysis, Jonathan Cohn writes: "The Obama administration has told the court that if it invalidates the mandate it should also invalidate two key insurance reforms that would prevent discrimination because of preexisting conditions. … But is the administration's claim correct? For some clues, the justices could examine what happened in New Jersey, a state that tried to reform its insurance markets without a mandate -- and failed pretty miserably" (Cohn, 3/20).
USA Today: Health Care Law's Defenders Look To George Washington
The father of our country could play a key role in defending what opponents of President Obama's health care law call the mother of all mandates. Seeking precedents for the law's requirement that Americans buy health insurance, some constitutional scholars are reaching back 220 years to a law signed by George Washington: the Militia Act of 1792 (Wolf, 3/20).
Medscape: Supreme Court Oral Arguments on the ACA, Part 2: Medicaid Offers You Can't Refuse, and Severability
The oral arguments on day 3, March 28, while not as central to the case, will be the lengthiest -- 1.5 hours in the morning and 1 hour after a Supreme Court lunch. ... The opposing attorneys will delve into the ACA's dramatic expansion of the Medicaid program, which the 26 state officials view as a usurpation of states' rights ... The Obama administration counters that the Constitution gives Congress not only the power to spend money but also the power to set conditions for federally funded programs (Lowes, 3/20).
Others probe the key question of what happens if the law is overturned or repealed --
Reuters: Q+A: U.S. Health Care: What Would Republicans Do?
As the U.S. Supreme Court prepares to hear legal challenges to President Barack Obama's health care overhaul next week, Republican lawmakers are weighing options for repealing the law or even replacing it with a plan of their own. In fighting the 2010 Patient Protection and Affordable Care Act that will extend health coverage to millions more Americans, Republicans have not offered a definitive alternative (Smith, 3/20).
Reuters: Few Options If Top Court Strikes Part Of Health Law
If the high court opted only to reverse the law's unpopular individual mandate, which requires most adults to purchase health insurance, the Obama administration could look to several alternatives to ensure that enough people participate in coverage to make the law work as envisioned. The options range from a new tax on individuals who do not acquire coverage to financial incentives that could encourage young, healthy people to sign up for insurance. The government could also consider special subsidies for high-risk individuals who are already sick or vulnerable to disease (Morgan 3/20).
And in the background, the continuing analysis of public opinion related to the law --
Los Angeles Times: Obama Health Care Law Not Resonating With Public Yet
Because key provisions of the law have yet to kick in, relatively few people have benefited from it thus far, making Democrats' defense of it a tough sell (Levey, 3/20).
This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from major news organizations. The full summary of the day's news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.
© 2014 Henry J. Kaiser Family Foundation. All rights reserved.


text:
Social Studies
Social Studies Homepage
BOARD APPROVES (December 7, 2012) NEW SOCIAL STUDIES STANDARDS:
- CSSAP Modules
- Library of Congress Workshop Video
- National History Day
- Nebraska Humanities Council
- New(er) Resources
- Organizations
- Civics Nebraska
- Civics
- Economics
- Geography
- History
- Holocaust
- International Education
Nebraska Counties
Provided below are links the 93 counties in the state of Nebraska. Each page contains a link to the partricular county in the top left hand corner of the page and the a pictorial, historical representation of the county taken from Nebraska in the Making by Mike Parks that was published by the World Publishing Company,Omaha, Nebraska in 1966.
|Otoe County
|Valley County
|York County


text:
(Source: julietao)
(via b1llionaire)
People will talk, so whatever— let them.
(via -infuckti0n)
(Source: skylertyler, via hardcore)
alright whoever it is putting spam in my ask
I do not appreciate it.
And I will delete it every single time.
so please stop
- 3 years ago on Saturday July 23rd
- , 2011 at 7:58:10AM
(Source: snoopturtle)
(via remindmetobr3athe)


text:
Find it here, go there on your phone.
what you want to do on Scout.me, open your Scout App, and tap the to get driving!
Matthews - Winters Park, Morrison, Colorado
Walk about 100 yards from the parking lot to reach an area equipped with picnic tables and toilet facilities ne... localhikes.com
Denver: Apex Park Loop
Just a short bus ride from downtown, this 5.1-mile dayhike climbs loops around the panoramic ridgelines of Indi... backpacker.com
Colorado Trail: The Trailheads
Waterton Canyon
This immensely popular route follows the South Platte River as it winds west into the mountains. Waterton Canyon se... trails.com
Little Dry Creek Trail
The Little Dry Creek Trail provides a paved, relatively flat pathway for bikers, walkers, and skaters through ar... traillink.com
Red Rocks Trail, Evergreen, Colorado
The towering, rosy-smooth stone edifices of the Fountain Formation, which makes up the ramparts of the famous Red R... trails.com
Apex Gulch Loop, Lakewood, Colorado
This loop is illustrative of the complex interface between the urban corridor and the relative wild of the foothill... trails.com
Mount Falcon Park, Morrison, Colorado
This ride is a climber's dream or nightmare (depending on your point of view). A continuous climb out of the prairi... trails.com
Ralston Creek Trail
Most of the Ralston Creek Trail follows its namesake waterway, winding through several parks, neighborhoods, and... traillink.com
Creekside Trail to the Castle
Follow beautiful Bear Creek through a narrowing canyon.You probably won't see any bears—just wildflowers and willow... trails.com
High Line Canal Trail: Blackmer Lake, Denver, Colorado
The track of land adjacent to this segment of the High Line Canal almost became the retirement home of President Dw... trails.com
Hayden / Green Mountain
Hayden/Green Mountain Open Space Park on the outskirts of Lakewood is awash with colorful flowers in spring and ear... trails.com
Mount Sniktau Trail
Many hikers wonder where Mount Sniktau got its name. The origin is not Native American, as some think. Sniktau was ... trails.com
Mary Carter Greenway (Arapahoe Greenway)
The Mary Carter Greenway (a.k.a. Arapahoe Greenway) runs for 8 miles along the South Platte River from Chatfield... traillink.com
South Valley Park: Coyote Song
Two Ponds National Wildlife Refuge
Two Ponds National Wildlife Refuge (NWR) is located in Arvada, Colorado, a suburb of Denver. The Refuge consist... recreation.gov
Chimney Gulch
The area surrounding Lookout Mountain, aside from being great for mountain biking, is also a well-known hang glider... trails.com
Colorado State Capitol Time Capsule
Even if you're not politically minded, you'll enjoy visiting Colorado's capitol building, which was designed to res... 10best.com
Dinosaur Ridge
The Friends of Dinosaur Ridge is a not for profit 501C3 organization that maintains a Visitor Center and two interpretive tra...


text:
Small colleges offer big rewards.
- Size: 1,000 – 2,000 students
- Private
- Tuition: less than $15,000
- Non-profit
- 4 year school
There are many options when it comes to traditional campus-based colleges. Most of the time we appreciate having such a selection, but sometimes that just makes it more difficult to make a decision. Whether you're a recent high school grad, leaving home to attend college, or an adult learner returning to the classroom, choosing the right college to attend can be somewhat overwhelming. With some time and research, however, things become a little clearer.
Below we've broken down the most important things to think about to help you determine what college best suits your personal interests and academic goals. Learn about the benefits of a campus college, important factors to consider when choosing a college, and the different types of colleges you can choose from. Understanding these categories can help guide you through the process and narrow down your options.
Attending a campus college can be a significant adjustment. You'll be exploring a new place, meeting lots of new people and learning new things. While college should be fun, juggling all these things at once can be stressful. The biggest adjustments for most students will be time management, socializing and managing finances.Time Management
One of the best things about a traditional campus college is that there are so many things to do outside the classroom, from extracurricular activities such as clubs and organizations to campus social events to work. These things can greatly enhance the college experience, but they can also easily become distractions. While you should partake in these activities, it's important to remember why you're there in the first place—your education. Attending a campus college means you'll need to manage your time accordingly in order to keep up with everything.Social Life
Attending a campus college means you'll constantly be around friends, which tends to blur the lines between home and school, especially if you choose to live on campus. You'll be encouraged to attend campus-organized events and invited to off-campus parties with friends, on top of going to class, studying and sleeping. Figuring out the best way to balance everything will be important.Managing Finances
College itself can be expensive, so when you add non-academic costs such as rent, bills and going out to the equation, keeping your finances in order and staying within budget can be a challenge. For some students this may be the most difficult thing about the campus college life.
There are many benefits to attending a traditional campus-based college. Being physically on campus means that you'll have easy access to a variety of different services and campus amenities. Additionally, many campus-based colleges and universities strive to create a sense of community so that their students feel at home. When you're in person, you'll have access to the following:Campus Services
When it comes to attending a campus college, there are bound to be some challenges and hiccups along the way, which is why most colleges offer various services to their students. These services are meant to help ease the transition as well as help students through the inevitable roadblocks that will come up. Below are some of the most common services that most colleges offer to students who need help with academic, personal, health or other issues:
Most colleges and universities have on-campus health facilities to treat illness and injuries as well as provide immunizations, conduct medical tests and offer basic medical advice.Counseling
Being a college student is stressful. Many students have a difficult time balancing all the new responsibilities while maintaining a decent GPA. Other personal issues can also arise, causing students to feel isolated and depressed. Many colleges provide counseling services to help students through these difficult times and campus-based students can easily drop in between or after classes to find the help they need.Academic Centers
Most professors hold office hours in which students can drop by to ask questions or get help on class material. Professors, however, aren't always available right when you need them, which is why most colleges have academic centers where students can find one-on-one tutoring services, study groups and other support to assist them with academic development.Commuter Services
Some campus-based colleges are commuter schools, which means that a majority of their students don't live on campus and instead travel to-and-from school when they have class. These schools usually provide special services and support programs to help commuters feel integrated with the campus life and help them make the most of their time when they're actually on campus.
Despite the social aspect of college, sometimes students have a hard time finding a sense of community at a new school. Many campus-based colleges have various student clubs or organizations on site to help students find their niche. For example, students who like to sing may feel at home joining a campus choir or a cappella group, while dancers might want to join a dance troop. Many colleges also have a variety of religious-, ethnic- or academic-based clubs or organizations.Sports
Sports can play a big role in campus-based college life, particularly at large colleges and universities with varsity-level teams. Whether you're an athlete yourself or just like watching from the sidelines, campus-based colleges usually offer a variety of club and intramural sports for student-athletes and sports lovers alike.
There are many different things you should consider before deciding on a college. After all, this is the place where you'll spend at least two years—it's important to make sure you pick a college that not only fits within your budget, but is also a place where you'll be happy and can thrive. The best place to start is by asking yourself what's important, both academically and personally? Below are some things to consider:
Other things you might want to consider:
Figuring out what's most important to you will help make this process easier. From there you can then talk to school counselors and teachers, research online, talk to current students or recent graduates and schedule campus tours to find out which colleges best match your preferences and goals.
When it comes to selecting a campus-based college, there are few different options to choose from and the best option will depend on you. Every learner is different and where some thrive others may not.Public Colleges
Public colleges are funded by state and local governments and typically offer lower tuition rates than private colleges, especially for students who live within the same state. Most public colleges have a broad range of academic offerings in order to meet the needs and interests of a diverse student body.Private Colleges
Private colleges receive funding from tuition, fees and private sources such as investments or donors. Because these colleges rely on tuition, they usually have a higher sticker price than public colleges. Some of the most prestigious and well-known schools are private such as Stanford, Princeton and Harvard.Community Colleges
These colleges offer programs two-year programs that lead to an associate degree. They may also offer vocational-technical programs that lead to a certificate. Community colleges cost significantly less than public and private colleges and most have an open admissions process, meaning that anyone who enrolls and has a high school diploma or equivalent will be admitted. Most students who attend community college are commuter students as very few have student housing available.Four-Year Colleges
These schools offer four-year programs that lead to a bachelor's degree. Most have offer programs in broad range of disciples, although there are some schools that are specialized—for example, liberal arts colleges or secular colleges. Four-year colleges can be public or private and typically offer undergraduate and graduate degree programs.
While there isn't a magic formula for choosing a campus college, having enough information to understand all your different options can help make the selection process less daunting. Consider the information above as well as the following lists for the most affordable small private colleges, large public colleges and large community colleges to help you decide what college is right for you.
Small colleges offer big rewards.
Take advantage of in-state tuition at these public colleges.


text:
Doubts nonetheless about euro zone recapitalization for Irish banks: central bank
DUBLIN (Reuters) – Moves to let euro zone rescue funds including the European Stability Mechanism to straight recapitalize a associate nation's banks are 'encouraging', however, a big query mark remains over whether they can apply retrospectively to the loves of Ireland, the country's central bank governor mentioned about Sunday. "I'm truly encouraged by the moves because way. But they are slow moves plus there is a big query mark over the degree to that they might look back about what has occurred inside the past. …
Business News Headlines – Yahoo! News
Category: Headlines
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text: Share Print Email The genetics of a coat Aug 28, 2009 By dvm360.com staff Scientists have discovered that just three genes account for the menagerie of coats seen in dogs: one for fur length, one for curliness, and one for growth pattern. Click here to read more. Hot topics on dvm360Follow dvm360 on Twitter, Facebook, and Pinterest Sell veterinary clients on your service Why veterinarians should be more like a Louisiana shoeshiner Texts from your veterinary clinic cat Learning goodbye: Veterinarians fill a void by focusing on end of life care


text:
Hang tight!
Recipe by CDICKE1
"I've been using this recipe for years; I just wish I had kept track of how much money I've saved by not buying all those little cans!"
Hmm. None of these ingredients are on sale today.
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1 cup
boiling water
1/4 cup
2 cups
white sugar
4 cups
nonfat dry milk powder
I've made this a few times and it is a great substitute for the canned version...and much cheaper. I have found that you can get away with about 1 cup less powdered milk and still get perfect results.
This is a great find. I have used this recipe for years. It has saved me a lot of money. I try to make the milk in the morning if I'll need it for dinner. That way it has time to chill and get thicker. I have also used it right away but the consistancy is a little loose.
16 Ratings
A great alternative to when shops are closed!
Ritianne Annalise Galea
Good stuff, thanks! This made a little under 3 1/2 cups. It's a good way to use up that nonfat dry milk I bought for one recipe.
A great recipe. Don't always have money in food budget for the canned variety but do keep dry milk on hand. With this recipe can always have sweetened condensed milk. Have used this recipe for years and always marvel at the ease and convience.
SO easy and MUCH less expensive than the canned version! next time I will use another reviewer's advice and only use 3 cups of milk powder, as this was a tad too thick. Will use again and again!
This recipie is an indispensable, must have! I used it in a homemade icecream recipie and it turned out great. Thank you so much!
worked pretty good, but you have to watch carefully so it doesn't burn.
* Percent Daily Values are based on a 2,000 calorie diet.
Homemade Condensed Milk
Serving Size: 1/4 of a recipe
Servings Per Recipe: 4
Amount Per Serving
Calories: 922
Calories from Fat: 109
Get cute n' creepy recipes to feed all your little monsters.
Fall and winter salads bring bright flavors to your favorite meals.
It's everything you need to cook your best. Learn more about Allrecipes Cooking School.
See how easy it is to make fresh butter from scratch.
See how to make homemade crème fraiche.
See how easy it is to make vanilla extract from scratch.


text:
GreatSchools Rating
Teacher quality
Principal leadership
Parent involvement
Great school. Best elementary school in Vernon. My sons been going here for 4 years now and the teachers have been excellent. My son is doing really well and they provide him homework on a regular basis, and give us tips on what we as parents can do to help our kids. I see parents sending their kids to magnet schools and I dont know why since this school provides already an excellent education.
LSS is an excellent school. I would recommend it to anyone! All three of my children have done very well. The teachers are very involved and caring. The school has high expectations and helps its students to achieve.
L.S.S is a very good school. The teachers and staff are friendly and helpful. If you show responsibility you get more fun oppurtunities. My duaghter was in 5th grade last year and she wants to go back! They went on a feild trip to Nomad's and Boston, MA Believe it or not my daughter is still in touch with her 5th grade teacher thay are caring and offer many programs for giffted kids or kids who just want to have funThey also have a math olympiads program for students who have accelerated in math!! I recomend this school to anyone!!!!!!!!!!!!!!
I find that my children have not only improved educationally but there communication skills and desire for learning has spiked to the top due to the care and concern of teachers and L.S.S. staff, and administartuion.
My sons have both had a good experience at this school. There is good PTO involvement by the parents and a few extracurricular programs. The emphasis at this school is on reading. I think it is a good quality school, although it would be nice to see more challenging curricula given to the students. the flex grouping in the 3rd grade seems to be addressing that issue though.
Community ratings and reviews do not represent the views of GreatSchools nor does GreatSchools check their accuracy or verify the reviewers' identities. Use your discretion when evaluating these reviews.
The Community Rating is the school's average rating from its community members (e.g., parents, students, and school staff). The highest possible rating is five stars; the lowest is one star.
201 Lake St
Vernon, CT 06066
Phone: (860) 870-6085
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text:
Yes, This is a 3D Chocolate Printer
Created by Liang Hao at Exeter University's College of Engineering, Mathematics and Physical Sciences.
Had I known that's what was going on in these departments I would have spent more time in them. — Michael
Take my money now!!!
This is necessary for my life, thank you.


text:
Playing tag~
tumblr will find a way to be offended about anything
it's breeding a generation of people who need to be coddled and protected from life, growing up believing that everyone should hold up a metaphorical sign saying 'TRIGGER WARNING' before anything that might be considered offensive (everything)
Crazy Ideas That Are Borderline Genius [via]
Previously: Useless Things You Don't Need to Know
there u go i did the reverse magic and ur all safe
posting as a link because it's literally the best website ever. you just tell it what ingredients you possess and it flings recipes at you!
well there goes my dinner plans
you know. heterosexual. heterosectional. large couches with several pieces. sectionals. sofa hitting on couch, couch is "heterosectional." couch wants a nice loveseat to hold and cuddle with but sofa is intoxicated and wants a nice choice piece of couch-cushion??? come on now that was my best text post yet don't snuff me out
oh my god i'm fucking sick of this generation's mentality that your sadness is beautiful and somebody will fix you and all this fucking john green shit nobody will find you in a bookstore reading bukowski and want to lie with you and nobody will kiss your scars and you will not be like effie and freddie you've got to be your own fucking hero and surround yourself with positivity
This is a resource post for all the Good White Person™s out there. You know, the ones who say things like "It's not my fault I'm white! Don't generalize white people!", or "I'm appreciating your culture! You should be proud!", or "Why do you hate all white people, look I'm a special snowflake who's not racist give me an award for meeting the minimum requirements for being a decent human being".
Well, if you are actually interested in understanding racism and how it ties into cultural appropriation, please read instead of endlessly badgering PoCs on tumblr with your cliched, unoriginal arguments and repeating the same questions over and over.
On White Privilege
aka don't blame me just because I'm white:
- It's Not My Fault I Was Born White: Basics of White Privilege x
- Racial Divide x
- Endless Examples of White Privilege x
- You Cannot Know What It's Like To Be A Racial Minority x
- Intersectional Feminism x
- White Privilege Does Not Mean White People Have Perfect Lives x
- White Privilege and White Supremacy: A Presentation x
- You Will Never Experience Racism x
- Understanding White Privilege x
- White Privilege and Double Standards x
- Systematic White Ignorance x
- The Invisibility of White Privilege x
- The Luxury of White Privilege x
- White Privilege: The Harry Potter Analogy x
- Privilege Denial Bingo x
- Privilege and Cost x
- Check Your Privilege 101 x
- Whiteness x
- Whiteness is Not A Culture x
- White Privilege and Racism x
- Deeply Embarrassed White People Talk About Race x
- When White Anti Racists Talk About ~Their Struggle~ x
- White Privilege As A System x
On Reverse Racism
aka you are being racist against white people:
- Are White People Racially Oppressed x
- White People, the new Racial Minority x
- People Don't Value Pale Skin!! x
- There Is No Such Thing As Reverse Racism x
- Racism vs. Not Racism x
- But White People Are Discriminated Against In Foreign Countries x
- The Myth of Reverse Racism: Why Cracker is Not N**** x
- Satire: A Step Wise Guide on Being Reverse Racist x
- Racism Against White People vs. Racism Against POCs x
On Cultural Appropriation
aka I'm just appreciating your culture:
- The Basics x
- Identifying Appropriation x
- But When We Wear It … x
- Why Can't I Wear It (Hipster Headdresses) x
- Not Yours x
- If You Take The Bindi x
- White People Do It Better x
- Multiculturalism and Appropriation x
- Cultural Appropriation and Portrayals In Print Media x
- Diminishing the Cultural Significance of the Bindi x
- The Cultural Appropriation Bingo x
- Why We're Fed Up of Your Responses x
- Identities Are Not Costumes x
- Hinduism And Appropriation x
- Religion and Privilege x
- Bindis Are Cool x
- Exotic India x
- What's Wrong With Cultural Appropriation x
- Racism, Bindis and Ganesh Tattoos x
- BUT YOU'RE SPEAKING ENGLISH! x
- Cultural Appropriation Trolls x
- Guide to Being An Appropriating Douchefuck x
- New Age ~Culture Mixing~ x
- In case you're tired of the prose, here's poetry x
- Why You Shouldn't Wear A Bindi x
- Appropriating and Sharing x
- Our Culture is A Punchline Until It's a Trend x
- Homage Or Insult x
- Tattoos and Appropriation x
- Bollywood is Not Synonymous With Indian x
- College Party Costumes and Stereotypes x
- Dotheads x
- Bindis and Racist Humour x
- Hindu Iconography x
- Misuse of Hindu Iconography x
- Your Appreciation Doesn't Help Us x
Assorted Vials of White Tears and Miscellaneous Antidotes
aka I can't change that I'm white/not all whites are racist/we are all humans:
- Unoriginal Arguments Refuted x
- Quick Checklist: You Might Be Racist If x
- Your Opinion Isn't Necessary x
- I'm Not Responsible For My Ancestors x
- The Kumbayah Myth x
- Proud to Be White x
- Good White Person x
- We Don't Hate White People x
- Brutality of Colonialism And Why You Can't Tell Us To Forget the Past x
- People Who Claim Not To See Race Are More Likely to Be Racist x
- All Races are Beautiful Said the White Girl x
- Race Blindness Is A Luxury x
- Well, You're Racist For Calling Me Racist x
- I've Read About Its Significance, I Know What It Means
- Angry Because Someone Called You Racist x
- We're Not All Like That x
- People Only Care About This Trivial Shit On The Internet x
- I Can't Apologize for Being Born White, It's Not My Fault x
- Why Can't You Tell Me What I'm Doing Wrong x
- It's Easy to Be Color Blind When You're White x
- A Diagrammatic Guide To White Tears x
- Conversations I'm Sick Of Having With White People x
- Why Do You Hate White People x
- I'm Trying To Be Cultured x
- Sisyphean Conundrum x
- What is Your Problem x
- We Are All Human, We All Bleed Red x
- It's Just A Bindi x
- How Not To Respond To Accusations of Racism x
- I'm Italian And 0.009% Native American x
- What White People Think Racism Means: A Venn Diagram x
- White Guilt x
- White Pride!!!111!!! x
- I Like *Insert Foreign Country* I Want To Live There x
- You Have So Much Hate, Fighting Fire With Fire Won't Help x
- BooHoo, Don't Call Me Racist x
- Not Everything Ended With Your Ancestors x
- The Racist Reaction x
- I Don't See Why That Is Racist x
- Crummy Apologies x
Okay. I agree. I've been socially conditioned not to notice racism and recognize my privilege. What can I do?
I don't care about this bullshit; you're making a big deal out of nothing, go home and delete your blog:


text:
London increases lead in foreign exchange trading as global turnover drops seven per cent
Related fund data links
The UK accounted for 37 per cent of global foreign exchange trading in October 2012, according to figures from TheCityUK.
Its estimates are based on individual surveys of foreign exchange activity released by central banks in the UK, US, Japan, Australia, Canada and Singapore.
The UK's share of global foreign exchange trading was up slightly compared to the previous year, and well ahead of the US (17 per cent down from over 19 per cent a year earlier), Japan and Singapore (with six per cent each). London accounted for the bulk of the UK's daily turnover averaging USD1,919bn in October 2012.
TheCityUK estimates that average daily global turnover in traditional foreign exchange market transactions (spot transactions, outright forwards and FX swaps) totalled USD4.4trn in October 2012, down seven per cent on the previous year. Despite the fall over the past year the volume of foreign exchange trading is on a long term upward trend, a result of the growing importance of foreign exchange as an asset class, the proliferation of electronic trading platforms which is making it easier to access this market, and an increase in global fund management assets.
Chris Cummings, chief executive of TheCityUK, says: "Twice as many US dollars are traded on the foreign exchange market in the UK than in the US, and more than twice as many euros are traded in the UK than in all the euro-area countries combined.
"Foreign exchange is the most traded financial market in the world and today's figures show that London is capturing a growing share of this market. The UK's strong international position is a result of trading generated by prime brokerage, investment banking and hedge funds, three areas of activity that are important to London's position as a global financial centre."
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NAPLES, Fla. - Police say a Naples man went on a stealing spree, stealing from a neighbor's home and several home goods stores.
WINK News is learning he may have stolen items to stock his own antique store.
"Talk, have coffee, everybody sits and enjoys the table," Anne Cooper says of the wrought iron table and chairs that sat outside her show room on 3rd Avenue North for the last year.
"She went out to water the plants and my assistant Annie says where are the table and chairs?"
Not only was the furniture missing, but a 100 pound pot of flowers that Annie was about to water was gone too.
Anne Cooper Interiors wasn't the only one missing stuff. Two Adirondack chairs were stolen from Whitman Designs next door.
And down the road...
"Do you notice something missing? And it was the concrete fruit baskets which weigh, I'd say about 70 pounds," Brenda Little at Twigs tells me.
The owner of Twigs, along with the other shops, called police.
Authorities got a tip they could find the goods at Regan Reed's house on 4th Avenue South. When they searched the property they found most of the merchandise in his front yard. Many pieces had been painted to disguise them.
"I had heard he had gathered all these things up actually to sell, to open up a store, or a shop," Little tells me detectives informed her.
A neighbor, who recently reported Reed for stealing money and a birdbath, tells WINK News Reed was outside painting furniture day and night.
He says Reed has a booth to sell items at Shirley Street Antiques.
The owner of the antique store says Reed did have a booth there, but police came and took items from it on Friday. He says he had no idea some of the items may have been stolen.
Reed is currently in the Naples jail on several theft charges.


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I love this, easy to blend, perfect tan colour and it looks so natural.
Perfect for summer and winter.
More reviews by Matilde_5_11_77
This product is not superior to Wet n Wild matte bronzer 701. The color, while natural, is simply too dark. The texture is nice, however.
The colour of this doesn't have any or very little sparkle in it so it looks really natural for daytime. You have to be quite careful putting it on or it can look dirty, but if I wait until moisturiser has soaked in and foundation is dry (if I bother with it) and use a massive brush it looks so natural. Somebody said I looked like I'd had two weeks in Spain.
I am a bit worried about the packaging as its only cardboard and has already scuffed.
More reviews by TOASTEDPUMPKIN
Hoola is such a unique product. It gives me and instant tan. Looks super nice after you've tanned...apply on your face and/or body and it really deepens your glow! The brush seems to distribute just a little too much...so either blow it off after swiping...or use another brush.
I made the mistake of buying this on impulse without trying it on first. The packaging was adorable. Got home, tried it on, and tada! Muddy cheeks. This was returned.
This is one of the most natural looking bronzers i've ever used. It made my NC25 skin looked like I just came back from a tropical island or something. I don't use the brush that comes with the package though, I think that it is key to use a softer and bigger blush brush to get the natural look. After using this product, I really want to try their Dandelion.
This is way too dark for my PPP-LLL complexion, so a no-go for me. The packaging is cute though- even though the little brush makes the powder apply all uneven and streaky. The powder isn't as fine as other bronzers either- I prefer Stila or Becca.
I really like this stuff gives you a golden tint and is quite subtle - not glittery and garish or too brown. you need to blend it though because otherwise you are left with a big brown square on your face. have had mine for ages and even though i regularly wash the brush it stinks a bit. hmmm i think that might be just me??but this is great for my pale skin
This is anoth hit for benefit!!! It's quite expensive but it lasts for ages, i've had mine for 6 months and use it every day. It relly does give me a tan!!! whenever i feel a bit pale and sickly(which is everydy) i just lightly dust it over my face and look like j-lo(well near enough). The brush that comes with it isnt very good though. i would stick to a normal bronzing brush
1 out of 1 people found this review helpful. Did you? Yes No
This is one of my must-haves. It looks totally natural on my PPP-FFF skin. While initially it does seem to go on streaky and dirt-like, it is so sheer that a few blends with your hands and -voila- you look perfect! When I don't want to use foundation, all I need is a bit of this and my skin looks so much better. Highly recommended.


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Comes with anyone tried this online business jobs? Can most people make money advisors or are all of them scams? Have you ever in your life known anyone to work from your home and make $ each week looking at message or doing details entry? I enjoy a friend that works at your house. He has the lab in his basement and she or he makes dental lamps and dental kitchen appliances. He supplies a huge number of dentist's around the land. His lab certainly would not look like a fabulous basement; very high quality and well lit operation. He's got justassistant and everything is to the level. Other as compared with him, I find out of nobody better. I have somebody that works at y 10 day weather uk our home He's a blogger. I can do business from home. I can remote control into my work computer from their home. Mostly do it pictures dont want to ride to figure or have to wait patiently for a shipping and delivery. Weekends are always do business from home. No way I'm going into the office on the weekend. Work at your house jobs I believe that the question, good replies, is confusing. If you are mentioning advertising for "work out of home", I have looked into that and the majority of are scam. They just wish their fees and you simply are left unclothed. However, as for working from your home, this is a common trend now. I run the financial business from my home office generally. I have an effect how to cook turkey neck ive computer network the fact that ties me towards the market and anyI must connect to. I even occasionally meet clients at my home ofice (I don't counsel that with new potential, since image is critical and still lots of people don't appreciate that). I have basiy no proble running business at home office but you must organize your effort and run it in the form of business. seattle art store
now... just got job as a support ser kevin jones snowboarder vices rep for a strong e-commerce company. I'm wondering what's the right option to take in case I happen for any or email right from someone I eventually know, like your former boss, classmate from college, or neighbor? Does an individual identify myself covering the phone, and express "hay, Jill, fresh salmon recipe this really Vicki. omg, how presently? " Is this considered professional? What wouldn't you do? it's just simply something I'm questioning about. how long are cross country skis
Do i need to or Shouldn't I After years associated with marriage, my not long ago divorced sister is entering the working world. She had jobs on and off (mostly off) while married. She ed everybody today all excited to express to me that all the temp agency she went to told her she scored the highest scores and so they would have basiy no trouble finding her organization. Should I burst her bubble and also tell her these say that towards everyone so your woman doe antique stoves restoration sn't get aggravated? Her last job was about yrs ago. I wouldn't burst open her bubble if completely recenlty divorced, amount s of these to burst a bubble around the temp agencies. it's possible that... just maybe this temp agent will get her something. I know it's really a long shot, but I don't think kicking people while there're down. anmar bath oil
Volvo I took on hard, too rapidly, coming out of a parking spot close to the curb along with scrapped a hose that's towards the bottom front of my personal car. The line is gray and reinforced. It wasn't a truly tall curb, as a result no puncture, and even everything works fine. But the reinforment threads got a horoscope for virgo 2005 bit shredded so wish to replace it. Is this a basic fix? Any ideas on cost utilizing a mechanic? stop driving a car now before its too late for the purpose of youJust wait until he's on the rd bottle associated with hooch and he'll keep returning and tell most people more (probably with his jwt handle). pizza frenzy game online
This really all's mistake. It's really Bush's fault. ^Still sucking's cawk! Its Bernanke's fault - he will be a bankster Some robust and self-sustaining. recovery is absolutely not on the greeting cards, and we really should now expect underneath trend growth for years to come, as reported by Nouriel Roubini, typiy the economist famed pertaining to his bearish landscapes. "Even this calendar year, the consensus started using it wrong, expecting a recovery to annual GROSS DOMESTIC PRODUCT growth of compatible with percent, " your founder of Roubini World-wide Economics wrote. "And nowadays, after getting the 1st half of bad, many are repeating the story book that a blend of lower oil values, rising auto income, recovering house price ranges, and a resurgence of. manufacturing will boost growth in your second half in the year and gasoline above-potential growth by. " Roubini is convinced the. economy will slow further the year 2010 and next as expectations in the "fiscal cliff" maintain spending and advancement lower - and uncertainty about the outcome of any presidential election k-9s markets. The fiscal cliff could knock p'cent off growth in the event that all tax sizes and shapes and transfer payments were permitted to expire and shelling out cuts where generated, according to Roubini. "Of path, the drag could be much smaller, as tax increases and spending cuts could be much milder. And yet, even if all the fiscal cliff actually is a mild progress bump - merely a percent of GDP - and annual growth towards the end of the year is only percent, as would seem likely, the budgetary drag will be sufficient to slow any economy to wait speed: a expansion rate of seldom percent, " they wrote. The. potential customer, which drives a good amount of the global economy as well as., will not be capable of keep spending the moment $ billion worth of tax cuts and extended transfer payments come to an end in line with Roubini. "In, as transfer payments are eliminated, however gradually, as some tax cuts are allowed to expire, disposable cash flow growth and ingestion growth will impede. The. will then face not simply the direct effects of an fiscal drag, but more its indirect influence on private spending, inches he wrote. The down sides in the dinar zone, a slowdown throughout China and appearing markets, added on the chance that oil prices may be driven higher just by tensions over Iran's nuclear program, will also help to increase America's economic obstacles, Roubini argued. He warned the Fed is definitely not able to ride on the rescue this time. arizona quail hunts
BE WARY!! Admin position throughout Doylestown, PA Possibly be WARNED! Admin status in Doylestown!!! < kellyd > Please be warned of any company looking to engage an administrtaive assistant for just a public adjuster's clinic in Doylestown. The owners on the company are heartless and greedy; they you should never care about their employees or perhaps their clients. Once you know of anyone who�s concidering using any public adjuster to manage a claim for them, tell them to stay clear of any PA's inside Doylestown. There's I worked due to this company for many months and couldn't afford to shell out my bills, I'm 1 mom with of course, if I asked for just a raise, they shot me. Heartless! Used to do excellent work in addition to loved my occupation. They just let go me because I told them I'd really like more money well, i can put food revealed for my sweet little babies. They have a home in a $, house them to got by ripping off unknowing homeowners who want to them for allow. They run some sort of scam and its life and fortune is made upon sleazy, money grubbing immorality. The owners from this Adjustment Group are couple who met at the previous adjustment business enterprise, owned by your ex ex-husband. Theones had an affair then stole the girl husband's client trust and totally screwed your man over, starting his or her company. I am wholly disgusted by this whole experience not to mention appreciate the forums here to tell other innocent those who find themselves desperate to earn a living. Some people though just is not to be trusted. Be warned connected with Public Adjustment Groups with Alliance-s in Doylestown. Never allow this happen to you personally. Email me if you wish some real dirt on this pair of scumbagsyes, we experienced it before. i thought consumer adjusters are purported to help people to never get ripped-off by insurance carriers? how does of which work? bath portable spa
Maybe you have been on a new bus? or a minimum of walked past a new bus stop? Wait around, what am My spouse and i saying? SF_Bag doesn't even walk towards the mailbox. Have you ever driven any rascal past a new bus stop? okay, next part in the story So I am sitting there inside font seats of the bus with my crochet at your fingertips (I have lately arrive at crocheting bright blue masons tie-line while Now i'm on mass transit) and I'm listening to this fight between the driver and non paying passenger of curiosity up so I look up and the no paying passenger is tall bearded man with a headcovering that will be either muslim and ganglands or manner, I can't tell anyway he sits down and it is about to commence eating his breakfast so I intercede and say in the most proper English I'm able to muster "excuse me personally Sir, there isn't eating or swearing on the bus, no no, you mustn't claim in public" and also to the dazed expressions of the bristling men which will fill the shuttle on either aspect of me, We add "its just not propah" grumbling echoes close to, the non paying out passenger folds together his breakfast along with doesn't eat this, this saving himself a $ ok (thats the okay for eating on the bus in LA) then an older man steps together and says "excuse me young lady, you should just back outta this" as well as I say "no". maps for gps
Think these people are up to scamming? Ad in Phx Administrative section: "Our company is undergoing an enormous internet related undertaking, which brings us looking for an employee to generate email accounts together with the addresses of stimulate. com, live. com, google. com, aim. com, aol. com, etc. We are seeking those people who are internet savvy, and incredibly familiar with producing email accounts with all the major internet businesses. We will have got additional data entry related duties for any assistant once this phase with the project is carried out. This will even be a Part Time placement, hours per working day, days per weeks time, at $ an hour or so. "They'll use those created makes up about spamming, correct? Why not send out them e-mails of inquiry to see how they respond to the real world. They will utilize the accounts to con others and when you do the shit visits the fan the authorities can look to the creator belonging to the accounts (you). Oops! (or maybe you may create them avoiding others from having the ability to trace them back - but a lot of people wouldn't know generate income think). I continue to say, send these folks innocent e-mails. Nicely... I took my own loss on Sketchers VSE video game trade today.... geeze dropped % of my own VSE dough.... right down to about K It's going to probaby bounce down the road... but there are usually some mighty shorts because stock... Hadbottle expected earnings... and still couldn't stay right up... Dog plus Unicorn = UniDog?? Would have been a great short..... Sorry For the Loss God, I should know anything better about precisely how to beat industry (I don't) but it surely would seem this when you hypothesise, you do the application gently. If this pays off, then you definitely reinvest your benefits again gently and await the moment, and so on. Even Apple can't indefinitely proceed winning before it tanks for some time. Then recovers. Diversify; end up being gentle, take more advisable risks. specialty food market