text:
Top Medicare Prescribers Rake In Speaking Fees From Drugmakers
Pay-to-prescribe is illegal, but doctors
say they haven't been influenced by the money they get for promoting
drugs they also prescribe to large
numbers of their patients.
This story was co-published with NPR.
When the blood pressure drug Bystolic hit the market in 2008, it faced a crowded field of cheap generics.
So its maker, Forest Laboratories, launched a promotional assault on the group in the best position to determine Bystolic's success: those in control of prescription pads. It flooded the offices of health professionals with drug reps, and it hired doctors to persuade their peers to choose Bystolic — even though the drug hadn't proved more effective than competitors.
The strategy worked. In the 2012 fiscal year, sales of Bystolic reached $348 million, almost double its total from two years earlier, the company reported.
Now, data obtained and analyzed by ProPublica suggest another factor in Bystolic's rapid success: Many of the drug's top prescribers have financial ties to Forest.
At least 17 of the top 20 Bystolic prescribers in Medicare's prescription drug program in 2010 have been paid by Forest to deliver promotional talks. In 2012, they together received $283,450 for speeches and more than $20,000 in meals.
Nearly all those doctors were again among the highest prescribers in 2011, the most recent year for which Medicare data are available. Forest began disclosing its payments only last year; the company didn't specify which drugs doctors spoke about.
Dr. Bernard Lo, who was chairman of a national panel examining conflicts of interest in medicine, said he doesn't believe the findings are coincidental.
Top Bystolic Prescribers
Below are the top 20 prescribers of the blood pressure drug Bystolic in the Medicare prescription drug program in 2010, as well as the speaking fees they received from maker Forest Laboratories in 2012. Forest only began reporting such information last year. Some of the prescribers below also may have received meals, educational items or travel expenses from the company.
|City, State
|Bystolic prescriptions
in 2010
|2012 speaking fees
|Mark Barats
|West Hollywood, CA
|Antonio V. Baute
|Marietta, GA
|Michael Dao
|Garden Grove, CA
|Shawn Dhillon
|Baltimore, MD
|$2,000 and $18,500
|Tao Duong
|Westminster, CA
|Eleonora Fedonenko
|Los Angeles, CA
|$3,750 and $1,250
|Jinesh Gandhi
|Phillipsburg, NJ
|Dannis Hood
|Ringgold, GA
|Moses Hyun (Deceased)
|Los Angeles, CA
|David Kavtaradze
|Cordele, GA
|Yousif Mansour
|Southfield, MI
|$1,000 and $12,750
|Sima Muster
|Brooklyn, NY
|Thanh Nguyen
|Garden Grove, CA
|Zhaoyang Pan
|Los Angeles, CA
|Hew Quon
|Los Angeles, CA
|Gary Reznik
|Los Angeles, CA
|Alexander Salerno
|East Orange, NJ
|$1,250 and $11,250
|Adel Sidky
|Boynton Beach, FL
|Steve Tam
|New York, NY
|Henry Yee
|Alhambra, CA
* The prescriptions attributed to Hew Wah Quon include 1,396 attributed to the doctor himself and 594 credited to his medical practice.
When there's no evidence a drug is better, "You have to question: Why are doctors prescribing this?" said Lo, president of the Greenwall Foundation, a New York City nonprofit that funds bioethics research. "What your evidence suggests is that there is a financial incentive for doctors who receive payments from drug companies" for pitching their products.
Until now, doctors' prescribing habits have been secret from all but pharmaceutical companies, which pay millions of dollars for such information from other firms that collect it.
ProPublica's analysis marks the first time anyone has matched payment data made public by drug companies with physician prescribing records from the Medicare drug program, which covers about 1 out of every 4 prescriptions in the U.S.
(Readers can search for Medicare prescribers in our Prescriber Checkup news app and for drug company payments to doctors and other health professionals in Dollars for Docs.)
Reporters identified the drugs that were most actively promoted to doctors in 2010 and 2011 using rankings from Cegedim Strategic Data, a company that tracks marketing expenses.
The top prescribers of some of these drugs, in addition to Bystolic, also received speaking payments from the companies that made them. As a group, these heavily marketed drugs were new or had new uses, were expensive and often showed little benefit over existing medications or generics.
For example, 9 of the top 10 prescribers of the Alzheimer's drug Exelon received money from Novartis, the drug's maker. Eight of the top 10 for Johnson & Johnson painkiller Nucynta were paid speakers, as were 6 of the top 10 for Pfizer's antidepressant Pristiq.
The same was true for 7 of the 10 top prescribers of the asthma drug Advair Diskus, made by GlaxoSmithKline. One doctor made more than $100,000 from 2009 to 2012.
Many of the physicians spoke for several drug companies.
If financial relationships influence physicians to choose pricier brand-name drugs that have little benefit over generics, everyone pays the cost – particularly taxpayers, who spent $62 billion last year subsidizing Medicare Part D.
"I've never heard a doctor that said they were influenced, but obviously the companies are interested in doing it because the evidence overwhelmingly suggests that doctors are influenced," said Rita Redberg, a cardiologist at the University of California, San Francisco, and editor of the journal JAMA-Internal Medicine.
Companies are "not doing it for any reason except it improves their bottom line," she said.
A survey published in the Archives of Internal Medicine in 2010 found that physicians with industry relationships said they were more likely to prescribe a brand-name drug when a generic was available. And federal whistle-blower lawsuits against several pharmaceutical companies have alleged that payments are little more than thinly veiled kickbacks, which are illegal. Companies have paid billions of dollars to settle the cases.
Each of the top 20 prescribers of Bystolic wrote at least 530 prescriptions in Part D in 2010. ProPublica attempted to contact all those who also received money from Forest. Only a handful responded to phone calls, emails and faxed letters requesting comment.
The No. 1 prescriber of Bystolic, Los Angeles cardiologist Gary Reznik, said that if patients have blood pressure under control with another beta blocker, he doesn't switch them. But he believes Bystolic is more effective at lowering blood pressure and doesn't cause the slower heart rate and erectile dysfunction of other drugs in the class.
"If you don't have to be on a beta blocker, I would not start you on a beta blocker," said Reznik, who was paid $3,750 to give talks by Forest in 2012. "If you have to have a beta blocker, Bystolic would be my choice." Reznik prescribed the drug more than 2,500 times in 2010 and more than 2,900 in 2011, including refills dispensed, Medicare records show.
"I have never felt that there were any expectations or pressure on the part of the company that I would prescribe it more or at all," he said.
Another top prescriber, internist Mark Barats, of West Hollywood, Calif., said he uses smaller doses of Bystolic to achieve the same effects as higher doses of generic medications. "It has much less side effects, particularly much less side effects on the respiratory system," he said.
"I've never seen anything that contradicts what Forest said about Bystolic," said Barats, who was paid $3,750 to speak for Forest in 2012.
Dr. Henry Yee, who was paid $5,000 by Forest, said he chooses the drug for many of the same reasons as Reznik and Barats. The cardiologist, whose office is in the Los Angeles suburb of Alhambra, said he learned about the drug from company sales reps and from reading studies. He started prescribing it "even before I started speaking for the company," he added.
Yee said he believes drug companies ask him to speak for their products because is an influential specialist in his community. "I think it is most likely because a lot of doctors listen to me," he said.
Among the 17 top prescribers with Forest ties, speaking payments ranged from $1,250 to $85,750. Seven doctors also received at least $1,000 in Forest-paid meals.
But several prominent cardiologists say no studies have proved that the benefits cited by Bystolic's top prescribers are real. Dr. Steve Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, said he understands why doctors would like to believe that the beta blocker has additional benefits. "Wishing it to happen isn't the same as proving it," he said.
In 2008, the U.S. Food and Drug Administration rebuked Forest for an ad claiming the drug was "novel" and superior to other products. The FDA said the claim wasn't factual.
"I don't see any purpose for Bystolic whatsoever," said Eric Topol, a cardiologist and chief academic officer of Scripps Health, a San Diego-based health system. Topol said he doesn't use the drug because it is expensive with no added benefit. "I have no idea how you could come up with a storyline for use of that drug."
Bystolic costs about $80 per month, compared with less than $10 for a generic cousin, according to Costco's pharmacy website. (Patient copays vary by drug plan.)
In an email, a Forest representative called Bystolic "an important treatment option" because it is effective and well-tolerated but didn't assert that the drug was superior.
Forest also defended its spending on physician speakers. The company "believes that patients benefit" from paid talks and other initiatives that "enable health care professionals to stay abreast of the latest treatment options available," a representative wrote.
Three years ago, Forest paid the government $313 million to settle civil and criminal allegations about its marketing of drugs, among other things. In its lawsuit, the government alleged that Forest made "cash payments disguised as grants or consulting fees, expensive meals and lavish entertainment, and other valuable goods and services" to doctors.
Forest denied those allegations despite settling the case.
More recently, in a lawsuit unsealed in April against the drug company Novartis, the U.S. government alleged the company's "own internal analyses showed that speaker programs had a high return on investment in terms of the additional prescriptions for its drugs written by the doctors who participated in the programs, both as speakers and attendees, with the highest return arising from payments to doctors as 'honoraria' for speaking."
Novartis disputed the allegations. In 2010, the firm pleaded guilty to a misdemeanor and paid $422.5 million to settle allegations that it illegally promoted Trileptal, an antiseizure drug, and paid kickbacks for prescribing it and other drugs. Trileptal isn't frequently used in the Medicare population.
Forest, Novartis and other drugmakers said they choose speakers based on their expertise and credentials.
Pfizer "explicitly prohibits the selection of speakers based on their prescribing behavior ... any inference to the contrary is misleading," a spokesman wrote in an email. Glaxo and Johnson & Johnson also said they don't choose speakers based on prescribing.
The spending by pharmaceutical companies on speaking and consulting fluctuates based on whether they have new drugs or are marketing older ones for new uses.
To date, only 16 companies have publicly reported their payments to physicians. All companies will be required to report such payments next year under the Physician Payment Sunshine Act, a part of the broader 2010 health overhaul law.
Boehringer Ingelheim Pharmaceuticals, the maker of the blood thinner Pradaxa, began reporting its payments just last month. Pradaxa, introduced in 2010, accounted for more spending on local promotional events than any other drug in 2011, according to Cegedim Strategic Data. Of the top 20 prescribers in 2011, six received speaking fees in the first quarter of this year.
Boehringer said it doesn't pay speakers based on prescribing.
The physician prescription tallies in this story are from Medicare Part D records in 2010. Recently obtained data for 2011 show similar patterns, however. The prescription counts don't include drugs paid for by other parts of Medicare or for patients with private insurance, on Medicaid or in the Veterans Health Administration system.
Some doctors say the drug company money can undermine patients' trust.
Nissen of the Cleveland Clinic said: "I don't want the patient sitting opposite to me in the exam room to have to worry about whether I am prescribing a drug because I am being paid by the company that makes the drug."
Correction, July 3: The original version of this story incorrectly said the blood thinner Pradaxa accounted for more spending on promotional speakers than any other drug in 2011 and attributed that to Cegedim Strategic Data. Pradaxa actually ranked first for spending on local promotional events, including meeting venue, speakers fees and catering, according to the company, which doesn't track spending on speakers alone.
35 comments
I think it's pretty unfair to automatically assume that a doctor that prescribes a medicine only does it because they pay him to speak. What if the doctor used the medication for a patient and found it to be good and then spoke for the company? I workin healthcare and although some generics are just as good there are some brand name drugs that patients respond better too. There are also some drugs that should not be given as generics as they affect patients health such as Coumadin or birth control
The issue to my mind is not generic vs. brand, but preferring to prescribe brand over generic because doctors are being paid to do so. Any good doctor would explore the potential side effects and health complications arising from any particular drug—sometimes a generic will be better, other times a brand will be. But if some doctors are truly being paid to prescribe not for the patient but for the pharmaceuticals, then how can that inspire full patient confidence? Not like this is happening with all doctors obviously, but the fact that it is happening at all is a problem.
A physician's job is to advocate for his or her patient, not drug companies. Since there is an inherent conflict of interest between healing and dealing, doctors who take payments from pharmaceutical companies should expect their motives for prescribing one drug over another to be called into question.
Drug companies have fiduciary obligations to their shareholders, but physicians have ethical obligations to their patients. It is in the best interest of drug companies to dispatch their armies of pharmaceutical sales representatives to doctor's offices all over the country to offer them incentives to earn, for instance, by speaking. The data that drug companies provide these physician speakers, however, is not regulated, and in some cases it is deliberately misleading. When doctors, who are supposed to represent people we should trust, give speeches to other doctors in which they knowingly or unknowingly spread misleading data, they contribute to a change in the prescribing practices of their audiences over time that benefits the drug companies.
As patients, we should not have to worry about whether our doctors are being tempted by offers of cash payments, extravagant dining, etc. We should be able to rest well at night feeling like we know that our doctors are prescribing us the medications that are in our best interests, not theirs, and certainly not those of the drug companies'.
April, as Meghan points out very well, it's a conflict of interest, whether or not it's an explicit wrongdoing. A lawyer, for example, isn't allowed to take your case against a company that employed her. It shouldn't be too much to ask that a doctor not be beholden to anybody but the patient. Nobody should have to question whether his doctor is trying to protect an investment.
I would be interested to see what percentage of these same prescriptions were actually filled with the brand vs a therapeutically equivalent generic. With many states having legislation that requires or allows the dispensing pharmacy to switch Rx unless expressly forbidden by provider this may actually be less an issue than it might appear.
I would bet that if you were to ask your Dr for the name of a therapeutic for heart disease or UTI or ED they can give you a couple names, then ask them if they know the name for a generic equivalent, I wouldn't be surprised if they come up blank…but they probably know you'll get the generic even if they write the brand.
So is it really wrong/conflict of interest for a Dr to take $$ from a pharmaceutical company if they know writing the brand on the Rx really doesn't matter?
It is absolutely a conflict of interest, I was married to a prescriber and the "unknown" incentives he received was mind blowing to include having boxes and boxes of meds delivered to his home address, this practice is shameful and only serves the drug company and the persons getting the incentives, definitely not in the interest of the patient.
Yes, it is a conflict of interest. Pharmaceutical companies purchase data from pharmacies so that they can analyze the prescribing behavior of physicians. Drug reps then initiate contact with physicians and work to manipulate prescribing behavior for the sole purpose of profit maximization.
Drug reps specialize in sales, not medicine. They are trained to sell product; they receive performance-based bonuses. If I am in the market to buy a car I'm not going to do my research at the dealership and simply take the word of the person who is trying to sell it to me in order to put food on his table; he or she doesn't have my best interest at heart. I'm going to read Consumer Reports, compare different makes and models, and generally know the facts before I go shopping so as to make an informed decision. Likewise, doctors can and should consult peer-reviewed journals for input on efficacy of medications before prescribing them. They needn't and shouldn't be influenced by salespeople to do their jobs effectively.
My doctor has a simple solution: He refuses to meet the "detailers," which is what drug companies call their sales people. And when he reads articles in medical publications about drugs, he will write to the author to find out if they receive payments from drug companies. Finally, when writing a prescription he always checks the "generic equiv." box on his pad.
Thank you Meghan for your regurgitation of a host of tired arguments. Just because a doctor gets information from a drug rep doesn't mean it is his/ her only source of information. However, time is tight for most clinicians and it is often easier to initially hear about a product from a drug rep who is paid to tout their latest wares. The information they receive is some of the most highly regulated in the world (FDA applies the same balance standards to drug rep-doctor encounters as it does to labeling). It is far superior to anything you could get from a car salesman, unless they were suddenly required to give you the "CarFax" report when buying a used car, and even then it really isn't comparable to FDA labels and off-label liability.
They are very restricted in what they can say. Now, April certainly has a point about the chicken and egg question regarding speaking and the drug in question. Lance also raises a good point about the important role of generic substitution by pharmacies. However, at the end of the day we need to put things in perspective. These are the top 20 prescribers out of millions. They are an extreme case and cannot be assumed to represent a larger pattern. This is just inflammatory table thumping. Perhaps these doctors did something wrong, perhaps they just relied heavily on generic prescribing. Such a superficial analysis tells us very little. You would have to audit their patient charts to get real information. In the big picture though, it doesn't matter what the top 20 prescribers do, they are just 20 of millions of prescribers. Their actions are necessarily limited in scope.
The other point worth mentioning is that people tend to prescribe what they are most familiar with, this is a simple availability bias. They may then rely on generic substitution for many of their patients. The basic facts are that most prescribers rely on an outdated prescribing core dating from around the time of their residency, they change relatively few drugs over time because their "clinical inertia"leads them to avoid prescribing unfamiliar products, rightfully so, however, after a point this becomes a ridiculous practice as many docs end up prescribing woefully out of date medications. Many more would invariably do so if detailing did not exist to let them know, conveniently, about new products. They can then opt to be as aggressive or conservative as they want in trying these new products. The benefit here is that they actually hear about them. If you just leave them with medical journals and the amazingly scarce academic detailing, most of them will never learn about new products because they are too absorbed in the practice of medicine. Detailing and speakers bureaus are a good way to break that inertia.
The information they receive is some of the most highly regulated in the world (FDA applies the same balance standards to drug rep-doctor encounters as it does to labeling)
right ;-)
Interesting to peruse the list of uber-prescribing doctors in this article.
Anyone notice the plethora of foreign-named doctors? Evidently they have learnednthe American way of getting rich. Since we don't do open bribes as readily as they would in their home countries, they adapt.
This article speaks nothing about what % of the time they use a particular product. So what if a doctor used a product 234 times if this represented only 3% of all prescriptions he/she prescribed. The % of utilization of a specificproduct within a drug class would tell you whether there is true influence of prescribing. Based on numerous studies and articles I have read, 85% of all prescriptions filled in the US are for generics and pharmaceuticals account for just $.13-18 of every health care dollar spent. If we truly want lower health care costs and better value for our health care dollar it seems like we are looking in the wrong direction.
I only have my doctor order me generic medications.
Opinions: Doctors should not receive any money from drug companies, for any reason? When people pay this type of money, they are expecting favors? Doctors need to make careful diagnoses, without any outside influences? Thank you.
As long as they are not harming the patienets, it does not matter. Any way Dr. and Drug maker relation is no different than the relationship between Congressmen and Special Interest Group. At least in case of Doctors and drug maker the relationship is transperent but not so when it comes to the lawmakers and the special interest group.
The whole pharmaceutical industry is based upon manipulated clinical trials. It is scary to think about how many people owe their jobs to fraud.
How extensive is this problem, in reality?
As a Senior Citizen who has multiple pain issues, and is outraged at the new Federal bureaucratic requirement that chronic pain patients, like myself, MUST participate in a pain management group in order to continue receiving opiate pain medications, I find myself comparing this issue to Gun Control: "Let's outlaw guns, then: only outlaws will carry guns!"
Because of the new Federal pain medication management requirement, my primary care physician will NOT prescribe an opiate pain medication unless I participate in one of these groups. Ironically, I'm an individual who is medication-aversive, and am continually reminded by my husband to take my meds: "You're getting irritable, honey…."
How many physicians (like mine) are now actually quite conservative about writing pain med. prescriptions because of extant federal mandates—compared to the few who are illegally profiteering? Let's not tar-and-feather (and possibly professionally hamstring?) all physicians for the abuses perpetrated by a relatively minuscule few.
And finally, last but not least: what might be the possible negative consequences for the unfortunate Medicare consumer—like me—of any universal policy changes, and/or actions taken against possibly, and I emphasize "possibly," inappropriate "Medicare Prescribers"?
MS drugs have got to be the worst ever. Many are very dangerous indeed and pharmas for decades have made trillions from. Its so easy to work out whats going on and no one is brave enough to investigate and write up on the real truths
David, presumably, you're also OK, then, with lobbyists contributing millions to reelection campaigns, sending politicians on vacations, and giving them high-paying jobs when they're out of office, since it's entirely possible that they'll accept all these things and still vote in the interests of the constituents.
If the drug companies weren't getting a benefit, they'd eliminate the programs. Therefore, if the drug companies continue the program, the doctors are biased by it. You can claim that it's harmless fun and marketing, but the math doesn't add up to that conclusion.
Maryann, nobody in their right mind advocates getting rid of drugs. Drugs, when prescribed correctly to the right people, are invaluable. The objection this story raises is that doctors are being paid to "know about" some drugs more than others. If you're not the only one paying your doctor, how do you know he's looking after your interests first?
Keep in mind that Pfizer, when their Lipitor patent was running out last year (year before?), tried to convince the chain pharmacies to fill generic prescriptions with Lipitor anyway (over the doctor's instruction) in exchange for letting them pocket some of the difference. To their credit, most pharmacies refused, and the publicity seems to have killed the "promotion."
But that's the sort of thinking we're dealing with. Whether their drugs help anybody isn't the issue, it's whether the right drugs are being prescribed or if some doctors are more interested in keeping the "marketing" going than healing the patient.
If someone was brave enough to investigate all the MS drugs and see all the ones that have killed many with MS at very young ages they would be alarmed .So many have made profits , shares and commissions on aswell as very high salarys for promoting many MS drugs . 100s of thousands in the UK alone are part of
I've noticed the label on some of my meds recording my primary care physician who has prescribed the drug but also the name of the drug rep. From a family member physician I learned that it is common for drug reps to pay for catered lunches for their client physicians and office staffs. In fact, according to the family physician, so much food was left over from the catering and the food was so good (expensive) that she and her husband usually had to prepare dinner only on weekends.
I suspect, therefore, that what is reported here in the article is only the tip of medical payola. What about paid trips for physicians to Hawaii to hear papers on various products? And then there is the related matter of physicians relying upon the recommendations of various prominent med school professors who are paid great sums by PHARMA.
So, in the twilight of my years I have come to see the corruption and criminality of too many physicians who derive more pleasure and self-worth from garnishing ill-begotten dollars on the backs of their patients, then the permanent satisfaction of performing a service to humanity. I have lived to see NPD (Narcissistic Personality Disorder) run rampant among too many physicians and healthcare providers, and have also lived to read in the daily media physicians being charged with multiple Medicare criminal violations. So much for ethics. I am going to propose to the AMA that the oath be changed to an oath to 'money' and the achievement of wealth over proper health care.
How do you spell "whores"?
As a physician, I find the ethics of some of my colleagues abominable!
Our facility accepts NO incentives from drug companies but we still prescribe some of these meds generics are NOT better do u know what generic birth control did to me I got pregnant twice on it generics have a lot of filers and in any medication where therapeutic levels are required it can be dangerous to use. In a warfarin patients generics are extremely dangerous I am a pristine nurse and have seen generic Coumadin cause unnecessary up and downs in pro times that have put patients in danger. Another example simvastin vs Crestor simvastin a common generic cholesterol med can cause dangerous elevations in lfts Crestor does not but many insurance companies refuse to pay for it. I look at this as yes there are prescribers abusing this but should we say that all prescribers who frequently use specific drugs are corrupt ? To me it makes sense that drs that have has good success with a drug should be those that talk about the drug.
Mary Ann I think that a lot of the reason that many drs do not give opioids is due to reputation. No one wants to be labeled as that dr that everyone goes to for pain meds. Also opioids are very addictive and not really all that effective for long term pain management. Often unless there is physical evidence of a need for opioids such as surgery or fracture drs refuse to prescribe opioids. They also have nasty side effects as someone who has worked in health care for years I can safely say that most patients are better off if they are never given these drugs.
Amazing marketing strategy. So it is basically still more about business rather than releasing the most effective drug out there to help people in need. The lives of people are somehow just being played with those pharmaceutical companies who are just in for the profits.
@ Alma….Yes it is about making money, how do you think drug developers pay for innovation? Yes, there are grants, angel investors and venture capital dollars to be had but that is a very small percentage of what gets spent annually on development. Try to remember that most drug companies are for profit business entities, they have investors/shareholders that expect a return on investment.
@Stan…so you never accept a rep lunch-n-learn or free CE at trade shows or a sponsored event? You always write generic to avoid evil big pharma right…well doesn't that make you beholding to the generic companies? You call your colleagues "whores" for what they do, aren't you being pimped by the generic companies? And truthfully given your comment I doubt you are a physician.
@Scott Miller…"The whole pharmaceutical industry is based upon manipulated clinical trials. It is scary to think about how many people owe their jobs to fraud. " You sir are clueless as to the amount of oversight that occurs in clinical trials.
@John H…I would agree if the Rx a Dr wrote was filled exactly as a Dr wrote it however in most states the brand name drug a Dr writes will be switched to generic without even a call to the Dr and the Dr knows that.
@Meghan Fitzpatrick….Pharma companies don't purchase Rx data from pharmacies…there is an entire industry built around that function and pharma purchases the data from them (google IMS Health for an example). As I mentioned earlier in this post big pharma is for profit. And yes the drug reps are sales people with the best interest of the company paying them at heart…Do you not trust your Dr to be intelligent enough to differentiate between "good" drugs and "bad" drugs regardless of what a salesperson tells him/her, if not, shouldn't you consider a change to a dr you do trust?
@Tess…Unless the prescriber you were married to ran a home office, I'm surprised he/she rec'd samples at home as there are a couple law enforcement agencies that frown on that practice
The part of this equation that should concern everyone is why does insurance reimbursement decide your health care treatment? If you pay cash for your Rx you will get the brand, if you use insurance you will most likely get the generic. I have nothing against generics in most cases, however I know in some cases they may be therapeutically equivalent but not "the same" (I can speak to the unfortunate difference between Branded Birth Control and Generic equivalent),
So the next time you go see your healthcare provider ask them who they believe has a bigger impact on your healthcare, the drug rep or the insurance company.
If you had any idea of the fraud in drug trials and promotion of drugs. You need to read Professor Emeritus of Organic Chemistry Joel Kauffman, Ph.D., MIT, 14 drug patents and 100 peer reviewed publications. Professor Kauffman spent many years in drug development and clinical trials. Stat-wise, the absolute risk of having a heart attack in one year is 0.2 percent. On mammograms, Professor Kauffman:
"The pain of mammograms is not accompanied by the gain of any lifespan. Undergoing annual mammography does not improve all-cause mortality after a diagnosis of breast cancer. The most careful examination of mammography trials does not even support a lower breast cancer mortality. If there is a lower breast cancer mortality, some of it may be attributed to the hormetic effect of the Xrays used in mammography. Another reasonable explanation is that aggressive treatment of the many false positives from mammography ... is replacing cancer deaths with deaths from treatment." (pp. 216-7)
@mark tell that to my friend who had a very aggressive form of breast cancer that was detected on a routine mammogram. Not all lumps are detectable by palpating. I work in a primary care setting and I can't tell you the number of times we have detected breast cancer on a routine mammo only to save the patients life. To me it's worth it to save even one person.
I spent several years working in the dental industry responding to patients' questions concerning Fluoride toxicity. (Yes Fluoride in too great a quantity can be toxic, however so can water - would you also recommend discontinuing water consumption or perhaps just recommend reasonable quantities (dose)?). So I'm familiar with Dr Kauffman's papers/books/theories, I just have less respect for his findings than he has for the FDA.
LOL "oversight"! Yea, there's enough oversight to make sure they are properly manipulated so when they hand it to the joke FDA they can approve it. O, but according to you the FDA is probably a paragon of protecting the publics interest. Get lost shill.
@ Scott
So when will your fact based, independently verified expose showing the fraudulent clinical trial / pharma / FDA consortium be aired ? Or is media part of the conspiracy also? With manipulation so common you should have quite the stack of documented verifiable proof. I'd zip down to Houston and talk with the Cetero Lab if I were you, I hear they have quite a fraud story to tell. Oh that's right, they went bankrupt and closed, reopened under a different name and closed again after they were shown to have manipulated data. (Or were they just a "fall guy"... Hey maybe you're on to something with this conspiracy theory)...I should stop commenting before they send silent black helicopter full of strom troopers to snatch me while I'm jogging
Whatever man. This country is so criminally medicated up the wazoo from little kids to seniors it blows my mind. I can't watch television without a drug ad or a law firm trying to get people to sue from being damaged by drugs. It's sad and you're sad. I'm done.
I'm re-posting this comment from June 25, because nobody seemed to notice it.
****Interesting to peruse the list of uber-prescribing doctors in this article.
Anyone notice the plethora of foreign-named doctors? Evidently they have learned the American way of getting rich. Since we don't do open bribery as readily as they would in their home countries, they adapt to our way of accepting "bribes" from Big Pharma.
What does this mean to you? As a patient, you might want to keep your eyes open. Please don't bother calling me "racist". This particular phenomenon is not limited to medical prescribing.
I'm guessing that most people involved in the conversation saw the comment; the lack of response indicates a lack of interest in the subject matter…
Commenting on this story is closed.
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Did you know?
The nearest rival in terms of plant biodiversity to the Cape Floral Kingdom is the South American rain forest.
In terms of natural capital, South Africa is one of the top 10 richest countries in the world. It has an exceptionally high number of mammal, bird, reptile and fish species.
But those involved with plant conservation in South Africa will rightly argue that it is the sheer wealth of plants that truly sets South Africa apart as a mega-diverse nation. Here you will find around 23 000 plant species, 7.5% of the world's total.
South Africa's conservation of ecosystems focuses on regions with the most concentrated splendour. Top of the list are fynbos (also known as the Cape Floristic Region or Kingdom) and the Succulent Karoo. The vast majority of these plants are found nowhere else in the world.
But because these are such specialised plants, very high numbers of them are threatened.
The other plant biomes are savanna, grassland, forest, Nama Karoo and true desert. Many biologists now also identify subtropical thicket in the Eastern Cape as a unique form of woodland or savanna.
As with animal species, plant conservation in South Africa benefits from natural corridors linking protected areas. Several noble initiatives co-ordinate work on the more threatened ecosystems.
They are the Succulent Karoo Ecosystem Programme (SKEP), the Subtropical Thicket Ecosystem Programme (STEP), the Cape Action for People and the Environment (CAPE), and the Grasslands Programme.
These are notable for the fact that government, non-governmental organisations and the private sector work closely together to safeguard ecosystems.
The same dynamic applies to the Working for Water programme. Here previously unemployed people are hired to remove alien invasive plants that threaten water sources and plant ecosystems.
South African conservation of plants is boosted by a strong grouping of national botanical gardens that help protect the biomes around them. They create awareness, propagate indigenous plants and fund research into the various ecosystems.

subset: commoncrawl


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A WOMAN set fire to her former school as part of a 'grudge' she had against it.
Kymberley Rowbotham, 23, had pleaded guilty to starting two fires at All Saints CofE Primary School, in Clayton-le-Moors, causing between £5,000 and £10,000 worth of damage.
A court heard how the defendant, of Owen Court, Clayton-le-Moors, had mental health and physical problems and that she had also appeared before the courts after setting fire to the UPVC window ledge at the Church Street school in 2009.
Amanda Johnson, prosecuting, said the latest fires both started in bins within the school grounds.
One caused smoke damage to the school kitchen.
She said: "It was in effect, a situation in which the defendant was bearing a resentment towards the school, particularly when under the influence of drink or drugs."
The court was told that after starting the blazes, Rowbotham flagged down a passing motorist and asked if he had a phone to contact the emergency services.
Mark Ford, defending, said: "What happened to her when she was much younger at the school has caused her to reconsider the view she took towards the school.
"All of her frustration and anger was bound up in turn with her mental problems, her depression and her dependancy on alcohol.
"Miss Rowbotham is a young lady with profound problems and they really ought to be professionally investigated and addressed.
"She understands the link between these various factors and as a result of having learnt about why she felt the way she did, she feels that this is a chapter in her life that she now wants to close."
Rowbotham was sentenced at Preston Crown Court yesterday to 13 months imprisonment, suspended for two years, as well as being made subject to a five-year anti-social behaviour order banning her from the grounds and premises of the school.
She was also subjected to a two-year supervision requirement and an alcohol treatment requirement for 12 months.
The defendant must pay £250 in compensation to the school at £20 per week.
Ian Spencer, headteacher at All Saints, said: "We were very lucky that the whole school was not burnt down.
"We are very sad that a past pupil feels that way about our school.
"We support and agree with the sentence and we just hope Kymberley will be able to become the person that we know she can be in the future, a past pupil we can be proud of."


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text: Ditto on the cabelas xpg. I have a marmot hydrogen 30 bag. One night the temp dropped down to teens and thought i was going to freeze. Next night stuff bag inside of bivy and stayed toasty warm all night. Make sure that your bivy doesnt cover your face or it can cause condensation between the bivy and your bag.


text:
Child Worshipers: Parents who are deaf, dumb, and blind when it comes to their childs behavior. They don't hear the screaming, yelling and tearing around that they do in public. (Libraries, grocery stores, funerals, fine-dining establishments, weddings, etc.) Also completely unaccountable for their childrens destruction, deeds and general unruliness.
Parents who never apologize, reprimand, affirm, or offer to pay for damage done by their children. "you brought your kids to my house and they set the dog on fire!, colored my car with magic marker, ripped the pages out of our first edition Pearl Buck's "A Good Earth" to make paper airplanes!" You said, "Aren't they creative?" I mean really WTF? You idolize and "Child Worshipers" these little monsters.
by THE SNICKERDOODLE February 22, 2011
The Urban Dictionary Mug
One side has the word, one side has the definition. Microwave and dishwasher safe. Lotsa space for your liquids.Buy the mug


text:
Michael Clarke's first calendar year as Australian captain has been too good to have been illusion or accident. He is revealing himself as a cricketer and leader whose well of potential is of unimagined depth. The signs are there that, against the odds, he might yet take his team all the way.
As a young man in a hurry, Clarke aspired to the top job and has exceeded almost every expectation on attaining it. Searching for a prominent parallel, Bob Hawke comes to mind - one who never for a moment doubted the childhood dream about being the chosen one. And one who, when the prize was duly bestowed on him, revealed sufficient substance, along with his undoubted style, to silence the detractors.
Perhaps being aware of detractors can help, for little motivates as strongly as wanting to prove the bastards wrong. Just so long as they're not too powerful. Kim Hughes, who also bore a sense of destiny, knew there were detractors. But time and circumstance were against him.
In the case of the Clarke ascendancy, the settings have all been right. His much-admired predecessor had reached the end of the line. Clearly, as Clarke demonstrated when Ricky Ponting later announced his retirement, the deputy felt deep affection and admiration for his predecessor. When the baton was passed, there could be no argument.
Yet during the 2010-11 Ashes series, Ponting's last Australian summer at the helm, a well-credentialled insider had put to me that no one was within a bull's roar of what was required to replace the incumbent. As Clarke was Ponting's second-in-command and the only apparent heir, if not the heir apparent, the implication was clear. The deputy wasn't ready.
There had been the dust-up with Simon Katich after a Test win at the SCG; there had been Lara Bingle and the need for Clarke to briefly leave his post as national vice-captain while on tour; he was seen as a man who travelled by Ferrari in preference to the team bus. Overall, his apparent enthusiasm for glitz looked excessive.
Well, perhaps the message is that you can't always tell a book by its cover. Either that or the other stuff can be over-rated. As a cricketer, Clarke's job is to play well; as a captain, it is to manage his team well. Even in a team, people must be allowed to express themselves as individuals.
As much as a sportsman's personality-type and potential can be interpreted from his performances, Clarke appears to be one who thrives on challenge and stimulation. And he has the undoubted talent to surprise each time a new challenge emerges.
He made 151 on Test debut in India where more seasoned players have often floundered. The following month he played his first Test on home soil and made a century against New Zealand. His first Test in England was at Lord's and, as Australia dug itself out of a hole, he produced a second innings of 91.
Six years later, the leadership was finally thrust his way. The fortunes of the national team appeared bereft. The coveted prize looked a poisoned chalice.
And the rest is rapidly becoming history. Only one of seven series has been lost, and that - recently against the world-leading Proteas - in a tight contest. And the captain has contributed more than 2000 runs in 19 Tests at an average of 74.
But the challenges have just begun. Next year there is England, away and at home. And the one- time ''Pup'', who now surely qualifies as an old dog, must continue to learn new tricks.


text:
Compare Yamaha Garages and Specialists in Gateshead with Who Can Fix My Car.
Enter your registration to check prices and reviews, and get your Yamaha booked in today!
Compare Yamaha Garages and Specialists in Gateshead with Who Can Fix My Car.
well where do I start with my praise for everyone at VRS REPAIR SERVICES who go that extra mile to put their customers first, after being totally ripped off quote wise by the big high street exhaust companies one of which refused my car because the manifold bolts were seized,VRS came to my help within minutes of posting on the site, cost was quarter than the high street exhaust places and an extremely fast turnaround. before paying any expensive high street fitting centre costs give VRS a call you will not be dissappointed, am so pleased to find these guys. VRS = VALUE RELIABLE SERVICE. Thank you VRS your a credit to the auto trade
Oil change fine. Follow-up jobs to hand brake and calipers were a joke. Returned twice to get hand brake sorted and ended up having to go somewhere else. And calipers were put on rear wheels shoddily. Had to return as wheels were hot. Pins were discovered as being disintegrated on all four calipers by another garage - how they didn't notice that I have no idea. The oil change was fine though.
Very efficient
Great service from this Garage. Very personable staff great information and explanation every step of the way. As a single woman did not feel unsure of honest quote which happens frequently and in fact felt very secure throughout the repair. Will certainly use again and would definitely recommend them. Thank you VRS.
Great guy & great price. I will be going back to Jack next time the car needs something. I had to have the clutch changed and now it feels like new. Great job, Highly recommend.
Arrived on time and did the job in a very reasonable time at a good price. Will use again. Thanks.
Excellent service especially given it was Bank Holiday, good communication, arrived promptly, sorted the problem, fair price, would definitely use again.
I would definitely recommend Jack to anyone who needs work doing on their car. My car had failed its MOT, and I was offered £350 by the garage to fix it. Instead, I put a request on whocanfixmycar and Jack came straight back to me with a quote for £140. We arranged a time for the following day, and Jack travelled to my house and carried out all the work I had asked for (including an advisory from the MOT) quickly and efficiently. The following day, the car passed its MOT retest with no advisories. Very happy customer.
Very reliable would use again
Fantastic, very thorough, i don't know Newcastle at all so it was great find the garage!
Full service and MOT done the same day had to pay for extras to pass the MOT but was also great and cheap. Very friendly also provided me a courstey car which is a bonus as need to go to work and then back for my car. Outstanding. Will definitely taking my car back there. Highly recommended cheers lads
Quick responses through the platform and good service for drop-off and collection. I would happily use Torque Garage again. Thanks
Work completed to price quoted. Finished promptly, staff were friendly and helpful.
I was stuck 200 miles from home with the slave cylinder gone.As I have previously run a small garage business I knew right away it was a gearbox out job and get clutch replaced at the same time.These guys sorted it out for me in the time they said it would take at the price they quoted.They did a great job with good communication throughout and gave good professional advice on anything to look out for.They also changed the gearbox oil while they were in that far.Would definitely do business with them again.Cheers guys,well appreciated.
Hard to locate the garage. Did a good job. Happy with the service.
Champion, everything was good!
good price and good work.
I would definitely recommend this garage. They found the problem of my car very quickly and solved it. Thank you!
An awkward job with the car requiring more work than initially expected, but dealt with very well and at a reasonable price by GC Autos.
Would use again, quick and the price was right.
Brilliant, fantastic garage!
Would use again.
Great service, picked up and dropped off. Low price and great result.
Got an appointment quickly, and didn't take long at all. Brakes working well, thanks.
Quicky and easy, would definitely recommend!
Top service i would recommend to anyone
Knew what be was doing, fixed my problem in minutes.
Will recommend use normal autocentre!


text:
Press Room
Press Releases
Senior Manager, Communications
The recent Bloomberg' article "Victoria's Secret Revealed in Child Picking Burkina Faso Cotton" contains serious allegations of child labor on a farm which appears to be part of a Fair Trade cooperative.
While this situation did not involve any business or producer partners of Fair Trade USA, we are saddened and dismayed to learn of any instance of child labor within or outside the Fair Trade system.
Rigorous Fair Trade standards are meant to ensure that farmers and workers can count on more than just better prices. For example, freedom of association, safe working conditions, proper disposal of waste, and limited use of agrochemicals are all part of Fair Trade. And of course child labor, forced labor and discrimination are also strictly prohibited.
Trained auditors inspect Fair Trade producer organizations to monitor for child labor. When auditors uncover suspected child labor situations, they immediately act to protect the safety and well-being of the impacted children, reporting the incidents to the relevant government and child protection authorities, with follow-up to ensure the wellbeing of the child.
Read FLO's response to this issue.
Response from Textile Exchange.
Learn more about FLO's proactive work to eliminate child labor.


text:
1) Apple® changes the connectivity specifications. There are thousands of people who bought expensive sound systems with iPod docks -- only to have the dock become obsolete when they bought a new iPod.
2) The 30-pin connectors built into the docks are susceptible to breaking. A friend of ours just visited his daughter in her college dorm room. The daughter, her roommate, and three people on the floor all had sound systems with broken connectors.
What we recommend.
Buy a separate iPod dock. The one from Apple is $50 and works very well. If the connector breaks, you can buy a new dock. If the connectivity or charging protocol changes for a new iPod/iPhone model, you can buy a new dock. It's a lot easier and cheaper to buy a new dock than to buy a new sound system.
And that is why we don't build them into our systems.


text:
The Division focuses on the poorest and most vulnerable developing countries in the world. Specifically, it aims to increase understanding of the development problems of Africa and the Least Developed Countries (LDCs), as well as countries with specific geographical impediments, notably Landlocked Developing Countries (LLDCs) and Small Island Developing States (SIDS).
The Division proposes policies for actions to support inclusive and sustainable development.
Over 90 developing countries fall under the Division's areas of work.
Eighty government officials and private tourism operators have received instruction by UNCTAD on how to practise sustainable tourism that contributes to economic development.
Fifty-nine senior and mid-level government officials in Angola have completed an UNCTAD training course on productive capacities and poverty reduction.
Ugandan officials are visiting Pretoria, South Africa, from 6 to 10 May, to learn how to expand their nation's services sector so that it boosts growth and makes the national economy less vulnerable to external shocks.
A programme designed to improve regional trade performance in Southern and Eastern Africa has decided to employ UNCTAD's new classification of non-tariff measures (NTMs).
More than 90 tourism experts have met to debate how this economic sector can carry out its activities sustainably and can add to economic growth in developing countries.
United Nations Conference on Trade and Development
Connect with us
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text:
At each prenatal visit, you
can expect to be weighed and have your urine and blood pressure checked. Your
health professional will monitor your fetus's growth and position by measuring
the size of your uterus (fundal height) and feeling (palpating) your abdomen.
If your fetus is not in the head-down (vertex) position after 36
weeks (as confirmed by
fetal ultrasound), your health professional may try to
turn it gently from the outside (version). Version carries some risks, and not
all health professionals are skilled in this technique. For more information,
see the topic Breech Position and Breech Birth.
Late in your
pregnancy, your health professional:
Later in pregnancy, your health
professional may recommend an
amniocentesis if:
Next Section:
Previous Section:
Last Revised:
July 23, 2012
Healthwise Staff
Medical Review:
Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
To learn more visit Healthwise.org
© 1995-2012 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.


text:
- "The smoke was still rising as Rabbi Herschel Schacter rode through the gates of Buchenwald." Thus begins the New York Times' moving obituary of the first Jewish chaplain to enter the concentration camp after liberation.
- The story of the 17-year-old Londoner whose news app has been bought by Yahoo for almost $30m is a tech fairytale. But some people are starting to question the narrative: Vibhu Norby argues "The Summly deal makes no sense"; and the FT's own Lex column asks: "Yahoo pays $30m for an iPhone app that has no revenue and is made by a teenager and this is what counts as product buzz at the $25bn internet giant?"
- The rest of the world may have stopped panicking about Cyprus, but on the island itself, the pain is just starting to sink in. "The whole point of the bailout was to shrink the banking sector, but they've destroyed our entire economy," one Cypriot told the FT's Josh Chaffin. From the comment section, Martin Wolf says there are at least four lessons to be drawn from the Cyprus crisis.
- On Tuesday, the US Supreme Court heard arguments on Proposition 8 – California's ban on same-sex marriage. The NYT's Lede blog covered the day live; you can also check out the excellent Scotus Blog, which has listed all its coverage of the Prop 8 argument, including a link to audio of the arguments synced with a searchable transcript. The FT's Richard McGregor argued in his Global Insight that whatever the result of the case, Republicans need to accept that "public opinion is moving in only one direction."
- The Guardian's Data Blog is showcasing a graphic that illustrates a day in the life of the internet – thanks to the work of an industrious hacker.
© The Financial Times Ltd 2016 FT and 'Financial Times' are trademarks of The Financial Times Ltd.


text:
The cardiac rehabilitation Phase II program is the transitional phase of cardiac rehabilitation (rehab) after you leave
the hospital.
The goals are to:
Follow your
discharge instructions to avoid postsurgical complications
and to prepare yourself for a more active lifestyle. Your home program will
vary in length depending upon your medical history and current
Your rate of recovery depends on age,
gender, and other health conditions. Depending on your condition and how you
respond to rehab, you may stay in a particular phase or move back and forth
among the various phases. There is no set length of time that you must stay in
a specific phase.
Your exercises at home depend on your medical history, clinical status, and symptoms.
Discuss additional physical limitations or medical issues with your doctor before you begin any exercise program.
Exercise progresses from activities of daily life to regular exercise. You will most likely walk or ride a stationary bike.
Aerobic exercise
A regular walking or stationary
cycling program is an essential part of your home exercise program. How fast
you progress will depend on your overall cardiovascular and muscular strength.
Always warm up and cool down. Never exercise at an intensity that causes
shortness of breath soon after open-heart surgery. Drink plenty of fluids, and
avoid extreme weather conditions and temperatures. In extreme weather, you can
try walking indoors at a mall or a gym.
Other Works ConsultedAmerican College of Sports Medicine (2010). Exercise prescription for patients with cardiac disease. In WR Thompson et al., eds., ACSM's Guidelines for Exercise Testing and Prescription, 8th ed., pp. 207–224. Philadelphia: Lippincott Williams and Wilkins.Graham IM, et al. (2011). Rehabilitation of the patient with coronary heart disease. In V Fuster et al., eds., Hurst's the Heart, 13th ed., vol. 2, pp. 1513–1530. New York: McGraw-Hill.
Next Section:
Previous Section:
Last Revised:
September 27, 2012
Healthwise Staff
Medical Review:
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & John A. McPherson, MD, FACC, FSCAI - Cardiology
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
To learn more visit Healthwise.org
© 1995-2012 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.


text:
DOVER, Fla. – The Saint Leo University men's and women's cross country teams opened its 2009 season at the annual UT Early Bird Classic following a nearly two hour delay due to lightning. Full standings of the event are still not available, although individual tallies have recently been made available.
Due to the delay, both the men's and women's squads were forced to run a 5K race together. Under normal circumstances both the men's and women's teams would run separately, with the men running the 8K.
On the women's side, Alison Luthman posted the best overall time for the Lions, crossing the finish line in a time of 22:29. Her teammate, freshman Jillian Browne, was nipping at her heels closing the race with a time of 22:32. Sophomore sensation Kelsey Bradley was the third Lion to break the tape with a time of 22:43. Tanja Redmond broke the 23-minute mark, as well, posting a time of 22:55.
The men sprinted from the starting line at the same time as the women. Freshman Eric Dirth, in his first collegiate race, concluded the race as SLU's top finisher with a time of 18:34. Matt Attal and Mike Berry also impressed in the first race of the season posting times of 18:37 and 18:53, respectively.
Complete individual times can be found in the box score with full results, including team points and positions, to be made public when full results become final.
Individual Results!


text:
? Don't
overload your site with animated graphics, cutesy backgrounds and huge,
memory-gobbling photos. They'll make your pages look cluttered and take
an eternity to download. Use "thumbnail" (small) photos instead. If you
want to include a large picture, put it on a separate page with a link
such as "See full size" next to the thumbnail. Then users can decide if
they want sit through the download.
? Do stick with
simple, easy-to-read type. Co easy on the use of italics. Make sure
there's adequate contrast between your type color and your background.


text:
GET ready to have your senses stimulated by a fun and thought-provoking exhibition.
Worcester City Art Gallery and Museum welcomes Sensational Clay fromJon Williams of Eastnor, near Ledbury, to the Foregate Street from Saturday, June 14 to Saturday, November 1.
The ceramics from the Flying Potter have all been inspired by the five senses and all have a secret to discover, from tiny hand-held items to huge one-metre wide pots.
Visitors are encouraged to get hands-on and explore the pieces to find out more – lift lids to discover hidden treasures, shake the musical pots to make some noise or try to guess the smell coming from the scented vessels.
Angie Bishop, manager of Worcester Art Gallery and Museum, said: "This summer brings bumper fun for families at the Art Gallery & Museum as we have not one but two family-friendly exhibitions this year! Our Summer of Fun starts this Saturday with Sensational Clay, then we unveil our fabulous costume collection in Fancy Pants which opens on 12 July.
"We hope visitors will enjoy Sensational Clay – it's not very often you get to shake, rattle and sniff the exhibits."
Saturday, July 19 is Sensational Clay Day, when children and adults can join Jon for a fun day with clay as he helps visitors to create beautiful clay objects either by hand or mastering the potter's wheel.
It runs from 11am to 4pm and costs £15 for children and £20 for adults, including lunch.
Children can then create a magical castle from scraptastic materials and clay on Thursday, July 31 and on Tuesday, August 12 they can make a mini monster world from clay and collage materials.
Both workshops run from 11am to 1pm, are suitable for ages 5-12, and cost £4.50 per child.
The art gallery and museum is open Monday to Saturday, from 10.30am to 4.30pm.
For more information and to book workshop places, go to museumsworcestershire.org.uk or call 01905 25371.


text:
ROAD improvements costing almost £2million are set to begin in Burnley.
Fresh asphalt will be laid on dozens of roads using a method called surface dressing, which will see potholes patched up for good.
And a further £1.2million will be spent by Lancashire County Council upgrading street lights by replacing outdated columns, repairing existing lights, and erecting new installations.
The surface dressing technique involves potholes being given a coat of bitumen with chippings rolled into the surface, making them waterproof and helping to prevent new potholes appearing.
Among the roads earmarked for improvement are Padiham Road, between Oak Street and Stephenson Drive, and a long section of Burnley Road north of Holme Chapel to the county border with Calderdale.
Brassey Street and Ightenhill Park Lane, from Lakeland Way to Padiham Road, Padiham's Victoria Road and its adjoining streets, and Richmond Avenue, Cliviger, are also included.
County Councillor John Fillis, cabinet member for highways and transport, said: "We have teams working constantly throughout the year to inspect our roads and make running repairs as potholes appear to ensure people can travel safely.
"Alongside this we also have a programme of planned work to extend the life of our roads and replace the most worn out surfaces, which is vital to maintain their long term condition.
"Roads are essential to our everyday need to get from A to B, and to Lancashire's economy. In spite of unprecedented government funding cuts we will continue to invest to maintain our roads and pavements to the highest standard we possibly can with the resources we have available.
"Most damage to roads is caused by the wet and cold winter weather, and as we move into spring our teams are already working hard across the county to keep our roads, as well as infrastructure such as streetlights, in good working condition."


text:
By Scott Trudeau
January 7, 2010
Walk down any high school or junior high hall and you will notice how popular mobile devices are. It seems that just about every kid has access to a "smart phone." However, students have been unable to access engaging and rich web content delivered in the Flash format. This is starting to change.
Recent releases of certain mobile devices are realizing how much content is delivered via the Flash format (over 80% of web video is distributed as Flash video) and will, in the near future, support Flash Player 10.1. Students that carry smart phones that include Flash Player 10.1 will be able to visit sites like National Geographic and Brain Pop (just to name a few) and teachers will gain an exciting instructional delivery tool!
Read more…


text:
Kneza Mihajla Visevica Humskog 13
Plan d'accès à l'établissement
In Mostar, there is only one main bus station and train station for intercity traffic. The easiest way to reach us from the station is to take a taxi, also, you can arrange transport with us in advance if you prefer us to come and get you. If you do not have too much baggage, and yet you choose to walk to our boarding recommend you to walk in the following way: go to the nearest bridge (Carinski), take the second street to the left (Dr. Ante Starcevic street) and go straight to the Spanish Square, continue walk down the street to the Boulevard until you get to Oil-Ac gas station. Behind the gas station you will see Pension Liska.
Les applications mobiles d'Hostelworld
Réservez facilement grâce à la nouvelle application mobile Hostelworld.


text:
An Indian Sikh devotee holds an oil lamp as he pays his respects at the Golden Temple in Amritsar, India on Thursday. It is the 392nd birth anniversary of the ninth Sikh Guru, Teg Bahadur. Guru Tegh Bahadur, the youngest of the five sons of Guru Hargobind, was born in Amritsar in 1621 and was executed on the orders of Mughal Emperor Aurangzeb in Delhi in 1675.
© The Financial Times Ltd 2016 FT and 'Financial Times' are trademarks of The Financial Times Ltd.


text:
(Pics: Pramod Samantray, BBC News)
Wetka and Melka, have declared their love for one another in a marriage ceremony in the Indian district of Koraput. Homosexuality has been criminalized since India was a colony of England. The 1861 law states:
Whoever voluntarily has carnal intercourse against the order of nature with any man, woman or animal, shall be punished with imprisonment for life, or with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine.
Though the government does not prosecute these offenses there is still an extremely high level of homophobia in India. According to the BBC their tribes were not initially pleased with the pairs decision to marry. The villagers were concerned that they would not be able to support themselves without the help of men. Apparently due to the obvious love between the couple they were "forgiven". Wetka and Melka were ordered to pay a fine consisting of a barrel of country liquor, a pair of oxen, and a sack of rice and hosted a family feast.
By holding on to this dated statue, the Indian government is identifying with its colonial roots. Acts of homosexuality are no longer illegal in Britain. Despite an appeal lead by the Naz Foundation India Trust, in the, Delhi High Court challenging the constitutionality of this law, the Indian government continues to uphold this archaic prejudicial law. According to the ILGA the government response was as follows:
42nd and the 156th reports of the Indian Law Commission states that society does not approve of homosexuality and that therefore there is a justification in retaining the section 377 IPC in the books of statutes, while conveniently ignoring to mention that the same law commission in a later report namely the 172nd report of the Commission has actually recommended that the rape laws be changed to [a] make it gender neutral; [b] make special provisions for child sexual abuse; and [c] repeal section 377 of the IPC.
In paragraph 32 of the reply the government states: "In fact, the purpose of this section 377 IPC is to provide a healthy environment in the society by criminalizing unnatural sexual activities against the order of nature." And then goes on to add in Paragraph 33: "If this provision is taken out of the statute book, a public display of such affection would, at the most, attract charges of indecent exposure which carry a lesser jail sentence than the existing imprisonment for life or imprisonment of 10 years and fine. While the Government cannot police morality, in a civil society criminal law has to express and reflect public morality and concerns about harm to the society at large. If this is not observed, whatever little respect of law is left would disappear, as law would have lost its legitimacy".
Despite its claim that it is not attempting to legislate morality, the governments position supports heteronormativity, by positing displays of public affection of same sex couples would lead to moral decay. Discursively heterosexuality can only be maintained as positive (read:normal) by creating homosexuality as somehow perverse and or deviant. To support its position the government refers to "unnatural" sex acts. The fact that the same statue is used to prosecute pedophilia further encourages the social acceptance of homosexuality as something that should be reviled despite the fact that the two have nothing in common. This essentially marginalizes, and silences a minority of Indian citizens. What we are seeing is truly the tyranny of majority at work.
In the example of Wetka and Melka we can see how patriarchy and homophobia can work together to limit human relations. Their of act of love, was denied because there was concern for two women supporting themselves. From this we can infer a justification of mandatory heterosexuality based in a patriarchal understanding of gender roles. Indian society still sees men as providers, and women as nurtures. Though we are far removed from a hunter gather society, women are still relegated to roles that bare no relevance to the way that modern society functions. This patriarchal understanding not only affects those that identify as lesbians, it further curtails opportunities for women to be self supporting. Without access to the money market economy women become slaves through financial dependency. In fact it was necessary to Wetka and Melka to prove that they could be self sustaining to achieve a small form of approval that should not have been required for their relationship. In this it is clear what is defined as "natural" supports traditional gender roles.
By holding on to its colonial past rather than using traditional understandings of gender, and sexuality as written by the Hindu sage Vatsayana, the Indian government in actuality is governing contrary to its own national history. The kamasutra dedicates an entire chapter to homosexual love acts. The very existence of the Kamasutra challenges the idea of "natural" sex acts, on the continent. It is also worth noting that during the Mughal period, homosexuality was well received in Muslim courts. Normalizing behavior only serves to create a docile populace. The state is creating conformity through ignorance, hate and fear. When societies learn to hate based in ignorance, they are less likely to challenge legislation that seeks to supplant personal agency unless they can recognize an individual link. In this instance by holding on to its colonial past long after India's oppressors have publicly decried such ideals, stops India from reconnecting with a past that does not involve western construction. In its desire to progress on the global stage supplanting false social constructions as normal does not in anyway equate to the progress that it is trying to achieve. Progress cannot be borne on the backs of the stigmatized bodies of women, and or specifically the GLBT community. Obedience to social construction does not allow for fluidity or experimentation. When we stop growing as a people, societies become stagnate and are subject to decay. Equal participation allows for a continual influx of new ideas. Looking backward in this instance may be a key to future progress.


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Cleaning Contractors in Langtoft ready to help
Thomas Cleaning
Thomas Cleaning has been running for 27 years and we clean around 300 homes a day, with lots of offices, schools, and surgeries, etc.. We use our own materials and equipment and do all the normal things re cleaning, but can include ironing, inside windows, ovens, etc...and of course we're happy to use your products should you prefer. All our lovely staff are full time employees and we're insured, uniformed, trained and supervised. We generally work in teams of three so we're in and out with the minimum of fuss. So for example a 3 hour clean would entail the cleaners doing 1 hour each, making a combined cleaning total of 3 hours. The cleaning would be on the same day each week, and our system will send you an email the night before, giving the estimated arrival time for the following day...and we can accommodate immediate starts. It's purely business, there's no awkwardness on your part, no necessity for polite chit chat or cups of tea, there's no slinking off 5 or 10 minutes early; you tell us what you want and we jump.! You say how many hours you want, there's no contract, and of course you can add or subtract hours as you wish. We'd love to help, so if there's anything that I haven't covered please don't hesitate to contact. We're purely here for you and not at all prissy about taking instruction.
Logic Service Management
Logic Service Management is a well established and highly regarded facilities management company with HQ in Peterborough and regional offices in London the West Midlands and the North West. The senior management team at Logic Service Management has over 70 years' combined relevant experience and a motivated workforce delivers reliable, robust and cost effective solutions for security, safety, cleaning, caretaking and concierge requirements. A long and diverse list of satisfied past and present clients, from individuals and small businesses to large corporations and local authorities, is testament to our expertise. Our own in house Training Academy ensures that we continue to develop excellence at all levels of the company. As well as our expertise at event safety and security we cover industrial, commercial, transport and retail site security and property protection assignments and offer corporate front of house concierge services as well as bespoke contract and commercial cleaning and caretaking solutions.
360Pro Cleaning Services Ltd
At 360Pro Cleaning services , we are focused on providing the best quality efficient and effective cleaning services with the highest levels of customer satisfaction – we will do everything we can to meet your expectations. With a team boosting with a minimum four years cleaning experience there is NO JOB TOO DIRTY FOR 360Pro Cleaning Services.. With a variety of offerings to choose from, we're sure you'll be happy working with us. We provide our services all across the United kingdom
Kings kleen
We are a small family run business based in St.ives Cambridgeshire. We are pro-chem trained carpet cleaners & we hold The British Cleaning Certificate. Fully insured. We are key holders to many businesses & property owners. We specialise in "one off" and end of tenancy cleaning. We have many reviews & photos on our face book page & website. We undertake Office cleaning End of build cleans End of tenancy cleans One off/spring cleans After party cleans Carpet cleaning Rug cleaning Oven cleaning (as part of a package only) Commercial cleaning We do not undertake regular weekly or Bi-weekly domestic cleaning. "Kings kleen for all your cleaning needs"
Worksop Cleaning Services
Worksop Cleaning Services serve both domestic and commercial customers with a high quality professional cleaning service in all areas of Chesterfield, Worksop, Retford, Mansfield, Sheffield, Rotherham, Barnsley, Doncaster, Wakefield, Huddersfield, Halifax, Bradford, Leeds and Manchester.... and more. We are a professional local cleaning company that is owned and operated by The Carpet Cleaning Pro and we believe "quality and value never go out of style" Our cleaners define "clean" not only in terms of appearance, but also in terms of hygiene, safety and benefits to indoor air quality! We believe in "A Deep Down Hygienic Cleaning Process" Our Cleaning Services Include: Domestic Cleaning One off Blitz Cleans Regular Daily/Weekly/Fortnightly Cleaning Commercial Cleaning End of Tenancy Cleans Carpet Cleaning Upholstery Cleaning Mattress Cleaning Flea Treatments Odour Removal Flood Damage Clean Ups Fire Damage Clean Ups Commercial Carpet Cleaning
The Carpet Cleaning Pro
The Carpet Cleaning Pro knows just how difficult it can be to maintain your carpets and upholstery, keeping them clean of inevitable dirt and stains. This is why we offer a 100% SAFE and EFFECTIVE carpet cleaning, upholstery cleaning and a mattress cleaning process in Chesterfield, Worksop, Retford, Mansfield, Sheffield, Rotherham, Barnsley, Wakefield, Doncaster and Scunthorpe that removes even deep down dirt and stubborn stains from carpets, upholstery and mattresses while remaining completely safe for children, babies and pets who spend much of their time in direct contact with the carpets and upholstery. A quality AFFORDABLE professional carpet and upholstery cleaning by trained technicians. We also offer High quality End of Tenancy Cleaning at remarkably good prices.
IMS General Services
IMS General Services provides cleaning services in Nottinghamshire and Derbyshire includes Window cleaning internal and external pressure washing solar panel cleaning carpet cleaning upholstery cleaning gutter cleaning services soffit and fascia cleaning conservatory cleaning office cleaning
Cleaning Expert 24-7 LTDCertificate of Excellence 2015
Our cleaning services we can offer: regular domestic cleaning, end of tenancy cleaning, one-off cleaning, spring cleaning, after party cleaning, housekeeper service, eco-friendly cleaning, ironing service, painting service, car cleaning, garden cleaning, carpet cleaning, Areas we serve: East Midlands, East England, South East England, West Midlands,
E.O.T Cleaning
We are an established cleaning company, we have done relevant training and keep our training up to date. We have been in the cleaning industry for over 23+ years and have the relevant experience to know how important a Deep End of Tenancy Clean is and how important it is to work with Students, Tenants to work to high standards making sure the property is spotless to get there deposit back. We have experience in: Communal Deep Cleaning of Kitchen including appliances, and Oven cleaning, and moving fridge/freezer, washing machine, dishwasher etc where durable. Deep Cleaning of Bathroom, removing, limescale, soap scum, mildew and mould, as much as we can but unlikely to be removed from sealant around the bath. Shower Panels will be scrubbed as much as possible to remove build up of limescale , toilets cleaned to high standards and around the bowl. Deep Cleaning of Bedrooms including furniture, everything including inside windows and opening of windows to do the recess. Also offering Spring Cleaning, Move in and out cleans, Selling home cleans. There is so much that we do, so please do not as if we can do this in a few hours there is no way a property can be cleaned to the standards that is needed. If a cleaner can do this all in less than 4-5 hours then they haven't done there job properly and unlikely is you will not get your deposit back, We work to a fixed fee and we are at the job until its 100% completed and everyone has done there relevant checks and are happy with the work. We are happy to rectify anything that isnt while we are there but i am sure once we have completed you will be happy. We also offer professional trunkmount carpet cleaning: SPECIAL OFFER: ANY 3 ROOMS £49.99 3 ROOMS + STAIRS, HALLWAYS,LANDING £59.99 5 ROOMS + STAIRS, HALLWAYS,LANDING £99.99 What you get from our service: - Eco-friendly, pet and child-safe detergents - Latest professional equipment used - Same day service possibility - The right care and treatment for your carpeting - We do bring that fantastic carpet feel back - Fully insured - CRB checked for your peace of mind - Fully Trained Some offers, refer a friend your friend receives 10% discount on there clean. Join our group for amazing offers, and up to date news. https://www.facebook.com/groups/1870806986575200/
We are a End of Tenancy Company with over 23 years in Deep Cleaning. We offer - One off Cleaning Spring Cleaning Deep Cleaning Move In/Out Cleaning also oven, appliances,inside windows, when you book any of the above. Please take a look below at our Twitter page for updates, maybe we can fit in a last min if we are in your area. Twitter is updated daily. I have now recently been qualified in professional oven cleaning.
Clean Space Solutions UK
Fed up with cleaning, feel like it mounts up week after week and you get no where? Well call the cleaning experts you can trust today.... Clean Space Solutions are a family run business that have a reliable, friendly and trustworthy team who can clean your house top to bottom and make your home sparkle once again. We offer a range of services from: • Regular & One-Off Domestic Cleans • Commercial Cleaning • Landlord & End of Tenancy Cleaning • Builders Cleans • One-Off Deep Cleans • Carpet Cleaning Email us today for a non obligation quote at email@example.com or Private Message us on Facebook --> www.facebook.com/cleanspacesolutionsuk
Five Counties Cleaning
Five Counties Cleaning provides quality reliable cleaning throughout Lincolnshire, Rutland, Cambridgeshire and Northamtonshire.
S & T Contracts
S&T Contracts is a specialist handyman service we also are a specialist cleaning company we cover domestic and residential and commercial cleaning and carpet cleaning.Our fully trained handymen can cover the following decorating, plastering,carpet fitting,flooring,bricklaying,fencing,carpentry, tiling, kitchen,bathrooms,electrical,double glazing repairs and installation, end of tenancy cleaning,deep cleaning,flatpack furniture, shelf building,sealant repairs,wallpapering you have a job we can help our main working areas at present are west midlands,Northamptonshire, Cambridgeshire,Buckinghamshire, Bedfordshire we can cover most of uk we are interested in any other area's no job to big or to small our minimum charge is 2 hours first 2 hours £60 and £22.50 per hours after please do not hesitate in contacting us we are here to offer all domestic and residential property's a one stop solution for all property maintenance.
Maguire PorterCertificate of Excellence 2015
When you need a cleaner - You need trustworthy, efficient, hardworking, conscientious people who put your needs first. So call First4Cleaning -We have your best interests at heart. First4Cleaning is a business that starts as it means to go on... We start with a visit to the client to assess and discuss their needs- filling out a checklist- paying special attention to the clients wishes, We pride ourselves on a personal, yet professional, service. We encourage feedback from all our clients and listen to our staff when they make recommendations. Your home and your business are important to you - therefore it is important to us and we strive to deliver a service that is second to none. Place your business with us - and you place it in safe hands!
Crystal clear cleaning
Spruced cleaning
Professional domestic and commercial cleaning company located in Northampton We pride ourselves on delivering a top class service All of our staff are fully insured, and are DBS checked
Dynamics Cleaners
We offer all contract cleaning daily, weekly and fortnightly as well as providing one-off deep cleans. When it comes to finding cleaners to clean on a regular basis we understand how time consuming it can be and your desire therefore to get it right first time and forge a long term working relationship. To this end we invite you to try our friendly, hassle free, professional service. Our supervisors work hard to meet your expectations and are available to action any extra jobs as and when you require them, they include our carpet, window cleaning and wheelie bin/commercial bin cleaning. This can be done through your preferred method which includes email, mobile or landline. We also appreciate the importance of maintaining security whilst on your premises and employ only experienced Managers insured to hold security codes and keys and cleaning teams who are well trained and know how to achieve the best results possible. We are a cleaning company with a proven track record.
TipTop Cleaning
TipTop is a cleaning company based in Great Casterton. The services we offer include domestic cleaning, commercial cleaning, one off and end of tenancy cleaning, carpet and hard floor cleaning as well as upholstery cleaning. we pride ourselves in providing a very high standard to our customers and are very selective of our cleaners, ensuring they are Trustworthy and reliable. All quotes are free with no obligation and no contracts so that the service is flexible and can work around you! New customers receive the 1st hour FREE!
JaydValentine Cleaning
I am a self employed cleaner with lots of experience and happy customers - references available. I pride myself in my attention to detail (especially sparkly taps!) and very thorough work. Cleaning is something I really enjoy doing - it isn't just a job. I will treat your home with care and respect, Cleaning to a high standard so you can relax or get more stuff done knowing that your home will be lovely and fresh when you return!
PPVS (PPV Solutions LTD)
PPVS is a facilities management company based in Cambridgeshire. We cover all services from reactive and planned maintenance, to day to day soft and hard FM services. We are a family run corporation offering facilities management services to our commercial customers only. Clients range with turnovers from £5m to £1bn +. We concentrate on commericial clients within Food Manufacturing, Waste Management, Financial Services, National Trusts, Confidential Media & Advertising, Public Sector services, Utilities and Specialised Security sectors.
Cleaning Made Easy with Manda
Domestic and office cleaning, we are professional , reliable and friendly. Fully insured. We are experienced in cleaning , dusting, washing, ironing and all general household tasks.
Gillings Cleaning Services
Gillings Cleaning Services offer a professional friendly cleaning service for your home or commercial offices. On a daily basis, weekly or one off clean. We cover Boston, Spalding, Sleaford, Holbeach, Kings Lynn and all surrounding villages. Fully insured and CRB checked and experienced.
Eco steam clean services
Maxim Facilities Management
Maxim Facilities Management is one of the fastest growing independent facilities management companies in the UK. We can support all of your facilities management needs; from daily office cleaning, window cleaning, landscape gardening, carpet and floor cleaning, graffiti removal, painting and decorating, through to the purchasing of consumables and arranging washroom and hygiene facilities.
Yorkshire and surrounding areas premier window cleaning, jet washing and internal cleaning company Trusted by over 500 local business and shops We can clean any windows at any site We can Jet wash any area at any height We can clean any internal house / business
Clean It Up
We are the UK's largest cleaning forum with over 32,000 cleaning companies registered covering all aspects of cleaning.
Umbrella Cleaning
Domestic and Commercial Cleaning Services
Spotless Cambridge Ltd
A professional domestic and commercial cleaning service based in Cambridge. Started in 2004, we currently have over 400 residential cleaning clients and 100 commercial cleaning clients.
Extreme Cleans LtdCertificate of Excellence 2015
At Scoobyclean we specialise in all types of builders, industrial and commercial cleaning processes, at premises throughout the UK. We are a quality-motivated company and commit ourselves to achieving only the highest standards. We pride ourselves on quality and continued customers satisfaction, much of our work is repeat business. Full Builders Clean and Sparkle Cleans Commercial & Ind Cleaning Daily Office Cleaning Window Cleaning Carpet Cleaning Communal Area cleaning And Ground Maintenance service Hygiene Services
Shineamite LtdCertificate of Excellence 2015
Professional, insured residential and commercial cleaning services throughout the UK. From houseboats to mansions, universities to pubs, our services extend to a wide range of commercial and residential customers from a minimum of 10 hours to a maximum of 480 hours at discounted rates. We only employ conscientious, dedicated and motivated members who are hard working and reliable. No job is too large or small for them! Cleaning products can be supplied according to your requirements, for your additional peace of mind we have key holder insurance in place if you are not based at the premises. Please do not hesitate to contact us if you require further information. Thank you for your time. We look forward to hearing from you!
KMB Security and Cleaning Service Ltd
Residing in Cambridgeshire, we are strategically placed with direct access to the areas we cover, Cambridgeshire, Essex, London and the Home Counties. From the start our company ethos was simply, to supply quality Security and cleaning solutions to grow relationships from trust and reliability. This has not changed and these are the principles that stand us in good stead today. With our loyal client base we aim to be around for the long term and to grow with our clients. Priding ourselves on our working relationships, we continuously strive for improvement and believe through strong communication and reliable service we have your interests at heart. Our strong emphasis on training and career progression, each and every member of KMB are fundamental to the growth and company's ethics. Our business is based on respect and selfless commitment which help us maintain standards that will last and offer reassurance, you can never under estimate the importance of quality work, that is why we invest in training programmes for all our operatives who are aware just how important this is to our organisation. Business relationships are built from a solid understanding that the work achieved will be of the highest standard, from management to operatives; it's driven into KMB personnel that quality is paramount at all stages. From the initial contact through to providing our service, our contract managers will be available to you and provide a professional service. We want you to be confident and safe in the knowledge that KMB will strive to offer the best in service.
J C Cleaning Services
Contract Cleaning and Maintenance works carried out to a very High Standard, we are a very few Companies that offer a One Stop Shop for all your needs. All Staff will be uniformed and carry an ID: whilst carrying out there duties at your location
High Shine LtdCertificate of Excellence 2015
DBT Cleaning Service Leicester 25 Millwood Close, LE4 2px
My Company deals with the following facilities Service: offices, schools, banks, retail stores, medical clinics, restaurants, fitness centres, hotels/bed and breakfast, industrial plants, childcare centres, events, Factory, homes, we do residential cleaning, Commercial cleaning, industrial cleaning, post construction cleaning, new construction cleaning, student accommodation cleaning.
Servants-R-Us Ltd
Servants-R-Us does not tie ourselves to one service in the Cleaning industry from End of Tenancy Cleaning, Domestic to Commercial to grass cutting.. We can provide a plethora of services to u based in the Midlands and surrounding areas we can provide these services nationwide given timely notice.. Check out our website to see the services we can offer u fora Free No Obligation Quote
Oltec Facilities Management
Oltec provide facilities Management services and self deliver on Manned Guarding, Cleaning and Mechanical and Electrical services.
jc cleaning partenership
we are the best cleaning company
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