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AAHA-accredited members may have noticed an important change to the dentistry standards that were sent via email Aug. 1. AAHA's new mandatory dental standard will impact practices scheduled for their evaluation on or after Nov. 1, 2013. Below, we share some facts about the new standard.
What is the new mandatory dental standard?MA 11.6: All dental procedures are performed under general anesthesia with patients intubated.
What has changed?This standard changed from a points-based standard (DE01, worth 100 points) to a mandatory standard requiring that all dental procedures be performed under general anesthesia with patients intubated.
Why did the AAHA Board of Directors decide to make this change?The introduction of the 2013 AAHA Dental Care Guidelines for Dogs and Cats, approved and endorsed by the American Veterinary Dental College, prompted AAHA to update the Dentistry Section of the standards. The Guidelines state that cleaning a companion animal's teeth without general anesthesia is considered unacceptable and below the standard of care. General anesthesia with intubation is necessary to properly assess and treat the companion animal dental patient. The use of general anesthesia allows for the necessary immobilization without discomfort, periodontal probing, intraoral radiology, and the removal of plaque and tartar above and below the gum line including polishing to ensure patient health and safety. Because AAHA-accredited hospitals are expected to practice the highest level of veterinary medicine, AAHA's leadership felt it necessary to update the standards to reflect best practices outlined in the Guidelines.
How will this change impact practices applying for accreditation? Any members scheduled for their evaluation on or after Nov. 1, 2013 will be required to comply with MA 11.6 in order to pass their evaluation and achieve accredited status.
How will this impact AAHA-accredited practices?While we hope accredited practices will implement the standard immediately, we will not assess their compliance until their next onsite evaluation.
Why is general anesthesia necessary for companion animal dental procedures? At least 60 percent of normal tooth structure for both cats and dogs is under the gum line. Partially removing plaque and tartar from the exposed crown is more cosmetic than therapeutic. Removing the plaque and tartar from both above and below the gingiva on the lingual and buccal surfaces requires general anesthesia and results in a cosmetic as well as therapeutic outcome. General anesthesia also facilitates proper pain-free probing of each tooth's support and the required immobilization necessary to take intraoral dental films. Finally, intubation during general anesthesia protects the trachea and prevents aspiration of water and oral debris.
Questions? Contact your practice consultant for more information.
I would like to know what scientific proof they Based their decision on. Have they done a com-parison study comparing anesthetic vsnon-anesthetic cleanings done by trainedhygienists.. not the cleanings that are being done in the back rooms of groomingpallors without veterinary supervision? IfI stop performing non- anesthetic denialsI fear owners who have been happy withthe results will seek out groomers etc whoPerform the procedure and now it willbe harmfull to the pet and cause problemsbecause it isn't supervised by me. And whatdo I tell these clients... Sorry we decidedIt is now harmfull?? I would be lying because I believe it's a valuable procedureI have done on my own pets. And what aboutthe clients who won't anesthetize their pets.just let the teeth rot..what kind of standardof care is that? I finally have many clientson a preventative teeth cleaning schedulethat is improving their pets life's and someone in a board room who may have nevereven seen the procedure performed makesdecision that affects not only the wellbeing of my patients but also eliminatesa large source of revenue for the hospital . I am up for renewal and have been a member for over 20 years but this ismaking me take a hard look if Aaha Accreditation is worth it. I think this time you have gone too far.. you are tellingme how to practice medicine without backingit up with scientific proof. Have you surveyedall your Aaha practices to see how manyProvide this service and believe in it?
Kristy, Thank you for voicing your opinion on this important issue. While we recognize that there is disagreement on this issue, we celebrate that it sounds like there is common ground in that we are both concerned with the best interest of the pet. As for what you tell your clients, we suggest explaining to them that just like people medicine, veterinary medicine is in a constant state of change. Veterinary medicine has evolved over time - as an example, hanging dogs from their hind legs used to be the standard for abdominal surgery in the early 1900s. While not comparing this to the practice of dentistry, dentistry standards also evolve as our knowledge base is expanded. Medicine must be in a constant state of evolution so that we may continue to provide better care for our patients. The AAHA standards are not determined by a popular vote by our members – our standards are revised and updated by experts who determine that the changes are the medically right things to do, even if it may seem controversial at first glance. The 2013 AAHA Dental Guidelines for Dogs and Cats state that general anesthesia with intubation is necessary to properly assess and treat the companion animal dental patient. Because AAHA practices are expected to practice the highest level of veterinary excellence, AAHA's leadership determined it necessary to update this standard to reflect the best practices outlined in the Guidelines. Additionally, we firmly believe that the loss in revenue, while only a secondary issue, can be made up in other health care areas including preventive care. While we recognize that not everyone will agree with the new mandatory standard, we firmly believe this is in the best interests of pets. The AAHA Board of Directors welcomes any further feedback – members are welcome to share their perspective by emailing [email protected] -The AAHA Team
I am not happy with this decision. Again the government is telling us how to do something. There are people who believe in natural ways of healing and caring for people and animals. This takes away from our CHOICE to do it this way.
I can't believe you are comparing this to hanging dogs from their legs for abdominal surgery in the 1900's!!!! Not a very good argument. This is not evolving. Medically the right thing to do? Right, it is such a good thing to put animals under anesthesia, because it is so safe and it cannot harm an animal in any way and it is so good to drug up an animal just to clean their teeth. Medically in this country the answer is always, just give them a pill or some kind of drug. It is sad. I am not saying that there is never a need to anesthesia. Somehow this will increase revenue not hurt it or this decision would not have been made.
I am happy with this decision. I think dental care is important in pets and I think putting them under is the right way to do it. Just like stated above, it is A. easier for the patient and tech/dr while cleaning teeth. B. it is more effective to clean the teeth while they're under. How do you know you're truly getting under the gum line when a dog or cat is yanking away, moving their head etc during a NAD? The comparison to hanging dogs up for abd. procedures is a little out there though. However, AAHA is correct in stating that medicine is always evolving. Anyways, I think this is a good change.
Dentistry in pets is performed using general anesthesia to protect the airway from aspiration of debris, saliva or prophy paste, to allow proper and thorough dental radiography, to allow subgingival curettage, to polish out microscratches from hand scaling and to provide adequate and safe restraint for all of the above.All sorts of excuses are made by lay persons, skirting practice acts while engaged in non-anesthetic "dentistry" about why their methods are safe and effective. Certainly our profession opposes such people because we oppose "the ways of the charlatan." As licensed professionals, we are expected to perform at a higher standard than such people, indeed at the highest standard. Trying to defend the indefensible denigrates our profession.Regarding "If I stop performing non- anesthetic denials (sic) I fear owners who have been happy withthe results will seek out groomers etc who Perform the procedure and now it will be harmfull to the pet and cause problems because it isn't supervised by me." The point is, it already is just as harmful and counterproductive when YOU do it, as when a charlatan does it. There is no need for you to lower yourself totheir level. The pets are suffering because of their owners, not because you didnt offer the highest level of service. Untreated mild and moderate gingival disease may be better than an incomplete or improperly conducted "prophylaxis."Regarding: "And what do I tell these clients... Sorry we decided It is now harmful??"Yes, that's exactly what you tell them, and carry your head high thereafter.
I am so pleased that AAHA is implementing this new standard. As an AAHA-accredited practice, we make every effort to educate our clients about the reasons behind quality recommendations. I personally probably would not use the example of hanging dogs from their hind legs for abdominal surgery to convince our clients of the value of dentals performed under anesthesia. I like to explain to skeptical clients that, unlike with people, animals cannot understand the benefit of holding their head perfectly still for a period of time to withstand scraping, poking, prodding, and polishing. And, we don't want to do anything that would cause any discomfort to their baby! Also, we do understand that, like many of us, our clients find veterinary care cost-prohibitve. As a practice, we would rather work with our clients to help them afford quality care than to decrease the quality of care that we provide. One approach we have had success with is to encourage interested clients to make monthly pre-payments to "save up" for the dental. Once they have 50% to 100% of the estimate waiting as a credit on their account, we perform the dental (obviously we handle things differently with more urgent cases).
By the way, bravo to AAHA, for asking something more of its accredited members. There will be those who disagree and may refuse to renew because of that disagreement. If AAHA accreditation is to mean anything at all, it has to mean the highest standard, rather than whatever is the lowest common denominator of its members.
For client information about the new standard, and for information on anesthetic dentals, please visit the AAHA pet owner website: www.healthypet.com/.../...r-dental-procedures.aspx
[By the way, bravo to AAHA, for asking something more of its accredited members. There will be those who disagree and may refuse to renew because of that disagreement. If AAHA accreditation is to mean anything at all, it has to mean the highest standard, rather than whatever is the lowest common denominator of its members.]Bravo, Dr. Goldman! I must say I appreciate your clarity of thinking.
That is the dumbest comparison I have ever heard. Hanging a dog upside down? Who is doing the writing for AAHA? You people at AAHA need to go back and resharpen your pencils and please come up with something we can understand. You have done no research regarding this procedure except for listening to Dr. Bellows talk about some groomers that has no clue with what they are doing. There are over 800 practices in the nation providing this service, are they all wrong? I don't think so. If you have not seen this procedure in a hospital environment you should not be posting an opinion. That means you Dr. Goldman. Why are you so afraid of this procedure? Afraid to the point that you burry your head in the sand and just say no instead of actually viewing it with your own eyes. It is very hypocritical of you. You are all vomiting the same excuses and are too afraid to be open minded about new things that benefit all parties involved. Obviously your handling skills with animals must be pretty bad, if you need your patients to be anesthetized for you to do anything. By the way, what should we do with pets that are anesthesia risk? Let their teeth rot out of their head with no care? I can guarantee our dental cleanings are up to par with us providing services to hundreds of vet hospitals and thousands of customers. I invite you anytime to critique our work and you might even learn a thing or two but I am sure this is falling on deaf ears as it has always in the past. Please stop comparing the professional companies with the lay people in groomers and pet stores.
CLARIFICATION: The intent of the comment about hanging dogs from their hind legs was simply to demonstrate that veterinary medicine has evolved over time, and continues to evolve. We are not comparing this practice to non-anesthetic dentals. The comment should simply be taken as an example of how veterinary medicine has evolved over the years.-The AAHA Team
I'm sorry but AAHA got it wrong. They proclaim that their decision was based on evidence based medicine. They assumed that the Dental College has it right. The Dental College's position was based on conjecture and illogical anecdotes. Comparing non anesthetic cleanings to anesthetic dentals is not useful. Unfortunately pet stores and groomers advertise this as replacement and that's where a lot of the confusion comes from. Doctors that use the service use it as part of a spectrum of dental care that is made available to their patients and clients. Our general population of dogs and cats continue to have rotten teeth. Some "A" clients will do what is necessary to maintain clean teeth, but the majority of clients either never have dental work or have work done once and then again maybe 3-4 years later when the teeth are showing signs of periodontal disease again. I've observed the use of non anesthetic cleanings in hospitals now for over 7 years. I have seen it increase compliance and impact the prevention of periodontal disease. It gets owners involved in dental care and often they become willing to place their animals under anesthesia when advised by a doctor. Doctors continue to recommend dental x-rays under anesthesia and clients seem to be much more willing to do what the doctor recommends when they believe the doctor has the patient's best interest in mind. Let's look at the dental college's objections: "1. Dental tartar is firmly adhered to the surface of the teeth. Scaling to remove tartar is accomplished using ultrasonic and sonic power scalers, plus hand instruments that must have a sharp working edge to be used effectively. Even slight head movement by the patient could result in injury to the oral tissues of the patient, and the operator may be bitten when the patient reacts. " Have they actually observed the procedure performed by a well trained technician? I doubt if the many doctors who use the service would do so if the above was true. In my 7 years of observation I have not found this to be true.""2. Professional dental scaling includes scaling the surfaces of the teeth both above and below the gingival margin (gum line), followed by dental polishing. The most critical part of a dental scaling procedure is scaling the tooth surfaces that are within the gingival pocket (the sungingival space between the gum and the root), where periodontal disease is active. Because the patient cooperates, dental scaling of human teeth performed by a professional trained in the procedures can be completed successfully without anesthesia. However, access to the subgingival area of every tooth is impossible in an unanesthetized canine or feline patient. Removal of dental tartar on the visible surfaces of the teeth has little effect on a pet's health, and provides a false sense of accomplishment. The effect is purely cosmetic. " Again, I refer to my comments on the first point. Are these statements based on conjecture? Or anecdotal evidence from those done in pet stores? I believe the professional doctors using this service are aware that an effective dental has to get below the gum line, and I'm confident that they would not allow a service that was not effective, they have made their conclusions by actual observation."3.Inhalation anesthesia using a cuffed endotracheal tube provides three important advantages—the cooperation of the patient with a procedure it does not understand, elimination of pain resulting from examinations and treatment of affected dental tissues during the procedure, and protection of the airway and lungs from accidental aspiration."Again, conjecture? I've seen many more cases of traumatized tracheas from intubation than aspiration from non anesthetic dentals. Again, perhaps the Dental College has seen these from poorly trained technicians who perform them in pet stores? I have not seen an aspiration problem in 7 years. The technicians have developed a method that captures debris. "4. A complete oral examination, which is an important part of a professional dental scaling procedure, is not possible in an unanesthetized patient. The surfaces of the teeth facing the tongue cannot be examined, and areas of disease and discomfort are likely to be missed. "I have seen over and over again where the well trained non anesthetic technician has found mobile teeth or deep pockets that were missed by the doctor. Then, when specific problems are pointed out by the doctor to the client, the clients are almost always willing to have an anesthetic procedure done to take care of the issue. Over and over again, periodontal disease is detected and then dealt with under anesthesia. Often these issues would have gone on unnoticed had they not agreed to a cleaning. So when we say "highest standard" do we mean that we can take great care of the 5-10% clients who have enough money and are willing to place their animals under anesthesia often to perform what is necessary or are our goals to improve the general population's dental health? Both are important, and I would not criticize any doctor that is not comfortable using non anesthetic dental cleanings as long its based on an open mind. When utilized properly, as I believe most AAHA doctors are capable of doing, this procedure adds to most dental programs by increasing compliance and adding a tool for prevention of periodontal disease. If AAHA wanted to set guidelines I believe these would be welcomed by those who do this responsively. AAHA, as a protective agent for the general public, is not contributing to the well being of the general companion animal population by abandoning this procedure. I would hope that some day AAHA and the Dental Board will take a deeper look at this and assist in developing this as an added tool for prevention of periodontal disease.
Dear Ken,I do not have to defend my profession's ethical standards to you or anyone else. They are what they are. Anything can be justified in an ends justifying the means format. I choose to defer to the Dental College, to the AVMA Principles of Veterinary Medical Ethics, to the AAHA standards and others because I recognize that I do not know everything and that I do not know better than board certified dental specialists, who have a deeper and broader experience in their areas than I can ever hope to have.I am not "afraid" of this procedure or any other method, but the evidence points towards anesthetized dentistry as the standard, one which you clearly reject. I do not claim to know better than the boarded specialists, as that would be the epitome of arrogance. My own eyes are no substitute for randomized controlled trials that have lead the specialists to define the standards for dentistry in pets. Choose to ignore them at your own ethical peril. I choose not to.Regarding: "what should we do with pets that are anesthesia risk?" Either anesthetize them in a safe manner or refer the case to someone who can.Respectfully,ALG
Dr Goldman,You are right. This should not be an attack on you or anyone else, I guess my deep frustration shows. You are certainly free to practice medicine as you want to as long as it contributes and does not cause harm. I did not mean to give the impression that anesthesia dentistry is not important. It is the standard and should remain so. Anesthesia free dentistry is an added tool that a veterinarian can use to increase compliance and keep the teeth clean between regular anesthetic dentals to assist in the prevention of periodontal disease. I also have a lot of respect for the dental college, they have moved the field tremendously in a positive way and do amazing things for the treatment of periodontal disease. However it is my belief that we should always question and I feel that statements made by the dental board , AAHA and others in regards to anesthesia free dental cleanings are not well substantiated. Ken
I do believe that AAHA has the right to set standards and regulations for hospitals. Most of the AAHA requirements and regulations are definitely in the best interest of the patient and the hospital. Unfortunately, I personally don't agree with their decision regarding non-anesthetic dental cleanings (NAD's). We are an AAHA approved hospital and when our owner heard of the new standards set by AHAA he was very upset. He said he would not be renewing our AAHA accreditation if they would not approve of non-anesthetic dentals at our hospital. I am a registered technician and have been doing anesthetic dentals for over 8 years. We have had the non-anesthetic dental cleaning performed at our hospital for as long as I've worked here. We have never had any issues. I have personally sat next to the technician while he was performing a non-anesthetic dental. They clean all surfaces of the tooth including 2-3mm under the gum line, inside and out. They also machine polish every one of the teeth and complete a very thorough charting of any pathology found. I always read on blogs and hear from other veterinarians that relief at our hospital that they believe it makes people not want to do anesthetic dentals. That is definitely not the case at our hospital, most of our anesthetic dentals are pets that were scheduled for NAD's but the technician found pathology while doing their oral exam. We find that people are more willing to follow up with anesthetic dentals when pathology is found during an NAD. I don't believe AAHA has done enough research about this procedure and definitely did not ask our opinion on the matter. I found it comical when we received an email asking our opinion on changing the design of the AAHA logo. Yet, they did not consider asking our hospital who has provided NAD's for over 12 years a single question on the matter. I find it to be very unprofessional that they are classifying all non-anesthetic dental companies in the same group. We have had Animal Dental Care as our provider of NAD's. I can personally attest to the fact that they practice their procedures to the gold standard. We will continue using their services because it is a vital tool in dentistry at our practice.
I find it hard to believe that any hospital, AAHA or not, would consider not having an animal under anesthesia for dental cleaning. We had a client who took his dog for non-anesthetic cleanings for years. He came in one day with an abscessed K-9 tooth, once under anesthesia and a proper exam could be done there were many teeth that needed to be extracted. No one is able to properly clean teeth without anesthesia, especially on small breed dogs who are famous for periodontal disease.
My name is Dr Mayra Urbieta, and I am a (human) periodontist. I have been working with Pet Dental Services for four years now. I completed my undergraduate work at Georgetown University, received my dental degree at Boston University, and completed my 3-year residency in Periodontics at Nova Southeastern University in Ft Lauderdale. I currently oversee the training of our hygienists and their study materials, which have been compiled using a combination of both human and veterinary dental literature to ensure the most accurate and complete program possible. An 11-step procedure was created to ensure continuity among the hygienists, allowing us, as a company, to be consistent with the quality of our service. I was brought on board to ensure that PDS would be able to offer the same value of service to pets that is expected from a human hygienist working under a periodontist. Working for PDS has allowed me to be involved with veterinary dentistry to a certain extent, giving me the opportunity to implement my 7 years of dental training into a service that is so valuable—a service that allows pets to be on a recall system that resembles that of human dentistry, thus providing them with true preventive dental care and maintenance.I applaud those who are cautioning against the traditional NAD. I too am familiar with the perils of stereotypical anesthesia-free dentistry in pets, and thus the stigma that surrounds such a practice and has lead to the AVDC's position on the matter. Unfortunately, because there is currently no official training program or regulatory group for dentistry without anesthesia, there are many companies performing this procedure who truly have a limited knowledge, if any, of dentistry.However, I respectfully disagree with several of the arguments made in these comments, namely with the generalizations. Not every NAD or practitioner of such is created equal, and a procedure should not be deemed impossible or inadequate merely because it is difficult. Although anesthetic dentistry is very safe, it would be considered equally unsafe if carried out by an untrained person outside of a veterinary hospital.NAD should only be performed under the direct supervision of a veterinarian because it is a medical procedure. When performed correctly by highly-trained professionals and prescribed appropriately by veterinarians the benefits of non-anesthetic dentistry can be extremely valuable. Yet it is important to recognize the scope of the procedure. Like any procedure performed by an auxiliary to a veterinarian, it is to be used at the discretion of the veterinarian, for the veterinarian is ultimately responsible for the overall health of each patient. It is up to the doctor to decide when and for what patients the service is appropriate. In addition, auxiliaries should never be expected to diagnose, but to recognize pathology, so that they may bring it to the attention of the veterinarian and know their limitations when performing a prophylaxis. It is this ability to recognize pathology that increases the numbers of anesthetic dentals performed in the hospitals where our services are provided and the countless referrals that are sent out to the veterinary dentists in those areas. Similarly, periodontists and (human) dentists depend on hygienists to recognize and make them aware of oral pathology that may arise between yearly examinations.Non-anesthetic dentistry is not meant to be an alternative to anesthetic dentistry, but to support it. It should not be promoted for its "affordability" or because it is considered "safer" than anesthetic dentistry, but as an adjunctive service.During the training of our hygienists, I often use the metaphor of human pediatric dentistry. Although the AVDC suggests that human dentistry can be performed without anesthesia because the patient can cooperate, they don't take into account pediatric dentistry, which is structured completely around behavioral management. Only children that need full mouth restorations or have extreme behavioral problems are treated under general anesthesia. The only difference between pediatric dentistry and non-anesthetic dentistry in pets is the ability to take a dental xray, which then brings into question the frequency with which dental xrays should be taken. Currently there are no set guidelines for such a timeline and a large percentage of veterinarians do not have access to dental xrays, thus it is up to the doctor to decide at what point xrays are necessary and to perform an anesthetic dental or refer to a veterinary dentist at that time. Again, the veterinarian is responsible for the overall treatment plan of each patient.The bottom line? Not every NAD or practitioner of such is created equal. Pet Dental Services provides a high-quality POPD, offering veterinarians an additional service to prescribe at their discretion on the appropriate candidates. It is medically beneficial to the pets, allowing them to be on a maintenance program in the intervals between anesthetic dentals.
Debbie Zabrowkski, Anecdotal evidence is often good but it must be investigated thoroughly. "He came in one day with an abscessed K-9 tooth, once under anesthesia and a proper exam could be done there were many teeth that needed to be extracted. "Where was this done? was it done under the supervision of a doctor? what were the recommendations? was the client well educated to what was needed? was this done by a well trained technician? etc.? Additionally a dental cleaning absolutely can be done without anesthesia, it is not meant to treat progressed periodonatl disease.
I have read the comments pro and con for non-anesthetic dental. As we are all aware, a single case gone wrong has no bearing on a greater medical discussion. The question at hand is whether a an all encompassing policy is appropriate. The same question has been asked in regards to pit bulls. Do you ban the entire breed for the actions of a few? I am not in favor of banning pit bulls and I am not in favor of banning non-anesthetic dentals. Like many other facets of veterinary practice, NAD's can be used appropriately and inappropriately. We are an AAHA accredited facility and we allow the occasional non-anesthetic dental. I do not believe that non-anesthetic dentals should be the norm nor even the majority of dental cleanings but they do have their place. There are some cases that benefit. Like anything else it is up to the doctor in charge to use the service or technique appropriately. There are so many treatments that have been used inappropriately over the years that have done so much harm yet we have banned none of them - depo-medrol, vetalog, flocillin, FIP vaccination and quite a number of others jump to my mind. We have banned none of these. The presumption is that there may be a small number of cases that benefit. If treatments are used inappropriately the liability as well as the negative impact to your patients is on your head. These have not been disallowed by AAHA because there are small numbers of cases that may benefit - the same is true with non-anesthetic dentals. I believe decisions should be left to qualified practitioners. That is what they were trained for. The more restrictions we put on our own profession and the less faith we put in the hands of those who practice, it will only be to our own detriment.I am in favor of quality practice and I am in favor of choice. Barak Benaryeh DVM, DABVP
Please explain why you have decided to mandate pass fail on this aspect of dentistry but not on dental x-rays ? You mean to tell me you will make such an aggressive stance on this, however you will continue to accredit clinics that perform extractions without dental RADS ? When do you plan to change this to a pass fail?
AAHA and the dental college have missed this one. I own a busy 6 doctor practice that has provided NAD through animal dental care for many years. I was against NAD for the first several decades I was in practice and, like many of you, routinely regurgitated the perils of NAD as speculated by the dental college. I, again like many of you, had never seen the procedure performed at all, much less by someone qualified. A very specific animal and client pushed the issue with us. I was her vet and she wanted me involved. she found animal dental care and through a battle of will and time got me to allow and watch a NAD at my hospital. It is impressive to watch. Real clinical goals are accomplished. The technicians are thorough, get under the gumline, and there is no risk of aspirating. If an animal is uncooperative, they just don't do it. They stop if disease is present that they can't handle and they drive anesthesia dentals by their findings more than I could have ever imagined. We do more anesthesia dentals because we provide non-anesthesia dentals.Realize when we discuss this that NAD and an anesthetic dentals are not the same thing and we do not have the same expectations from them nor do we discuss them as equals. Despite our defense of NAD, we still go to anesthesia 80-90% of the time as a practice. NAD has a niche in care that I've watched emerge as part of our scope of dental care. Some clients will go to it much earlier in life if given the choice and they often pursue it much earlier between anesthetic cleanings. The really remarkable niche is for the client that won't allow anesthesia. We all have them or we aren't paying attention. And while I could sell water to a drowning man and am a huge believer in, and proponent of, safe anesthesia, not all of my recommendations are followed. These anesthesia fearing people are often some of our best clients and they WANT to provide dental care but can't get past the fear. By supporting them and allowing care within what they will emotionally allow, you get to help. These animals typically go completely untreated or go to substandard locales like the pet shop. The other kicker is a significant number of these clients will then go for further anesthetic dental care when the dental technician finds pathology. This scenario plays out all the time. The original cat I referenced has had three anesthetic cleanings and several teeth pulled since the original NAD. None of that care would have happened if I hadn't allowed the NAD.AAHA is imposing the will of a specialty college that is increasingly ever distant from the general practitioner. I am absolutely providing the best care that I know how and I know this helps patients. I truly don't care if others don't wish to provide this or some doctors want to blindly follow AAHA, AVMA, and the dental college. I just don't want to be told how to practice. I did 180+ hours of CE in the past 4 years or so and am an ABVP diplomate. I am open to change, being wrong, and progress. That is not what this is. I find immense irony that the dental college could be so adamantly against something that could help dental care when there is so much untreated dental disease. They are against it without parsing the vast difference in how and who provides a NAD and for most of them without even seeing one. They could be on the forefront of this in defining the parameters and setting standards,For opponents of this who wish to be vocal, please actually see one of these procedures by a trained dental technician. Make your opinion informed. For Debbie, your comment is what those of us in support of NAD are talking about. The animal you reference "went" elsewhere for NAD. If a similar animal was treated by an animal dental technician care under direction of the animals doctor, in the hospital, they may have noted the loose teeth and recommended against NAD.I also resent that I was not contacted and at least warned. AAHA knows from inspections who does this. They made their choice that alliance with the dental college was more important than us and the other clinics that use NAD in their practices. Once this standard is in force hospitals like ours will either leave AAHA or stop doing NAD. The caseload at groomers and pet stores with substandard procedures and no oversight will increase. There will be no increase in anesthesia dentals. There is no positive outcome for this standard. I for one will no longer be AAHA after this becomes a mandatory standard.
I've been associated with AAHA in one way or another almost continuously since 1981, when I was our vet school class rep to AAHA. Fast forward to 2013, and my practice is gearing up for our accreditation reevaluation due this fall. My staff and I share a commitment to AAHA and the high standards set by our organization. We are proud to be able to tell our colleagues that our hospital is one of the few AAHA-accredited practices in our (small) state. We leverage our AAHA accreditation in explaining our higher fees to clients, explaining how these standards, while costing us more, enable us to deliver the highest level of care to their pets.And because we want the best care for our patients, we also do non-anesthetic dentals (NADs).So you can see the conundrum that has been created in a practice such as ours- and apparently in many others- by the new AAHA mandate forbidding NADs.About 5 years ago, my classmate and dear friend from vet school started telling me about Pet Dental Services (PDS), the company that was doing NADs at her practice. She really wanted me to consider offering this service and could think of nothing bad to say about them. She had a strong anesthetic dental service in her practice and felt that the PDS dentals offered a logical compliment to her anesthetic dentals.When her PDS technician moved to my area, my friend once again contacted me and advised me to not let this opportunity slip by. Of course, having heard only bad things about NADs and associating them with the catastrophes created by certain groomers in our area, I was very reluctant to pursue her advice. However, she put me in contact with one of the owners of the company, Josh, who spent over an hour on the phone answering my many questions. We do a lot of dentistry at our practice, and I wanted to make sure that we would not be substituting lower quality dental cleanings for our anesthetic cleanings, and that their procedures were safe. Moreover, I had no concept of how one could comfortably restrain a dog or cat and do a thorough cleaning at the same time.Josh answered all of my questions, including those that probed, in depth, a clinical trial he had just completed with Dr. Jan Bellows. [I believe this study just came out this week or will be out next week.] He assured me that his technicians were highly trained, having completed a minimum of 2 years apprenticeship and having passed an 800-question exam. They knew how to chart mouths and look for oral/dental pathology, often better than veterinarians. He assured me that rumors of aspiration of calculus and other horror stories did not occur with their dentals due to their techniques, training and various levels of patient screening.Intrigued but still a bit leery, we invited a PDS technician to perform a cleaning on a dog belonging to one of my vets. We were impressed- by her handling, by her ability to thoroughly clean the entire mouth using what seemed like all 10 of her fingers independently- cleaning all tooth surfaces and subgingivally- and polishing…and when she finished, the dog jumped up, faced her, smiling and wagging its tail.Fast-forward to now: We've been working with PDS for 1.5 years. All patients are first seen by one of our vets. Some of these are new patients to our hospital, as we are the only one in our region offering this service. Our vets screen the patients for mild tartar, 2mm or less pockets (via probing) and lack of other oral problems as well as a temperament that is amenable to someone working in their mouths. Many patients (most) don't pass this first screening level. Quite often, the patient that is new to our hospital actually needs an anesthetic cleaning, and the client, being impressed with our assessment (and presumably our staff, hospital, etc.) opts to have us do the procedure. PDS has the client fill out a form so the technician can make sure there are no concerns that would disqualify the pet from the dental. For example, if a dog has a back or neck problem, then technician will not want to risk injuring the dog during restraint. We had one such disqualification recently.Their technician then performs the oral exam. Because of their skills in being able to visualize the entire dentition in the awake dog/cat, these techs quite often find lesions that we missed. When this occurs, the tech brings this to a doctor's attention immediately, and we then decide if we want the tech to continue with the cleaning or stop and schedule an anesthetic dental. We've increased our number of anesthetic dentals since using PDS. Moreover, in the cases in which we've had the tech proceed with the cleaning and we address the identified issue with anesthesia, we've seen how thorough their procedures have been.The client acceptance has been overwhelming. Many of our clients want to start good oral care when their pets are young but the tartar gets ahead of them. When we detect early tartar and up to 2mm pockets, the clients are thrilled that this can be simply addressed with the PDS dentals. Since our cheapest anesthetic dentals- those that entail routine cleaning and are 25 minutes or shorter- cost over twice as much as the NADs and involve the risks of anesthesia, clients are much happier with this option. Clients also are thrilled that sometimes our expensive anesthetic dental procedures can be followed up with non-anesthetic cleanings for a while. In fact, we've heard countless times from clients how grateful they are to us for offering this service. [A note about anesthetic safety: We have a LVT monitor 7 parameters during anesthesia. At least a few times a year, we detect arrhythmias, for example, in the patient anesthetized for dental work. Yes, anesthesia introduces risks that are not present in the awake patient.]So you can see the dilemma we're facing. AAHA has decided, without asking its members if any of us are participating in non-anesthetic dentistry and what our experiences are, to mandate that this vital service not be allowed. We practitioners are now in a position to either discontinue a service that we feel is safe and effective because it's being done properly, a service that has garnered high client satisfaction rates and expanded the reach of our dental care program, a service that now has a clinical trial to support it; or relinquish our AAHA accreditation. We don't understand why this one standard, without discussion among members, has been elevated to the level of a mandate when, as pointed out, tooth extraction without radiographs are not a mandatory disqualifying standard.And given the recent/pending peer-reviewed clinical trial on NAD, the use of NAD has a higher level of evidence to support it than does the mandate which is purely based on expert opinion with no supporting clinical trial.I've been asked countless times by my staff what I am going to do: Give up NADs or relinquish our AAHA accreditation. I have answered them with "neither." I have every hope that AAHA, as a member-driven organization, will listen to concerns and experiences of its members who utilize NADs and reconsider their stance. In my opinion, now that AAHA has discovered the prevalence of NADs among their members, a new set of standards governing the use of non-anesthetic dentals in practice would be a much more prudent option.
AAHA- You are all forgetting about prevention in between anesthetic dentals with radiographs, are you suggesting owners are to put a pet under every 3-6 months for a dental cleaning ? Are you suggesting that there is no alternative available to pets for routine cleanings and surgery is the only option? Have you ever taken a child to the dentist for a cleaning? Or do you believe pediatric dentistry is impossible? What do you think parents would say if you told them that every time their child needed a routine cleaning we needed to place them under general anesthesia? I'm pretty sure a large portion of the population would be walking around with horrific dental disease. This is really a simple service and in no way has Pet Dental Services suggested they replace anesthetic dentals with dental radiographs. The entire model for Pet Dental Services is an adjunct therapy in between routine anesthetic dentals, a compliment to an already existing dental care program. This is an ideal procedure for young pets with healthy gingiva and minor calculus, for pets who have recently had anesthetic dentals with radiographs that need a routine cleaning and for pets with pre-existing medical conditions that a specialist would conclude a poor candidate for general anesthesia. Please explain to me why you are not mandating dental radiographs?? That is the real shame. We all know how risky it is to conduct extractions without dental radiographs, but yet you are still accrediting hospitals that do not have them. That seems un-expectable to me. Something seems very strange about this mandate and it appears there is a large group that agrees. We are all waiting for answers.
My hospital has been AAHA accredited for over 25 years. Mandating that dental cleanings be performed only under anesthesia has surprised and disappointed both me and my partners. I perform most of the anesthetic dental procedures in our hospital and am able to do more advanced procedures than most general practices. We have great high-speed equipment, digital radiography and perform both periodontic and endodontic procedures. We carefully select pets for non-anesthetic dentals, as not all pets are candidates. The dental technicians that perform the non-anesthetic dentals are professional, well-trained, patient and thorough. They also know this procedure is very beneficial for patients and clients, provides another forum for client education and increases preventive dental compliance. I would respectfully request that AAHA reconsider this very broad mandate and formulate guidelines and voluntary standards that will benefit our profession rather than hinder it.
Our hospital has been an AAHA affiliated practice for over 25 years. We feel that mandating that all dentals be performed under anesthesia is the wrong approach. When we were first contacted about offering this service to our clients, we were very skeptical. But instead of saying "no-way," we agreed to see the very skilled dental technician perform this procedure on several of our employee's pets. We were absolutely amazed at how smooth all the cleanings went and what a completely thorough job the technician did – not only cleaning and polishing all surfaces of the teeth, but also probing, charting and looking for pathology – and the pets were not stressed, were very compliant and awake and happy when the technician was done. After offering this procedure for 2 years, we KNOW that this is a step forward in veterinary dental care. We are able to prevent some of the nasty, tarter-filled mouths in dogs while their teeth are in good shape, instead of having to do multiple extractions later. We have been able to convince clients, after performing a non-anesthetic dental, that their pet will need x-rays and possibly extractions, once they see the teeth clean. It also allows clients to plan for their pet's anesthetic dental when it best fits their budget. We carefully screen each patient for applicability and temperament and only recommend NAD's for those pets that would benefit from it. We have always strived to maintain the highest AAHA standards and will continue to do so regardless of this mandate. We will also continue to offer non-anesthetic dentals to our patients. Non-anesthetic dentals are professionally done procedures by extremely well-trained technicians under the supervision of our veterinary staff. We have had no problems. We are offering better dental care and are achieving better compliance than we have ever had. NAD's are NOT sub-standard dental care; they are progressive dental care. We have not mislead our clients, nor are we doing this to boost revenue. Our veterinary staff is honest, ethical, dedicated, caring and responsible. We do not perform or allow procedures that are not in the best interests of the client and the patient. If the group of veterinarians who chose to mandate anesthetic dentals only would actually see the procedure performed ONCE by a trained dental technician, they would see the value that non-anesthetic dental procedures will ADD to a preventive dental program. We would certainly welcome guidelines and standards, but not a mandate regarding this procedure.
I was also a skeptic when I heard about non-anesthetic dentals. Surely, no animal would allow anyone to clean its teeth awake. After watching the Animal Dental Care technician clean our pets' teeth - our staff's not-so-nice cats and dogs - I was convinced. I have always been a technician (patient advocate) first and practice manager second. Adding this service to our practice allows me to be both. Our patients are getting the best care available and our practice has benefited by increasing client satisfaction and dental compliance as well as allowing our doctors and staff to provide better client education and patient care.Mandating that all dental cleanings be performed under anesthesia is to the detriment of the pets. Most everyone in our profession has worked hard over the years to increase dental compliance, but usually by small increments. Now we have another tool that allows us to make some real progress towards better dental care. It's not for everyone (practices, clients or pets) but for those practices that have made a real effort to check out non-anesthetic dental procedures for safety, quality and applicability, it has definitely added value to preventive dental care.We are all hoping we don't have to choose between AAHA and NAD's because we all want the same thing - quality patient care. Guidelines, minimum standards and/or voluntary standards for non-anesthetic dental procedures would be much more appropriate, especially in light of not having dental radiographs as a mandated standard. Regardless, we will continue to practice veterinary medicine to the highest standards.
There is lots of misinformation and rhetoric being passed around about this issue. Where is the evidence based medicine that you are basing your decisions on. We too are a long standing AAHA hospital that thoroughly investigated the option of NAD. I for one was very skeptical but was also completely convinced of the value of NAD. The ABVD and the AAHA statements seem to be referring to groomer dentals. I would request the AAHA take a leadership role in this process rather than making a decision which it says is evidence based. Anecdotes are not evidence!!!. It would seem wise to us (with a combined 82 years of practice) for the AAHA to table this dramatic change in position and partners with ABVD and set some standards and get some evidence to base their decisions on. There are at least two very reputable animal dental care companies who I am confident would be more than willing to participate. We are very pleased to offer NAD as one component of veterinary dental care. It is a great service which can be used properly. When was the last time anyone of you had anesthesia for your routine dental care. Did you aspirate?? Did the technician not probe your teeth??? Did they skip the subgingival scaling because it was too painful and you were awake??? I think not!!!. We all too often just keep hanging dogs by their feet to do abdominal surgeries. It is time for a good change. Don't ignore the great number of well established good docs who are willing to give up their accreditation because they believe with good reason and experience that NAD are a viable procedure. Table the decision and get some solid evidence from reputable sources.
I am an associate at an AAHA hospital and was also skeptical about NADs when we first met with Pet Dental Services. We do a lot of dentistry and I spent a lot of time upgrading our dental program when began as a new associate. Upon the upgrade, we started performing dental radiographs for all extractions and made a tremendous upgrade to our equipment. Quality dentistry is very important to me so I really wasn't sure how NADs would fit in and if they would be up to our hospital's standards. Over the time that Pet Dental Services (PDS) technicians have been coming to our hospital, I have seen more owners agree to dental care for their pets because of the decreased cost of the procedure. Interestingly, however, if their pet "fails" a NAD, they are quick to sign up for an anesthetic procedure because the PDS technicians has been able to really encourage them to follow through on the dental care. The technicians are able to identify lesions and pathologies that I am just not able to find or address in my office during an annual examination. I feel that we are doing more anesthetic procedures because of the PDS technicians recommendations. Maintaining oral health care has become more "doable" for our clients after anesthetic procedures because they are able to get a NAD in between anesthetic procedures. They are realizing how important oral health care is and how much more accessible it can be when they do not have the expense and worry of having to anesthetize their pet every 6 months.I was very surprised that AAHA made anesthesia a mandatory standard when dental radiographs are not mandatory for extractions. I can't imagine performing any type of extraction (other than the loosest of teeth) without the benefit of dental radiographs. In my opinion, AAHA has mandated the wrong standard. Instead of a mandate that all dentistry is done with anesthesia, why not mandate the quality/type of dentistry that is performed (with and without anesthesia)? IA reputable NAD service has technicians that are much better trained in dentistry than many veterinarians are coming out of vet school. I am a relatively recent graduate and had no clinical dentistry training - having to learn through CE, reading on VIN, and wet labs. I think the PDS technicians I have worked with could actually have taught me a lot about oral pathology and dental care when I was a new graduate.I am not sure why hospitals are being asked to choose between NAD and AAHA accreditation. It shouldn't be an either or situation. It is very upsetting to me, as I find that AAHA helps our hospital to keep up with the highest standard of care. It will be a very sad day to see our hospital part ways with AAHA because of the inability to find a middle ground - ie, standards for a service that is not going to go away just because of AAHA's most recent mandate.
Thank you for your comments. We appreciate feedback from our members, and all of your comments have been forwarded to AAHA leadership. At this time, we will be closing comments on this issue. If you would still like to share your perspective, please email [email protected] Thank you! --The AAHA team
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AAHA hospital- Sweet kitty is doing GREAT after toe amputations - City the Kitty - Official
Red is your guide to everything AAHA. Whether you're looking for association news, updates on our educational offerings, the latest books from AAHA Press, deals from our Preferred Providers, or fun reads from various AAHA staff and AAHA-member veterinary professionals, this is where you'll find it.
Questions or comments? Email us at [email protected] or call AAHA's Member Experience Team at 800-883-6301.


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DOWNLOAD Music: The Messenger – Taking Over (ft. Prime X)
Gods people had been given a command to bring Gods kingdom down for the world to see,here,learn,know,believe and experience God. It is his desire that the world learn from us all things,thats why he made us great,filled us with his power and authority to pull kingdom resource down,and unless we walk in this truth we will deny the world true blessings cuz the whole world awaits us.Daniel 7:27…That is what the song is about.Believers waking up and taking there inherent positions.
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Twitter: @dmessenger_baba
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7 thoughts on "DOWNLOAD Music: The Messenger – Taking Over (ft. Prime X)"
this is very timely and the power of God is upon his righteous sons
Wow this is great more of u I pray IJN
Ayuba Ahmed dawa….. Wooooooooooooooo what a wonderful, great and marvelous song.. So more grace to your gospel music ministry..
Wow!!!!!!tankx guys,more grace…its indeed time to take over.
Wawo, I was blessed by that song, keep it up more grace.@iliya
it's marvelous… May God establish you.
You keep on the good work guys. More grace…..

subset: commoncrawl


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Are you looking for some extra space at home? Imagine you have nearly a full floor above your head that could become the ideal place for that extra bedroom, study, or even an entertainment room. What you choose to do with the space is your call, how you do it is ours!
We have put together a series of frequently asked questions that will help you decide if your attic is suitable for conversion and if you want to explore the option further.
Do I need planning permission for my attic conversion?
- In most cases attic conversions are exempt from planning permissions. These usually consist of conversions that have windows facing the rear or side of the house (if they are not overlooking a neighboring property).
- Attic Conversions that make any material change to the front of a dwelling (windows / dormer windows) will require planning permission.
- If in doubt contact us and we can discuss your attic conversion further.
Is my attic suitable for conversion?
- Unfortunately not all attics meet the criteria for conversion.
- You can do a quick test yourself and venture into the attic space (if safe!). Take a measurement from the central roof beam to the floor boards, then deduct about 6-10 inches from that and you will have a reasonable estimate of your final floor to ceiling height.
- Or take a look on your street, if your neighbors have attic conversions then the chances are your house attic will be suitable too!
- If in doubt you can contact us and we can discuss your attic conversion further.
So my attic is suitable for conversion and i dont need planning permission… how much will it cost?
- Again this varies from property to property and each dwelling can present its own unique situation.
- The easiest thing you can do is contact us today and arrange your free quotation for your attic conversion in Dublin


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Audi A4
since 1994 of release
Repair and car operation
A4 Audi
+ Running gear
+ Regular servicing
+ Engines
+ Turbo-supercharging
+ exhaust System
+ cooling System
+ Fuel tank and fuel pump
+ Air filter and absorption channels
+ injection System
+ Coupling
+ Transmission and main transfer
+ Suspension bracket of wheels and steering
- Brakes
Independent work on brake system
So the brake system works
Check of brakes
Brake liquid
Check of level of brake liquid
Check of brake system on tightness and existence of damages
Replacement of brake liquid
Disk brakes
Measurement of thickness of overlays of forward disk brakes
Check of a condition of brake disks
Replacement of overlays of disk brakes
Back disk brakes
Measurement of overlays of back disk brakes
Hand brake
Check of idling of the lever of the hand brake
Main brake cylinder
Brake amplifier
Check of the brake amplifier
Works on hydraulics of brake system
Pumping of brake system
The help at malfunctions
ABS and EDS
What does ABS?
Function of separate knots
Electronic system of distribution of brake effort (EBV)
Violations in ABS system work
Electronic blocking of differential (EDS)
+ Wheels and tires
+ Electrotechnical equipment
+ ignition System
+ Lighting
+ Alarm equipment
+ Tools and devices
+ Heating and ventilation
+ body Details
+ Salon
Search of malfunctions
Technical characteristics
Check of idling of the lever of the hand brake
Cable of the hand brake on the case of a back brake support
Brake of the hand brake in the quattro model
Brake of back wheels in the front-wheel Audi model
Replacement of a cable of the hand brake
Adjustment of the hand brake
At the left: so the screw-driver fixes on the average situation a yoke of the hand brake.
Thanks to the automatic mechanism of adjustment of disk brakes the hand brake needs to be regulated only after replacement of a cable or a brake support.


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The 2018 Formula 1 season witnessed a tremendous battle between Ferrari and Mercedes, two squads with which Ross Brawn shares a great deal of history. Now, as the sport heads into its winter off-season, when engineers will try and work out how to come back in 2019 better, stronger and faster, Formula 1's Managing Director of Motorsports looks back on what he rightly hails as an 'action-packed' year...
Lewis does it his way
With the images of the donuts performed on the Yas Marina Circuit by Lewis Hamilton, Sebastian Vettel and Fernando Alonso still fresh in my mind, my first thoughts are that it was a fittingly spectacular and emotional end to what has been an intense and action-packed season.
Lewis Hamilton dominated the season, although this was probably the most difficult of his five title wins, and certainly the most complicated of those he has taken with Mercedes.
For the first time in the hybrid era the Silver Arrows were up against an opponent, in the shape of Ferrari, that was usually stronger, especially in the first half of the season. However, over the course of the year, Hamilton hardly put a foot wrong, winning not only the races he should have, but also some where the opposition was stronger, and that is the true mark of a champion.
After retiring in Austria, Hamilton's record was impressive: eight wins, two second places and a third. Strangely, Mexico, the only race after Austria in which he didn't finish on the podium, was where he took the title.
As always, Lewis did things his way, proving that he is able to win titles and accumulate record after record without altering his lifestyle one jot. In the words of the Paul Anka song immortalised by Frank Sinatra: "I've lived a life that's full, I've travelled each and every highway, and more, much more than this, I did it my way."


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If you follow the Golf Gourmand with any sort of regularity you know what our philosophy is on fantasy golf. We basically follow this little formula and try to double our money every week. Last week we doubled our money in two contests we entered so we were feeling good. In fact, in last weeks summary we said that we had a feeling we were going to start making some big strides…and guess what? Last week we had a 4th overall (out of 4,000) and took home $150!!!
We took $150 on a 3 dollar tournament. What is that, like a 5000% ROI? Not a bad weekend at all. It was strange because the CIMB Classic was in Malaysia so the time difference was crazy. Basically the tournament started at 8 pm and ended about 2-3 am for me. After the first 2 days when it was obvious we were going to place well we stayed up late over the weekend and was constantly checking my lineup.
Free Fantasy Golf Picks – Sign Up Today!
At one point during the tournament it looked like I might've even taken first place. Going into the final round I needed Kang to win the tournament and he was in the last group. Just about everyone in front of me that had a chance of winning had Pat Perez in their lineup. So it was either Perez was going to win and I'd get a top 5, or a real nice Sunday from Kang would get me the win. Overall I couldn't be happier with how it turned out. This one tournament pretty much bankrolled me for 2018, and morale is high. We're ready to keep our winning streak going.
Like we say…be consistent and try to double your money; More money = more entries, & as you start to learn the players you'll hit a high number.
I must say, we are absolutely loving these no cut events. Obviously it's the same for everyone who enters a fantasy golf lineup but it helps take some pressure off. You can analyze players games and just go with it. You don't have to worry about one or 2 guys missing the cut and ruining your lineup.
What lead to the success we had this weekend was Kang obviously, because no one else really had him in their lineup. He was a relatively unknown sleeper for only $6,900 and it paid off big-time. Bradley also scored a ton of points, and finished second for only $7,000. Cink was also a great find, and scored a lot of points for finishing the tournament in 13th place. We purposefully stayed away from Justin Thomas because we thought he was too expensive. We didn't want him hogging the payroll and compromising the rest of the lineup and it worked out nicely. Leaving him off allowed us to get better players around the $7,000 mark instead of third tier. (Don't ya just love it when a plan comes together) Besides Matsuyama this was a very middle tier lineup.
We're very much looking forward to handicapping the next event in South Korea. It's a smaller field with no cut again, so we're hoping to keep the momentum going. If you'd like to play along be sure to sign up for a our weekly picks.


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Anderson addresses Scugog
DAN CEARNS The Standard
SCUGOG: Regional Chairman Roger Anderson made his annual address to Scugog Council on Monday, June 1, providing an update on the recent actions of Regional Council, including housing, transportation and the upcoming review of Regional Council representation.
One of the next steps for the Region that Mr. Anderson mentioned was the implementation of the Durham Housing Plan this year. The plan is active until 2024. The goals of the plan are to provide more affordable rental housing options for low and moderate-income families, housing that supports diverse communities and more information about support services. The plan will be funded by a one-time investment by the Federal and Provincial governments of $28.2 million over the next five years.
"We will be able to create 120 new rental units, we'll be able to work with habitat for humanity to provide 16 new affordable home ownership opportunities and we'll be able to offer rent subsidies to over 600 households on the Regions social housing waiting list of 5,400 people," said Mr. Anderson.
According to the Plan, households in Durham are forecast to increase from 214,000 in 2011 to 356,000 in 2031 and seniors will increase to about a third of the Region's population by then.
Mr. Anderson also said that the Region is currently looking at the right size for their Regional Council, after many years of debate over the current levels of representation. The Region has sent off a letter to the Chambers of Commerce in Brock, Uxbridge and Scugog and are waiting for them to nominate one person to represent North Durham.
"Hopefully we'll be able to get the answers back from the chambers of commerce and the boards of trade across the Region of Durham in the next couple of weeks so that we can begin commencing.," added Mr. Anderson.
Members of the committee that will be looking into it will include Mr. Anderson, eight regional councillors, a representative from UOIT, Durham College and Trent University as well as representatives from the Region's boards of trade and chambers of commerce.
The report will come to Regional Council in November and will be finalized by March 16, 2016. After that, it would be up to Regional Council to decide if they would like to restructure the current distribution of representation.
Mr. Anderson also said the region plans to invest $10 million dollars this year in road rehabilitation programs to fix over nine kilometres of regional roads in Scugog, including intersection improvements along Simcoe St, and repairs to a section from Hwy. 12 to Marsh Hill Rd.
We reserve the right to remove any and all comments for any reason. Comments with swearing will be deleted without exception.
May 2019


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Absolutely—if your doctor participates in an ACO, you can see any health
care provider who accepts Medicare. Nobody—not your doctor, not your
hospital—can tell you who you have to see.
No. An ACO is a group of doctors, hospitals, and other health care
providers who work together to provide you with better, more coordinated
care. Doctors and hospitals in an ACO communicate with you and with
each other to make sure that you get the care you need when you're sick
and the support you need to stay healthy and well. An ACO isn't an HMO,
managed care, or insurance company. Unlike HMOs, managed care, or some
insurance plans, an ACO can't tell you which health care providers to
see and can't limit your Medicare benefits. If your doctor participates
in a Medicare ACO, you always have the right to choose any doctor or
hospital who accepts Medicare at any time.Only people with Original
Medicare can be assigned to an ACO. You can't be assigned to an ACO if
you have a Medicare Advantage Plan (like an HMO or a PPO).
Click here for a list of providers participating in the Princeton HealthCare Partners ACO.
If your doctor or health care provider chooses to participate in an ACO,
you'll be notified. This notification might be a letter, written
information provided to you when you see your doctor, a sign posted in a
hospital, or it might be a conversation with your doctor the next time
you go to see him or her. If you aren't sure if your doctor or health
care provider is participating in a Medicare ACO, ask him or her.
Over time, if you see a doctor or health care provider participating in an ACO, you may notice that:
Your Medicare benefits won't be limited because your doctor is part of
an ACO. Also, you still have the right to choose any hospital or doctor
that accepts Medicare, at any time, even if that hospital or doctor
isn't part of an ACO.
You'll continue to get the same rights all people with Medicare get. To
help you to get the best-coordinated and highest quality care, Medicare
will share certain information about your medical care with your
doctor's ACO, including medical conditions, prescriptions, and visits to
the doctor. This is important to help the ACO keep up with your medical
needs and track how well the ACO is doing to keep you healthy and
helping you get the right care.
Your privacy is very important to us. You can tell Medicare not to give
your doctor's ACO information that your doctor needs to coordinate your
care by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call
1-877-486-2048. Unless you take this step, your medical information will
be shared automatically with your doctor's ACO for purposes of care
coordination and quality improvement.
If you're now getting or received treatment in the past for alcohol or
drug abuse, Medicare won't share any information about that treatment
with any ACO unless the you give Medicare your written permission to do
The group of doctors, hospitals, and other health care providers working
together in the ACO will be able to read your medical records, along
with other office staff authorized to help coordinate your care.
The privacy and security of your medical information is protected by
federal law. Contact your doctor's office for more information about how
they protect your medical information, or call 1-800-MEDICARE
(1-800-633-4227) 24 hours a day, 7 days a week. TTY users should call
When your health care providers have access to your health information
and are able to share that information with one another, they can give
you better, more coordinated care. Each of your health care providers
won't only know about the health issues that they've treated, they'll
have a more complete picture of your health through communicating with
your other health care providers.
When your health care providers participate in an ACO, you should see
better, more coordinated care over time. With an ACO, you're the center
of care, and your satisfaction is one of their goals.
Princeton HealthCare Partners, LLC
Address: 1 Plainsboro Road Plainsboro, NJ 08536
Compliance Line: 609.853.7900
Email: email@example.com
ACO Primary Contact: Patricia Muniz, email firstname.lastname@example.com or call 609.853.7256


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White iPhone 4 confirmed
The arrival of the White iPhone 4 may have finally been confirmed. The Wall Street Journal reports that the White iPhone 4 may be due for release this spring.
On Thursday, Apple said that the White iPhone 4 would be released in spring, and is rumoured to support both Verizon and AT&T networks.
With the release of the iPhone 5, which is expected to come out this summer, so close to the release of the White iPhone 4 only reinforces the rumour of a 2012 iPhone 5.
(via RedmondPie)


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Funko Bat Girl Pop Heroes
- Ages 3 and up
- Head turns and looks amazing
- Stylized and fun
- A great take on the heroes and villains of the DC Universe
- Adorable 3 3/4" collectible Batgirl Pop Heroes Vinyl Figure
Inspired by designer toys and stylized character collectibles the world over, Funko is back with Pop! The distinctive design brings Funkos house style in to the planet of plastic figures, and we just know that Batman is going to appear great on your desk. This adorable collectible figure of The Penguin comes packaged getting a smile specifically, yours! Heroes Vinyl Figure!
Copyright © 2019 - Funko Dolls


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Mambo Mamas
Northwich Youth Centre
Mambo Mamas is a baby friendly Latin dance exercise class & coffee morning.
11-12.30 pm
Thursdays term time.
£5 per session including a tea/ coffee.
It is a relaxed environment to meet other like minded ladies and have some fun whilst exercising. The babies and children love it too!
Free first lesson when quoting Kidsguide


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Can Kylian Mbappe replace Neymar?
PSG's £166m wonderkid faces biggest test of his young career against Real Madrid, one year on from stunning burst onto Champions League stage
becoming the world's biggest talent
It was a year ago that a raw but exciting young forward called Kylian Mbappe exploded into our consciousness by masterminding a spectacular and unexpected Champions League victory at the last-16 stage for Monaco against mighty Manchester City.
Mbappe scored in both legs as Monaco won on away goals after the tie had finished 6-6 on aggregate, City winning the first game 5-3 at the Etihad Stadium before losing 3-1 in the Principality.
Monaco went on to reach the semi-finals, Mbappe secured a mouthwatering £166million move to Paris Saint-Germain and on Tuesday night he'll carry the main responsibility in Neymar's absence of overturning a 3-1 first-leg deficit against Real Madrid, the team he was tipped to join last year. Mbappe is still only 19.


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Get an exclusive look at the making of Disney Pixar's The Good Dinosaur
Disney Pixar's new animated adventure The Good Dinosaur comes to DVD next month and we've got a exclusive clip from the making of features, which you can watch below:
Featuring the voices of Raymond Ochoa, Jack Bright, Sam Elliott, Anna Paquin, A. J. Buckley, Jeffrey Wright, Frances McDormand and Steve Zahn, the movie is set in a world where dinosaurs and humans live side-by-side and follows the unlikely friendship between an Apatosaurus named Arlo and a human named Spot.
The Good Dinosaur is available to purchase from March 21st and is available to pre-order on DVD, Blu-Ray and 3D Blu-Ray on the right-hand side of the page.
©2015 Disney.Pixar


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5th June was recognized globally as the World Environment Day and has been celebrated by hundreds of environmental organizations worldwide. The Armenian Society for the Protection of Birds (ASPB) joined the "Let's do it!" Armenia movement which was celebrated by a flashmob chalk drawing contest titled "Armenia without garbage" in Yerevan and other regions of Armenia. The event is part of the World Cleanup 2012 action aimed at uniting Armenia and cleaning the country from waste to be held in the country on 15 September 2012.
In Yerevan, the contest was organized in the Yerevan Children's Park and the main task of the drawing contest was to picture a clean environment. Children drew trees, flowers, forest and other nature elements. Participation involved more than 80 schoolchildren aged 6-12 years. Upon the completion of the event the participants received prizes prepared by some organizations including ASPB.
This event was spearheaded by the Young Biologists Association NGO and joined efforts of other partner organizations such as WWF-Armenia, Armenia Tree Project, Yerevan, Hrazdan, Alaverdi, Aparan, Eghvard, Ijevan and Gavar Aarhus Centers, Armenian Environmental Network, DJ Vakcina (The Laboratory), Kanachastan NGO, "Yeghvard" Youth Environmental NGO, "Tapan" Eco-Club NGO, Consumers Support Center NGO, Youth Journalists Association NGO, Armyouth.am website, Ohanyan Educational Complex and more.
P. Sevak 7, Yerevan, 0014, Armenia
by phone & fax: (+374 10) 20 87 25
by e-mail: firstname.lastname@example.com
or fill in the form on our contact page


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Financial Results - Quarterly Comparison March 2018
FINANCIAL HIGHLIGHTS (consolidated)
FINANCIAL HIGHLIGHTS (consolidated)
By Craig H. Howie
Senior Executive Vice President
The foundation for the merger of BBN with ACBB was to provide a stronger bankers' bank for community financial institutions throughout the Mid-Atlantic states and New England. We can achieve this through operational efficiency, a broader array of competitive products and better customer pricing through greater aggregation. We are now in the process of streamlining and synchronizing our business practices and procedures. Depending on products and services used, this may result in changes that could affect your institution.
By Kevin Martin, CRCM, CAMS
Compliance Anchor Consultant
Compliance Anchor is one of ACBB's best-kept secrets! Many of you are new to ACBB and/or Compliance Anchor and may only be aware of us as webinar providers. There is so much more to tell! Here's an overview of what Compliance Anchor does for community financial institutions:
By Jon Evans
On April 6, we implemented the conversion of our systems with those of BBN. While we experienced some problems at the time, operations should be flowing smoother now. There still need to be some changes made to XNET and for that, we seek your input, as our goal is to have an efficient, user friendly customer communications platform.
ACBB reported net income (unaudited) of $2,732,495, yielding an ROAA of 0.43%. This included a deferred tax adjustment of $1,594,173 which was primarily due to our robust loan loss reserve coverage. On a consolidated holding company basis, earnings were $2,549,941, primarily due to merger related legal expenses. It should be noted without the DTA we would have experienced near record levels of earnings. Please also note, remaining estimated merger related expenses (i.e. severance, vendor contracts) of approximately $500K will be realized within the first half of 2018.


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Social Media/Growth Hacker
We're a forward thinking recruitment agency that hires globally, delivers locally and puts up content upon platforms such as LinkedIn, Medium, Instagram and more.
We do things different, we smell different and we're set to reinvent the art of recruitment
Whats needed:
Elevano is a premier provider of innovative Information Technology Solutions and Resources. We offer a wealth of employment opportunities for technical professionals. You will be empowered to do the best job and achieve your professional goals. Our goal is to match your talent to the best job. Elevano is an equal opportunity employer.
Elevano Consulting Inc.


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The suit must be perfectly sewed so that you are totally comfy wearing it. Be sure you to try your own suit and maneuver around a bit to be sure the fit is ideal. Remember additionally, you will dance with your guests and you will move the legs easily.
Always, a custom suit could make one completely stay ahead of the crowd around him. Why? Off-the-rack suits are usually of lower top quality make people look dull or in-distinctive, while a tailor-made garment sewed by hand will make a daring statement about one's fashion taste. It doesn't matter what styles, a well used suit for work or something fashion-forward, the custom clothes are talked highly in many occasions.
Even though it is great to wish to improve your posture, it is vital to allow yourself to be in your natural posture while becoming measured for any custom made suit. Straightening your spinal column or pulling back your shoulders will give a misrepresentation of the natural dimensions, thus leading to an unflattering suit.
With all the current standing up of the industry and also the ongoing occurrences of financial issues, it is currently the stated reality to always pick less costly options. Certainly, if you're just using all of them for one or perhaps two occasions, it is best if you simple employ suits. If you don't have a lot of money to pay for a high quality coat, it is best to rent one. bespoke suits Also, they are pricey in nature so if you're only working together with it for 1 or 2 occasions or events, renting could be the best choice.
With all the advent of online shopping several retailers have exposed their own online retailers where you can search through all the various models and make options as per your needs. Many customers that had a difficult time choosing the perfect Designer Salwar Kameez are the caring the online setting of purchasing. You can easily check all aspects of any dress without restrictions and take informed decisions. It is a very comfy way of purchasing your favorite dress. Even in the actual changing fashion trends these racial Indian attire remain the most sought after garments among the public. Go ahead and get a dream outfit to make a difference.
In case you are particularly eager to appear fashionable and arrest the attention of all guests in any gathering, choose a slim cut suit. With the reduce somewhat slim at the midsection and legs, this suit will appear sleek, trendy and amazingly different from the original men's suit. Any slim suit can be the perfect clothing for an office function, a church collecting and many additional formal events.
- 788 Visitors


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At long last the Government is making some effort to improve the UK's cumbersome and antiquated conveyancing process.
Last week, the Land Registry published the first of a series of consultations on what Lord Chancellor, Lord Irivine claims will be a 'world class, speedy and easy to use electronic conveyancing system.'
According to the Land Registry, a fully developed e-conveyancing system would enable authorised solicitors, licensed conveyancers, estate agents and mortgage lenders to carry out business with each other and with the Land Registry through a private and secure nationwide network and to access necessary information online.
Solicitors, meanwhile, will be able to draw up contracts, draft deeds, handle mortgage offers and complete and register sales online.
Hopes for the initiative are high. Experts believe that, in time, buying a house will be as simple as buying a car. After viewing a property and making an offer, buyers will be able to walk into an estate agentcy and exchange contracts within hours. However, if the conveyancing process speeds up as much as the industry anticipates, lenders will have to embrace technology to ensure they can issue mortgage offers as quickly as possible. While some are making great strides in this direction, the rest of the lending community will have to follow suit if they are to remain competitive.
These proposals are long overdue. We currently have the slowest house sales and purchase process in Europe. Back in 1997, when the Government started its review process, the Department of Transport, Local Government and Regions carried out research across Europe ,which revealed the process took an average 65% longer in England and Wales than it did on the Continent ' a whopping 10-12 weeks compared with a much more respectable seven weeks in other parts of Europe.
The Government is allowing itself 10-15 years to achieve its objective, but others in the industry are confident that e-conveyancing should be widespread within the next four to eight years.
So, change is definitely a long way off, but the benefits should be worth waiting for, if they take the pain out of buying and selling property.


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Culture in the wilds
Culture in the wilds
The Rauniokaupunki cultural association brings music and theatre to Kajaani, a town in the North of Finland, surrounded by wilderness.
Doing leads to action - these are the words used by the cultural association Rauniokaupunki to describe its philosophy. Rauniokaupunki means "town in ruins", and during the past few years, some strange tremors have shaken the Finnish town of Kajaani. There have been awesome cultural happenings, concerts and other similar events that were unheard of when I lived in Kajaani. Behind many of these is the Rauniokaupunki Association, founded in 2010. The name partly refers to the town's ruined castle, but it is appropriate in other ways too, as the association came into being when the town planned to cut its spending on cultural activities.
I moved away from Kajaani in 2003, just when some new and interesting developments were happening in the field of culture. In the same year the town's three-year Generaattori project was started up, its aim being to empower activities at grassroots level. The project created activities of a new kind under the leadership of artists employed by the town, and at the same time a subculture scene was born – one that took a stand and played an active part in bringing culture to life in Kajaani. Even after the project ended, Generaattori continued, in premises run by a cooperative called G-voima, or G-power. In 2009, however, due to the poor economic situation, the town proposed cutting all financial support for the project. At that point Veikko Leinonen and a group of other local activists stepped forward to act.
"We felt it was absolutely necessary – they more or less wanted to rob Kajaani's young people of their future – the project is our generation's best achievement. If that's not good enough – what will the next step be?", Veikko Leinonen asks. He himself was not involved in the Generaattori project, but took an active part in the discussion in newspaper columns. The protests did in fact bring results – the cuts were cancelled and the project was able to continue in the G-power premises.
"Money is not the main concern"
This was not enough. When Leinonen moved back from Joensuu to Kajaani in 2010, he and his friends had the idea of creating more inter-arts activities in the town. There was no money on offer but they didn't need it. "The feeling was that we're going to do something now where money is not the main concern. And that's how we did it." The Rauniokaupunki Association's activities have for the most part been carried through without funding, and the events have been organized in cooperation with restaurants and pubs.
The association's core group is relatively small, but in the case of bigger events, about 30 organizers have been involved. Most of the events organized by the Rauniokaupunki Association are musical, but there have also been other happenings, such as pub theatre performances, stand-up comedy evenings, Reclaim the Streets demonstrations, and handicraft fairs. In 2015 there were altogether 20 different events. The same core group has also mainly been responsible for renting and renovating a rehearsal room for more than ten bands. The idea was born after a building previously used by a number of bands had been demolished a few years earlier.
At the moment Leinonen is kept busy by Suuri työttömyysmusikaali, the Great Unemployment Musical he is directing. It literally starts on the streets of Kajaani and moves indoors from there. The musical addresses unemployment. "There are many people, even well educated and trained people, who are just not needed. The labour market simply can't swallow them all, so there are plenty of people without jobs. Even top-level qualifications are not necessarily worth money", Leinonen states.
The spirit of Kajaani
At first Leinonen was slightly doubtful about how Rauniokaipunki's new cultural activities would be received. People's reactions have in the end turned out to be positive. There is often a very good vibe at the gigs, which has surprised even many of the band members. "It has meant a lot to me, too, to see how people have joined in. The gigs have been great experiences for everybody. Another thing that's good is that the audiences vary. Even at some of the most way-out events, the audiences may include yuppies and yokels as well as hipsters. And people have gone to these gigs with a very open mind and had a great time."
The community spirit can also be seen in the organization of events. Participation has been open to all, and many of those taking part have simply turned up and tugged someone's sleeve. At times, similar ideas from different people were combined. The musicians taking part in the events have been put up in the organizers' homes. Cooperation like this is absolutely necessary in a small town like Kajaani, where resources are limited. Leinonen sums up: "Kajaani is a fantastic place to work: I have simply asked local vocational schools, theatres and other parties to help, and help has been offered very willingly."


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Solar LED Dock & Deck Light
Features and benefits:
- 3 Colors Built In With a Push Of A Button (Bright White, Candlelight, Blue)
- 3 LEDs Illuminated Simultaneously
- Replaceable AAA NiMH Rechargeable Battery
- Auto On/Off at Dusk and Dawn
- Waterproof For Heavy Rain, Wind, and Snow
- No wiring needed
- Installs in minutes
Switch from white to candlelight to blue!
NOTE: Duration of light output varies directly with the amount of sunlight exposure. Expect less burn time when daylight conditions are shorter, overcast, or cloudy.
Light is shipped in the "Off" position. Simply press the button to switch between the three color modes and use the "Off" position for long term storage.
|Stock No.


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Issue 79 26th July 2004
Packed full of information, articles, advertisements, jobs and hints & tips for easy living in The Red Sea!
mobile: 012-3399334
NEW this year: DIVEX will market MOBBY's Dry Suits exclusively in Egypt. Starting from September 2004, in time for the winter season, DIVEX will launch its amazing promotional offers to all Diving professionals
Features & Articles
Belly Dancing ... the new Vogue!
Apparently, belly dancing costumes are no longer only for the professionals. 90 per cent of the market for beaded dresses and scarves used to be artists and tourists but now the local market is growing.
Now many young girls have become keen to add a belly dancing costume to their wedding accessories, and your very own belly dancing outfit has now become de rigeur for the young women attending a henna party or a "women's only" night. Girlfriends even circulate the latest video tapes of belly dancers so that they can practice new dance moves to match their costumes.
However, women's only belly dancing sessions are nothing new. Ordinary family women used to set aside a day of the week where they would meet, dress up, listen to music, dance and eat rich food. These occasions were also a good opportunity for many mothers to pick and choose brides for their sons.
The belly dancing costume is made up of a bra and a one-piece belt, a skirt, which may or may not be attached to the belt, and a veil. However,the costume can differentiate according to the number of layers that make up the bra and belt.
Excerpt from Al-Ahram
Local News
6th Shopping & Tourism Festival 20th July - 19th August 2004
Launched in 1998, this festival has now spread to a wider geographical presence as it now covers Cairo, Giza, Alexandria, Hurghada, Ismailia, Luxor, Marsa Matrouh and Port Said. Products for sale will also be available at the Cairo International Conference Center and the Cairo International Fair Ground. During the festival, shoppers will benefit from reductions in price on goods, whether locally produced or imported, and special rates will also be available in hotels and restaurants.
Nile Festival Day - 7th August
One of the commemorated annual festivities of Egypt is "Wafaa El Nil" or "Fidelity of the Nile". Wafaa El Nil is a festivity reflecting the rituals of the Pharaonic legend of how ancient Egyptians venerated and cherished the Nile, being a symbol of life. From an ancient legend to an ongoing tradition, Egyptians have always been keen to celebrate this festivity every year.
New Direct Flights from Manchester, UK to Hurghada Regaldive has announced a new weekly regional flight with Excel Airlines from Manchester to Hurghada. Commencing November 2004, the Friday flight will open up the entire Red Sea Riviera to divers in the north of England and are available all year round. Visit www.regaldive.co.uk for further information.
What's On ... in Canada!
4th AIDA World Freediving Championship by Team 2004 Vancouver, British Colombia, Canada 4th to 12th August 2004
Featuring 84 athletes, alternates and coaches, from 20 teams, from 11 countries (including three current world record holders) over 3 disciplines - Depth Diving (Constant Ballast), Time (Static Apnea) and Distance (Dynamic Apnea).
Good Luck to the Egyptian Team:
Yehia Safwat (Competitor) Mahmoud Abdalla (Competitor) Salah Taher (Alternate) Jennifer Toepke (Coach)
Mares exclusive distributor in Egypt
Mall 8 - Naama bay - Sharm El Sheikh - South Sinai - Egypt
phone/fax: 069 603103 - mobile: 012 3399334
Parents & Kids
Teaching Children Values While Living Abroad
Expatriate couples who move their children to a new culture face yet another parental responsibility heightened by relocation: How does a parent teach values to a child who is being exposed to so many different ones?
Not only can the values of the new culture be very different from those we, as parents, learned growing up, but the culture of the host country can have a direct impact on the expatriate family. It may force us to re-think our own values and traditions and can make it more difficult to show our children the importance of our own values when everyone around them believes something different.
Of course every parent, mobile or not, struggles to instill their children with the basic human values such as honesty, integrity, kindness, hard work, charity and love, and there are always going to be outside influences on children which parents can't prevent. However, teaching values may be a greater challenge for mobile parents.
It is virtually impossible to 'shelter' children from the strong influences of, for example, their international school community and culture, and it's unreasonable if parents expect their children to remain unchanged by their experience, but it should be stressed that there are many positive advantages to be gained from the experience of international living and these should be recognized and honoured.
Wherever we live, it is most important parents live up to their own beliefs and values. The more we live up to them, the more our children will take them seriously. Excerpt from The Weekly Telegraph
Jobs Find out more at : http://jobs.red-sea.com
Les Petites Nursery, El Gouna, is looking for a female from overseas who can speak & read English or an Egyptian English Teacher. For an appointment please call: 012 393 4407 or 065 549702/03 ext 2225.
This weekly Newsletter is created and managed by Red-Sea.com


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You are going to fail. How you deal with it is important. It's important in many ways mostly what you do after a failure occurs. In the box we come in and look at the whiteboard and see the day's work and sigh. Thoughts run through your mind. "I can't do that, How long, how far, how heavy is it?" 'I will die!" It happens time and time again, mostly i see The Look when an athlete first sees just the warmup. "Burpees?!!" Right now we are in the Games' competition season and it's intimidating to say the least. Many did not get pull-ups or a muscle-up. What happened after? Did you get the bar and just look at it? How many set your mind that you were going to get those dumb pull-up/muscle-up whatever it takes? Pushing through failures and misses will take a mindset that will potentially get you over any obstacles in your way. I once couldn't do multiple double unders. I went to several competitions not being able to do them. I hated failing at them and set mind to getting them and I did. It wasn't until i set mind to the task (which took 3 years) and after 1 month of ten minute practice sessions I had them. Don't let anything hold you back from whatever goals you may have.
Coach Shawn
4 TGU Right
4 TGU Left
25 Sit Ups


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Get Involved with Bike Advocacy
Here are several ways to get involved with or support IndyCog
We will leverage every cent of your membership dollars to build a stronger bicycling community and engage in bike advocacy efforts focused on infrastructure, safety, and education in Indianapolis. The stronger our biking community, the more apparent our message and our needs as cyclists become, and the more likely they are to be met by our city.
If you're in the giving mood, member or not, INDYCOG accepts one-time donations that go directly to the cause!
INDYCOG wants you to be involved at our bicycle events to help spread our message!
Sign up for Amazon Smile and they will give a portion of your purchases to IndyCog.
Kroger Community Rewards
Login and connect IndyCog (76323) to your Kroger Plus card and Kroger will give a portion of your purchases to IndyCog.


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It's always good to experiment with food. But when cooking with something relatively new, it can be difficult to know where to start. That's how we felt about the aubergine. Until, that is, Heather Thomas created the incredible, The Aubergine Cookbook which is dedicated to it.
So, whether you've got a taste of it through the recipes we've shared, enjoyed our review or just to get experimental, we're very pleased to say that we've got a copy of this amazing cookbook to giveaway to one very special reader.
Check out the recipes for:
For your chance to win, simply complete the below form. Don't forget to follow us on Facebook and Twitter too and look out for extra ways to enter.
Please note, that by completing the below form you agree to the sites terms and conditions and privacy policy. The winner will be selected and notified by Friday 24th August.
NOTE: Our redirect is a little rubbish, so we'll send you an email to confirm your entry which may go into your junk folder. Be sure to add firstname.lastname@example.com to your contacts to ensure you get your confirmation email.


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Oklahoma Firefighters Stage Photo Shoot After 7 Kids Are Born in 2 Years
The Glenpool Fire Department added seven babies to their fire family in the span of two years. They recently got together to do a photo shoot to mark the extraordinary occasion. The group says the births were a "coincidence" and not planned. "The wives had a talk about it and wanted to do something once all the babies that were due were born," Kyle McMurrian, a firefighter with the department, told InsideEdition.com. InsideEdition.com's Keleigh Nealon (http://twitter.com/KeleighNealon) has more.