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Effectiveness and acceptability of lidocaine spray in reducing perineal pain during spontaneous vaginal delivery: randomised controlled trialBMJ 2006; 333 doi: https://doi.org/10.1136/bmj.38878.833241.7C (Published 13 July 2006) Cite this as: BMJ 2006;333:117
- Julia Sanders, MRC HSR training fellow (julia.sanders{at}cardiffandvale.wales.nhs.uk)1,
- Rona Campbell, professor of health services research1,
- Tim J Peters, professor of primary care health services research2
- 1 Department of Social Medicine, University of Bristol, Bristol BS8 2PR,
- 2 Academic Unit of Primary Health Care, Department of Community Based Medicine, University of Bristol
- Correspondence to: J Sanders, Midwifery Led Unit, University Hospital of Wales, Cardiff CF14 4XN
- Accepted 27 April 2006
Objectives To evaluate the effectiveness and acceptability of a lidocaine spray in reducing perineal pain during spontaneous vaginal delivery.
Design Randomised controlled trial.
Setting Consultant led obstetric unit.
Participants 185 women who had a spontaneous vaginal delivery without epidural analgesia.
Interventions Topically applied local anaesthetic spray (93 women) and placebo spray (92 women).
Main outcome measure Primary outcome measure was pain during delivery (0-100 scale). The 16 secondary outcome measures included second degree perineal trauma during delivery, trauma of the genital tract, and dyspareunia by two months.
Results Lidocaine spray did not reduce pain during spontaneous vaginal delivery: mean 77 and 72 on a scale of 0-100 in the lidocaine and placebo groups, respectively (difference between means 4.8, 95% confidence interval −1.7 to 11.2). Lidocaine spray may reduce genital tract trauma during delivery, in particular second degree perineal trauma. The intervention was highly acceptable to the women and midwives.
Conclusions Although lidocaine spray applied to the perineum during spontaneous vaginal delivery did not reduce perineal pain, it was acceptable to both the women and the midwives.
Trial registration Current controlled trials ISRCTN99732966 [controlled-trials.com].
Numerous studies have been published on analgesia during labour.1 Yet it is common for women having spontaneous vaginal delivery not to be offered analgesia for perineal pain during second stage labour. A national survey of UK midwifery practice found that midwives applied a variety of substances to the perineum to reduce pain, including lidocaine in a few cases.2 Although midwives considered these techniques to be effective, none has been rigorously evaluated. Moreover, many randomised trials of management of second stage labour, including analgesics, have not measured pain experienced by the mother.34
Although care of the perineum has been extensively researched, studies have focused on preventing trauma, including episiotomy, rather than on reducing pain explicitly.5–8 We compared the effectiveness of a local anaesthetic spray with a placebo spray in reducing perineal pain in women having a spontaneous vaginal delivery. We also ascertained the views of the women and midwives on acceptability of the sprays.
Participants and methods
Between February 2003 and May 2004 midwives provided written and verbal information about the trial to potentially eligible women more than 30 weeks' pregnant who attended antenatal clinics in the area served by the participating hospital. The midwife placed a sticker on the maternity notes indicating whether the woman was ineligible, had declined participation in the trial, or had expressed an interest. Exclusion criteria during the antenatal period were multiple pregnancy; booked in for a caesarean section, instrumental delivery, or episiotomy; previous adverse reaction to a local anaesthetic; and insufficient English to provide consent or complete the study questionnaires. Exclusion criteria during the intrapartum period were pregnancy less than 37 weeks' gestation, epidural analgesia, non-cephalic presentation, and baby expected to require intensive neonatal care after delivery.
Women who had expressed an interest in the trial were identified by hospital based midwives when they were admitted to hospital in labour or for induction of labour. After checking eligibility and obtaining written consent, the midwife asked a member of the medical staff to prescribe the trial solution. Before randomisation the attending midwife reconfirmed the woman's consent to participate.
Trial interventions
The active trial solution was formulated to equate to Xylocaine spray (AstraZeneca, Bedfordshire), omitting cosmetic ingredients. The active and placebo trial solutions were of similar appearance, consistency, and odour. Attending midwives were instructed to apply five sprays of the solution, each of 0.1 ml, to the woman's perineum and inside aspect of the labia once spontaneous birth was imminent. Spraying was to be suspended if the fetal head had advanced such that the dosage could not be completed before the midwife needed to prepare for delivery. The number of sprays administered was recorded, and the time between application and delivery was calculated. The five sprays were to be administered at least three minutes before delivery to have time to take effect.
Randomisation was undertaken by an independent agency, which produced and packaged the trial solutions. Allocation was on a 1:1 basis using computer generated random permuted blocks of 10.9 The placebo and active trial solutions (5 ml each) were packaged in identical bottles. Each was labelled with a unique trial number and placed in a sealed trial box. Women were randomised when the attending midwife judged spontaneous vaginal delivery imminent, and the next consecutive trial box was opened.
Outcome measures
The primary outcome was pain during delivery, self reported before leaving the delivery suite and assessed on a 0-100 scale from 0 (no pain) to 100 (worst possible pain). The 16 secondary outcomes were: delivery pain by a four level ordered categorical assessment of severity and the adapted McGill pain questionnaire (short form) total score10; satisfaction with analgesia; second degree perineal trauma (including women who had an episiotomy); genital tract trauma and its management; feelings during delivery11; overall rating of birth experience12; perineal pain one week after delivery; resumption of intercourse by two months; dyspareunia by two months; maternal adjustment to motherhood13; and condition of the baby at birth. Nonresponders to questionnaires were sent a reminder letter after two weeks and a letter and additional questionnaire after four weeks. Midwives collected a sample of cord blood for ascertainment of lidocaine levels. They also completed a questionnaire on deliveries. We obtained data on sociodemographic characteristics and the acceptability of the intervention to women through a questionnaire given 6-8 days after delivery. Acceptability to 14 midwives was ascertained through semistructured interviews, the transcripts of which were subjected to a thematic analysis.
Sample size
In a pilot study carried out at the trial site, the levels of pain experienced by 67 women without epidural analgesia during spontaneous vaginal delivery were ascertained on the primary pain outcome, yielding a mean 65.3 (SD 25.7). We considered as clinically significant a reduction in pain during delivery of 0.5 standard deviations (13 scale points); 180-212 women were required to detect such a difference with 85%-90% power and a two sided 5% significance level, allowing conservatively for 20% attrition.
We analysed the data using SPSS. The primary comparative analyses were carried out on an intention to treat basis, with data analysts blind to treatment group. We used regression analysis to compare the outcomes between groups. Secondary analyses also involved regression models: firstly, adjusting for variables that showed a potentially important imbalance at baseline; secondly, restricting analysis to those who received either spray fully in accordance with the protocol; and thirdly, including the relevant interaction to carry out a planned subgroup analysis according to whether or not it was the woman's first delivery. Perineal pain was the primary outcome. Before inspection of the data, we considered possible mechanisms by which the intervention might affect the primary outcome. As a consequence we identified perineal trauma as a secondary outcome of particular interest. The reason for this was that perineal pain could be closely related to perineal integrity. For example, reduced pain might be associated with increased perineal trauma if the birth was accelerated by the intervention. We therefore calculated the number needed to treat for perineal trauma, along with a 95% confidence interval.14
Of the 2200 women delivering at the participating unit during the recruitment period, 680 were interested during their antenatal period in participating (fig 1). Of these, 66 became ineligible once in labour and three had been randomised but had ventouse assisted delivery, precluding use of the spray. These women were excluded from analyses because their primary outcomes could not have been influenced by the intervention and the decision on delivery method was independent of trial allocation. Consent was not sought in labour from a further 429 women, due primarily to admission in advanced labour or request for an epidural. All 185 women approached in labour provided consent and were randomised: 93 to lidocaine spray and 92 to placebo spray.
Characteristics at baseline and delivery of the interventions
The women in the trial groups were similar for several baseline obstetric and sociodemographic characteristics, apart from smoking, parity, augmentation, induction, use of pethidine before randomisation, and birth weight (table 1). Since these variables could be associated with the outcomes they were adjusted for in secondary analyses.
The mean (SD) number of sprays administered in both groups was 4.8 (0.9). Almost two thirds of women received the intervention as intended. The mean difference in time between intervention and delivery was also similar between the groups: lidocaine group 11.0 minutes and placebo group 12.5 minutes. Although these times varied between individual women (standard deviations of about 10 minutes), about 80% of women delivered within 15 minutes of receiving the spray in both groups.
Blinding was successfully maintained in the women and midwives, with neither group able to identify the trial solution with any accuracy beyond chance. Of the 88 cord blood samples collected from women who had received lidocaine, 86 contained low or very low levels of lidocaine and two contained levels at the upper limit of the therapeutic range (5.60 and 5.70 µg/ml; fig 2).
Ten women in the lidocaine group and six in the placebo group reported an unpleasant experience with the spray. In contrast, 32 women in the lidocaine group compared with 22 in the placebo group reported either a cooling or analgesic effect. The midwives unanimously considered perineal analgesia during second stage labour to be an acceptable addition to current practice.
Primary outcome
Mean pain scores were high and similar for both groups. No evidence was found of a sizeable reduction in pain using lidocaine spray compared with placebo spray (table 2); the suggestion was that pain may have been slightly increased.
Adjusting for imbalances at baseline had little effect on the results, as did restricting the analysis to the 124 women who received five doses of the lidocaine spray as intended at least three minutes before delivery (table 3). Although power is limited for subgroup analysis, no evidence was found that the effect of the intervention differed by parity.
Secondary outcomes
Most secondary outcomes were similar between the groups (table 4). However, a smaller proportion of women who received the lidocaine spray compared with the placebo spray sustained second degree perineal trauma. Of the 59 women in the lidocaine group and 67 in the placebo group who sustained any genital tract trauma, 17 and 14, respectively, experienced first degree perineal trauma, and 26 and 41 experienced second degree perineal trauma, including two and eight women who had an episiotomy. No woman in either group sustained third degree or fourth degree perineal trauma. Women in the lidocaine group were also less likely to experience dyspareunia when resuming sexual intercourse.
Although a local anaesthetic (lidocaine) spray applied to the perineum of women during spontaneous vaginal delivery was acceptable to the women and midwives, it was not associated with any reduction in perineal pain; if anything the trend was to worse pain. The intervention may reduce the occurrence of second degree perineal trauma and have longer term benefits—namely, a reduction in the proportion of women reporting dyspareunia two months after delivery. These findings seem to be contradictory. This may be because the findings are due to chance or because the spray enables a more controlled delivery of the fetal head and therefore prolongs this process. If so, the intervention could prevent trauma while not reducing pain. Further studies, including randomised trials, are needed to confirm or refute the findings of perineal trauma.
The levels of lidocaine in the cord blood were almost always within acceptable limits except in two cases. These two exceptions may have occurred through contamination of the cord sample after delivery, placental transfer, or direct absorption through the fetal scalp during delivery. Placental transfer is unlikely at these levels.15–19 Contamination is also unlikely—the spray comprised free lidocaine in ethanol, which evaporates rapidly, and both lidocaine and ethanol were detected in the cord samples. Lidocaine hydrochloride does not readily permeate the skin of neonates, but free lidocaine as used here maydoso.2021 If this hypothesis is confirmed by further research then there are implications for administration of the spray.
Strengths and limitations of the trial
This trial was powered to detect a difference in the primary outcome of perineal pain. In the event, the confidence interval for this outcome was moderately wide, including the null and extending close to the target difference in a direction not favouring lidocaine spray. The trial was not powered for binary outcomes, and the confidence intervals for secondary outcomes of this type, including second degree perineal trauma, were commensurately wide. The potential clinical implications of the finding for perineal trauma mean that it should be a primary outcome in future similar trials. Moreover, adequate sample size for perineal trauma would improve the precision of the estimate achieved here, as illustrated by the 95% confidence interval for the number needed to treat (n = 6) for this outcome being from 4to25.
In terms of generalisability, only one maternity unit was involved in the trial but a large number of midwives were involved in recruitment (34 in the community and 67 in the hospital), serving a wide geographical area encompassing a socioeconomically diverse population. In addition, recruitment took place over a considerable period (16 months). Although only a third of the 2200 women booked to deliver at the unit were approached antenatally about the trial, just 18% of invited women declined participation. All those who were eligible in labour were randomised.
Other strengths of the study include the successful blinding of the women, midwives, and data analysts; a high and similar level of adherence to the protocol for administration of the lidocaine and placebo sprays; and negligible attrition.
Relation to the literature
The pain scores recorded in this trial were similar to those obtained in previous studies of second stage labour, including high mean levels and considerable variability.2223 In keeping with the findings of previous randomised trials of second stage care,724 overall levels of genital trauma were higher than generally reported. This may result from trauma being recorded in more detail in the trial questionnaires than would normally be required in clinical notes or on a computer.
The use of a topically applied local anaesthetic during second stage labour was acceptable to women and midwives. The lidocaine spray during delivery did not, however, reduce perineal pain. The secondary findings relating to reductions in second degree perineal trauma and dyspareunia at two months after delivery need to be substantiated in further randomised trials. The potential clinical implications of these outcomes and the possible magnitudes of effect suggested in this trial mean that such research should be a priority.
What is already known on this topic
Spontaneous vaginal delivery is associated with severe pain and trauma to the genital tract, resulting in short and long term morbidity
Perineal analgesia is not normally offered to women having a spontaneous vaginal delivery
What this study adds
Perineal analgesia during second stage labour was acceptable to women and midwives
A lidocaine spray had no noticeable effect on perineal pain during spontaneous vaginal delivery
We thank the women and midwives who participated in the study; Angela Ralli-Thomas and Mr Colin Ranshaw of St Mary's Pharmaceuticals, Cardiff; Mike Harmer for facilitating the study; and Jenny Donovan, Deirdre Murphy, and a reviewer for helpful comments.
Contributors: JS conceived the study. All authors obtained the funding, designed the study, and comprised the Trial Management Group. JS managed the trial on a day to day basis and carried out the analyses, supervised by RC and TJP. JS wrote the first draft of the paper. RC and TJP led the redrafting and attended to reviewer's comments. JS is guarantor.
Funding This research was carried out while JS was in receipt of Medical Research Council/Wales Office of Research and Development special training fellowship in health services research, with additional funding for the trial provided by Wellbeing for Women and the Obstetric Anaesthetists Association.
Competing interests None declared.
Ethical approval This trial was approved by the Medicines Control Agency, the local research ethics committee and the participating NHS trust research and development directorate.


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Age is the length of time a person has been alive. --
Variable name: Age Definition: Age is the length of time a person has been alive, measured in complete elapsed years. It is measured as the difference between 'date of birth' and '6 March 2001'.
Questionnaire: Date of birth is collected on the Individual form (Question 4) and age is collected on the Dwelling form (question 4) Subject population: Census Night Population Count. There were 3,820,749 people in New Zealand on Census night - all of whom have age derived for them. Non-response: Age is imputed for non response to year of birth question. Quality level: Age is a foremost variable.
3.7% age imputation for usually resident population compared with 3.9% in 1996. Substitute forms increase the level of age imputation. Recognition rate of the date of birth variable was over 99.7%. Comparability with previous census data: Age data is comparable with the results of previous censuses
Things to be aware of: Age is derived from date of birth. There are inconsistencies between Date of Birth, Age on the Dwelling Form, Years at Usual Residence and Years Since Arrival in New Zealand. No consistency edits were applied to the data in 2001.
If help is required with using this variable, email us on firstname.lastname@example.com or phone 0508 525 525

subset: commoncrawl


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Agile Frameworks and the PMO
Price £390+VAT \\ Takes place in Central London
This class is designed to enable senior members of the PMO community to actively engage in the selection of appropriate Agile Framework(s).
The Agile Framework and the PMO
Successful Agile change comes from within an organisation and this class shows how the the PMO becomes a catalyst during the change; allowing the PMO to participate, support, or influence external consultants as necessary. This class also acts as a foundation for a PMO seeking to lead an Agile Transformation with further study and experience gained from Agile at the team level.
All scaling frameworks share some common patterns: Scrum at the team level; many teams sharing a backlog; planning is done collaboratively across teams; and the general principles of pull, self-organisation and continuous improvement.
This class is designed to give an overview of the main Agile at Scale frameworks. To identify the unique elements of each so that PMOs may decide how the Agile Frameworks can be used and governed. By way of introduction, the class explores what is meant by Agile stepping beyond the Agile Values and Principles identified in the Agile Manifesto.
Finally, this class will discuss some of the considerations needed to the implement Agile at Scale in an organisation.
Following this course participants will:
- Understand the key features of the leading Agile at Scale Frameworks.
- Recognise how the PMO needs to adapt and support each of the Frameworks.
- Understand a typical roadmap for an agile transformation and the key stages for the PMO in the conversion from waterfall to Agile.
What we will discuss:
- The class starts with a description of Scrum and illustrates that it is designed for small teams of between 3 and 9 individuals. An overview of Scrum is given. This explains that SCRUM is used as the common basis for scaling Agile to the enterprise.
- The class outlines the features of each of the key Agile at Scale frameworks. LeSS, Scrum@Scale, SAFe and Disciplined Agile. The key elements of PRINCE2 Agile are also identified.
- The different implications for the PMO in each of the Frameworks is explained, this will include the differences with regard to Portfolio Management and Status Reporting
- By its' design, the class equips the participants to be actively involved in an Agile transformation. An Agile implementation roadmap is outlined, enabling the Agile concepts to be applied in the workplace.
Want more Agile?
Our Lean-Agile PMO course is a great precursor to Agile Frameworks and the PMO, we recommend you undertake it before this course. If you want to learn more, read our Lean-Agile PMO overview. These course are being run together and are available to book at a discount price!


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The chapel lace hankie combines the tradition of a handkerchief, but its design works for the modern bride. The lace border is a simple and elegant block pattern. The best part? It's completely hand washable so when the waterworks, I mean ladylike tears, start coming you'll be prepared!
100% cotton, 11"
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Are You Looking For BAR Registered Movers Serving Cowdenbeath
Do You Need Experienced Movers Serving The Cowdenbeath Area of Fife
If you are one of the many house movers this autumn, you will probably be planning to complete your move to Cowdenbeath before Christmas. It is really important that you pick a sensible and achievable moving date before the 25th December and work towards this.
Research removals companies in your area to find out who would best meet your needs and make sure you book them well in advance as they will become very busy in the months leading up to Christmas.
Initially, thinking you can carry out the house move yourself may not sound too problematic. However, there is a certain amount of skill involved when packing household effects in order to avoid damages. Lifting heavy items of furniture is very hard work not to mention potentially dangerous, many back injuries have occurred during home moves. It also takes time which is always a precious thing in our busy lives. Invariably, the weather will also play a part in the move this time of the year, all these things combined, can leave you drained and very
You can avoid this trauma by choosing a professional removal company such as White & Company. They are members of BAR (British Association of Removers), FIDI & OMNI. All members have to adhere to the very highest of standards of service and code of practice. Their staff will have all the necessary training, expertise, experience and professionalism to carry out your move as efficiently as possible.
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Queensferry Road
To book your free home survey, simply contact your local branch on Tel: 01383 721 697
E: email@example.com
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• Mon 09:00 – 17:00
• Tue 09:00 – 17:00
• Wed 09:00 – 17:00
• Thu 09:00 – 17:00
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• Sun Closed
Estate Agents & Movers Cowdenbeath
Here is a list of estate agents in the Cowdenbeath area. Before instructing an estate agent it would be wise to make sure you have an idea of the value of your property. We recommend looking at what similar properties are being sold for in Cowdenbeath on sites such as Zoopla:
Delmor Independent Estate Agents & Mortgage Brokers
208 High Street, Cowdenbeath KY4 9NP
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Atholl Stuart Anderson Properties
140 Stenhouse Street, Cowdenbeath KY4 9DH
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Solicitors & Movers Cowdenbeath
Before you exchange contracts you will need to instruct a solicitor or conveyancer. Here is a list of solicitors and conveyancers in the Cowdenbeath area:
Baird & Co. Lawyers
Cowdenbeath Branch Library 41 High Street, Cowdenbeath KY4 9QA
01592 891627
North House North Street, Glenrothes KY7 5NA
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Schools & Movers Cowdenbeath
There are a number of schools in the Cowdenbeath area. Here is a selection covering all age groups in the Cowdenbeath area:
Foulford Primary School
Lumphinnans Primary & Community School
Cowdenbeath Primary School
Beath High School
Lochgelly High School
Carnegie College
Lochgelly North School
Calaiswood School
West Fife Alternative Day Resource
Property Prices & Movers Cowdenbeath
Property values in Cowdenbeath have shown a rise of 3.35% over the last 12 months and the average house price is now £129,000. You can purchase a detached home from £206,000, a semi-detached house for around £114,000 and terraced homes for approximately £102,000. The Average price paid is £131,000. Statistics provided by Zoopla 1st November 2017.
Transport Links & Movers Cowdenbeath
Moving to an area that has good transport links can be very important, especially if you need to commute to work.
Cowdenbeath's connections are good, close by is the A92, a route east to Kirkaldy and west to Dunfermline. The main M90 motorway heads south to Queensferry and north to Perth. Cowdenbeath train station has services to Edinburgh, Fife, Glenrothes with Thornton and Dunfermline. The nearest airport is Edinburgh Airport (11 miles)
Council Tax Bands & Movers Cowdenbeath
If you are planning to move to Cowdenbeath the council tax bands are as follows:
A Band £1,013.00
B Band £1,182,00
C Band £1,351.00
D Band £1,520.00
E Band £1,857.00
F Band £2,195.00
G Band £2,533.00
H Band £3,040.00
Doctors & Movers Cowdenbeath
Cowdenbeath Medical Practice
173 Stenhouse Street, Cowdenbeath KY4 9DG
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Kelty Medical Practice
80 Main Street, Kelty KY4 0AE
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Dentists & Movers Cowdenbeath
There are a number of dentists in Cowdenbeath, here is a list of some of them:
Breeze Family Dental Care
25 Links Street, Kirkcaldy KY1 1QE
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Millar & Glen Dental Practice
1 Foulford Street, Cowdenbeath KY4 9NB
01383 511242
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Devorah Thomas
More About the Professional:
Co-owner of City Real Estate in Asheville, North Carolina. City Real Estate is a boutique style office offering deep knowledge of the area and a professional friendliness that creates an atmosphere where the best results are achieved. An Asheville lesbian Realtor, Dev has been doing full time real estate for almost 20 years and is still enjoying helping folks find their place in the Asheville area.
Professional Category: Real Estate Agent


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Hembree: Joey Logano keeps his cool to collect third Talladega win
TALLADEGA, Ala. – Joey Logano made one thing very clear in winning Sunday's GEICO 500 Monster Energy NASCAR Cup race at Talladega Superspeedway.
First place is the safest place.
Blocking and weaving with skill developed over years of restrictor-plate racing, Logano held off several challengers over the closing laps and won for the first time in more than a year.
"At the end you are racing and don't know what will happen, you just hope to get in the right lanes at the right time with the right moves," said Logano, who has won three times at the giant track. "It is always exciting to win at a superspeedway, especially Talladega, because you never know you've got it until you cross the line."
Every time a field of 200-mph cars comes screaming to the green flag to start a race at Talladega, a nervous mix of excitement and angst hangs over NASCAR's biggest track.
At its best, the racing here is riveting. At its worst, cars fly out of the track or into the fencing protecting spectators from a nightmare incident or into wild, flipping rides that usually – but not always – end with drivers climbing out wobbly but well.
Sunday's race, the first of two visits here this year by the Cup Series, opened under a bit more anxiety than usual.
On Friday, the track bit Jamie McMurray. A tire issue and contact with Ryan Newman in practice sent McMurray into the sky and then into a nauseating series of rolls. As so often happens in similar accidents here, McMurray stepped out of his mangled car with no significant injuries.
Considerable experimentation by NASCAR and its teams has resulted in roof flaps and other advances that have significantly reduced the possibility of cars going airborne at high-speed tracks. But McMurray's incident was a Taser-like reminder that the right circumstances can lead to sudden calamity. And enough of that calamity eventually will lead to the ugly sort of results feared by NASCAR and its competitors.
RACE RECAP:Logano takes Talladega to snap one-year winless streak
BOXED IN:Ford cars keep Elliott's Chevrolet at bay at Talladega
TV TIME:NASCAR Cup drivers get turn in Fox booth for Xfinity race at Talladega
WATCH:Wild and memorable NASCAR crashes at Talladega Superspeedway
NASCAR responded quickly to the McMurray crash, announcing a slight reduction in the size of the restrictor plates that rob engines of power here, trimming speeds by two to four mph. There are two things NASCAR doesn't like at Talladega – flying cars and sustained speeds pushing into the 205-mph range. There is a near-constant give-and-take between officials and mechanics as speeds rise with advances in technology, then fall with restrictions from the powers-that-be.
That dance was on display Friday, and the results spilled over into Sunday's pre-race environment as drivers buckled in for 188 tightrope laps. Drivers take much of this in stride as part of the job, and none would ever show a tinge of fear starting a super-fast 500-mile race, but there is little question the wicked stew that is Talladega heightens tensions.
Before the race, veteran driver Elliott Sadler, current points leader in the Xfinity Series, tweeted: "Don't really care who wins the race today but just praying for a safe race for all the guys and their families…"
For much of the first stage, drivers lapped the track in single file, testing the limits of their cars before the tighter racing that was sure to come later in the race.
The second half of the race produced the big, tight drafting packs typical of Talladega. And, to no one's surprise, the result was a huge crash. It began with a slip by Jimmie Johnson. Within seconds, 13 other cars were involved, eliminating several contenders from the front group.
Logano was left among the potential winners. When he got to the front, he protected the spot jealously.
"Teamwork is what did it today," Logano said, referring to the fact that six of the top seven finishers were driving Fords. "Not only with the Team Penske Fords, but all of the Fords out there. Kevin (Harvick), Kurt (Busch). It feels so good to be back in Victory Lane. There's no feeling like this.
"We don't have to worry about the whole playoffs thing now."
On a day of nerves and with danger lurking around every turn, Logano both survived and thrived.


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WWE Superstar Sin Cara was involved in an altercation with Chris Jericho over the weekend … and now he's been ordered to attend anger management classes.
Pro Wrestling Sheet has confirmed that WWE ordered Sin Cara to go to the classes following his fight with Chris Jericho this week, the news of which was first reported by Dave Meltzer.
In case you missed it, the incident occurred between Sin Cara and Chris Jericho Sunday night while the two were traveling to Glasgow, Scotland on the RAW crew's tour bus.
Jim Ross spoke with Jericho about their altercation Monday and reported on his blog that, "Chris said it was largely about nothing and that it resembled more of a scuffle than a full fledged fight. Sin Cara threw one punch and then the minor melee was broken up."
As previously noted, Sin Cara's scuffle with Jericho is the second incident that he's allegedly been involved in this year — having reportedly faced off with Simon Gotch this summer.
He has yet to comment.


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LawnSite Member
- Location
- Winter Haven, FL
does any one give discounts? I've got 3 lawns all in the same neighborhood, all three are good size. they take me between 2 1/2 - 4 hours, each one different, so I usually spend a whole day there which means less traveling and stuff. does anyone mark down 10% if it takes longer than 2 hours or if you have more than 2 lawns in one neighborhood?


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BETHUNE, be-thün', GEORGE WASHINGTON: Reformed (Dutch) clergyman; b. in Greenwich, now a part of New York City, Mar. 18, 1805; d. at Florence, Italy, Apr. 27, 1862. He was graduated at Dickinson College, Carlisle, Pa., 1823; studied at Princeton Seminary 1823-25; served for a year as missionary among the negroes and sailors at Savannah, Ga.; was ordained Nov., 1827, and was pastor of Reformed (Dutch) churches at Rhinebeck (1827-30) and Utica (1830-34), N. Y., Philadelphia (First Church, 1834-37; Third Church, 1837-49), and Brooklyn (1851-59); was associate minister at the Twenty-first Street Church, New York, 1859-61. He was famed as a preacher and orator, as a poet, and as a wit. Of his numerous publications, perhaps that of most permanent value was his edition of Walton's Complete Angler (New York, 1847; new ed., 2 vols., 1880).
BIBLIOGRAPHY: A. R. Van Nest, Memoirs of Rev. George W. Bethune, 2 vols.; New York, 1880.
BETHUNE-BAKER, JAMES FRANKLIN: Church
of England; b. at Birmingham Aug. 23, 1861. He
was educated at Pembroke College, Cambridge (B.A.,
1884), and was head master's assistant at King
Edward's School, Birmingham, and assistant curate
of St. George's, Edgbaston, from 1888 to 1890. In
the following year he was elected fellow and dean
of Pembroke College, and since 1905 has also been
examining chaplain to the bishop of Rochester.
He has been the editor of the Journal of Theological
Studies since 1903, and has written The Influence
of Christianity on War (Cambridge, 1888); The
Sternness of Christ's Teaching (1889); The Meaning
of Homoousios in the Constantinopolitan Creed (1901);
An Introduction to the Early History of Christian Doctrine
(London, 1903); and Christian Doctrines and their Ethical Significance (1905).
BETKIUS, bęt'kî-üs (BETKE), JOACHIM: Lutheran preacher and forerunner of the Pietistic movement; b. at Berlin Oct. 8, 1601; d. at Linum, near Fehrbellin (33 m. n.w. of Berlin), Dec. 12, 1663. After finishing his course at Wittenberg, he became associate rector at Ruppin, then was for more than thirty years pastor at Linum. He wrote several theological and devotional works, by the reading of which Spener said he had profited. They contain edifying exhortations against forgetting the need of sanctification in addition to justification, but are marred by intemperate fanaticism; Betkius holds the clergy responsible for all the anti-Christian phenomena of his time, and for the divine judgments of the Thirty Years' war.
Calvin College. Last modified on 05/10/04. Contact the CCEL.


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Advances in clinical information technology are likely to make hospitals more efficient and widen the gap between hospitals and health systems that are financially strong and those that are not, Moody's Investors Service said in a new report. Despite uncertain near-term benefits, IT investment will be one of the main vehicles for hospitals to achieve long-term strategic goals, Moody's said. Benefits of increased IT spending include improved patient safety and quality; better decisionmaking by administrators; eased use of electronic health records; more competitive hospitals; and better preparedness for pay-for-performance initiatives. Hospitals that can't afford to spend on IT will find it harder to compete with those that can, Moody's said. Challenges remain to implementing IT efficiently, including the high costs associated with keeping up to date and difficulties getting physicians and nurses to use the systems. -- by Paul Barr
Clinical IT to yield more efficient hospitals: Moody's
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|US Army Major John L. Cockerham
Over a decade ago, which seems like yesterday, my best friend and confidant was caught in a dangerous Web of Army Corruption which ultimately costed her her life.
This past Memorial Day Reflection, I placed a flag on my front lawn in honor of her service, to other fallen soldiers and in remembrance of my late father and my Uncle; who'd proudly served our country.
To this day I'm not convinced that Gloria killed herself, she was filled with so much Youthful Energy and Life!!
The Army's LIES and COVERUPS of military fraud is no different than the Navy's Fat Leonard Fraud Scandal....
It's Rooted to the SOUL of the Pentagon!!
I've never reviewed any of the evidence that linked Gloria to the Cockerham's Case, and I'm sure the Department of Justice Anti-Division will keep this file under Tight Seal, like all other military fraud scandals involving HIGH RANKING Pentagon officials!!
Having served as a prior enlisted Cryptologist, I know the importance of safeguarding military Secrets yet as a 13-year seasoned Budget officer, auditor and IG Investigator, I bore witness to fraud, abuse of (financial) authority, as well as other blatant mismanagement (ignoring) of DoD Directives, Federal Statutes and Financial Regulations.
Working with so many morally corrupted individuals always made my job difficult.
I will always have a special place in my heart for Gloria and I've come to terms that no matter how well you think you know someone, there's always another side to them. Gloria was my friend in life and will always be in Spirit.
May She Forever Rest in Peace!!
May She Forever Rest in Peace!!
Read more articles on Gloria's alleged suicide and the Cockerham's case here:


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Gum care
Defining gum disease
Gum disease is an insidious condition that can go undetected for many years if you avoid dental appointments. Generally, there is soreness or swelling of the tissues supporting the teeth. There are two main types of gum disease: gingivitis and periodontal disease.
In recent years gum disease has been linked with health conditions such as diabetes, strokes, cardiovascular disease, poor pregnancy outcomes and even dementia. Research is ongoing, but there is more and more evidence emerging that healthy gums can help improve general health.
What is gingivitis?
Inflammation of the gums defines gingivitis. A telltale sign is bleeding gums, especially when brushing. Often they become swollen and red around the teeth.
What is periodontal disease?
Gingivitis, if untreated, can turn into periodontal disease. There are several types of 'perio' disease, and they all affect the clever supporting tissues of the teeth. As the disease progresses, the bone erodes that anchors the teeth and the teeth become mobile. Teeth will fall out if left untreated.
Symptoms of gum disease
The first sign of gum disease is blood on your toothbrush or in the sink after rinsing when you clean your teeth. Gums may also bleed while eating leaving a bad taste in the mouth and breath can also become unpleasant. In later stages, deeply rooted infections can set up and cause an abscess.
What causes gum disease?
Plaque, a film of bacteria that forms on the surface of the teeth, is the main culprit. Brushing and cleaning in between the teeth with fine interdental brushes or floss helps prevent the build-up.
I am a smoker
Science tells us that smoking hugely increases the risk of gum disease with smokers more likely to produce bacterial plaque. Smoking causes reduced oxygen levels in the bloodstream, so the infected gums don't heal.
Gum care – what treatments?
Our dentists or hygienist will remove all of the plaque and tartar from the affected teeth. Central to gum care and proper maintenance will be teaching our patients how they can remove plaque successfully themselves. Once teeth are clean, it may be decided to treat the roots to ensure that we remove the last pockets of bacteria. This is called root planing.
Can periodontal disease be cured?
There is no cure for periodontal disease, but you can control it so that you can keep teeth for many years. Key will be regular dental appointments and doing exactly as our dentists and hygienist instruct regarding your oral cleaning routine.
Oral hygiene
North Street Dental based in Dudley, West Midlands offer comprehensive dental hygiene therapies. See our webpage for more information and oral health tips.
Book an appointment now
We now offer same-day appointments at our dental clinic for a scale and polish. If you would like to book an appointment directly or would like to ask any questions about direct access, please get in touch and we'll do our best to help you make a properly informed choice. Call us on 01384 254 067 or fill out the form on our contact page.
We also have a wealth of information and tips on oral health on our blog page. Bookmark it and check back regularly as we update it every week. Another great source of information is over on our Facebook page.


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|123 Ontario St
Age. 2017
Bedrooms. 3
Baths. 2.5
Finished area. 1557 square feet
Patio. 18 x 16 feet aprox
Fireplace. Gas in living room
Heat. electric baseboard with under floor heat in tiles area
Parking. Single attached garage and driveway
For more information on this property click on anyone of the underlined topics below:
Strata plan floorplans
1. Front exterior
2. Front door
3. Entrance has heated tile floors
4. cozy gas fireplace and a wall of windows
5. Living room from back porch
6. Open floor plan from upper stairs
7. Open floor plan from corner of living room
9. Dining room and kitchen
10. Open floor plan from kitchen
11. Quartz counter top
12. View from corner of diningroom
13. Powder room
14. Main bath
15. Huge windows in third bedroom
16. Second bedroom has vaulted ceilings
17. Master bedroom has a nice outlook
18. Master bedroom has vaulted ceilings
19. Private oasis
20. Master bedroom view towards deck, ensuite bath and huge walk in closet
21. 6 foot seated shower
22. Ensuite bath has a comfy soaker tub
23. View to the South from upper deck
24. Stone paver patio in South facing yard
25. Great patio to relax
26. Towards the rear exterior
27. Front exterior from side walk
Bright and modern brand new 3 bedroom, 2.5 bath strata homes are located in an awesome location and are sure to please. The beautifully finished exterior features hardi board siding with ceramic tile on the front and cedar on the corner rooms in front. Huge windows up to 8 feet tall on all sides of the building allow wonderful lighting in all rooms. The open floor plan living area looks over the large patio in the private South/West facing back yards and has a cozy gas fireplace. The small deck off the dining room is covered and would be a great place for the BBQ as it is plumbed for a gas hook up. The kitchen comes with high quality Samsung Black stainless appliances including a four door pantry style fridge with a double freezer, a gas range and ultra quiet dishwasher, The cabinets feature quartz countertops and tiled backsplashes with under valance lighting.
Nine foot ceilings in living area and all the bedrooms have vaulted ceilings up to 11 feet high. There are stairs down to a 4 6 heated and ventilated crawlspace that has windows for natural light and is fantastic for storage. The home comes with a Venmar air exchange unit which will ensure that your home will be fresh smelling for years to come.
A half flight of stairs lead to the next level that has 2 good size bedrooms with vaulted ceilings and a four piece main bath that has heated tile flooring. The laundry room is conveniently located off this bathroom and the energy efficient hot water on demand is also located there.
Another half level up is the grand Master bedroom. This spacious 14 x 15 room has vaulted ceilings up to 11 feet and a wall of South facing windows with distant glimpses over roof tops to the Olympic peninsula. The luxurious ensuite bath features heated tile flooring, comfy soaker tub and a six foot seated shower. The vanity features his and hers sinks with maple cabinets and quartz counter tops. The massive walk in closet is well organized and about 12x 8 feet in size. This Master suite is truly a wonderful space on its very own level which gives it great privacy. Even a small deck for your morning coffees.
The location cannot be beat as it just steps to Fishermans wharf and a few blocks to Ogden Point and the Legislature buildings and all the activities that are available in downtown Victoria. Good travel options are available as it also just blocks to the Helijet terminal, the Harbour plane terminal and the US ferry terminal.
The South West facing back yard is level and private. There is a stone paver path down the side that leads to an entertainment size patio. The yard is fully landscaped with beds front and back and a sprinkler system to keep everything green.
This brand new Side by side duplex is beautifully finished with interior and exterior finishing details provided by Zebra Designs. These homes offer a rare opportunity to own a new home in a premium area with lovely private South/West facing back yards. Offered at only $929,900 including GST. Available for immediate possession,


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Back to Journals » Pharmacogenomics and Personalized Medicine » Volume 10
Is there evidence that we should screen the general population for Lynch syndrome with genetic testing? A systematic review
Authors Prince AER, Cadigan RJ, Henderson GE, Evans JP, Adams M, Coker-Schwimmer E, Penn DC, Van Riper M, Corbie-Smith G, Jonas DE
Received 4 October 2016
Accepted for publication 22 November 2016
Published 20 February 2017 Volume 2017:10 Pages 49—60
DOI https://doi.org/10.2147/PGPM.S123808
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Martin Bluth
Anya E R Prince,1 R Jean Cadigan,1,2 Gail E Henderson,1,2 James P Evans,1,3–6 Michael Adams,1,3 Emmanuel Coker-Schwimmer,7 Dolly C Penn,2 Marcia Van Riper,1,8 Giselle Corbie-Smith,1,2,6 Daniel E Jonas1,6,7
1Center for Genomics and Society, 2Department of Social Medicine, 3Department of Genetics, 4Carolina Center for Genome Sciences, 5Lineberger Comprehensive Cancer Center, 6Department of Medicine, 7Cecil G. Sheps Center for Health Services Research, 8School of Nursing, The University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
Background: The emerging dual imperatives of personalized medicine and technologic advances make population screening for preventable conditions resulting from genetic alterations a realistic possibility. Lynch syndrome is a potential screening target due to its prevalence, penetrance, and the availability of well-established, preventive interventions. However, while population screening may lower incidence of preventable conditions, implementation without evidence may lead to unintentional harms. We examined the literature to determine whether evidence exists that screening for Lynch-associated mismatch repair (MMR) gene mutations leads to improved overall survival, cancer-specific survival, or quality of life. Documenting evidence and gaps is critical to implementing genomic approaches in public health and guiding future research.
Materials and methods: Our 2014–2015 systematic review identified studies comparing screening with no screening in the general population, and controlled studies assessing analytic validity of targeted next-generation sequencing, and benefits or harms of interventions or screening. We conducted meta-analyses for the association between early or more frequent colonoscopies and health outcomes.
Results: Twelve studies met our eligibility criteria. No adequate evidence directly addressed the main question or the harms of screening in the general population. Meta-analyses found relative reductions of 68% for colorectal cancer incidence (relative risk: 0.32, 95% confidence interval: 0.23–0.43, three cohort studies, 590 participants) and 78% for all-cause mortality (relative risk: 0.22, 95% confidence interval: 0.09–0.56, three cohort studies, 590 participants) for early or more frequent colonoscopies among family members of people with cancer who also had an associated MMR gene mutation.
Conclusion: Inadequate evidence exists examining harms and benefits of population-based screening for Lynch syndrome. Lack of evidence highlights the need for data that directly compare benefits and harms.
Keywords: Lynch syndrome, systematic review, targeted next-generation sequencing, genetic screening, general population
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]


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Mac Foundation Price in Pakistan - 24 results
Mac Foundation price in pakistan ranges from Rs. 399 to Rs. 9,200 with an estimated average price of Rs. 549
Mac Foundation Price in Pakistan - 24 results
Mac Foundation price in pakistan ranges from Rs. 399 to Rs. 9,200 with an estimated average price of Rs. 549
Mac Foundation Price List
|Original MA C Studio Face and body Foundation Natural shade
|Rs. 399
|MAC Pro Longwear Foundation
|Rs. 8,599
|MAC Studio Fix Powder Plus Foundation
|Rs. 7,299
|MAC Studio Fix Fluid SPF 15 Foundation
|Rs. 7,899
|MAC Pro Longwear Foundation, NC25
|Rs. 7,000
|MAC Pro Longwear Waterproof Foundation NC35
|Rs. 7,000
|Mac Mineralize Moisture Foundation SPF15 NC20 30ml
|Rs. 9,200
|MAC Studio Fix Fluid Foundation SPF 15, NC20
|Rs. 7,500
|MAC Studio Fix Fluid Foundation, NC25
|Rs. 7,500
|Mac Moisture Foundation 30ml-NC 35
|Rs. 6,950
Mac Foundation Overview
MAC cosmetics serve the needs of consumers and professional makeup artists alike. Amongst the most famous and widely used MAC products is their range of foundations. They have a shade for every skin colour that exists and a texture and finish for every skin type out there. In short, there is a MAC Foundation for everyone. Considered a mid-range cosmetic brand, MAC foundations are available at affordable prices in Pakistan.
Mac Foundation Pros and Cons
Great quality
For all skin types
Flawless coverage
Designs need improvement
Some dry out really fast while applying
Mac Foundation Description
Why MAC?
The best thing about MAC foundations is that they are pretty affordable as compared to the high-end brands, at the same time being no less than them in quality.
Best Sellers
Mac's best selling foundations are MAC Studio Fix Powder Plus Foundation, MAC Pro Long-wear foundation, MAC Mineralize Moisture SPF 15 Foundation and MAC Next To Nothing Face Color Foundation.
Available in Sheer, Medium and Full coverage formulations, MAC foundations are just the right texture that blends in like a second skin. From a dewy glow to a matte finish and full coverage, MAC foundations have it all.
For All Skin Types
MAC Face & Body Foundation is a hydrating formula that suits all skin types.
For Oily Skin
For oily skin, MAC Matchmaster SPF 15 Foundation, a matte formulation is the best bet as it controls oily skin and prevents the pores from getting clogged up.
For Dry Skin
For dry skins, formulations with a sheer hydrating finish can be a life saviour such as the MAC Studio Sculpt Foundation.
Sensitive Skin
MAC Mineralize SPF 15 Foundation is best for people with sensitive skins.
Flawless Finish
MAC foundations blend in your skin really well and create a flawless and uniform complexion, covering all your flaws.
Diverse Variety
Sold in a diverse array of textures and shades, they are hands down amongst the most high-quality and safe products sold in the market today.
About MAC
Make-up Art Cosmetics, commonly known as MAC is a world-renowned cosmetic brand that caters to the makeup needs of people of all ages, genders and races. Originated in Canada in 1984, MAC cosmetics took the makeup industry by storm and since then has gained global acclaim and popularity. Today, MAC is sold over 120 countries around the world, thanks to its diverse range of products that are for all skin types. Strongly committed to developing new categories, products and over 50 collections each year, MAC cosmetics continues to serve the needs of consumers and professional makeup artists alike.


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Flexi-Rods on My Pressed Hair, I'm in LOVE!
So I did my new straightening technique and my hair was perfectly straight leaving the house but the humidity had plans of its own so my hair reverted a bit during the day.
My new go-to for reverted pressed hair? Flexi Rods! Put those sucka's in (taught to tight) over night or even for a full day and I PROMISE you your hair will go right back to silky and front like nothin ever happened lol its great. All I used was extra virgin coconut oil.
(Put more rods then pictured here....put 10 ideally)
These are pics immediately after taking the flexi rods out
This is when it had a chance to loosen


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"I might be moving to San Antonio. Is there anyone you can recommend and I am hoping you can also benefit somehow from the referal. If all goes well, probably three of us are going to buy a house.
The area codes we are looking for are around 78251 and 78245 unless I find a better one since I will be working around the 78251 area which is around the Sea World area. Hopefully your referal can recommend some other areas since we know nothing about San Antonio.
Hope all is well with you" - XXXXXXX
Words like these, it is what gives me the greatest satisfaction of my job. In addition, this makes me feel honored to be the Spanish Realtor in Atlanta that he trusts and relies on me only to find him an agent who can represent him in his purchase as I represented him in the sale of his home in Atlanta GA. Thank you Mr. XXXXXXX!!
Giuliana Enriquez, Associate Broker, REALTOR®
Agente y Corredora de Bienes Raices/Inmobiliaria en Atlanta Georgia USA
Better Homes and Gardens Real Estate Metro Brokers
Call me today at 678-439-5857 to get your house sold
Llameme Hoy al 678-439-5857 para Vender Su Casa de Atlanta o ayudarle con una Venta Corta (Short Sale) exitosa de su casa.
Clique aqui para Ver Todas Las Casas en Venta en Atlanta y todas las ciudades de Georgia


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Join us and learn more about whole food plant based nutrition in a very short time than you thought possible at NorthShore VegFest !
AND, have the opportunity to hear Dr. Terry Mason, COO of Cook County Public Health speak about the benefits of plant based nutrition.
Bring the children as we will have cooking demos for them as well.
Tickets are 5.00 for adults; children under 12 are free.
Save the date and make your reservation here for this great upcoming event.
Event Date: Saturday April 16th
Time: 11:00 AM – 2:00 PM
Place: National Louis University – 5202 Old Orchard Rd. Skokie, IL


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New Guideline
Guideline Reference Centre
Read the latest EAN Guideline on Sleep in the Guideline Reference Centre.
Clinical Fellowship application deadline
The application deadline for the EAN Clinical Fellowship 2021 is at the end of the month. Apply now!
Registrar's Reading List
New Dementia Registrar's Reading List
New Registrar's Reading Lists on Dementia are online! Read them now.
European Academy of Neurology
Our mission is to promote neurological excellence in Europe and across the world, leading to better patient care and outcomes. We unite 47 national societies and represent more than 45,000 neurologists to achieve this goal.
Find out more.
your home of neurology.
EAN pages: Latest posts
- Neurology Update: Dementia and Cognitive Disorders
- Neurology Update: Epilepsy
- Present Your Business or Idea at the Brain Innovation Days Pitch Competition
- Neurology Update: Autonomic Nervous System Disorders
- EAN consensus statement for management of patients with neurological diseases during the COVID‐19 pandemic
- Neuro-oncology Management During the COVID-19 Pandemic With a Focus on WHO Grade III and IV Gliomas
Free for EAN members
Read the online version of the European Journal of Neurology here.
EAN Priorities 2020-2024
Vision: Be the Home of Neurology and advance high-quality patient care
Mission: Reduce the burden of neurological diseases
EAN survey on neuroCOVID-19
A survey on the clinical presentation of neurological symptoms in COVID-19 was conducted by EAN. More than 4000 physicians responded. Read more on the features pointing to neuro-COVID 19.


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Vestaboard is approximately the size of a 42 inch LCD TV.
41.2 inches wide (1046 mm)
22 inches tall (561 mm)
3.5 inches deep (89 mm) with mount
3.2 inches deep (81.5 mm) without mount
45 lbs (20.4 kg) without frame
55 lbs (24.9 kg) with frame
As we finalize a few specs of the internal mechanisms of Vestaboard, dimensions may change very slightly. We will update customers and this FAQ as the designs are finalized.
Vestaboard is powered by a single standard 3-prong plug. It does not need to be on a separate circuit breaker. When changing messages, it will pull similar power to an LCD television but when idle, will use greater than 90% less power.
Vestaboard supports 100-240V for US and International power consumption and requires 121 watts usage when updating message. Power consumption is very low when Vestaboard is not changing messages.
Vestaboard requires a WiFi network connected to the Internet in order to display messages.
First-time setup is performed using the Vestaboard app for iPhone and Android (coming soon). Setup consists of a few simple steps where you will create and/or link a Vestaboard account to your Vestaboard and connect it to your WiFi network.
Once your Vestaboard is connected, you will not need to re-connect it to WiFi unless you make changes to your router or Internet connection.
You may connect multiple Vestaboards to one WiFi network. The Vestaboard app will allow you to connect and control an unlimited amount of Vestaboards, whether they are on one network or multiple networks.
Vestaboard displays messages automatically through channels you subscribe to or create for yourself. You can also send individual messages on-the-go. Vestaboard receives the message information via wi-fi, and flips the characters to the proper letters or numbers to show exactly what you want to see.
After performing initial setup from the Vestaboard app (coming soon), you will be able to control and display messages on your Vestaboard from anywhere in the world through the app, or from any web browser, such as Chrome.
Vestaboard has room to display 132 characters, including letters, numbers, symbols, and colors. It's perfect for displaying news and weather updates, quotes, and whatever messages you want to share.
To display the message on the board, Vestaboard will process the text entry and smartly arrange it to look seamless on the board or allow you to control it so that what-you-see-is-what-you-get (WYSIWYG).


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You probably already know about the diners and the other usual (and good) suspects for a morning meal in Portland. But if you haven't been to breakfast at these hot spots, put them on your list.
64 Pine St., Portland | 207-871-9060 | auroraprovisions.com | $$
The cafe at Aurora, known for off-premise catering and gourmet take-out, has been a West End Haunt for 15 years. Locals stop in for a breakfast of homemade granola and raspberry scones, or a breakfast panini (which usually sell out pretty quickly) and locally roasted Carpe Diem coffee. The blackboard menus also lists a variety of smoothies, and Aurora's substantial oatmeal, nut and fruit breakfast bar is one of best around. There's outdoor seating in the warmer months and (bonus) a parking lot.
390 Congress St., Portland | 877-890-5641 | thepresshotel.com/union | $$$
Portland's newest place for power breakfasts is in the chic new Press Hotel, the former home of The Portland Press Herald, across the street from City Hall. French press coffee service is available, as is a "detox smoothie." On the menu: Croissant with "local artisanal cheese and salumi, hard boiled egg, fennel mustard and fig jam," and "vanilla brioche French toast with local maple syrup, whipped butter and grated cinnamon," along with omelets, benedicts, fruit and yogurt. There's also a kids menu, because not everyone is there on business.
649 Congress St., Portland | 207-899-3529 | localsproutscooperative.com | $
Run by Local Sprouts Cooperative, the cafe uses local, organic ingredients and offers budget friendly food that will please vegetarians, vegans and meat eaters. It also may be the only place in town where you can get authentic Acadian ployes — French Canadian pancakes made with buckwheat flour. You'll also find a vegan tofu scramble, vegetable fried rice, a hearty breakfast burrito and plenty of baked goods. The atmosphere is earthy, casual, and ideal for families with kids.
87 Brackett St., Portland | 207-774-0773 | ohnocafe.com | $
Slightly off the beaten path in the West End, quirky OhNo Cafe is known for its breakfast sandwiches, served on a bagel, bialy, or English muffin. Favorites include maple glazed prosciutto, egg, Vermont cheddar and Tabasco on a bagel and Browne Trading's smoked salmon, cream cheese, spinach and red onion on a bialy, but you can also come up with your own combination. There are a few tables and a bench outside, which is a great spot for people watching. Or take your sandwich down the block to Harbor View Memorial Park.
703 Congress St. Portland | 207-871-5005 | hotsuppa.com | $$
Home-style Southern cooking is the distinguishing characteristic of this cozy spot in the West End, which despite its name also serves breakfast and lunch. Biscuits and sausage gravy, corned beef hash and buttermilk waffles (plain, or with bacon or pecans) are highlights of the menu, but you can also get 7-grain porridge from Maine's Fiddler's Green Farm, New York-style bagels with smoked salmon and eggs benedict with fried green tomatoes or pulled pork, in addition to the usual egg dishes. In good weather, try to grab a table on the back patio.
The approximate cost of two breakfast entrees (not including drinks, tax and gratuity).
$ – $15 and under
$$ – $16 to $25
$$$ – $26 to $45
$$$$ – $46 and up


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These sessions, for the trial of the principal rioters in the late disturbances at Blackburn and the neighbourhood, were held this morning.
Mr. T. B. Addison, the recorder of the town, officiated as chairman, and on the bench were Colonel Austen, Mr. T. M. Lowndes, Mr. W. Birley, and several other county magistrates.
The first prisoners indicted were John King, John Harwood, John Lord, Joseph Johnson, George Pilkington, and James Grimshaw, for a riot at Blackburn, on Monday, the 15th of August last. It appeared from the evidence, which was very conclusive against the prisoners, that an attack was made upon several of the mills in the town in the forenoon of the day, and that the mob succeeded in turning the hands of many of the principal establishments out of work. The prisoners were proved to be the most active of a large assemblage, who were all well armed with bludgeons of a very formidable description. They were arrested by a strong body of the special constables, sided by the military, and offered considerable resistance.
Johnson and King pleaded guilty.
Mr. J. Addison, the recorder of Clithero, and Mr. Ingham conducted the prosecution, and the four remaining prisoners were defended by Mr. Wigham.
The Jury, after a short deliberation, returned a verdict of Guilty.
Lord, Pilkington and Grimshaw were sentenced to twelve months imprisonment in Kirkdale gaol; Howe and King, who pleaded guilty, to six months' imprisonment; and Johnston to three months' in the House of Correction in this town.
William Proctor, William Hutchinson, Abraham Rogers, William Smalley, Roger Walsh, and Squire Hutchinson were next indicted for committing a riot at Blackburn on the same day. These prisoners headed the attack on the mills of Messrs. Eccles, at 5 o'clock in the afternoon, outside which they violently assaulted and knocked down Mr. Montagu Fielden, a county magistrate, in the exercise of his duty whilst reading the Riot Act. On this occasion the detachment of the 72d Highlanders, who were stationed in the town, fired upon the mob, by which a female who took an active part in the disturbances, with several other persons, were severely wounded. This mob, as in the former case, were armed with powerful bludgeons. The hand in the establishments were armed to protect the premises, many of them with fire-arms, which they used against the mob prior to the arrival of the military. The mob consisted of upwards of 500 persons, all of whom were armed, walking 12 or 14 abreast. Proctor, who was 59 years of age, it appeared, acted as one of the leaders on the occasion. The evidence, as in the former case, was very conclusive, and the whole of the prisoners were convicted. Rogers was sentenced to imprisonment for six months, as was William Proctor, for the assault on Mr. Fielden; Smalley and Hutchinson for three months, and Walsh and William Hutchinson for two months.
John Wilkinson and Joseph Rawlinson were next indicted for a riot at Blackburn on the same day. They each pleaded guilty, and were sentenced to six months' imprisonment.
William Rawlinson, Richard Holden, Ann Yates, Jane Catterall, James Hurst, James Driscoll, William Hodson, and Joseph Yates, were indicted for having, on the 15th of August, turned several persons out of employment at Blackburn, and assaulting two of the police in the execution of their duty.
Holden, Yates, and Hurst pleaded guilty.
The prosecution was conducted by Mr. J. Addison and Mr. Walmsley, and the prisoners were undefended.
The two women were very active in heading an attack upon a coach which was conveying some prisoners to the barracks, and the male prisoners, particularly Rawlinson, made use of very violent expressions, stimulating the mob to acts of violence.
The prisoners were all found Guilty; the two women being sentenced to six months' imprisonment in Lancaster Castle, Yates and Hurst to six months' imprisonment at Kirkdale, Rawlinson (who received a good character from several persons, and who was proved to have received a wound on the head at the last Guild, 20 years since, which rendered him insane when under the influence of drink) to six months' imprisonment, Driscoll to four, and Holden to two months.
Benjamin Wainscot, William Cook, Henry Thompson, James Barker, and John Hanson, pleaded guilty to an indictment charging them with coming riotously in a crowd from Accrington to Blackburn, where they violently assaulted the Yeomanry on duty by pelting them with brickbats from behind a hedge.
Barker was sentenced to four months' imprisonment; Hanson, Wainscot, and Cook to two months'; and Thompson to one months' imprisonment, at the House of Correction in this town.
Robert Hartley, a man well-dressed, and in a superior situation of life, Ratcliffe Ingham, William Brennand, Ratcliffe Hoyle, and Riley Catterall, were indicted for riotously assembling and endeavouring to enter into Blackburn on the 16th of August, when they were intercepted by the military and police. The prisoners all pleaded guilty, and Ingham, who flourished a bludgeon over the heads of the police, was sentenced to six months' imprisonment, and the other prisoners to two months' each.
The RECORDER, in addressing the jury, took occasion to remark that the results of the trials at the present and the preceding sessions had shown that the parties engaged at the recent riots did not belong to the poorest classes of society. They were generally persons in good employment, who should have been content with the wages which they received, but had in a great many instances subscribed towards the trades; unions. They had aggravated greatly the distress under which the working classes laboured, and they would always be the sufferers from such illegal combinations.
© David Haworth
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Booty Deluxe
SKU: WS19 Booty Deluxe-Indigo
This Booty is a beauty. With three more liters of capacity than our standard Booty Bag, the BOOTY DELUXE is a feature-rich version with additional storage and organization options.
Our mid-size backpack/tote to carry a bit more Booty.
Though simple and versatile like the original, our BOOTY DELUXE is a plus-sized, carryall bag for hauling your necessities. Featuring multiple carry options – backpack or tote – the shoulder straps conveniently unbuckle for unfettered access to the main bag. Whether you're headed to the farmer's market, climbing gym, or the beach, this is a workhorse backpack-style tote, you'll use every day.
- These bags feature the same design principles and durability that MYSTERY RANCH is known for and are built to survive the harshest commute, wherever that may be.
- Front drop-in pocket for quick access
- Main zippered compartment to secure additional stuff
- Sliding straps for easy open/close with buckle closure
- Top zipper detail pocket with key clip
- Foam back panel for comfort and support
- Padded side-zip compartment fits laptops up to 13"
- 500D CORDURA® fabric
- YKK® zippers
|UPC Code
|WS19 Booty Deluxe-Indigo
|CAGE Code:
|DUNS Number:
1.4 lb
0.6 kg
1280 cu-ins
Rated 5 out of 5 by Anonymous from Great simple bag for everyday essentials.Fantastic build quality and cool design. I was searching for a simple bag to take to work everyday, something a little more nondescript than my military bags covered in MOLLE, and this fits the bill. I carry a 13" Chromebook and file folder in the padded rear compartment, wallet, small EDC kit, keys, sunglasses and few small odds and ends in the small top pocket. The main pocket swallows two Nalgene bottles and a wind-breaker with room for more. I wish there was a hook and loop panel somewhere sewn in, but I happened to have a stiffened panel that fits perfectly in the front slip pocket and this accommodates my sidearm and extra magazine securely with no problems. Its really a nice, simple bag for basic everyday needs and I wouldn't think twice about using it on a day hike.
Date published: 2018-04-05
Rated 3 out of 5 by dino from I love the looks and the concept, but...This is my first MR bag, used daily for more than a month. Love and hate it. Access: The main compartment's opening is 1-2 inches shorter on both sides than the entire width of the bag. Difficult to put in/get things inside. Height/Organization: Everything falls to the bottom. The outer pocket is only good for long items needing carabiners to stay upright. No internal organizational features. Youâll need a vertical backpack organizer for this. Grab handle: Front grab handle is attached to the middle part of the bag. It doesnât directly connect to the structure, it's connected to an internal layer of material that separates the main and the outer pockets. The tension on this grab handle pulls at the sides of the bag and flexes. This front grab handle will be higher by an inch, making the bag tilt and hit your leg. Capacity: For its rated capacity, it feels much smaller. It always feels tight. Maybe because the volume is wasted airspace in the upper part of the bag.
Date published: 2019-01-30
Rated 5 out of 5 by Snargrumple from Beautifully simpleI bought this bag to replace my FAVORITE rucksack that finally called it quits after 2 times around the world. The release buckles are a nice touch making it simple to get stuff out of the main compartment.Very well made and all design features are well thought out.My only wish for this model is that they make a larger size. Often I carry lots of bulky stuff especially in winter (down sweater, dry clothes...) and would certainly buy a larger size in addition to the one I have.
Date published: 2020-05-28
Rated 5 out of 5 by Chris75 from Great for spouse!I bought this bag for my wife who uses it for work and travel. It sits comfortably on her shoulders when she uses both straps and holds up to daily use. Thank you Mystery Ranch!
Date published: 2019-04-15
Rated 5 out of 5 by None from So fitting and fun !I bought it for a friend to use as a utility bag for her newborn. She loves it
Date published: 2020-09-04