Nowadays, there are two vaccination strategies in Colombia to prevent pneumococcal diseases in people over 50 years. Our aim is to estimate cost-effectiveness of pneumococcal conjugate vaccine 13-valent (PCV13) versus pneumococcal polysaccharide vaccine 23-valent (PPSV23) to prevent pneumococcal diseases and their related mortality in people over 50 years old in Colombia.
A Markov model was developed with national data, including pneumococcal serotypes distribution in Colombia between 2005 and 2010. Vaccination of a cohort was simulated and a five year time horizon was assumed. Analysis was done from a perspective of a third party payer. Direct costs were provided by a national insurance company; sensitive univariate and probabilistic analysis were done for epidemiological and clinical effectiveness parameters and costs.
PCV13 avoids 3 560 deaths by pneumococcal infections versus PPSV23 and 4 255 deaths versus no vaccine. PCV13 prevents 79 633 cases by all-cause pneumonia versus PPSV23 and 81 468 cases versus no vaccine. Total costs (healthcare and vaccines costs) with PCV13 would be U.S. $ 97,587,113 cheaper than PPSV23 and it would save U.S. $ 145,196,578 versus no vaccine.
PCV13 would be a cost-saving strategy in the context of a mass vaccination program in Colombia to people over 50 years old because it would reduce burden of disease and specific mortality by pneumococcal diseases, besides, it saves money versus PPSV23.
Streptococcus pneumoniae (pneumococcus) is a frequent cause of serious infectious diseases in children and adults. Pneumococcal infections may be invasive such as sepsis and meningitis [Invasive Pneumococcal Disease (IPD)], or non-invasive, such as pneumonia, the most common form of serious pneumococcal disease in adults . According to the World Health Organization (WHO), in 2000 there were about 14.5 million cases of pneumococcal disease (invasive and noninvasive) .
Pneumococcal pneumonia is the most common bacterial cause of community acquired pneumonia (CAP) in adults . Mortality rates for pneumococcal CAP are between 10% and 30% in adults and have remained constant over the past four decades [4–8].
Increased bacterial resistance , an increase in the prevalence of immunocompromised people, especially by HIV, immunosuppressive therapy in oncology, and transplantation medicine; as well, the increase in life expectancy that is accompanied by immune senescence processes likely contribute to sustained morbidity and mortality impact of this disease [10, 11].
Given the burden of disease by pneumococcal diseases in worldwide, a prevention strategy with vaccination may be the most cost-effective approach to health systems. This is not a new topic, there are randomized clinical trials (RCTs) from 1940s [12, 13], but it was just until 1977 that began the widespread use of this technology, when pneumococcal polysaccharide 14-valent vaccine (PPSV14) was authorized and later, in 1983, PPSV23 was launched. The latter is a vaccine made with 23 different capsular polysaccharide serotypes and has been indicated to prevent pneumococcal disease in children over two years old with risk factors and adults over 50 years old. International clinical guidelines generally recommend its use in adults over 65 years old, and for people under 65 years old, who have chronic comorbidities that put them at higher risk of disease .
In 2000, a pneumococcal vaccine with a different technology was launched, which conjugates pneumococcal serotypes with a diphtheria protein (CRM197). This one was the pneumococcal conjugate vaccine 7-valent (PCV7) that demonstrated its effectiveness [15–17] to prevent IPD, pneumonia and acute otitis media (AOM) caused by vaccine serotypes in children aged between 2 months and 9 years old. It has also been studied in adults, including patients with HIV . Later, in 2006, a WHO expert group established that future pneumococcal conjugate vaccines may be evaluated on the basis of immunogenicity studies, such that efficacy studies with disease outcomes would not be necessary for regulatory approval. This statement was based on the PCV7 and PCV9 RCTs, that found an association between an antibody concentration > 0.35 mcg/ml of the serotypes contained in these vaccines and prevention of IPD by the respective serotype .
In 2010, a 13-valent pneumococcal conjugate vaccine (PCV13) was approved for prevention of IPD, pneumonia and AOM caused by serotypes included in the vaccine in children between 2 months and 5 years old. Later, in 2011, PCV13 was approved to use in people over 50 years to prevent pneumococcal diseases (IPD and pneumonia) caused by serotypes 1 3, 4, 5, 6A, 6B, 7 F, 9 V, 14, 18C, 19A, 19 F and 23 F.
Given that there are two technologies for prevention of pneumococcal diseases in people over 50 years old, the 23-valent polysaccharide vaccine and the 13-valent conjugate vaccine, the aim of this study was to estimate incremental cost-effectiveness ratio (ICER) of PCV13 versus PPSV23 and versus no vaccine in people over 50 years old in Colombia.
A cost-effectiveness analysis was performed using a Markov model with a first-order microsimulation to determine the risk of developing IPD and pneumonia in people over 50 years; the original model was developed by PAI (Policy Analysis Inc.) to Pfizer. The model simulates cohorts of individuals which represent the age and risk profile of the populations. Each individual's risk was adjusted based on age and risk profile of individuals according to their medical history, such as chronic diseases or immunocompromised illnesses. No previous vaccination with PPSV23 was assumed. The model assumed that at the beginning, individuals would be vaccinated with PCV13 or PPSV23 or would not be vaccinated. Over the course of the simulations, individuals were at risk for four clinical outcomes: sepsis, meningitis, inpatient pneumonia and outpatient pneumonia. Mortality rates from IPD and pneumonia were considered to calculate deaths avoided. Risk reduction associated with the vaccines relied on the clinical presentation of diseases: IPD, inpatient pneumonia or outpatient pneumonia; as well as the vaccine, time since vaccination, age at time of diseases, and risk profile  (Figure 1) Further methodologic details can be referenced from application of the model to the US setting .
Markov microsimulation model of pneumococcal diseases to determine the cost-effectiveness of vaccination with PCV13, PPSV23 or not vaccine, in people older than 50 years in Colombia.
Costs of medical treatments were calculated based on the site of healthcare (inpatient or outpatient), age of patients, and their risk profile. To determine epidemiologic distribution of S. pneumoniae serotypes, we used the data of Regional Vaccine System (SIREVA II, by their acronym in Spanish), which reports serotypes of all isolates made in Colombia by IPD. For this purpose, we took the distribution of S. pneumoniae serotypes found in Colombia between 2005 and 2010 in people older than 50 years . The model was calculated using a discount rate of 3% for both costs and effects, according to WHO recommendations .
Analysis was done from the perspective of a third-party payer in Colombia. Three alternatives were considered: no vaccination, vaccination with PCV13 or vaccination with PPSV23. The model horizon was five years and we assumed vaccination coverage of 70%. An incremental cost-effectiveness analysis was made among these three strategies in terms of avoiding cases and deaths for each disease and life-years gained (LYG).
The data used in this study are referenced in each item and are publically available in medical databases and official reports of Colombia, except hospitalization costs, which were provided by SURA, a national health insurance.
Low risk: immunocompetent people without chronic diseases.
Medium risk: immunocompetent people with chronic diseases, such as cardiovascular, hepatic, lung illnesses or diabetes.
High risk: immunocompromised people as a result of splenic dysfunction, malignancies, HIV, organ transplant or chronic renal failure.
The model assumed that high-risk people who were vaccinated with PPSV23 will be revaccinated five years later .
We calculated the likelihood of falling ill with IPD, inpatient pneumonia or outpatient pneumonia based on two age groups of 50–64 years, and > 65 years. No literature that would identify the specific risk for additional age groups was found (Table 1) [27–30]. Mortality by IPD and pneumonia was calculated according to official data of general mortality by age groups in Colombia  and it was adjusted based on Koivula et al. .
Pneumococcal serotype distribution in adults older than 60 years between 2005 and 2010 in Colombia was based on reports of SIREVA II. Thus, proportion of S. pneumoniae serotypes circulating in Colombia covered by each vaccine was calculated, as well: PCV13 covers 64.6% and PPSV23 covers 76.9% .
Parameters of effectiveness of initial vaccination with PPSV23 in immunocompetent adults over 50 years and immunocompromised adults over 65 years were adapted from the approach by Smith et al., and it was adjusted for age, risk group, and time since vaccination . As these data were taken from a panel of experts through Delphi methodology, sensitivity analysis and probabilistiva analysis were done , and these have been consistent with former results in the United Kingdom . Effectiveness of initial vaccination with PPSV23 in immunocompromised adults between 50 and 64 years old in the year after vaccination was based on data from Shapiro et al. . In the same way, we assumed a rate of decline in protection after vaccination . It was assumed that the effectiveness of revaccination with PPSV23 was 75% of initial value (Table 3).
Effectiveness of PCV13 for people over 50 years in the groups of low and moderate risk in the year after vaccination, was adapted from the effectiveness of PCV7 for children [15, 35, 36], assuming similar effectiveness against the six pneumococcal serotypes not included in PCV7. It was assumed a conjugate vaccine would have similar effectiveness as in children, but that this effectiveness would decline with increasing age after 50 due to immune-senescence. The decline in PCV13 effectiveness with age in people over 50 years was assumed as 50% of the corresponding rate of decline for PPSV23. Further for people in high-risk group, it was assumed PCV13 would have 78% of the corresponding age-specific effectiveness of adults with low and moderate risk . It was assumed that effectiveness of both vaccines was constant across each of the serotypes contained in each vaccine, according to WHO recommendation of non-inferiority in the proportion of vaccine serotypes with antibody levels > 0.35 mcg/ml [38, 39] (Table 3).
An effectiveness of zero (0) for PPSV23 against all-cause pneumonia was assumed; based on several studies that also have served as information source in other economic assessments [40–45]. For PCV13, effectiveness observed in children with radiological-confirmed pneumonia was assumed in inpatient pneumonia and it was adjusted for the effect of immune-senescence following a similar procedure as described with IPD . For outpatient pneumonia, the starting point for effectiveness estimation was 6%, based on the percent reduction in children with pneumonia without radiological confirmation . We assumed the same decline rate of effectiveness adjusted by age, used in patients over 50 years with IPD. In immunocompromised patients, it was assumed a PCV13 effectiveness of 65% less than immunocompetent adults of the same age, based on data of Klugman et al.  (Table 3).
Vaccine costs were taken from the Pan American Health Organization Revolving Fund prices; which lists values of different vaccines for the Americas in 2013; cost per dose of PCV13 is U.S. $ 15.84 and cost per dose of PPSV23 is U.S. $ 6.60 . For administration cost for application of either vaccine, we assumed a value of U.S. $ 1. To calculate these values in American dollars, we assumed a value of $COP 1800 per U.S. $ 1 .
To determine the costs of treatment of sepsis, meningitis and pneumonia in adults over 50 years in Colombia, we took the information from a health insurance company with national presence and over 1.8 million members, which ensures the representativeness of Colombian population. Costs were determined based on the value actually paid by insurance companies to different hospitals and includes all services rendered during the stay including visits-hospital, diagnostic aids, antibiotics and other treatments necessary for recovery until discharge. These costs are based on national tariff manuals. In 2012, this insurance company reported a total of 48 cases of meningitis, 1 526 cases of pneumonia and 389 cases of sepsis. These costs were validated with data from a study in three hospitals in Bogota, Colombia, for a period of 18 months in 2011 . The values were adjusted at 3.73%, which was the Consumer Price Index for 2011 reported by National Administrative Department of Statistics of Colombia (DANE by their acronym in Spanish) .
Probabilistic and univariate sensitivity analyses were made for epidemiological parameters, effectiveness of interventions, and costs included in the model. The parameters that generated a higher level of uncertainty were identified and variance reported. For probabilistic sensitivity analysis a Monte Carlo simulation with a thousand iterations was performed, in order to evaluate each expected value in the distribution of costs and diseases likelihood for each strategy. In the base case, the probabilistic sensitivity analysis report both there were 7,5000,000 simulations and 1,000 trials.
We assumed a gamma distribution for medical costs avoided and the costs of vaccines, considering the kurtosis thereof. Alpha and beta parameters were calculated from standard deviations of the actual data. Results of Monte Carlo simulation show robustness of the model. A univariate sensitivity analysis was made with minimum and maximum values, with the aim to observe the sensitivity of ICER to change in the parameters of each variable.
A cost-effectiveness analysis was made to calculate the ICER of vaccines and number of avoided cases in relation to the four conditions of interest: sepsis, meningitis, inpatient pneumonia, and outpatient pneumonia. The calculation was made considering in numerator the costs difference of both alternatives and in denominator their effectiveness difference. Costs were result of the value of one dose of PCV13 or PPSV23, as well as the lower cost incurred on medical treatment for least number of cases of each disease.
Cost-effectiveness analysis of vaccines in relation to specific mortality from sepsis, meningitis and pneumonia and mortality added were made also. Finally, a cost-effectiveness analysis was made in relation to the LYG for each strategy.
Compared to no vaccination, use of PCV13 in adults over 50 is expected to prevent 49 857 cases of pneumococcal bacteremia; 3 135 of pneumococcal meningitis; 496 795 of inpatient pneumonia, 866 189 of outpatient pneumonia; and 33 980 deaths from pneumococcal infections, over 5 years. Moreover, total costs with the not vaccinating strategy were U.S. $ 145,196,578 greater than vaccinating with PCV13 (Table 4).
Both vaccination strategies would prevent more deaths and IPD that no vaccination and PCV13 would reduce more than PPSV23. A mass vaccination program in Colombia for adults over 50 years with PCV13 would avoid 79 633 additional cases of pneumonia, both inpatient and outpatient, to those prevented with PPSV23. Furthermore, PCV13 would prevent and additional 5 127 cases of IPD and 3560 deaths by pneumococcal infections, more than PPSV23 (Table 4).
Total costs (medical costs and vaccination) were highest with the strategy of not vaccinating, and both PPSV23 and PCV13 were cost saving compared with no vaccination. However, vaccination with PCV13 saves U.S. $ 97 million versus PPSV23 (Table 4).
PCV13 is dominant over PPSV23 in terms of mortality avoided and LYG in adults over 50 years, because PCV13 avoids more deaths, generates more LYG, and healthcare costs expected would be lower than PPSV23. ICER indicates that PCV13 would be dominant over PPSV23, both in terms of illness and deaths averted by pneumococcal disease as well as LYG (Table 4).
PCV13 would prevent 52.0% of the cases of pneumococcal bacteremia and meningitis and 12.6% of all-causes pneumonia versus no vaccination strategy, unlike PPSV23 that would prevent 26.9% and 6.2%, respectively (Table 4).
In the probabilistic sensitivity analysis, among one thousand simulations of the model, PCV13 had a lower cost than PPSV23 in 100% of cases, there was more LYG in 64% of cases and it was cost-effective in 87% of cases, taking into account a willingness to pay of 3 GPD (U.S. $ 23,799)  (Figure 2).
Probabilistic sensitivity analysis, which plotted life years gained versus costs for PCV13 and PPSV23 in a cohort of people over 50 years in Colombia, 2012.
In the same way, in cost effectiveness plane, PCV13 is dominant over PPSV23 and no vaccination, which is due to be a strategy with greater clinical effectiveness and lower costs (Figure 3).
Number of cases avoided with PCV13 and PPSV23 compared to no vaccination in a cohort of people over 50 years in Colombia, 2012.
This cost-effectiveness analysis has identified both clinical and economic outcomes of the alternatives that exist in the Colombian market to prevent pneumococcal diseases in adults over 50 years: PCV13 and PPSV23. From the perspective of a third-party payer, both strategies are dominant versus non-vaccination, in terms of avoided diseases and deaths, ICER, and LYG. In addition, PCV13 was cost-saving, and is below the threshold of 1 per capita gross domestic product Colombian in 2012 (estimated at U.S. $ 7.933) , according to WHO recommendations .
Since 2009, several Colombian cities are including PPSV23 within their immunization plan. In 2011, PCV13 received health registration for use in people over 50 years to prevent pneumococcal diseases. Results of this cost-effectiveness analysis are intended to generate information to make decisions regarding the choice of two options that are on the market.
The results of this cost-effectiveness analysis are similar to those reported recently by Smith et al. and Weycker et al. in the US, both of which concluded that PCV13 in adults over 50 years of age is a better strategy than PPSV23 in terms of cost-effectiveness, to prevent pneumococcal infections in adults in the United States [24, 51].
Although this cost-effectiveness analysis only considered the use of one dose of both, PCV13 or PPSV23 because the time horizon was five years, it is important to note that if the time horizon would have been the life expectancy, two doses of PPSV23 should be used for people at high risk, according to its manufacturers.
In the other hand, a meta-analysis published by Moberley et al. recommends PPSV23 versus placebo to prevent pneumococcal diseases . RCTs used in that meta-analysis and published between 1980 and 2006 did not found any evidence about PPSV23 as protective vaccine to avoid pneumonia [40, 41, 53–58]. It means that the conclusion of Moberley et al. is based on only two RCTs: Kaufman (1948)  and Riley (1977) . It is important to note that these RCTs [13, 59] did not identified infection by S. pneumoniae but Diplococcus pneumoniae, which is a different microorganism.
Clinical effectiveness of pneumococcal conjugate vaccines for IPD in adults is judged by non-inferiority of antibody response compared with PPSV23. Jackson et al. showed that in people aged 70 years and older, opsonophagocytic activity titers were significantly greater in the PCV13 group versus PPSV23 group for 10 of the 12 serotypes common to both vaccines and to serotype 6A which is only in PCV13. Responses were non-inferior for the other 2 common serotypes . Much effectiveness, particularly in pneumonia, is inferred based on PCV13 being a conjugated vaccine and eliciting a T-cell dependent response. This is supported by effectiveness in children reducing pneumonia and nasopharyngeal carriage, in fact, Cappuy et al. demonstrated that 2 to 4 years following PCV7 introduction, predominant pneumococcus serotypes carried in children with community-acquired pneumonia were non PCV7 serotypes .
A main strength of this study is that it has local information, which helps determine the epidemiological parameters for diseases of interest in Colombia . Also, medical costs of treatments are based on local data  and are not supposed on studies done in other countries with different economic realities. In the same way, to adjust efficacy of both vaccines based on pneumococcal serotypes circulating in the country between 2005 and 2010, allows having an updated analysis . So, by having local and updated economic and epidemiological information, we can develop a robust economic model, that allows to national and regional health authorities assess their vaccination plans and take decisions.
The biggest limitation of this study is that there is not effectiveness data for PCV13 in this population. However, the advantages of conjugation are expected to enhance effectiveness against mucosal disease, such as pneumonia, increase immune memory compared to plain polysaccharide vaccine, and improve effectiveness in high risk populations such as immunocompromised. In a study of PCV7 versus placebo in HIV patients, French et al. found a vaccine efficacy of 74% (95% CI: 30% - 90%) to prevent pneumococcal diseases . In other study, Klugman et al. found that vaccination with PCV9 reduced the rates of radiologically confirmed pneumonia, and PCV9 also reduced the incidence of vaccine-serotype and antibiotic-resistant IPD among children with and those without HIV infection .
Another weakness of this study, is that there is limited information comparing clinical outcomes of PPSV23 and PCV13 in adults to prevent IPD, which are the most lethal diseases caused by pneumococcus. In the same way, by taking data of disease prevalence from an official source, it could be some underreporting, because quality of this kind of information depends that medical practitioners use the correct codes to identify diagnosis.
This analysis did not evaluate after-effects of any of the diseases, why not were estimated years of disability-adjusted life. But it is noteworthy that in terms of prevention of death from all causes, PCV13 was dominant over PPSV23.
The results of this study indicate that PCV13 and PPSV23 are better alternatives in terms of cost-effectiveness compared with no vaccination. PCV13 is dominant over PPSV23, since PCV13 prevents more deaths by pneumococcal diseases, generates more LYG, and costs are expected to be lower than PPSV23 in adults over 50 years. Implementation of a vaccination program for adults older than 50 years in Colombia with PCV13 would decrease morbidity and mortality by pneumococcal diseases and would be a cost-saving strategy.
This research was sponsored by Pfizer, Colombia. Researchers declare our full independence of the contractor and we are solely responsible for methods, results and concepts raised in this paper.
To Sura EPS, a Colombian company health insurance, which provided the data for hospitalization costs.
JEO reviewed the scientific literature and identified local epidemiological data. JJO adapted economic model developed by Policy Analysis Inc. Both authors read and approved the final manuscript.


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Bye-Bye Boeing
Written by Vicky Dixon
Posted Oct 10, 2013 7:54
Updated Aug 31, 2021 22:50
Japanese Airlines (JAL) has officially signed a deal worth $9.5 billion with aircraft manufacturer Airbus. This comes as a shock to many as thus far Boeing has enjoyed 80% market dominance in Japan.
JAL has signed a deal for 31 A-350 aircrafts with an option to purchase 25 more. The A-350 model has already departed and landed successfully on its maiden voyage this year and is expected to be ready for commercial use in 2014.
Japanese Airlines had previously been weighing its options between the A-350 and Boeing's 777X jet.
However, the delays faced by Boeing in launching this new aircraft is a probable reason for JAL's switch.
This order is expected to replace Boeing's 777 line for long haul flights with seating for over 300 individuals.
Many speculate that Boeing has been very slow in beginning production for the 777X and this allowed Airbus the opportunity to jump in.
Due to the growing concern for the environment in addition to the soaring costs of fuel, both aircrafts have been required to be fuel efficient and as eco-friendly as possible, which was initially an issue for Boeing.
That is not to say that Boeing has completely lost it's footing in the Japanese market. It is probably that JAL will stick with Boeing for its smaller aircrafts which contain less that 300 seats.
The Dreamliner was intended to be a showstopper and started off with the name 'The Sonic Cruiser'. With a sleek design enabling the aircraft reaching close to Mach speed, it would have shaved off hours of long haul flights. It soon became apparent that this idea would not be feasible in any way. Environmental lobbies began voicing concerns over the amount of fuel that would be needed and in addition to the high maintenance costs the aircraft would expect to be prone to. The idea was called off and after a series of other impractical ideas, the Dreamliner was born.
It seemed like the perfect solution to all the needs of the current market and so far orders for 950 aircrafts have been made.
The first Dreamliner completed its maiden voyage in 2009 and subsequently became available two years later in October 2011.
The technical faults began surfacing and the concern that Dreamliner carriers were prone to fires grew. This year, all Dreamliners were grounded for three months as a result. The cause was discovered to be the lithium powered batteries on the aircraft that was the catalyst for the fires.
These problems have finally been resolved and the 787 line is back in action.
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MC Mong tops music charts with sixth album
MC Mong. (IS Entertainment Group)The embattled South Korean hip-hop artist MC Mong, who was once mired in controversy over draft evasion, topped major local music charts with his latest track for the second straight day. As of Tuesday morning, the single "Did you miss me?" off his sixth full-length album "Miss Me or Diss Me," took the No. 1 spot on all 10 online real-time music charts including Naver Music, MelOn...
Published : Nov 4, 2014 - 20:33
Updated : Nov 4, 2014 - 20:33
MC Mong. (IS Entertainment Group)
The embattled South Korean hip-hop artist MC Mong, who was once mired in controversy over draft evasion, topped major local music charts with his latest track for the second straight day.
As of Tuesday morning, the single "Did you miss me?" off his sixth full-length album "Miss Me or Diss Me," took the No. 1 spot on all 10 online real-time music charts including Naver Music, MelOn, Daum and Mnet after its release on Monday.
The 13-track album comes five years after the release of his previous full-length album, "Humanimal," in 2009. The funky title song, featuring Jinsil of vocal group Mad Soul child, tells of MC Mong's inner conflicts before he returned to the K-pop scene.
MC Mong's unexpectedly strong performance on the music charts surprised the K-pop scene as the public anger towards him still remains over his alleged draft dodging.
The 35-year-old rapper kept low for nearly four years after being charged with deliberately delaying his military duty in 2010.
MC Mong allegedly paid dentists to pull out two of his teeth to be exempted from the mandatory military service, although he claimed that the procedure was for medical reasons.
Given the persistent public outcry, it remains unclear whether he will make any appearance on TV to promote his album.
MC Mong debuted as a member of the hip-hop group People Crew in 1998. The artist rose to prominence after appearing on the MBC sitcom "Non-Stop 4." After he launched his solo career as a rapper in 2004, his upbeat music and comedic style gained broad popularity.


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Greg Greenway
Deeper Than The Skin
Songs from the Beginning
20,000 Versions of the Sun
Greg Greenway: Live
Something Worth Doing
Singing for the Landlord
A Road Worth Walking Down
Between Hello and Goodbye
Songs from the Beginning Lyrics
20,000 Versions of the Sun Lyrics
Standing on the Side of Love Lyrics
Weightless Lyrics
Greg Greenway – Live Lyrics
Something Worth Doing Lyrics
Archaeology Lyrics
Lyrics for Singing for the Landlord
Lyrics for A Road Worth Walking Down
Selma: "There is Power in the Blood"
Camera lenses, like childhood memories, make spaces appear much larger than they are. Like the Dallas book repository, like the Lorraine Motel, Selma emerges, from the cold rain, small – only a few blocks in each direction. Our three modern buses took an opportunistic driving tour, making turns every two blocks or so, winding carefully through the narrow streets as veterans of the '65 action provided commentary. The ones who'd been there spoke, as they would for the entire conference, like war veterans, expansively of the larger experience, modestly of their own part.
Our first impromptu stop was by the marker for Rev. James Reeb, the Unitarian Universalist minister whose fateful wrong turn out of a restaurant cost him his life. (The movie, "Selma," called Rev. Reeb a priest, the smaller of many unexplainable inaccuracies) Rev. Reeb died days later of head wounds from the blows of White attackers. Such was the state of justice in Alabama that none of the local men were convicted by the all male, all White jury. But, in the small town of Selma, it was common knowledge who wielded the metal pipe – his auto dealership was pointed out on our August planning trip. It was business as usual in the the Jim Crow South. (I'll get to Jimmy Lee Jackson's death later).
I stepped carefully off the steep narrow steps of the bus into the rain to feel a space hallowed by blood. I didn't know him, but I did. I met him in planning meetings, in hallways, and ballrooms throughout the conference, in those who would describe themselves in the movement as interchangeable parts – one soul with many faces. It could have been any one of them. They answered Dr. King's plea to the nation, they put themselves in harms way.
As we were to hear later that night, "There is power in the blood."
My eyes were drawn to where people had gathered under a small funereal tent. The soft unpracticed voice of a young women had drawn everyone into a close huddle, silently leaning in, straining to hear. The word "grandfather" rippled the palpable sadness. I could only sporadically understand what she was saying, but words weren't necessary. Standing solemnly together in the cold felt like the very roots of human experience. I was drawn to Selma, as probably everyone was to some degree, to experience it in my guts. It was happening.
We moved on slowly, thoughtfully, back to the buses – reticent to let go of what we'd just experienced. In front of Brown Chapel A.M.E. Church we stopped for the Martin Luther King, Jr. memorial. It was explained that this was the SCLC church, while SNCC was typically down the street at the 1st Baptist. Word spread that we were being allowed into the sanctuary and it was confirmed by the sexton of the church striding past, articulating loudly to himself the full names of those who had paid our admission: "James Joseph Reeb, Viola Gregg Liuzzo" (the Unitarian Universalist housewife murdered by the Klan as she drove marchers back from Montgomery). As a member of the planning committee, I wish I could say that we had arranged this, but it was a tremendous stroke of luck.
To walk into Brown Chapel is to walk into history. Martin Luther King, Jr. defined moral courage from this very pulpit on the day after Bloody Sunday. Under pressure from every possible direction to back down (including the President of the United States), under the constant and very real threat of assassination, King defiantly said that "a man dies when he refuses to stand up for justice." He and the marchers the next day went on to defy, for the first time, an order of the very Federal Court that had been the movement's staunchest ally from the beginning. Brown Chapel has been filled with indescribable tension and fear, blessed by brilliance under fire, and sanctified by ineffable courage and hope. It is humbling to stand in that space.
The sanctuary, itself, is unusual in that the pews slope downward to the pulpit, more like a theatre. The minister is not on an elevated platform above the attendees. Being there in the afternoon, it's emptiness was a little like being on a jet, powered down on a runway. The organ, directly behind the pulpit, drew me and led me to imagine what hands had earned that honor. I was taking photos of the keys when I felt a tug on my sleeve. I turned to see a beckoning finger – we were going to get to sing in this incredible place. Kim and Reggie Harris led us: "this little light of mine, I'm gonna let it shine," "we shall not, we shall not be moved." Everyone in the church stopped, came forward, and immediately joined in.
To sing in Brown Chapel with Reggie Harris was, for me, at once the most normal thing in the world, and an unforgettable apogee in a conversation that began more than three decades ago. Born three days apart, we share many many common life experiences. But I have never presumed that I could any more understand the experience of being a Black male in America than I could understand being pregnant. So we have always talked about Race. In fact the first line of "In The Name of Love," ("when I get tired") comes from a phone call I made to Reggie years before I wrote the song. It had become apparent to me that I could cut my hair, say the right things, play the game, and blend seamlessly back into mainstream America. I told him that I couldn't imagine how tiring it must be to be responded to every second of your life on your most superficial characteristic. Without hesitation, he responded, "you have no idea."
We have sung together, cried together, laughed together (everyone should know Reggie's laugh). I have helped him walk the halls of the hospital where he'd just received a new liver, I've told him things I'm not proud of, I've felt his wrath when I didn't pass him the ball when he was open. For as much as I comprehend the word, we are friends. He is my chosen brother. To sing with him in Brown Chapel was a transcendent moment, a tribute to openness, understanding, respect, and love. It is no accident that those same words were uttered manifoldly throughout the conference as to what took place in 1965 – and as to what must take place.
"When I get tired, it's like I was dropped into the sea,
you could swim your whole life and be nowhere you want to be.
Everyone gets tired, and the water is so wide,
Then somebody comes and shows you, shows you the other side."
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← On the Eve of the Whitney Plantation
Email: greg@greggreenway.com
© 2023 Greg Greenway


The RIV4L Lan Tour stops at our favourite lan of the Benelux twice. They will return in our September edition! Find out more information about the RIV4L Lan Tour on the Gamelux website.
Thanks to our awesome partner Razer, we were able to organise a sponsor cooperated League of Legends competition.


Lamborgini Aventador Roadster is an Italian masterpiece for hire in Dubai.
Aventador, it's a supercar capable of overtaking the wind. The new version has an improved splitter, the nose is now more aggressive, the clamping force has increased by 130%. There were additional branch pipes, air intakes, active wing. There are four variants of driving: corsa, sport, strada, and ego. Each mode exposes different traction, steering and suspension parameters. You choose the most comfortable option for driving. Enumerate the merits of the new creation of Italian engineers can be infinite, take this car for hire in Dubai and experience the results of many years of work of the auto concern Lamborgini.
We recommend you to view other Lamborghini models and rent it in Dubai at a bargain price.


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Vietnamese folk singing genres seek UNESCO recognition
Xoan singing and Bai choi singing, two forms of Vietnamese folk music, are among 35 cultural heritages applying to be added to the UNESCO Representative List of the Intangible Cultural Heritage of Humanity.
VNA Tuesday, December 05, 2017 15:07
Phu Tho eager for Hung Kings Temple festival
Friday, March 31, 2017 10:41
Phu Tho opens Xoan singing exhibition ahead of Hung Kings Temple Festi
Tuesday, March 28, 2017 16:52
Bai choi folk songs fill island
Sunday, February 07, 2016 17:48
Xoan singing impresses international heritage experts
Friday, October 09, 2015 10:10
Bai Choi singing seeks World Heritage status
Xoan singing comes from Phu Tho province.
(Photo: VNA)
Hanoi (VNA) –Xoan singing and Bai choi singing, two forms of Vietnamese folk music, are among 35 cultural heritages applying to be added to the UNESCO Representative List of the Intangible Cultural Heritage of Humanity.
The applications will be considered at the 12th session of the Intergovernmental Committee for Safeguarding of the Intangible Cultural Heritage which opened in the Republic of Korea on December 4.
Xoan singing comes from the northern province of Phu Tho, and is practiced in front of communal halls at spring festivals. It is said to have appeared about 4,000 years ago, during the time of legendary Hung Kings.
Singing events were organised not only to honour the founders of the nation and entertain villagers, but also to pray for good weather and harvests and depict daily life in rural areas.
UNESCO listed xoan singing as part of the world's intangible cultural heritage in need of urgent protection in 2011. At that time, there were 13 xoan singing clubs with nearly 300 members. To date, the number rises to 33 clubs across the province.
In 2013, Phu Tho province prepared a 165 billion VND (7.85 million USD) project, entitled "Maintaining and Developing Intangible Cultural Heritage of Humanity- Xoan Singing in Phu Tho", funded by the Government.
Two years later, Vietnam submitted a report to the UNESCO stating that xoan singing saw a revival thanks to the great efforts made by the Government and local people.
Meanwhile, Bai choi singing is a folk art form that originated in the south central region of Vietnam. It is popular in Thua Thien-Hue, Quang Nam, Binh Dinh, Phu Yen and Khanh Hoa.
Bai choi is often seen at local spring festivals and resembles a game, using playing cards and village huts. The bai choi songs are about festivals, daily life and work and are accompanied by musical instruments.
The Vietnam National Academy of Music joined hands with southern central localities to prepare an application dossier which was submitted to the UNESCO in March, 2016 to seek recognition.
The UNESCO Representative List of the Intangible Cultural Heritage of Humanity will be announced on December 7.-VNA
Xoan singing Bai choi singing Vietnamese folk music UNESCO Representative List of the Intangible Cultural Heritage of Humanity 12th session Intergovernmental Committee for Safeguarding of the Intangible Cultural Heritage vietnamplus
Vietnam Motorkhana Championship 2021 opens
The Vietnam Motorkhana Championship 2021, the first-ever international-standard professional sport car race in Vietnam, opened in Hanoi on January 15.
Miss Fitness Vietnam 2022 to be launched
The selection round of Miss Fitness Vietnam 2022, a national event featuring fitness enthusiasts, will open on January 16 in Ho Chi Minh City.
Hanoi remains at top of travellers' lists despite COVID-19
Hanoi has remained at the top of global travellers' wish lists although COVID-19 travel restrictions severely hit the city's tourism last year.
Vietnam photographer wins gold at int'l photo contest
The photo "Afternoon on the Cat Ba Bay" by Vu Manh Cuong has won the International Federation of Photographic Art (FIAP) gold medal at the international photo contest RGB 2021.
Motorkhana races to entertain fans of speed this weekend in Hanoi
The Vietnam Motorkhana Championship finals will be held at the Hanoi Circuit around the My Dinhh Stadium on January 15.
Two sets of 300-year-old whale skeleton restored
The recreation of two sets of whale skeleton in Ly Son island district off the coast of the central province of Quang Ngai basically completed after two months of the work, Secretary of the Ly Son Party Committee Nguyen Minh Tri has said.


Created in C4D. Used multiple instances of the dumbbell like objects inside of a cloner with different materials and set to pull them randomly. Needed to find a way to use the floor texture that I made and this sort of worked. Might use it again in the next project but with a camera move so you can see more specular glimmers. DoF was rendered in C4D.


Home showings are inevitable when you're selling a home. Highly experienced real estate agents know to employ safety measures while showing your home, but it pays to be vigilant as well.
So you're getting ready to sell your home and you've immersed yourself in A LOT of research — asking friends and family who have previously gone through the home selling process, scouring the internet for tips and tricks, and getting flyers and brochures from several local brokers.
Selling a home might not be as scary as buying one, but there are still a few things that could go wrong when you're putting up your property for sale.


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Book: My Life My Africa by Philén Naidu
Have you ever had the desire to just drop everything and follow your Heart? Philen Naidu did just that. Faced with a choice between risking it all on a dream, or dying with regrets of choosing the comfort zone instead, Naidu dropped out of university, strapped on his backpack, left his family and friends behind and set off into the deep and wild unknowns of REAL Africa, with nothing to rely on [...]
Book: Lucy Green Eyes - Not Everything Green is Gold by Paulette Benjamin
"Oh, how I wished I could've told her what had happened. How I wished I could've let go and allowed the tears to spill. But I knew that if I had cried, Mama would've asked me what the matter was. And if I had told her the truth, she would've said that I was lying. And if she thought that I was lying . . . well, you know the rest. Still, I wonder . . . did she know? Did anyone know? Didn't [...]
Book: Why I Started Smokin' Cigarettes by Bea Cannon
Shaniqua Jones smokes like it's going out of style. One day a friend of hers asks her why she smokes so much. Her explanation is so convoluted that the friend tells her to write it down which led to Shaniqua giving this account. In fact, it led to Shaniqua deciding she wants to tell the entire story of her life. Or at least she's trying to - it's taking a while. It is, in fact taking so long that [...]
Book: American Entrepreneur - An autobiography of William Henry Joiner, Jr.
American Entrepreneur follows the amazing life of Bill Joiner, a true self-made businessman in the best American tradition. From wild early days in Texas to a life of service to God and his church, Joiner blazes his own path through hunting, sports, adventure and his love of life. Joiner's say-yes, can-do attitude leads to adventures across the United States, Japan and Europe. He creates [...]
Book: Coming to America - A Journey of Faith by Dr. Eric Tangumonkem
Do you struggle with trusting God with your finances? Feel that God is calling you to do something big but you can't see how it will be accomplished? Fear that He has abandoned you after starting your journey of faith? Coming to America: A Journey of Faith is Eric Tangumonkem's story of wrestling with these thoughts and doubts. God called him to America from Cameroon to pursue graduate studies at [...]
Book: An African Heart by Liberty Dendron
An African Heart is an inspirational transformational personal growth, a spiritual awakening short story that will leave you with a tune that you can hum in your daily life. Mrs. Taraji's husband catches a contagious disease and dies. The disease is not like other diseases. It is caused by a demon and his body must be burned. After his father's death, the story takes Kenya to a different part of [...]
Book: Black Mamba White Settler by Ken Tilbury
This moving, action-packed story based on the authors life is of betrayal, war, hate and vengeance. And of loyalty, love and friendship. Farmers and their families and workers after the horrors of the 'Bush War' in Rhodesia now have to struggle for survival in Zimbabwe as land seizures threaten the lives of thousands of people. Many are tortured, raped and murdered while government sponsored [...]
Book: Amie - An African Adventure by Lucinda E Clarke
Would you leave your family and friends and follow your husband to start a new life in Africa? Amie did and lived to regret it. Just an ordinary girl, living in an ordinary town, with nothing but ordinary ambitions, Amie is plunged into danger when her husband is posted to a country she's never heard of. As she adapts to a different environment, events overtake her and land her in more trouble [...]
Book: Stories From The Central African Republic by Philomene Koya
Please change the wholesale summary to the following (this was uld through the XML process and only the first sentence was pulled): Life can be unfair sometimes, but as beings, we should not be unfair to one another. Every story in this book teaches lessons about life. All the stories are well written with details that capture the reader's attention. Every reader will find the stories in this [...]
Book: Sex, Drugs & Islam - Autobiography of an X Fighter Pilot by Dari Ghaznavi
Sex, Drugs & Islam "April Fools Day 2006 was an awesome day until around mid-night. Then an event occurred that shattered my life forever. The higher you go, the harder you fall. Life was simply too good; it was unreal, a fairytale life like Princess Diana. Something had to give. The Princess is dead and this Prince was about to be shot" Laced with cynicism, profanities and humor, this hardcore, [...]
Book: Story of a Texas Marine - The Autobiography of Nick Quintanilla by Nick Quintanilla
The autobiography of brave Texas Marine Nick Quintanilla, now sadly afflicted with Parkinson's disease. Follow Nick through his colorful childhood in the racial hotbed of South Texas, his hilarious introduction to the Marine Corps at boot camp, his progression through the ranks as he traveled the world, and his very colorful and often newsworthy post-military career in construction project [...]
Book: Dapper Carter's 8 Rules of Dating by Alan Mitchell
If you want to laugh out loud at a true player who gets his or have ever wondered what a man goes through after he gets his heart broken then this book is for you. This ain't no self help book! What they're saying about Dapper Carter... Fifty Shades of Awesome! 5 Stars "Grabbed me in from the first chapter. It's so refreshing to read relationship challenges from a man's perspective and the [...]
Book: Fifth Anniversary Edition - I'm Your Baby Tonight - but what about tomorrow? by B.L. Wilson
Suppose you could be anybody you wanted to be just for one night. You dress up in a magical costume for a special party. Nobody, not even your mother, if you had a mother, would know it was you. You learn that a woman you're attracted to- she's rejected you a hundred times- will be at the party too. What do you do? Would you go to the party? How would you dress? Who would you be? How do you find [...]
Book: Ava and Patience - a purple love story by B.L. Wilson
Ava Thomas is an attractive, wealthy, older single Black woman who practices abstinence, that is, until she meets a shy, quiet bartender at her friend's private club who loves purple as much as she does. Patience Meeks has been observing Ava throughout her dinner with friends. When a drink order from Ava's table comes to Patience, she decides to mix a special concoction in honor of the sexy [...]
Book: Deliverance Mary Fields, First African American Woman Star Route Mail Carrier in the United States - A Montana History by Miantae Metcalf McConnell
A FEATURED OPRAH "10 Titles to Pick Up Now" February 2018 AWARD-WINNING CREATIVE NONFICTION BIOGRAPHY 1885 - 1914. Mary Fields, a fifty-three-year-old second-generation slave, emancipated and residing in Toledo, receives news of her friend's impending death. Remedies packed in her satchel, Mary rushes to board the Northern Pacific. Days later, she arrives in the Montana wilderness to find Mother [...]
Book: Ode To You by Shameeka Williams
Author Shameeka Williams, Releases her sixth book in Poetical form, The Realest Ode she's ever written, paying homage to Every Author, Musician, Every Actress, Every Poet, Every Revolutionary, Every Influential person in her life in the Lyrical form of an Ode!!! Each Ode delivers her Acknowledgment and Appreciation for every testimony shared, every journey shared, every role ever played that got [...]
Book: If She Can Beat Me Rockin', She Can Have My Chair! - by Carla Ladd
Are you looking for a great gift for a special teenage girl? This is the book for you. My granny was a compassionate, fun-loving, no-nonsense woman with firm beliefs and values and she was never at a loss for words to express them. Her words of wisdom have instructed, encouraged and inspired me to become the self-confident woman I am today. The lessons that I learned at Granny's kitchen table [...]
Book: If You Think You're Lonely Now - Valetta & Tyla's story of love and devotion (Forever Woman Book 10) by BL Wilson
A shy deputy sheriff, Tyla Chester, wants to convince a sexy, independent older woman, Valetta Pinkney, to go out with her. The deputy stutter-stumbles every time she asks a question about the break-in and attempted burglary in the store Valetta owns. Valetta thinks the deputy is immature and a little bit odd. Two hit and run accidents change everything for Deputy Chester. First, the discovery of [...]
Book: Queen of Zazzau by J.S. Emuakpor
Precolonial West Africa against a backdrop of gods and magic. " Emuakpor craftily weaves fascinating characters, facts, and folklore together into a riveting adventure steeped in African culture." Publisher's Weekly "A smashing tale of war, love, magic and gods, with seriously strong female characters." Ragdoll Reads UK Amina is heir apparent to the throne of Zazzau and must prove herself worthy [...]
Book: Marrying the Marine - The Brides of Hilton Head Island by Sabrina Sims McAfee
Fall in love with the Brides of Hilton Head Island, Sabrina Sims McAfee's, International Bestselling contemporary romance series. MARRYING THE MARINE is an emotional, sexy love story with light suspense. When the alpha men in this series falls in love it's always and forever. And their dashing brides couldn't be happier. Book Description: Criminal Investigator Braylon Wexler has arrived in Hilton [...]
Book: The Prisoner and the Lawyer - can love free the heart? by B.L. Wilson
Ex-con Joan Richmond has enough problems when she is finally released from prison after an eight-year sentence for a crime she didn't commit. She needs a place to live, a job, and to get used to the outside world again. However, she doesn't count on two escapees with a vendetta forcibly recruiting her to take the fall for their dirty deed. And, she doesn't expect to fall for the victim of their [...]
Book: Tyson - a sister's love be limitless by B.L. Wilson
Tyson, a sister's love be limitless is a fictional whodunit written in the voice of a 27-year-old, southern "colored" woman, Leonia Gillette. She and her big brother, Tyson, come north to escape a drunken father who tried to rape her. They settle in Harlem in 1927 during the Harlem Renaissance and just before the Great Depression. In 1932, somebody castrates, then murders Tyson in a Harlem [...]
Book: No Longer Brokenhearted (Freedom Series Book 2) by Rai Lindsay-Wallace
Queenie had lost everything her husband, twins, her home, and her will to live. Existing, but not really living, Queenie was a desolate soul living a shell of a life. She blamed herself. She didn't deserve to live. Raised in a chaotic environment, Queenie never thought she would return to the one place she loathed her childhood home. There was no other place to go. From the outside, Gabe Delany [...]
Book: His-Story is My Story's Mystery by Ralph B. Cooper
Maafa for African Americans represent the horrors and outcome of the Middle passage. Our varied stories and observations are the "aftermath" of our abduction from Africa, years of slavery, further years of Jim Crow apartheid and our opinions and reflections that keeps us strong and vibrant to this day...while still being endangered in this land called the United States!!??? These are the stories [...]
Book: Overlords Karma; Miami's Urban Chronicles; Volume 1 by Thomas Barr Jr.
Overlords Karma; Miami's Urban Chronicles; Volume I, an urban literary fiction portrays a biopic of the career of African-American politician; Arthur E. Teele; set in Miami's Overtown community. A Miami city commissioner commits suicide, after being overwhelmed by the trials and tribulations he faced as a professional minority which are comparably different from his nonminority counterparts. For [...]
Book: The Doctor Is In - River's Bank, a small town full of big love by B.L. Wilson
Dr. Rebecca Davis is an OBGYN on a forced vacation due to a sixty-day suspension from her job at a New York City hospital. Aggravated and upset, not only over the issues at work but a failed and complicated relationship, she takes an impulsive trip to a rural town and gets drunk, waking up the next day in an unfamiliar motel room. Here, she meets the motel's charming and attractive owner, Colleen [...]
Book: Heart of Crystal - Book One - Trust Me by Obelia Akanke
Crystal was permanently scarred by her ex-boyfriend last semester. After a few months of attending a writers' group she joined as a form of therapy, Mario, the group leader and a spoken word artist, asks her out. She is reluctant to start another intimate relationship, so things are further complicated when a second group member pursues her and causes her to question what she really knows about [...]
Book: MARRYING THE MILLIONAIRE (The Brides of Hilton Head Island Book 2) by Sabrina Sims McAfee
Fall in love with the Brides of Hilton Head Island, Sabrina Sims McAfee's, International Bestselling contemporary romance series. MARRYING THE MILLIONAIRE is an emotional, sexy love story with light suspense. When the alpha men in this series falls in love it's always and forever. And their dashing brides couldn't be happier. Book Description: Kayla Crawford is having a bad night. Things are [...]
Book: Game Changers - Add one then two and everything changes by B.L. Wilson
Deanna Jones, a transportation director for the city, stamps an indelible impression on her new boss when she makes a pass at her before Deanna is introduced. From there, it is all downhill for Deanna, who cannot stop bumping heads with Deputy Commissioner Amanda Taylor. The two women continue take potshots at each other every time they come within range, sniping about lost furniture, bad [...]
Book: The Darker The Berry The Deeper The Roots by Queen Brown
Facing diversity from every angle, Ebony experienced and witnessed things no child should. With a crack addicted mother, an incarcerated father and a devoutly religious grandmother, whose disdain for her could not go unnoticed, there was never anyone to protect her. From sexual and physical abuse to rape and spousal abuse as an adult, Ebony has endured too much pain for far too many years. After [...]
Book: Partially Broken Never Destroyed 5 - The Devil's Advocate by Nataisha T Hill
What do you do when you realize the only way to maintain the lifestyle that you're adapted to is to play around with a little fire? For Kayla, it's not only a way of life, but keeping secrets is what's keeping her alive. Her boss, Ms. Wright is a walking soap opera in the flesh and is willing to deceive anyone in order to uphold her social status. Not only has she dragged Kayla in the middle of [...]
Book: Adam - a mother's love lasts forever (The Unfinished Business of Love Book 3) by B.L. Wilson
When Julia Walters receives word that Adam, the son of her ex-lover Nikki Barrett, is dying, Julia rushes over to Nikki's house to offer her assistance with Adam and also hopes to find closure to the romance that ended abruptly four years before. Upon arriving at Nikki's house, Julia discovers that her ex-mother-in-law, Mavis, is hoping Julia will stay and relieve an exhausted Nikki from taking [...]
Book: What's Love Got To Do With It? - is one woman enough? is love enough? (Songbook Book 1) by B.L. Wilson
Kameron Mills, a love 'em and leave 'em stud, runs through women like water. Until she meets Ernestine Williams a successful restaurant owner. The older woman has a certain something that Kam cannot resist. Ernestine has accumulated a history of failed relationships, attracting player-player, Romeos, and stud lover types who won't commit to anything but adultery. Kameron seems like more of the [...]
Book: Waiting for the Good - already had the bad (Cops In Love Book 5) by B.L. Wilson
Newly promoted police sergeant Ellison Jackson literally bumps into Annabelle Leith Fletcher, a defense attorney who ripped into her on the witness stand six years ago. The attorney has changed somewhat from their last meeting, due in no small part to a brace on her leg from an unfortunate injury. Ellison finds Annabelle very attractive and asks her to lunch. Unfortunately, the restaurant they [...]
Book: Sunrise from An Icy Heart - A Memoir [Paperback] by Claudette Alexander
Do you want to overcome betrayal, grief, and/or manage a chronic health condition, and find fulfilling love? SUNRISE FROM AN ICY HEART: A MEMOIR begins with love and ends with love. You go on a discovery of the human need to find a special love, no matter what, no matter where, no matter how. This novel will have you believing in true love even after a heart damaged from debilitated relations. As [...]


2018 Jeep Wrangler JK manual – The standard engine was a 3.6-litre Pentastar V6 which be addressed to make it more efficient. Power 285 hp and torque of 353 Nm is not changed. There are automatic transmission option 8-speed Chrysler and Fiat had a manual 6-speed Aisin plots. Other options, engine V6 3.0-litre EcoDiesel powered 240 hp with a torque Nm 599. This machine is only available in the transmission of automatic and in variant 4-door Unlimited only.
The most interesting of course new engine 4-cylinder 2.0-litre turbocharged. His energies to 270 hp less than the V6, but torsi excelled at 400 Nm. Jeep not to discuss this machine base, but certainly from the ranks of the latest Alfa Romeo DOHC engines. Unfortunately only given the choice automatic transmission only.


Those of us who have been sales professionals in the life sciences industry for the past ten years know how drastically the role has changed in that short amount of time. Before digital marketing and online ordering centers, the role of the salesperson was to inform potential clients about their products and how these products were needed to improve their work operations with the hopes of booking an order.
The advent of the internet brought about some interesting changes to the role that the salesperson and potential buyer plays in a sale. Life science clients can get valuable product information on the seller's site, and compare competitor's products on Amazon, VWR International, and many other reputable sites before they commit to purchasing from any salesperson. The buyer is also able to easily find reviews on products, fine-tuning their purchasing process and accessing the most recommended product by other life science industry professionals. This can be problematic for companies that don't have a significant presence online, but it can also be incredibly helpful for the life science organizations because they can have peace of mind with their purchases. Companies and sales departments must adapt to the changes, and quickly, to compete with large online retailers because technology will only become more prevalent in our lives and the convenience of these tools will continue to be attractive for buyers.
Prior to the internet, the salesperson was more critical during the entire sales process, from product education, through closing the sale, then handing off to customer service for post sales activities. Because so much product information is available online, buyers are more self-educated about products, and in many cases, can purchase the products directly online without any salesperson contact. These days, a salesperson in the life sciences industry needs to be more of an account manager, answering questions and concerns of their clients long after the initial sale took place. Getting the client onboard is only the first part of the sale, keeping the lifetime value of a client as long as possible is much more difficult.
Since life science buyers have access to so much relevant product information online, the salesperson must be seen as a knowledgeable partner, not just about the products they're selling, but about the industry in general. They should be well-equipped with an understanding of the industry and be able to talk to the buyer at length about the entire product portfolio and how they can build a long-term business relationship with the buyer. For this reason, salespeople should start to be trained with more in-depth knowledge about their company's long-term value to the customer and preferably have a background in the life sciences industry, which is much different than even ten years ago.


I use an alternative I use Verdana Font and machine with 1/16 ball mill 1/32 deep and pocket mill by opening the properties dialog and set the thickness -.032 in Aluminum.I set the Acis to custom with one degree for normal tolerance,I used two point light,one ambient,I put profiles & text on layers and hide them,The text is set to the flexible mode,I have few screen shots to look over you'll see the degree of smoothness in the close up.This file is around 4mb.
V19.1 just came out with this tool. Not sure how that will help you, but perhaps it is worth the upgrade.
But sill waiting on the v19 CAM plugin. I wonder if I make a drawing & do a polyarc conversion, then save as v18.2 file format, will v18.2 have any issues with the file. Just thinking out loud. I will test this and get back on it.


Chaninomi Michael premiers his latest single titled "Unstoppable" to usher us into the new year.
Chaninomi Michael is a passionate dynamic young gospel music minister from Delta state, Nigeria who is based in Lagos. He is serving as a parish Pastor in RCCG (The Wealthy Place Church) in Lagos.
He is out with a brand new song titled "Unstoppable", produced by Victor Sunday to usher you into all that God has prepared for you this new year.
This is a song of courage, affirmation and declaration that no matter the obstacles confronting you, you are indomitable, indestructible and more than conqueror.


Privacy is under assault. Cyber crime damages are forecast to reach $6 trillion annually within the next three years. Just as digital technology has expanded the reach of information, it has also exposed all of us to more vulnerabilities. This article will focus on security while broadcasting live private events. Specifically, we'll review 7 live streaming solutions that deliver tools and functions for privacy and security.
First, we'll review the essential features you need to stay digitally safe. Then, we'll dive into 7 streaming platforms that provide secure live streaming solutions, and we'll compare security and privacy features of each service. The platforms we'll compare here include: IBM Cloud Video (UStream), Livestream, JW Player, Wowza, DaCast, Brightcove, and Kaltura.
Whether you are broadcasting TV shows, movies, sports, corporate events, or any other private material, you need the right tools to help you stay safe. Let's explain what a few of these tools look like in the online video industry.
One of the most basic forms of security for a private event is password protection. Generally, this setting allows you to set a password. Unless a visitor to your website can enter the password, they will be unable to access the stream. This can be an ideal solution for smaller events among trusted people.
This leads us to more complex security tools such as restrictions. Restrictions allow you to, as the name implies, restrict who can access your content based on various factors.
There are two types of restrictions in common use. Geographic restrictions allow you to restrict who can access your online video via IP address. Unless someone is using a VPN, IP corresponds to geographic location. This tools works by "whitelisting" countries from which your audience can view your content. This allows you to bypass hackers or unauthorized people located in other countries.
The second type of restriction is referrer. A referrer is the website that a visitor came from to access your video content. The referrer restriction allows you to only allow users who came from pages on your domain, for examples, https://dacast.com/*. The * symbol indicates that any page on your site is acceptable for users. This restriction prevents users from illegally embedding your stream on another site. In fact, the embed may work ,but the video won't play.
One of the best ways to keep content secure is to make them pay to access it. This also provides a revenue stream. However, this payment must be managed securely.
Luckily, online payment systems are more robust than ever. These authorization schemes may be supported by a tokenized security system. This prevents anyone who has not been authorized from accessing the stream. Just make sure whatever live streaming solutions you choose use SSL encryption for payment information.
Let's change directions now and focus on the 7 best live streaming solutions for private events. The services that we'll highlight here are established, robust competitors who bring a variety of compelling features to the table. However, different users have different needs. Taking a closer look at each online video platform will enable you to make a good comparison.
IBM Cloud Video came about after IBM acquired Ustream a few years ago. The IBM Cloud Video platform provides live streaming solutions as one product offering alongside other OTT video services.
Payment security: IBM Cloud Video doesn't include a built-in paywall. However, it can be integrated with external services.
Password protection: Available on all pro accounts ($99 per month and up).
Geographic / Referrer restrictions: Referrer restrictions and geographic restrictions are available for all pro accounts.
IBM Cloud Video streaming services range from $99 to $999 per month for pro accounts. These include a basic live streaming platform supporting up to 720p resolution. Customized packages are available for larger clients.
Payment security: Monetization is enabled for Enterprise ($799/month) customers and above, and includes SSL payment security.
Password protection: Similarly, password protection is only available to users on the Enterprise plan and above.
Geographic / Referrer restrictions: Geographic and IP restrictions are available on Enterprise plans and above.
Livestream is priced towards the high end. Recently, Livestream dropped the basic plan, and so the first-tier plan starts at $75 per month (billed annually, $199/month billed monthly). Many of Livestream's key security and other professional live streaming features, however, are only available to larger clients willing to pay $999 per month for the Enterprise plan. Custom plans are available for larger clients with large budgets as well.
Payment security: JW Player is optimized for advertising; it does not support direct payments from viewers.
Password protection: The JW platform does not support this feature.
Geographic / Referrer restrictions: Geo-blocking is available for users on the JW Player Enterprise plan. Referrer restrictions are not available.
JW Player is available at three pricing levels. The Starter Plan ($5/mo) includes a basic platform for hosting up to 500 videos. The Business plan adds live streaming functionality for $50/mo. For those with larger needs, Enterprise plans are available on a custom basis.
Payment security: Wowza doesn't have any built-in functionality for monetizing video.
Password protection: No built-in feature for password protection.
Geographic / Referrer restrictions: All Wowza plans support geographic restrictions. Referrer restrictions are available via Wowza's token authorization system, but must be configured manually.
Pricing for Wowza Streaming cloud is either monthly or based on usage (for API plans). Monthly plans start at $199 per month. This basic plan includes 3 TB of bandwidth and 50 processing hours. The Plus plan ($499/month) and Premier plan ($999/month) provide increased bandwidth and processing hours.
Payment security: Integrated paywall for pay-per-view or subscriptions protected by SSL security, and available at the Premium plan level ($125/month) and above.
Password protection: Included on all accounts.
Geographic / Referrer restrictions: Included on all accounts.
DaCast live streaming pricing plans are either monthly or via "event" pricing.
Monthly plans start at $19 per month for 100 GB of bandwidth and 20GB of storage. The Premium plan ($125/month) adds API support and paywall monetization, and reduces bandwidth costs. The Enterprise plan ($289/month) reduces bandwidth costs further, and are ideal for business and OTT media users with high-volume streaming needs.
Event pricing is ideal for one-time or occasional events. In this model, you to purchase a "bucket" of bandwidth that doesn't expire for 12 months.
Payment security: Brightcove includes a range of tools aimed at advertising monetization, but no paywall.
Password protection: Does not include this functionality.
Geographic / Referrer restrictions: Brightcove supports geographic and referrer (domain) restrictions on all plan levels.
Brightcove recently started to list their pricing on their website. Their monthly plans start at $199 per month and range up to $499 per month. Custom Enterprise plans are also available.
Payment security: Kaltura supports subscriptions and pay-per-view, and uses standard SSL encryption for payment processing.
Password protection: Not built-in, but available via an extension.
Geographic / Referrer restrictions: Both of these security options are available to Kaltura users.
Kaltura VPaaS prices video hosting and streaming based on usage.
So there you have it! We hope this review of 7 live streaming solutions and their privacy and security features has helped you to narrow down your options. And of course, we do hope you'll give the DaCast live streaming solutions a try!
One way to start streaming live today: take advantage of DaCast's free 30-day trial (no credit card required)! This allows you to test out all the features for yourself to see if our streaming solution is a good fit for you. Just click the link below to start streaming live in a matter of minutes.
For exclusive offers and regular live streaming tips, you're also welcome to join our LinkedIn group. We'd love to connect with you!
Have further questions, thoughts, or feedback about this article? We'd love to hear from you in the comments below, and we will get back to you.
Thanks for reading, and good luck with your events.
Note to our readers: We've updated this article to reflect the most up-to-date information as of late 2018.


text:
Overprotective Aunt
How do you keep your child safe online?
Facebook/ Social Media/ Training
How to Find Which Private Facebook Groups You Are Connected To
internetchildsafeguard Child, Facebook, Facebook Groups, Internet, Monitor, safeguard, secure	0 Comment March 8, 2017
Facebook is a cool and fun way to interact with family and friends and also be in the social media lives of your children. It shouldn't be something something that bars a household family from interacting with each other or interfering in that.
But as Facebook continues update and bring out new features which they seem to do at a break neck pace they keep adding in more features for kids to separate from their parents more than anything. Instead of making it a safer way for parents to keep their kids safe on the social media giant.
From picking their audience of who can see their posts on their own profiles to even having specific group chats in their messages which can involve anyone that they add to it. Another widely used and known Facebook feature is groups.
Groups might not be as new of a feature as many of the others but there have been many additions to these groups such as being able to make a group private and manage how they are seen if seen at all if posted to your child's profile timeline.
This type of setting is pre-built into all private groups and can be turned on with public groups if they are the Creator or an admin of the public group they can still change the settings to make sure that certain people are blocked from seeing the post.
If you have access to your childs Facebook which would not hurt in this day and age with the current way Facebook works. You can find the groups that they are part of in their tabs which have a drop down section and just click groups.
How to find Facebook Groups With Access to Their Account
From there you should be able to see all the public groups that they are part of and also all of the private groups that either they are a part of or that they created.
There are still very little ways to monitor your child's Facebook activity without having access to their Facebook but that is slowly changing. We will keep you updated as we look to find more ways to keep your child safe on the internet.
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1) Save the Frugal Firefly way! This version contains the same expense categories we track each month. Follow along as we move towards financial freedom together.
2) Use your own categories! Each line is editable so you can decide what to track.
This comes to a total of ten budget sheets! And you can always print more to track expenses month after month.


Hraunfossar, also known as Lava Falls, is a beautiful waterfall in western Iceland. There are over 900 meters of waterfalls along this ravine at flow into the Hvita River, all of them coming out from the thick shrubbery. It's a majestic sight to see and should be experienced if possible, the blue the in the Hvita River from the glacial particles was simply breathtaking.


Dear Guest, we are really sorry for the inconvenience and we apologize for it. Unfortunately, the outside temperature increased suddenly, rising from 6-8° to 25° Celsius within 24 hours, which caused a temporary malfunction of the boiler during the air conditioning start operations that involved a part of our rooms. We immediately worked to resolve the problem as soon as possible and offered solutions to all guests who reported the issue. As the rooms involved were in the opposite side of the hotel, we were sure that your room was ok, as confirmed by our digital monitoring system. We would certainly found a way to make your stay more comfortable if we received any reports from you. We hope to have the chance to regain your trust in the future and stay at your disposal for any further information! Best regards.
Dear Henrik, we are very happy to know that you enjoyed our hotel services and thank you very much for sharing your experience with us! We hope to have you very soon for another stay with us! Warmest regards from all our staff.


HSC All Board Economics Board Question 2016. A focus of the subject is how economic negotiators act or interact and how markets work. Consistent with this, a primary textbook difference is between microeconomics and macroeconomics. Microeconomics observes the behaviour of basic elements in the economy, including separate agents (such as households and firms or as buyers and vendors) and markets, and their connections. Macroeconomics examines the entire economy and subjects affecting it, including unemployment, rise, economic growth, and financial and fiscal policy.
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Opportunity to provide feedback to newly launched Congressional Caucus on Social Determinants of Health
By Karen Kali / September 8, 2021 September 8, 2021 / Policy
Social determinants of health refer to the social, economic and physical conditions, where people live, work and play in an environment that affects health, such as housing, jobs, transportation and food access.
This past July, a bipartisan Congressional Social Determinants of Health Caucus was formally launched by Reps. Cheri Bustos, G.K. Butterfield, Tom Cole and Markwayne Mullin.
Addressing social determinants of health (SDOH) at the federal level includes multiple government agencies and committees. The purpose of this new caucus is to convene members of Congress from geographically disparate jurisdictions to enhance coordination around the social determinants of health with the ultimate goal of improving health outcomes while maximizing federal investments in critical upstream drivers of health.
NCRC members have a unique opportunity to provide feedback on challenges and opportunities in your communities around social determinants of health. The caucus asks respondents to provide feedback to some or all 17 questions, ranging from insight around gaps in care, programs and services addressing SDOH to local best practices to legislative solutions.
Members may find and complete the form from the caucus here. For a sneak peek, we have created this resource to help you consider the questions before responding.
Questions? Contact Karen Kali at kkali@ncrc.org or 202.464.2716.
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AIG wanted to gain a wider audience for their messages than just those at the Forum. They asked us to develop a campaign that would allow a broad range of messages to be distilled into a concise idea that could then engage with the wider market.
By combining AIG's insights with our knowledge of the risk management world, we developed the theme 'Focusing on Tomorrow'. An engaging theme that communicates AIG's deep understanding of the future of risk for global organisations and how this might effect long-term investment into their businesses.
Using a range of creative assets and communication tools, the theme resonated globally with outstanding numbers, share of voice, and identified business opportunities. We supported AIG by also writing all of the content across multiple channels and interviewing a range of key members of their European team.
The FERMA Forum is an important event in the European risk management space with over 2000 risk professionals coming together to share experiences and expertise. AIG had already asked us to design and build an exhibition stand for the event, but the brief was extended to look at developing a campaign that would help them extend the activity and maximise their exposure from the event.
AIG is a market leader in the risk management space and, via the numerous experts within the business, produces insightful content that helps risk managers understand and stay ahead of the current and emerging risks affecting their organisations. We developed a number of ideas that we felt would engage AIG's audience and communicate the right sentiment. The theme that was chosen for the campaign was 'Focusing on Tomorrow' as it was felt that it best encapsulated AIG's thought-leadership and expertise around the future of risk.
An example of different types of Tweet structures we used to help drive engagement and clicks through a variety of creatives.
With a clear objective comes the ability to develop a strong plan and directly measure success. That is what we were able to do with this campaign.
Activity was coordinated across a wide range of channels and communication methods from a couple of months before the event through to a month after to maximise the engagement before, during and after the FERMA Forum. We ensured that the content we created was consistent, maintained high production values, and worked to demonstrate and engage the risk management community through AIG's expertise and professionalism.
Below offers just a few of the statistics that demonstrates the success of the campaign.
Our focus on the insurance and resinsurance, financial services and banking sectors mean we truly understand your audience and the messaging that will resonate with them. If you would like to discuss how we can help you maximise the opportunity and extend the reach of your messaging please get in touch. Alternatively, you can find out more about our exhibition services here.


54 Antique Cook Book Lot!. - One Hundred Recipes For the Chafing Dish by H.M. Kinsley. Printed 1894. - Women�s World Chart of Properly Balanced Menus. Printed 1922. - Mama Segedi�s Cook Book. First Edition. Printed 1950. SIGNED COPY! All show some signs of wear but are all complete.


I keep hearing the word sustainability, what is it and why is it so important?
Sustainability is a broad and complex topic that touches on every aspect of our lives, from the water we use, how we power our homes and lives, the air we breathe, the food we eat, our shopping habits, how we get around and how we dispose of our waste. It's synonymous with the terms green, eco-conscious, eco-friendly and earth-friendly.
I think this definition beautifully describes why incorporating sustainability into our homes and lives is so imperative. Our future on this planet and the future of our children and grandchildren will be determined by the actions we take today.
What is sustainable living and how can incorporating sustainability into your home support the health and wellbeing of you and your family? What are the benefits?
I think of sustainable living as a holistic framework for maintaining balance, not just ecologically but also within our own home environments and lives. The average American spends 90% of their time indoors but according to the EPA, indoor air pollution is in the top five environmental risks to public health.
We are exposed to many harmful chemicals and pollutants inside our homes on a daily basis, coming from sources as varied as our mattress, carpeting, furniture, cleaning supplies and personal care products. "Green Homes" are healthy homes, and when we take the time to question the materials we are surrounding ourselves with, we can avoid the potential sources of pollutants that create adverse health effects for ourselves and our children.
What are TWO simple ways we can start to incorporate sustainability into our homes and lives today?
There are so many ways to incorporate sustainability into your home and lifestyle, and it absolutely doesn't require drastic changes or giving up the things you love! I like to describe it as a reorienting process; it's a shift from not knowing the environmental and health impacts of what we consume, to consciously consuming products and services that are aligned with our personal and environmental values.
Water: The first thing I recommend to all my clients is to stop drinking bottled water, and instead purchase an unlined reusable stainless steel or glass water bottle and water filter.
There are fewer regulations for bottled water than tap water and the FDA does not require any certified lab testing for bottled water; nor are the companies required to disclose the water source, how the water has been treated or what contaminants it contains.
Speaking in terms of the environmental effects, over 500 billion single use plastic water bottles are disposed of every year, and only about 20% are recycled. It's estimated that one water bottle can take around 700 years to decompose, and since plastic water bottles are made from crude oil, a non-renewable resource, the energy and resources required to manufacture just one bottle are equivalent to filling 1/4 of each bottle with oil.
Filtering water directly from the tap is the safest, healthiest and most sustainable choice, and there are excellent drinking water filter options for every budget, from pitcher, countertop and under counter models.
Cleaning Supplies: Along with a multitude of other concerns, conventional cleaning products contain VOCs (Volatile Organic Compounds), which are chemicals that release into the air as vapors or gases and are sometimes referred to as "off-gassing." These chemicals contaminate your indoor air, causing harm to both human health and aquatic species after being discharged into our water systems.
They are associated with many potential health hazards including respiratory irritation, asthma, cancer, hormone disruption, reproductive and developmental harm, and many others. Babies and children are especially susceptible to these toxic exposures due to their increased vulnerability compared to adults.
There is no legislation that requires manufacturers to disclose the full list of ingredients on their packaging or online, and given the many potential hazardous health effects, it's a good idea to minimize your risks and use less toxic alternatives.
Luckily it's easy and inexpensive to find safe alternatives. First check out all your current cleaning products on the Environmental Working Group's Guide to Healthy Cleaning.
If your products don't measure up, make sure to purchase and use only those products rated A or B on EWG's scale. You can also look for Green Seal, Ecologo or U.S. EPA Safer Choice certifications, which guarantee safer products. Or if you're really committed, homemade cleaning products are just as effective, completely non-toxic and cost a fraction of their store bought counterparts. You can find simple cleaning product recipes online and make your own.
How do you work with homeowners to incorporate sustainable living into their homes and lifestyles?
I begin with a client or family wherever their own personal starting point happens to be. We all have to start somewhere, so I assure my clients that there are no judgements and no need to feel guilty about what they do or don't do yet. I generally do in-home consultations but I also meet clients for phone and Skype consults if they live outside of the Los Angeles area or they need a quick support call.
I provide education, resources and recommendations for everything they need to get started, and the support and encouragement to keep moving on the sustainable path. I also assist my clients with everything from shopping trips to grocery stores, farmers markets, home furnishing stores and clothing stores, as well as helping to plan sustainable parties and weddings, building non-toxic baby registries and nurseries, and guidance on home decoration and renovations.
I've always been passionate about sustainable living and my own personal environmental health, but when my son was born in 2015 it truly shifted my perspective to the larger issues that he will be forced to deal with in his lifetime. Environmental issues are becoming a more frequent topic of conversation in our culture, and many people are interested in living more eco-conscious and sustainable lifestyles, but they don't know what to do or how to do it.
There is a demand for personalized guidance and support in making the shift, particularly since the topic is so broad and can be overwhelming for those just starting out. Even though I've been immersed in sustainable living for the past 15 years, I learn something new everyday. I'm always excited to share my knowledge and resources with my clients, and to help them navigate through this simple yet rewarding process that promotes a sense of awareness and balance within their own homes and lives.
Simone Paz is a sustainable living and non-toxic home consultant in Los Angeles, CA. She works with individuals and families to educate and support them in their pursuit of living a safe, healthy and environmentally balanced lifestyle. She is an accredited LEED Green Associate through the U.S. Green Building Council, a Global Green Eco-Ambassador, a UC Certified Victory Gardener, and has a certification in Recycling and Resource Management.


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William E. 'Bill" Popham
William E. 'Bill" Popham started life on December 19, 1938. He was born to Nathan and Belva Popham in the Paradise Bottom community of Battletown, KY. Bill started his life fighting, born what they called a "Blue Baby", with his mid-wife grandmother throwing him in a snowbank so he would take his first breath. (He took great pride in that story.) Bill died on December 16, 2020, at Harrison County Hospital, Corydon, IN.
Bill was a life-long member of Blue River Island Baptist Church where he served as Deacon, Sunday School Teacher, moderator, and Music Director over the years. He was a former member of the Harrison Masonic Lodge #122 F&AM and the J.R Dink Chapter of the Eastern Star. He was a life-long farmer and took a lot of pride in his farm. Bill retired from Padgett's Inc. of New Albany, IN, and was a member of Local 181 Operating Engineers of Louisville, KY.
Bill joined his loving wife of 46 years, Judy, in Heaven. He was also preceded by his parents, one brother, and four sisters, a daughter Debbie, a granddaughter, and many other loved ones.
He is survived by his children, Stephanie Popham, Richard (Donna) Popham both of Battletown, and Jim (Debbie) Popham of Spring, TX. He has 8 grandchildren and 23 great-grandchildren who will miss him tremendously. He is also survived by 3 sisters; Lorene Lovan of Evansville, IN, Marian (Claude) Kidder of Flaherty, KY, and Margaret (Jack) Bailey of Smyrna, TN. He also has a sister-in-law, Cathe Chapo of Harrison Township, MI. He is also survived by many, many nieces and nephews.
Funeral Services will be held Sunday, December 20, 2020, at 2 P.M. EST from the Chapel of Bruington-Jenkins-Sturgeon Funeral Home with burial to follow in Cap Anderson Cemetery.
Visitation will be held Saturday, December 19 from 2-6 P.M. EST and Sunday after 11 A.M. at the funeral home. COVID 19 precautions will be required, including the use of masks and social distancing, during the visitation.
Expressions of sympathy may be made to: Blue River Island Baptist Church, 595 Big Bend Road, Battletown, KY 40104.
Online condolences may be made at www.bjsfunerals.com
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Bill (James William) Straney
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Please come and enjoy our beautifully designed clinic thanks to Janna's sister, architect Amy Johnston (a77 design), and QS Gustav Van Niekirk (SSA). After all, we made it just for you.
Lakeshore Vein & Aesthetics Clinic is a facilitly accredited for EVLT and VenaSeal by the Non-Hospital Medical and Surgical Facilities Program (NHMSFP) administered by the College of Physicians & Surgeons of British Columbia (CPSBC). Details of those who have received accreditation can be found on the CPSBC website. The NHMSFP Program has "the mandate to establish, monitor and ensure standards of practice in private medical and surgical services in BC." In other words, it helps ensure best practices in patient safety and care. Lakeshore Vein & Aesthetics Clinic is reviewed / inspected every year to ensure the highest levels of safety and sterilization, and has on staff a Laser Safety Office, Sterile Processing Technician and a Certified Occupational Health and Safety Officer.