text:
Difficulties associated with outpatient management of drug abusers by general practitioners. A cross-sectional survey of general practitioners with and without methadone patients in Switzerland
Anne Pelet1,
Jacques Besson2,
Alain Pécoud1 &
Bernard Favrat1
BMC Family Practice volume 6, Article number: 51 (2005) Cite this article
In Switzerland, general practitioners (GPs) manage most of the patients receiving methadone maintenance treatment (MMT).
Using a cross-sectional postal survey of GPs who treat MMT patients and GPs who do not, we studied the difficulties encountered in the out-patient management of drug-addicted patients. We sent a questionnaire to every GP with MMT patients (556) in the French-speaking part of Switzerland (1,757,000 inhabitants). We sent another shorter questionnaire to primary care physicians without MMT patients living in the Swiss Canton of Vaud.
The response rate was 63.3%. The highest methadone dose given by GPs to MMT patients averaged 120.4 mg/day. When asked about help they would like to be given, GPs with MMT patients primarily mentioned the importance of receiving adequate fees for the care they provide. Secondly, they mentioned the importance of better training, better knowledge of psychiatric pathologies, and discussion groups on practical cases. GPs without MMT patients refuse to treat these patients mostly for emotional and relational reasons.
GPs encounter financial, relational and emotional difficulties with MMT patients. They desire better fees for services and better training.
Methadone maintenance treatment (MMT) is extensively used for opiate addiction. Providing care in an office-based practice is feasible [1, 2] and produces outcomes comparable to those from specialist treatment [1, 3–7]. Furthermore, it reduces the stigma associated with the diagnosis and treatment of substance abuse and increases the amount of attention paid to medical and psychiatric conditions [3, 4]. Easy geographical access to treatment encourages employment rehabilitation and retention in treatment [4]. However, GPs encounter specific difficulties with this population: burnout, lack of training, a negative attitude and a lack of motivation have been widely reported [3, 8, 9]. These difficulties prevent some GPs from accepting MMT patients.
Furthermore, each country manages MMT in a different way: the UK encourages every general practitioner to prescribe methadone through national policies and guidelines; France usually reserves MMT for specialized centers and promotes the use of buprenorphine [10]; and the United States only recently began to allow GPs to prescribe MMT.
In Switzerland, most patients on MMT are treated by GPs, currently using the oral liquid form of methadone. Buprenorphine use is very rare and codeine is not encouraged. Only some specialized centers treat opiate abusers with injectable heroin. GPs have to register for every opiate substitution with methadone to afford the double prescription.
The Swiss government encourages substitution treatment for drug-addicted individuals in the context of a harm-reduction policy, but does not push GPs to accept these patients and has never distributed national guidelines broadly as has the UK. Generally, however, Swiss GPs are used to providing pharmacotherapies and other treatments to drug users in our country. There is no shared care as in England, but Swiss GPs use a pragmatic approach, including meeting with social workers and pharmacists in charge of MMT patients. Groups of GPs involved with the drug-addicted have been created and receive support from the Federal Office of Public Health for continuous formation and clinical discussion.
Specialized centers with psychiatrists, social workers, psychologists and medical doctors offer multidisciplinary management for unstable patients. However, in Switzerland as elsewhere, there are not enough specialized centers for all drug addicts requiring treatment, and access is limited by geographical barriers and the restricted number of treatment places that can be offered [11]. Furthermore, some geographical regions do not have specialized centers.
Office-based treatment provides clear advantages for drug-abusing patients. However, primary care practitioners encounter specific difficulties with this patient population. Burnout, lack of training, a negative attitude and a lack of motivation have been reported widely among the GP population [3, 8, 9]. These difficulties discourage and prevent primary care physicians from accepting drug abusers for substitution treatment.
The aims of this study were to (1) to describe the specific difficulties with the MMT population encountered by primary care physicians and to identify why primary care physicians are reluctant to manage drug-abusing patients in Switzerland; and (2) to identify primary care physicians' needs in terms of future management of drug-abusing patients in the French-speaking part of Switzerland and to suggest solutions to help them.
We mailed a multiple-choice questionnaire designed to evaluate various aspects of the difficulties encountered in treating MMT patients: pharmacological issues (highest methadone dose), legal requirements, financial issues (how GPs get paid), emotional and psychiatric aspects (including psychiatric medication and referral to a psychiatrist), relationships, multidisciplinary interactions (e.g. with social workers or with pharmacists), motivation of primary care physicians, and specific management in the office setting. We collected the material to develop this questionnaire during semi-formal interviews with the staff at Saint-Martin (a specialized center for managing drug abusers). MedRoTox practitioners (a group of general practitioners concerned with the problem of dependency and supported by the Swiss Federal Office of Public Health) reviewed the questionnaire. During the calendar year 2000, we mailed it for anonymous completion to every primary care practitioner with MMT patients in the French-speaking part of Switzerland (556 physicians). This figure includes every GP prescribing methadone in this part of the country, which has a population of 1,757,000. We sent the questionnaire again three months later to increase the response rate and received answers over the following three months.
We sent another questionnaire to GPs without MMT patients to evaluate more specifically the factors that kept them from accepting these patients. We used the mailing list kept by the outpatient clinic at Lausanne University Hospital. These 365 GPs represent most of the primary care practitioners in the Swiss canton of Vaud. This questionnaire, also for anonymous completion, was also sent twice at an interval of three months.
Both questionnaires are available from the corresponding author.
We used descriptive statistics and the chi-square test for comparison. We performed all statistical analyses by SPSS software, version 11.
Of the 556 targeted GPs with MMT patients (PT: practitioners with MMT patients), 63.3% (352) responded. We received replies from 231 (63%) of the targeted 365 primary care physicians without MMT patients (PWT: practitioners without MMT patients). Table 1 shows the profiles of both groups of GPs.
Table 1 Profile of office-based physicians with and without methadone substitution treatment
Both populations (PT and PWT) were similar in terms of gender frequencies, practice location and the percentage who work in a group practice. The only statistically significant difference was the mean number of years in medical practice (PT: 14.8 years, PWT: 17 years).
Table 2: Of the total PTs respondents, 73% would not accept more patients. The mean number (± SD) of MMT patients that a PT would like to have (5.8 ± 6.9, median 4) was slightly less than the mean number that they actually treat (mean: 6.2 ± 9.04, median 4). Responding PTs reported an average highest daily methadone dose of 120.4 mg/day (median = 100 mg/day, mode = 100 mg).
Table 2 General practitioners who treat patients with methadone substitution (PT, n = 352)
The percentage of PWTs who had received requests for methadone treatment was 52%. Of the responding PWTs, 42.9% had been involved in methadone treatment in the past but were no longer treating such patients. Of the PWTs, 88.7% did not treat MMT patients because they refused to accept them into their practice.
Table 3 shows the improvements reported by both PTs and PWTs as necessary for improving MMT patient management. PTs mostly emphasized better reimbursement for related items of service. They also frequently mentioned better training (post-graduate or specialized psychiatric training) and more interaction with other professionals, including groups for discussing clinical cases. PWTs gave priority to having more centers and more specialized professionals for treating drug-addicted patients.
Table 3 What could be done to improve the management of patients on methadone maintenance treatment (MMT)?
Of the PT group, 56% of physicians reported difficulties with medical care reimbursement (table 4). Also, a total of 76.1% had learned about MMT through their own practices rather than receiving formal training. Most PTs are interested in investing time in further training.
Table 4 Questions about reimbursement and training for general practitioners who treat patients with methadone substitution (PT: n = 352)
Table 5 shows reasons why PWTs refuse MMT patients. PWTs rated non-compliant patients as the biggest obstacle to management (59.7%) and preferred patients to be managed by a specialized center (57.1%). The "time-consuming" nature of treatment for drug-addicted patients was another major reason (54.5%) cited for not accepting them.
Table 5 Why do you refuse care for methadone treatment patients (general practitioners with no patients on methadone substitution treatment) (PWTs) (n = 231)
The disinclination of the PWTs to treat MMT patients (88.7%) raises the question of how to change this attitude, especially in light of the growing need for MMT (9,700 patients treated with methadone in 1991 and 15,382 in 1997 in Switzerland) [12] and the lack of specialized centers and government policies encouraging easy access to MMT. More medical training, specific training during residency and the development of faculty role models would probably contribute to improving attitudes [7]. A strikingly high percentage of GPs refuse to treat MMT patients for reasons linked to relationships or management of emotions (noncompliant patients, fears, feeling of powerlessness, or burnout in the past, as illustrated at Table 5). Again, better role models, a more positive attitude during basic medical training and greater emotional and professional support for practitioners involved with MMT patients could perhaps overcome these barriers. Of the PWTs, 11.3 % would still accept MMT patients. This information suggests an area warranting further research, and we need better tools to identify, reach, teach and encourage these physicians.
The highest average daily dose of methadone (120.4 mg/day, table 2) is not surprising in view of the recommendations in the literature: although daily doses of methadone may differ from one patient to another, some authors recommend daily doses between 60 and 100 mg/day [15–19]. A UK postal survey addressed to GPs in 2001 identified a mean methadone dose of 36.9 mg [14]; although this information (the mean) differs from the information obtained in our study (highest methadone dose prescribed), our result is still higher than expected: generally, GPs are known to prescribe low doses of methadone, contrary to international recommendations [14, 16]. However, Swiss GPs with MMT patients seem to be more aware of these recommendations. We hypothesize that PTs may have better formation and could be more concerned about methadone issues.
When asked how the management of MMT patients could be improved (table 3), PTs first mentioned better reimbursement for services provided. In Switzerland, patients pay part of the costs of health care, with the mandatory health insurance system picking up the rest of the bill. In some instances, health insurance companies reimburse patients so that they can pay their physicians directly. This practice was intended to create a stronger sense of responsibility among patients for the cost of their medical treatment. However, it is often difficult for a drug-addicted patient to reimburse physicians with these funds; the drug-addicted usually have difficulties with money management and may spend the money instead on illicit drugs. If the patient does not pay, money is rapidly deducted from the social help provided to pay the monthly health insurance. But the physician may not receive the portion for which the patient is responsible. This payment system is specific to Switzerland but shows that adequate reimbursement is important.
Weinrich and Stuart have demonstrated that professional and financial help are crucial for primary care practitioners in Scotland [2]. In the UK, financial rewards for general practitioners helped them to accept and continue working with MMT patients [2, 14].
In contrast, PWTs suggest increasing the number of specialized centers and developing more accessible specialized professional help as the first steps towards improving MMT patient management (table 5). These suggestions are fully in keeping with their attitudes about not accepting MMT patients. As the results showed, significantly more PTs than PWTs felt that better postgraduate training could improve the management of patients in MMT.
PTs mentioned lack of training as the second area for improvement in the management of MMT patients, suggesting better postgraduate formation, discussion groups focusing on clinical cases, better knowledge of psychiatric pathologies, and better training during residency. The need of GPs for adequate training in addiction is well known [9]. Miller et al. [13] emphasized the lack of specific training at medical schools and the absence of a positive attitude and role models among faculty and physicians. In the French-speaking part of Switzerland, two universities have medical schools. One (the University of Lausanne) offers a 12-hour teaching module including alcohol- and drug-related dependence and one day of practice in the psychiatric service; the other (the University of Geneva) has 80 hours of teaching on alcohol- and drug-related problems. However, this formal training in addiction began only a few years ago. Each region also has its own training opportunities, depending on the local network. Although local discussion groups for clinical cases already exist, the high percentage of PTs who expressed a need for more training points to a current overall lack of training.
Our study found that 76.1% of PTs have learned through their own daily practice how to manage methadone treatment (table 4). This is another powerful illustration of the lack of training that doctors receive and makes an urgent case for the development of better training opportunities for primary care practitioners who provide methadone treatment in Switzerland.
Two concerns mentioned with similar frequency by PTs were the need for more political support in the treatment of drug-addicted patients (provision of more centers, more specialized professionals) and the need for more accessible specialists (table 3). Interestingly, PTs are more interested in improving their own practices (through reimbursement of fees and training) than in developing other infrastructure for treating drug abusers. This finding illustrates the concentration of MMT patient treatment in the outpatient setting in Switzerland.
The median number of patients managed by the PTs represented in the survey is fairly low (four per practitioner, table 2) but is comparable with a recent postal survey in England (3.58 patients with opiate substitution per prescribing GP) [14]. However, when asked how many MMT patients they would like to treat, PTs responded with an even lower number. This finding underlines the limited capacity of a single physician to accept and treat MMT patients and the burden represented by these patients. In Switzerland, the primary care practitioners who accept patients for methadone treatment probably represent those doctors who are more trained and more interested in MMT patients.
Our study has some limitations. First, the PWT population was sampled from the Canton of Vaud. We intentionally chose this Canton because it includes both an urban and a rural population. Both survey populations (PT and PWT) were similar in terms of sex, location in a village or a town (>10,000 inhabitants) and the type of practice (single or shared). The only statistically significant difference was the mean number of years of practice in the two populations. Age and training in treating drug misuse have been shown to affect attitude (9); thus, younger practitioners may be more likely to consider MMT patients as medical patients than as stigmatized individuals. Furthermore, older practitioners were not as accustomed to delivering methadone.
The response rate to the survey (63.3% of PT and 63% of PWT) is another limitation. Although it is a high rate for a nine-page questionnaire, the survey still represents the opinions of only some practitioners. Compared with the literature, it was better than expected from a busy general practice [20]. Even if the return rate was similar for PTs and PWTs, there could be a bias of greater interest in the subject or of greater personal involvement.
A final limitation is the fact that the questionnaire was not formally validated by inter-rater techniques.
Each country has specific needs and characteristics for drug management, depending on government policies and the existing health care network. Switzerland has a policy of decentralization and harm reduction based on a low-threshold approach and a broad access to MMT through GPs, a policy embroiled in major political and emotional controversies. "Shared care" only exists in specialized centers in the form of multidisciplinary work with drug nurses, psychiatrists, social workers and GPs, but is reserved for more disruptive and unstable patients. In Switerzland, MMT prescribed outside specialized centers involves only a highly selected group of GPs trained in the addiction field. National policies, however, encourage GPs to work in multidisciplinary teams and to meet regularly with social workers and other healthcare providers.
If the intention is specifically to achieve a low-threshold approach through generalizing MMT prescription, we need to listen to suggestions made by the principal players, i.e. the general practitioners. PTs want reimbursement for their services and better training. The growing needs of drug-addicted patients, the spread of HIV and the greater emphasis on harm-reduction policies are surely powerful reasons for answering this plea and providing support to practitioners who accept MMT patients.
GP:
MMT:
Methadone maintenance treatment
PT:
Practitioners with patients on methadone maintenance treatment
PWT:
Practitioners without patients on methadone maintenance treatment
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The pre-publication history for this paper can be accessed here:http://0-www.biomedcentral.com.brum.beds.ac.uk/1471-2296/6/51/prepub
We would like to thank every general practitioner who answered our questionnaires, the MedRoTox association for improving the questionnaires, and the staff at the Saint-Martin Centre for gathering the material used in the questionnaires.
Policlinique Médicale Universitaire, Lausanne, Switzerland
Anne Pelet, Alain Pécoud & Bernard Favrat
Centre Saint-Martin, Département de Psychiatrie Universitaire de l'Adulte, Rue Saint-Martin 7, 1003, Lausanne, Switzerland
Jacques Besson
Anne Pelet
Alain Pécoud
Bernard Favrat
Correspondence to Jacques Besson.
A. Pelet designed the questionnaires, performed the statistical analysis and drafted the manuscript. A. Pécoud provided input on interpretations discussed in the manuscript and aided in manuscript preparation. JB helped with study design and manuscript preparation. BF participated in the design and coordination of the study, helped to perform the statistical analysis and helped to draft the manuscript.
Pelet, A., Besson, J., Pécoud, A. et al. Difficulties associated with outpatient management of drug abusers by general practitioners. A cross-sectional survey of general practitioners with and without methadone patients in Switzerland. BMC Fam Pract 6, 51 (2005). https://0-doi-org.brum.beds.ac.uk/10.1186/1471-2296-6-51
DOI: https://0-doi-org.brum.beds.ac.uk/10.1186/1471-2296-6-51
Methadone Treatment
Primary Care Practitioner
Methadone Maintenance Treatment Patient


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The painting and drawing course for children is an introduction to various mediums and the artistic expression.
In order to keep the students motivated, we will propose topics that interest them and give them the basics of plastic language. We will discuss the notions of forms, proportions, values and the mixture of colours (for painting).
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Sons of Famous Players at the World Cup
News >Sons of Famous Players at the World Cup
By: Eniko
We can find sons of famous football players on different teams at the World Cup
Like the son of Lilian Thuram, Marcus Thuram, or son of Danny Blind, Daley
The son of George Weah, Timothy Weah plays in the US team
Timothy Weah in '21 – Image source: Supporterhéninois, CC0, via Wikimedia Commons
We can find several young footballers in the 2022 FIFA World Cup whose fathers also had great careers. Even though some of them never had the chance to compete in a World Cup. Like Timothy Weah's father, George Weah, or Abedi Pele, the dad of Ghanaian players Andre and Jordan Ayew. Let's meet the sons of famous players at the World Cup who can follow in the steps of their famous fathers.
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Having a famous father or any other relative can sometimes be a huge weight, as not everyone can live up to expectations. Just imagine being the son of Lionel Messi or Cristiano Ronaldo, surely it won't be an easy path if they choose to become a football player as well. But some players could manage this pressure and continue the family traditions. Like Paolo Maldini whose father, Cesare Maldini was a member of the Italian team in the 1962 World Cup. His son featured in four World Cups between 1990 and 2002, finishing as a runner-up in the 1994 World Cup. Paolo's sons, Daniel and Christian are also footballers, but they haven't played in the national team yet. Unlike the following young players with similar backgrounds.
The Sons of Famous Players at the World Cup Include French and Dutch players
Lilian Thuram in '13 – Image source: Matthieu Riegler, CC-by, CC BY 3.0, via Wikimedia Commons
The son of 1998 World Cup winner Lilian Thuram, Marcus Thuram also plays for the French team. He has every chance of achieving the same result after France have been very impressive so far. They won their group with 6 points and will meet Poland in the last 16. The team is favored to win the match. What's more, Didier Deschamps' squad is mentioned among the favorites to win the whole tournament. Online sportsbooks in the Netherlands offer odds of 6.10 for their victory. Marcus Thuram entered the pitch twice so far as a substitute. But he can still be a member of a World Cup-winning team in Qatar.
Just like Daley Blind, the son of Ajax defender Danny Blind who took part in two World Cups, in 1990 and 1994. This is also the second tournament for his 32-year-old son, who is a stable member of the Dutch team. Daley has even got better results than his father after the Netherlands finished third in the 2014 World Cup. Now their chances of a podium finish seem less likely. Even though they also won their group with two wins and a draw. Louis van Gaal's team will meet the USA in their next match. Danny Blinds will have an important role to stop the young American players. And create some chances for the Dutch strikers. In the American team, we can find other examples of the sons of famous players at the World Cup.
Weah and Reyna also have famous fathers
Timothy Weah is the son of the legendary Ballon d'Or winner football player, George Weah. He is playing for the US though. Unlike his dad, who was a member of the Liberian team. He couldn't qualify for the World Cup with his national team, so in this sense, his son has already surpassed him. Timothy is a talented player who scored the USA's first goal in the tournament against Wales. While scoring against the Netherlands would be an even bigger achievement for the 22-year-old winger.
His teammate, Giovanni Reyna also has a famous father, Claudio Reyna who played in three World Cups as a captain of the American team. What's more, his mother, Danielle Egan was also a football player and a member of the US women's national team. Giovanni is a great talent as well. But he hasn't played too much in this World Cup yet. It might change in the crucial game against the Dutch team. In spite of the US team's great performance, online gambling sites in the Netherlands still favor the Oranje to win the match with an odds of 1.94.
Schmeichel and Szczesny followed their dad's examples
Peter Schmeichel was a legendary goalkeeper of Manchester United and the Danish national team. His son, Kasper also became a great goalkeeper, who won the Premier League with Leicester City. And he is the number one goalkeeper of the national team too. Unfortunately, Denmark is already out of the World Cup following a disappointing performance. They finished last in their group with one draw and two defeats. Wojciech Szczesny, the goalkeeper of Poland has been more successful so far after his team got to the last 16. The Juventus goalie's father was also a goalkeeper on the national team. But he only appeared in seven games and none of them happened in a World Cup.
Abedi Pele, the father of Andre and Jordan Ayew didn't play in a World Cup either in spite of being one of the best African players of his time. He won the Champions League with Marseille. He was also the captain of the Ghana national team but they didn't qualify for the World Cup then. Unlike now, when his sons represent the country at the Qatar World Cup. Ghana can still reach the last 16 after standing in second place in their group. Just like Costa Rica where we can find Celso Borges who plays in his third World Cup. His father, Alexandre Guimares also played for the national team. And even led them as their manager in the 2002 and 2006 tournaments. Now Costa Rica would need to beat Germany to qualify for the last 16, which has an odds of 26.00 on 22Bet.
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Eniko
Fan of all sports, especially football and Formula 1, but gladly covering cycling, winter sports, and darts too. I'm also interested in poker news, checking out the latest slots, and sharing some great gambling tips.

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Do I Need Particulate Fire Testing?
Char: Char consists of irregular shaped fragments of combusted material greater than one micron in size. Using a light microscope, microscopists are able to identify char and differing fuel sources that will produce char particles with different morphologies.
Ash: Ash particles consists of fuel material that has had almost all of the organic material burned away, leaving inorganic remnants that re often crystalline.
Soot: Soot particles are smaller particles formed from incompletely combusted, volatile fuel material and considered a secondary indicator of fire residue. Soot particles may darken the surface of a wipe sample and they can cluster to form agglomerates as large as 1 mm.
Benzene – a carcinogen that may lead to acute lymphocytic leukemia, chronic lymphocytic leukemia, multiple myeloma, and non-Hodgkin lymphoma.
Arsenic – an extremely toxic poison that can occur through inhalation or dermal absorption.
Sulfur Dioxide — Sulfur dioxide can cause breathing difficulty, airways inflammation, psychic alterations, pulmonary edema, heat failure and circulatory collapse. It is also associated with asthma, chronic bronchitis, and mortality increases for both the elderly and infants.
How is Particulate Fire Testing Performed?
Surface samples are collected to determine the presence of soot/char/ash. Trained analysts can use appropriate light microscopy to identify soot and to differentiate it from dirt or char particles. If primary indicators, like char, are present, the standard does not require analysis of a secondary indicator (soot).
During the sampling process, fire-related particle material on HVAC interior surfaces can be tested in the same way as surface sampling for mold. "Clear" or "Crystal clear" ¾-inch wide and 2-inch long transparent tape is pressed down on a relatively smooth area that is likely to have deposited car or soot particles.
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Why should I have my home or building tested for fire-related particles?
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Finance question
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Finance Question Finance Question Nike The Nike Inc. was founded in 1964 under the Blue Ribbon Sports as a distributor for Onitsuka Tiger's shoes. It changed the name to Nike Inc. in the year 1971. The Incorporation majorly deals with making of sports clothing and equipment. With the Incorporation's first products being track running shoes, it has evolved into products for all categories of games. Currently, the Incorporation makes cleats, shorts, jersey, and shoes. In 2014, Nike Inc.'s most exciting product was not their usual clothing products but an application. The application enabled companies to measure the effects that their raw products had to the environment.
Besides selling games products, the Nike Inc. also produces urban fashion clothing common to the youth. Urban clothing has enabled the Incorporation to secure significant awareness especially in the hip-hop culture. Nike Inc. ration also teamed up with Apple Inc. to produce a product that allowed monitoring of athletes through taking statistics of their performance.
Nike Inc.'s major competition comes from Adidas. According to Amed (2014), Nike Inc. had an upper hand in winning customer's top of mind awareness. Nike exploited its endorsement by sports superstars to advertise its Mercurial and Magista superfly boots. The advertisement saw Nike Inc. dominate during the 2014 FIFA world cup (Amed, 2014).
According to Amed (2014), uniqueness of the Nike Inc.'s products emanates from the necessity in the sports society as a strategy to ensure sustainability in the market. Uses of sports stars endorsement and frequent innovations have given Nike Inc. an upper hand in the market. Nike Inc. has maintained competitive advantage over it rivals in the market (Nike Inc., 2014)
Nike Inc. has formed business collaborations and partnerships in order to achieve the technological breakthrough as a way of increasing its market empire (Amed, 2014). Nike Inc. aims at improving its marketing by use of software. As a result, the Nike Inc. has formed collaborations such as with Apple Inc. to enable the development of personalized software for the Incorporation.
Exposure to Currency
Nike Inc. diluted annual earnings and revenues per share have increased by 13 and 9 percent in 2013 and 2014, respectively (NIKE Inc., 2014). Nike Inc.'s investment returns increased from 22 to 25 percent in 2014 with the expanded gross margins increasing by about 190 basis points. The fiscal growth of Nike Inc. resulted in earnings, revenues and cash returns to the incorporation's shareholders. In 2014, continuing operations net income increased to $2. 7 billion an increase of 10% from 2013 fiscal year.
The revenue also increased to $27. 8 billion, which was an increase of 10%. Diluted earnings per common share were offered at $2. 97 billion, which was an increase of 11% from 2013 fiscal year. Diluted earnings per common share in 2014 grew relatively faster than net income due to a decrease of 1 percent in the weighted shares after repurchase of the shares in 2013 fiscal year. Nike Inc. sold Umbro brand assets in the second quarter of the fiscal year of 2013, which caused a loss of $107 million, net of tax. Cole Haan brand was sold in the third quarter of fiscal 2013 marking a sales gain of $231 billion, net of tax. A general inference of fiscal year 2013 compared to that of 2012 implies financial growth of the incorporation (NIKE Inc. 2014).
Amed I. (September 29, 2014). CEO Talk Decoding Nike: Mark Parker, Chief Executive Officer, Nike. The Business of Fashion. Retrieved from http://www. businessoffashion. com/2014/09/decoding-nike. html
NIKE Inc. (2014). Annual Report on Form 10-K. Retrieved from http://investors. nike. com/files/doc_financials/2014/docs/nike-2014-form-10K. pdf
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This Tournament Walleye rod is 7ft one piece rod, rated from 7g to 21g. In the range it is called the "deep cranker" that said it is more than at home doing several tasks. The blank is a nice dark blue colour and the rod comes with a St Croix 15 year 5 star warranty.
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8-9 p.m. "Deal or No Deal"
10-11 p.m. "JOURNEYMAN" - Voyagers! and Quantum Leap combined, wherein a bloke is torn back in time to parts of his own life in an attempt to "fix" it... or is he?
8-9 p.m. "The Biggest Loser" - now with 100% less Caroline Rhea, as Alison Sweeney steps into the host slot.
10-11 p.m. "LIFE" - A cop is convicted of murder and sentenced to life. The case is reopened and he's suddenly not guilty. So he gets his police job back (?!?!?) and has a different perspective on the cop story and life. The end of the preview said it best -- "that's what I don't understand..."
8-8:30 p.m. "My Name Is Earl" - a total of 25 episodes, up from 22.
10-11 p.m. "ER" - This show won't die!
9-10 p.m. "Las Vegas" - James Caan out, Tom Selleck in.
10-11 p.m. "Friday Night Lights" - They actually moved it to Friday. Shame that means a lot less viewers for this show.
7-8 p.m. "Football Night in America"
8-11 p.m. "NBC Sunday Night Football"
*L&O: CI is going to the USA Network. Love corporate synergy!
My take - Well, I'm not impressed. I don't see this lineup as really helping NBC get out of fourth place. Journeyman is going to be slaughtered by CSI Miami. Chuck is an hour long comedy that will probably wear out it's welcome quickly. Bionic Woman will either be the next BSG or be the laughing stock of the season. Life, well, doesn't look good. And while I H-A-T-E that Studio 60 is being canceled, I understand because of the costs associated and ratings. Dang it.


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LessonsGuitar Technique
Weekly Workout: Build Your Speed by Using More Efficient Fingerings
Bill Evans August 16, 2018
From the October 2018 issue of Acoustic Guitar | BY JEFFREY PEPPER RODGERS
If you watch the hands of guitarists who play with enviable speed and fluidity, you may notice how little effort they seem to exert. Their finger movements are relaxed and minimal, considering the amount of music they are generating. What they're playing is surely not easy, but it looks that way. So how does a guitarist achieve that state of grace?
Part of the answer is, naturally, hard work. To develop speed, you need to practice new maneuvers over and over until they become second nature. Equally important, though, is being efficient with your technique—learning to achieve the sounds you want with the least amount of movement and effort. The faster you play, the more important efficiency becomes—a small stumble in a chord change will become a big bump at higher speed. But even at slow, manageable tempos, efficiency pays off. It helps you play more musically, because if you reduce setup and transition time, the notes can connect and ring more.
This workout focuses on efficiency in the fretting hand when you're playing chord sequences. Finding smart ways to finger chords and transition between them makes a huge difference in the sound of accompaniment. These exercises use progressions—drawn from fiddle tunes, bluegrass, and rock—that make speedy changes primarily with open chords. This is a bit of a rhythm workout, but the ultimate goal is to work less.
To kick off the workout, play an accompaniment part for the fiddle tune "Bill Cheatham"—specifically the B section, which barrels through the I, IV, and V chords, changing mostly every two beats. I've arranged it in G, the default for bluegrass guitarists. Fiddlers typically play "Bill Cheatham" in A, so capo at the second fret if you want to match that key.
For comparison's sake, first try Example 1 with the exact chord fingerings shown, and bring it up to a fairly fast tempo. Notice anything? Those fingerings have you scrambling all over the fretboard. Your third finger, for instance, has to race from the first string on the G chord over to the fifth string for the C, and then double back to the second string for the D; your second has to zip from the first string on the D over to the sixth for G. With all that moving around, it's tough to stay in time, let alone play cleanly.
So now check out Example 2, the eight-bar B section of "Bill Cheatham." Instead of a regular G major chord, use a G5: take out the thirds, the Bs, by fretting the second string and muting the fifth string (by leaning your second finger against it). A power-chord voicing like this works great for this style. Hold down the top two strings with your third and fourth fingers at the third fret, and leave the fingers there for the rest of the example; having those G and D notes on top turns the C chord into Csus2 and the D into Dsus4. Not only do these treble notes sound good throughout, especially if you play them with a percussive chop like a mandolin, but they keep you anchored. You move only your index and middle fingers—very efficient compared with Ex. 1.
As with the G5, mute the string above the bass note for the Csus2. You can play the second fret on the fourth string if you want, but I like leaving it out for a tighter sound and more separation between the bass and the chord chop. Start at a moderate tempo—say 100 bpm—and ratchet it up. With these fingerings, you should be able to roll through the progression even at a good clip without working too hard. For extra credit, see Take It to the Next Level on p. 50.
Beginners' Tip #1
Look for opportunities to keep a finger anchored on the same string/fret during a chord change.
Staying in the bluegrass realm, this week's workout is inspired by the classic "Rocky Top," often played at a brisk tempo. In Example 3, play a four-bar progression with the fingerings shown. (As with all the other examples in this lesson, you can loop it for practice.) Again you're in the key of G, but the G fingering is not the same one used in Ex. 2; this time, fret with your third and fourth fingers and leave the second string open. The main reason for this fingering is the quick change to C in measure 2. This G fingering allows you to leave your fourth finger in place and move your third finger over just one string at the same fret—a smooth and easy change.
In measure 3, I've used chord voicings on the low strings only for Em and for D/F# (in place of a standard D). The logic behind these fingerings is that, again, your fingers make only a small move (the first and second fingers each shift over one string at the same fret); plus the low F# bass note under the D sounds good as a connector between the sixth-string E and G. Sure, you could play more strings/notes with these chords, but keeping them simpler and more contained works better in this context. It gets the job done, harmonically speaking, without extra effort that will slow you down.
Example 4 is based on the chorus of "Rocky Top." In measures 3 and 4, note how little your fingers move between F/C and C—much less than if you were playing a full F barre chord. The same is true in measures 7 and 9, where you use an F/C (this time on only the four middle strings) for the quick bounce between G and F.
Instead of using a full barre chord, try simplifying the shape to three or four strings.
This week's examples venture toward rock 'n' roll. Example 5 is inspired by the Outlaws' 1970s southern rock jam "Green Grass and High Tides." In this four-bar progression, you've got to be nimble to get through the changes at a fast tempo. So make life easier by simplifying fingerings: use only one fretting finger for the G, D5, and A5 chords. The Em and C fingerings are chosen for efficiency, too: you can keep your third finger anchored on the second fret for both chords. Playing A5 with a one-finger barre is crucial to nailing the rhythm riff in measures 3 and 4. Keep your index in place and reach up to the fifth and fourth frets with your fourth and third fingers, respectively.
Example 6 tips its hat to the Everly Brothers (and to Felice and Boudleaux Bryant who, as it happens, also wrote "Rocky Top") and the song "Wake Up Little Susie." The example is in D, with quick, syncopated strums on the F and G in measures 2 and 4. Use an F/C and slide up two frets for a G/D, and then back down for another F/C on the way to D. (If you like, strum percussive scratches over the rests between these chords.) The F/C and G/D inversions sound full while making the changes easier to navigate than if you'd used six-string barre chord shapes.
Often the bass note and just one or two other notes is all you need to establish a chord.
Several of the earlier examples included power chords, which make sense when you're stripping chords down to the essentials—each power chord includes only the root and the fifth. This week, you'll employ a bunch more power chords in a couple of rhythm patterns inspired by the Who's "Pinball Wizard."
In Example 7, use a third-finger barre for the B5 and a first-finger barre for A5. From there, it's a small move to the D5, and then your first finger stays on the third string for the E—it just slides down a fret. Your first is serving as a guide finger and helping all your fingers change shapes more quickly.
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Notice how Example 8 starts with an atypical E fingering—the first finger isn't fretting anything. Why play an E like this? The answer is in the next beat. If you fret the E with your second, third, and fourth fingers, you can slide the same shape up two frets and just add the bass note with the index to get the F# chord. I like the smoothness of that change compared with reshuffling the fingers from a standard E fingering.
As you work on other songs, if you find that a particular change is tripping you up, think about alternative ways to finger or perhaps reduce the chords. Often the solution is not to push yourself over the obstacle but to remove it—by playing smarter, not harder.
When possible, use a guide finger, which stays on the same string from chord to chord.
For extra practice with quick chord changes, try playing the "Bill Cheatham" progression from Ex. 2 in other open keys: A, C, D, and E. In each key, find the I, IV, and V fingerings that provide the most efficient path through the progression. Here's a sample in the key of A to get you started. As you can see, the first finger stays on the third string throughout and serves as a guide finger.
Jeffrey Pepper Rodgers is author of the new Acoustic Guitar book/video Beyond Strumming.
beyondstrumming.com
Video Lesson: An Intro to Bottleneck Blues
How to Play I–ii Progressions in C and G Major | Chord by Chord
The Basics: A Bluesy Lick You Need to Know
I–IV–V7–I Progression G Major | Chord by Chord
Crosspicking 101: A Private Bluegrass Lesson with Molly Tuttle [VIDEO]
Learn 5 Ways to Play a G7 | Chord by Chord
Weekly Workout: Building Dynamic Song Arrangements
How to Fingerpick the Blues Like Mississippi John Hurt: The Alternating-Bass Pattern


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Niki Hare
The artist's works on display.
July 01, 2013Posted by Saatchi Art
British artist Niki Hare says she paints in order "to stave off the nausea". Her work dissects and explores the world around her, breaking it down into frames, maps, diagrams and aerial views. Niki only started exhibiting this year and has already taken part in three shows in the UK, as well as a show in Cologne, Germany, and a project in the US. Her work was selected from almost 1,000 entries for the Royal Society of Portrait Painters Self-Portraiture competition and was exhibited alongside paintings by some of Britain's leading portrait artists at the Mall Galleries in London.
Works for sale by Niki Hare
Nothing is Beautiful 3,500
Niki Hare View artwork
Sea Line 550
Mountain Side 2 350
Interior 5 2,500
Idea 1,500


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Exploring Belgium alone
In September 2016 I decided to travel alone for the first time ever, in a safe familiar country that I have visited before. I re visited Brussels like a local and discover new cities like Ghent and Antwerp.
Brussels sprouts have been grown in Belgium for over 700 years.
Brussels is a major trader of beer, waffles and chocolate. There are more than 800 brands of beer on sale in Brussels. Also French Fries were invented in Brussels.
I had visited Belgium before. Back then I visited Brussels and Brugge. I didn't enjoy Brussels a lot during my first visit because it was raining a lot and we didn't stay in the city for a long time. This time my experience in Brussels was quite different.
Before the trip I had met an Italian guy here in Porto, Fabio, though Couchsurfing. He lives in Brussels. Since we got along, he invited me to visit him in Brussels and that's how the idea for trip came up. It was my first trip alone. But the truth is that I didn't spend a lot of time alone in Brussels because I was almost always with him.
I went to revisit some of the main monuments (Grand Place, Jardin du Petit Sablon and Mont des Arts) and got to know Parc du Cinquentenaire, that I haven't visited before.
Most buildings of the U-shaped complex which dominate the park were commissioned by the Belgian government for the 1880 National Exhibition commemorating the fiftieth anniversary of Belgian independence. The centerpiece triumphal arch was erected in 1905. The Royal Military Museum has been the sole tenant of the northern half of the complex since 1880. The southern half is occupied by the Cinquantenaire Museum and the Auto World Museum. The Temple of Human Passions, a remainder from 1886, and the Great Mosque of Brussels from 1978 are located in the north-western corner.
We also went to Musée Magritte, to see the work of the surrealist artist René Magritte. The Magritte Museum opened to the public on 30 May 2009. It displays some 200 original Magritte paintings, drawings and sculptures including The Return, Scheherazade and The Empire of Lights.
We went to a coffee place in the rooftop of a building – Musée des Instruments de Musique de Bruxelles, close to Mont des Arts, that has an amazing view to the city. The museum itself is internationally renowned for its collection of over 8,000 instruments.
We were also in a big park close to St. Gilles, where Fabio lives. The weather was good and the park was full of people enjoying the sun. There we took a boat to an island in the middle of the park, where there's a coffee place that is really nice.
In one of the nights we went to have dinner in a restaurant with almondegas with different sauces. We also took breakfast in a place where we ate Moroccan crepes. Once Fabio organized a dinner at his place so I could meet his friends, all from different nationalities. It was very nice.
We also went out together. We went to a square with a lot of bars and pubs to drink belgium beer in a bar called Maison du Peuple. We even took pictures together in a vintage machine there. I had a lot of fun!
Ghent promotes a meat-free day every Thursday called Donderdag Veggiedag. Vegetarian food is promoted in dining rooms and public schools. Ghent is said to have the world's largest number of vegetarian restaurants per capita.
Ghent is known for purple cone-shaped, jelly-filled candies called cuberdons or neuzekes ('noses'). You can buy Ghent noses at street stalls that specialize in these overly-sweet candies.
Even though in Brussels I was always with my friend, in Ghent and Antwerp that didn't happen. I took the train in the morning to St. Pieters station. The ticket is 9€ and it takes about half an hour. The station is a bit far from the center: you can walk, but I don't recommend it because it's not beautiful. I recommend taking the tram number 1 and get off in Korenmarkt. The ticket is 1,20€.
Ghent is a beautiful medieval town, very similar to Brugge, but smaller. In the map below you can see the route I did, that allowed me to see the main places and monuments in the city. It's 1,3 km and just 16 minutes walking. That's why I chose to visit Ghent and Antwerp in the same day, because you can see both really fast.
I really enjoyed sitting there next to the Graslei and Korenlei ports. Graslei is a quay located on the right bank of the Leie river. The quay opposite of the Graslei is called Korenlei. Both quays were part of the medieval port and are now a cultural and touristic hotspot of the city, with a high concentration of cafe patios. Today these ports are surrounded by historical buildings and they are the heart of the city.
I went to a small wooden bridge called Grasbrug, as well as St. Michels bridge, and from Koranlei I enjoyed the view to Graslei.
I visited St. Bavo Cathedral, from 1559. The masterpiece inside this church is the painting "Adoration of the Mystic Lamb" from Jan van Eyck, 1432. I didn't go inside to see it unfortunately.
I also went to see the Belfry and St. Nicholas church. Belfry is the symbol of independence. It was built in 1313 and it's 91m tall. The panoramic view from the top is higher than the one from Gravensteen, but less central. St. Nicholas church is next to Belfry. Despite being older than St. Bavo's, it's more preserved. The sculptures are really nice.
Gravensteen is a medieval castle in the middle of the city. The present castle was built in 1180 by count Philip of Alsace. The castle served as the seat of the Counts of Flanders until they abandoned it in the 14th century. The castle was then used as a courthouse, a prison and eventually decayed. Houses were built against the walls and even on the courtyard. They wanted to demolish it but in 1885 the city bought it and started the renovation project. The newly built houses were removed and the walls and keep were restored to their original condition.
The castle has been repaired enough to allow people to travel through it and climb on top. It has a nice view from the top. Inside is a museum with various torture devices (and a guillotine) that were historically used in Ghent. Getting out of the castle, we see a nice square with historic buildings. The Sint Veerleplein is today one of the most touristic squares, with several bars.
It was a shame that there was a lot of restoration works going on and a lot of the monuments were covered. I stopped in a coffee place for a bit and I spoke on the phone with my best friend for a long time, it felt nice. Finally, I went to McDonalds to eat and then went back to the train station, to continue my trip in Antwerp.
While the country of Belgium has three different official languages including Dutch, French and German, the official language of the Antwerp province is Dutch, as in all Flemish provinces.
Between 80 and 90 percent of the world's rough diamonds, and 50 percent of its cut diamonds are traded in Antwerp each year, earning the city the "The World's Capital of Diamonds" moniker.
Even though Antwerp is not so beautiful, I preferred the vibe of this city. Or maybe it's just because I got more comfortable traveling alone. So comfortable I even had people asking me for information on the streets, thinking I was a local. Like Ghent, you can visit this city really fast.
I arrived at the train station, Antwerpen-Centraal, considered in 2014 the most beautiful one in the world. The ticket from Brussels is 7€ and it takes about 50 minutes.
To get to the city center, I walked along Meir, one of the main commercial streets in the country. The street is huge and you can find all the famous brands and a lot of coffee places and restaurants.
I visited the Cathedral of Our Lady, with its giant towers. It took them 170 years to build it and it was finished in 1521. The project for the second tower, however, mas never finished and they don't have the same size today. It contains a number of significant works by the painter Rubens.
I continued in the direction of the Grote Markt, the colorful main square, with a lot of flags from different countries. You can see the Town Hall there, built in 1565 and the Brabo statue. He was a mythical Roman soldier who is said to have killed a giant who asked money from people who wanted to pass the bridge over the river Scheldt. When they didn't want to or couldn't pay, he cut off their hand and threw it in the river.
I went for a walk close to the sea and the castle. The Castle of Het Steen is a medieval fortress built in 1200. It used to be a prison and now is a memorial of the II World War. In front of the castle is Lange Wapper, a statue of a guy who people say used to chase the drunk men in the city. It was a busy but cool day. This trip was very important to me, because it made me think about everything in my life.
Sandra Soares	Europe	Leave a comment January 30, 2018 February 12, 2018 6 Minutes


Customer Acquisition: Focus is targeting & reaching out to prospects, explaining them about the products and services and on-boarding the customers.
Customer Development/Build/Growth: In this phase organizations leverage the existing relationship for growing the engagement with newly acquired customers or existing customers. So, the focus is both on increasing level of engagement on the existing product or relationship (i.e. spend/balance build on credit card) and identifying customers' needs & soliciting for a right product (i.e. cross sell a credit card to mortgage customers).


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A truly massive interest rate hike is now on the table
By Julia Horowitz, CNN Business
Published 8:33 AM EDT, Thu July 14, 2022
'Worse than we anticipated:' CNN reporter breaks down inflation data
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A version of this story first appeared in CNN Business' Before the Bell newsletter. Not a subscriber? You can sign up right here. You can listen to an audio version of the newsletter by clicking the same link.
London CNN Business —
Central banks have made clear that after a sluggish start, they're serious about putting a lid on inflation. Now, as prices soar even faster than expected, they're weighing increasingly drastic options.
What's happening: Investors see a growing probability that the Federal Reserve could hike interest rates by a full percentage point at its next meeting for the first time in the modern era. In June, the Fed raised interest rates by three-quarters of a percentage point, which it hadn't done since 1994.
US stocks mostly shrugged at the news on Wednesday that consumer prices jumped 9.1% year-over-year in June, a fresh 40-year high and a larger increase than forecast. But policymakers indicated deep concern.
"Everything is in play," Atlanta Federal Reserve Bank President Raphael Bostic told reporters on Wednesday.
Previously, Fed officials had expressed worries about the consequences of a hike of that magnitude.
"I think the markets would have a heart attack," Fed Governor Christopher Waller said last month.
Yet traders see such an extraordinary increase as more and more likely. Markets on Thursday assigned it an 81% probability, according to data from CME Group.
Breaking it down: Short-term, the inflation picture is undeniably nasty, putting pressure on central bankers to get the situation under control quickly.
"I saw that data and thought: This wasn't good news," Mary Daly, president of the Federal Reserve Bank of San Francisco, told the New York Times on Wednesday — though she added she hadn't been optimistic.
Much of the June increase was driven by a jump in gasoline prices, which were up nearly 60% over the year. But inflation concerns have moved beyond energy. The shelter index climbed 5.6% over the last year (more on that below). The price of household furnishings jumped 9.5% during the same period, while airline fares leaped more than 34%.
For guidance on what comes next, look to America's northern neighbor. The Bank of Canada increased its main interest rate by a full percentage point on Wednesday, noting that inflation in the country was "higher and more persistent" than the central bank thought in early spring.
Other policymakers are in action, too. South Korea and New Zealand raised rates yesterday, while Singapore's monetary authority and the central bank of the Philippines made emergency decisions to tighten policy earlier Thursday.
"Clearly, given other central banks are acknowledging the need to step up, the Fed isn't alone anymore," James Knightley, ING's chief international economist, told me. That gives it "more cover to go more aggressively."
Knightley still predicts a hike of three-quarters of a percentage point later this month, given concerns among many Fed officials about pushing the United States into a recession. But a full point increase is "certainly on the table" due to the recent batch of inflation data, he noted.
Housing costs are making inflation much worse
Yesterday's edition of Before the Bell focused on the more hopeful case that inflation could come down in the medium-term. Today, after sorting through the data in the Consumer Price Index, I wanted to dig deeper into one of the strongest counterpoints: the cost of shelter.
The shelter component of the CPI continued to rise sharply in June, logging its biggest annual increase since February 1991.
That's concerning to economists because rising housing costs are sticky. Food and gas prices can change quickly. But people are locked into rent for 12 to 24 months when they sign a lease.
Watch this space: The average monthly rent in Manhattan topped $5,000 a month in June for the first time ever, according to a report from brokerage firm Douglas Elliman and Miller Samuel Real Estate Appraisers and Consultants. That's up nearly 30% from a year ago.
Housing represents about a third of the value of the basket of goods and services that the US Bureau of Labor Statistics uses to track consumer prices, making its trajectory especially important.
Remember: The Federal Reserve Bank of San Francisco wrote in February that rents and home prices can push up the Consumer Price Index "for as long as 24 months into the future."
That complicates "peak inflation" hopes, even as oil prices drop and consumers put their faith in the Fed's ability to do its job effectively.
The crypto bankruptcies keep coming
When I've spoken to backers of digital currencies recently, many have put a positive spin on the deep "crypto winter" that's set in.
Their pitch: As prices plunge and turmoil spreads across the market for cryptocurrencies, weaker or dubious projects will fail. Only solid businesses will reach the next chapter, establishing a stronger foundation.
Even if you subscribe to that logic, however, the interim period promises to be messy.
Celsius became the latest firm in the industry to file for bankruptcy on Wednesday. The crypto lender, which has 1.7 million users, froze withdrawals and transfers last month, citing "extreme market conditions."
Another crypto lender, Voyager Digital, filed for bankruptcy last week. It said the "prolonged volatility and contagion in the crypto markets over the past few months," as well as the default of a customer on a loan, required "deliberate and decisive action."
Investor insight: There are likely to be more casualties in the coming months. Bitcoin is languishing below $20,000 as fear continues to dominate investor sentiment, squeezing those who made risky bets when prices were much higher. The digital coin is off more than 70% from its November peak. Ether is roughly 78% below its all-time high.
Conagra, Ericsson, JPMorgan Chase and Morgan Stanley report results before US markets open. American Outdoor Brands follows after the close.
Also today: The US Producer Price Index, another key measure of inflation, arrives at 8:30 a.m. ET.
Coming tomorrow: Earnings from BlackRock, Citigroup, BNY Mellon and Wells Fargo.


Strawbees wanted the complete branding and packaging of their new product, the Strawbees Hovercraft. The product is a modular DIY hovercraft kit made from up-cycled material. Since, the original invention was from the 50's, the idea was to package this modern product with a 50's vibe. Colors, fonts, graphic elements and illustrations were carefully chosen to suit the vintage aesthetics. Lettering for the bold header type 'Hovercraft' was custom created for the product. Promotional material was also created in the form of countdowns, posters and graphics for the product's Kickstarter campaign and social media.
The photos used here are not taken by me. They are from strawbees.com.


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We Want to Know: Megan Fox
In this segment of "We Want to Know" Dr. Ashley Gordon, a board-certified plastic surgeon from Austin, Texas takes a look at Megan Fox's before and after photos. Megan is considered one of the most beautiful women in Hollywood, and we want to know what cosmetic procedures has she had?
"People are always asking, what surgical or non-surgical procedures has Megan Fox had? I think she hasn't had very many, especially for a Hollywood actress. As you can see, this is a picture of her in her late teens. Now she's in her 30's. She's stunning and she has great eyes," says Gordon.
"I think the main thing that she's had done is she's had a rhinoplasty. You can see here, the dorsum of her nose is really wide and the tip is a little bit, Ill-defined. You can see here she really has a perfect nose. It's thinner, it's more dainty, it's more feminine, and I think it really suits her face," explains Gordon.
"I think she's doing a really good job with her eyebrows. She hasn't had a brow lift or any eyelid surgery. It looks like she may have a little bit of lip filler because her lips are really nice and plump. So I think overall probably the only surgical thing she's had is a rhinoplasty and some lip filler. So beautiful, Megan Fox!"
We Want to Know: Mel B
What Makes Millennials...
Pain Doesn't Have to be a...
Ashley Gordon, MD Lip Injections Rhinoplasty Celebrity Plastic Surgery lip fillers Prejuvenation


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The Last Five Years
An emotionally powerful and intimate musical about two New Yorkers in their 20s who fall in and out of love over the course of five years. The Last Five Years is a beautifully compelling chronicle in the book of love. Support American Theatre: a just and thriving theatre ecology begins with information for all. Please join us in this mission by making a donation to our publisher, Theatre Communications Group. When you support American Theatre magazine and TCG, you support a long legacy of quality…
By American Theatre Editors
An emotionally powerful and intimate musical about two New Yorkers in their 20s who fall in and out of love over the course of five years. The Last Five Years is a beautifully compelling chronicle in the book of love.
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https://www.middletownpress.com/nfl/article/Houston-RB-Arian-Forster-out-for-season-with-11787556.php
Houston RB Arian Forster out for season with Achilles injury
Kristie Rieken The Associated Press
Published 4:46 pm EDT, Monday, October 26, 2015
Houston Texans running back Arian Foster (23) is out for the season.
Photo: Wilfredo Lee — The Associated Press
HOUSTON >> Texans running back Arian Foster is out for the season with an Achilles tendon injury, a significant blow for a team that was just blown out for the second time this season.
Coach Bill O'Brien said Monday he expects Foster to miss the rest of the season but didn't elaborate on the injury to Foster's right leg.
Foster was injured without being hit late in the Texans 44-26 loss to Miami on Sunday. He was in motion when he fell to the ground at the beginning of a play.
Foster missed the first three games of the season after tearing his groin muscle in training camp.
"I know he's hurting," O'Brien said. "He worked hard to come back for the season, had the groin injury and now this injury. He's a guy that's proven he can come back from injury and I'm sure once he's able to rehab it he'll rehab it very diligently and try to come back. We're all supportive of him in that rehab."
Foster hasn't played 16 games since 2012 after missing three games last season and sitting out eight in 2013 after back surgery. The 29-year-old, who ran for 1,246 yards last season, had 163 yards rushing with a touchdown and 227 yards receiving with two scores this season.
Left tackle Duane Brown, a close friend of Foster, talked about how much he feels for him.
"It's devastating," Brown said. "Just because I know how much he puts into this thing, how much work he puts in to be great, to be healthy, and to stay on the field. I know how hard he worked to come back from his groin injury. To have this happen, I'm really hurting for him. I know it's pretty frustrating."
The Texans are also dealing with a situation with backup quarterback Ryan Mallett after he missed the team charter flight to Miami on Saturday and took a commercial flight instead. Mallett said that he was late because of traffic.
O'Brien said he and general manager Rick Smith are handling the situation internally unspecified "options" were being discussed.
"So 48 hours after he missed the flight you still haven't decided what to do yet?" a reporter asked the coach.
"Right," O'Brien said.
Brian Hoyer and Mallett are Houston's only two quarterbacks on the active roster with Tom Savage on injured reserve. A fourth quarterback, Zac Dysert, is on the practice squad.
With Foster out the Texans (2-5) will look to Chris Polk, Jonathan Grimes and Alfred Blue to try and keep the running game afloat. Blue started the three games that Foster missed this year and leads the team with 234 yards rushing. Most of those yards came in a win over Tampa Bay in Week 3 when he ran for 139 yards and a touchdown.
Polk has 138 yards rushing and Grimes has added 54. O'Brien was asked how the three running backs have performed so far.
"I think it's been decent," he said. "When you're 2-5 I don't think anybody's performed great (but) I think that those guys have shown some flashes."
Grimes said it will take all of them to make up for Foster's absence as they prepare to host Tennessee (1-5) on Sunday.
"It's the same mode," he said. "Everybody's just got to step up and get better."


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Il distretto di Hojai è un distretto dello stato dell'Assam in India. Il suo capoluogo è Hojai.

È stato costituito a partire dal 15 agosto 2015 scorporando parte del territorio del distretto di Nagaon.

Hojai

redpajama_set_name: RedPajamaWikipedia


Star Wars Ultimate Playing Cards Pack: Set of 3 decks (Classic Trilogy Villains, The Last Jedi (The Resistance v. First Order) and Star Wars Rebels).
These Star Wars playing cards feature visuals of the classic and new films.
Star Wars The Last Jedi features Rey, Kylo Ren, Stormtroopers and other characters from Episode VII and Episode VIII.
The Classic Trilogy Villains playing cards deck showcases movie moments and concept artwork of the most feared villains in the Star Wars saga including Darth Vader, Boba Fett and more.The Star Wars Rebels playing cards deck features favorite characters from the animated series.
Perfect as Star Wars party favors and party supplies. A great gift for any Star Wars fan. Officially licensed Star Wars merchandise.
Star Wars Ultimate Playing Cards Pack: Set of 3 decks (Classic Trilogy Villains, The Last Jedi (The Resistance v. First Order) and Star Wars Rebels). These Star Wars playing cards feature visuals of the classic and new films. Star Wars The Last Jedi features Rey, Kylo Ren, Stormtroopers and other characters from Episode VII and Episode VIII. The Classic Trilogy Villains playing cards deck showcases movie moments and concept artwork of the most feared villains in the Star Wars saga including Darth Vader, Boba Fett and more.The Star Wars Rebels playing cards deck features favorite characters from the animated series. Perfect as Star Wars party favors and party supplies. A great gift for any Star Wars fan. Officially licensed Star Wars merchandise.
1767 Features: -Playingcards. -Pokersizedcards. -charactersfromstarwarsepisodeIVtrilogyincludingepisodeIV,Anewhuope,episodeV,TheempirestrikesbackandepisodeVI,returnofthejedi. -Made in the USA. Product Type: -Traditional Playing Cards. Gender: -Boy/Girl. Dimensions: Overall Height - Top to Bottom: -3.5 Inches. Overall Width - Side to Side: -2.5 Inches. Overall Depth - Front to Back: -0.5 Inches. Overall Product Weight: -0.2 Pounds.
Each Star Wars Playing Card in the deck has a different image of a hero from all six Star Wars films, making them fantastic for any Star Wars collector or regular card player. And if you're searching the universe for the most impressive price, you'll see these really pack the most powerful deal.
Set of 3 decks of Star Wars movie playing cards: Star Wars Heroes, Star Wars Villains, and Star Wars Prequel.
Star Wars Classic Heroes playing card deck features images from the first six Episodes including Episode IV: A New Hope, Episode V: The Empire Strikes Back, and Episode VI: Return of the Jedi. Each card features a different image; for a total of 54 unique images! Includes Yoda, Luke Skywalker, Han Solo and more.
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Three individually packaged standard sized decks. Each deck includes 52 cards plus 2 Wild cards. Air cushion finish. High quality, durable and long lasting cards.Star Wars Playing Cards make a great gift for any Star Wars fan!
Set of 3 decks of Star Wars movie playing cards: Star Wars Heroes, Star Wars Villains, and Star Wars Prequel. Star Wars Classic Heroes playing card deck features images from the first six Episodes including Episode IV: A New Hope, Episode V: The Empire Strikes Back, and Episode VI: Return of the Jedi. Includes Yoda, Luke Skywalker, Han Solo and more. The Star Wars Villains deck features Darth Vader, Bobafett, Jabba the Hut and other classic villains. Star Wars Prequel playing cards tell the story of the most iconic character from the Star Wars saga. Three individually packaged standard sized decks. Each deck includes 52 cards plus 2 Wild cards. Air cushion finish. High quality, durable and long lasting cards.Star Wars Playing Cards make a great gift for any Star Wars fan! Also great as Star Wars Christmas stocking stuffers.
Different image of the classic iconic bounty hunter on every card; Great for simply playing supplies card games, collecting memorabilia & kids party favors; Makes for an excellent birthday present or stocking stuffer!
Each Boba Fett Playing Card in the deck has a different image of the Mandalorian warrior, making them fantastic for any Star Wars collector, or regular card player. And if you're hunting for a most impressive price, you'll see these really pack a deal.
Includes 7 Decks and 5 Dice!
Check out the other Star Wars items from Cartamundi!
Star Wars Playing Card Collector's Set includes a total of SEVEN decks of playing cards plus FIVE dice! Decks 1 through 6 feature movie stills from the first six films in the Star Wars saga. Deck 7 comes in a collectible tin and features heroes and villains from "Star Wars: The Force Awakens".
Star Wars Saga Double Deck Playing Cards in Tin. Celebrate the first six installments of the Star Wars Trilogy with this amazing double playing card collection. The character jump out of the embossed tin and the colors and details in both the tin and card decks inside are remarkable! 2 decks inside!
Double deck set of quality plastic coated playing cards with deck box tin case; Full color film photos and illustrated images; Traditional suits for bridge, poker, gin, more. Perfect cool present for kids both boys and girls as well as teens / teenagers.
Fun for card games, collectors, children & adults; Licensed by Lucasfilm, Disney; made by Cartamundi. Great for simple card games. Collecting memorabilia & child / kids party favors; Makes for an excellent birthday present, Star Wars gift, Star Wars party supplies, party favors for kids or stocking stuffer.
At parties or get-togethers, geek out with games from a distant galaxy, or enjoy a stellar round of gin rummy. One deck sweeps you away into epic conflicts from across the Star Wars universe, and the other brings knowledge of blasters, lightsabers and more.
Comes in an exclusive Stormtrooper helmet container!
"Star Wars: The Force Awakens" Villains playing cards come in an exclusive Stormtrooper helmet container. The cards feature the Stormtroopers who enforce the will of the First Order as well as their commander, Kylo Ren, a dark warrior strong with the Force.
This is the first-ever deck of Star Wars playing cards to feature 3-D lenticular artwork on the card faces. Rotate each card and watch the image change right before your eyes. The deck features 27 of your favorite characters from the star Wars Saga. These 3-D lenticular cards are created on extra durable, plastic card stock that is virtually indestructible. The cards come in a collectible embossed tin that features the star Wars logo.
By our suggestions above, we hope that you can found the best playing cards star wars for you. Please don't forget to share your experience by comment in this post. Thank you!
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