Consumer language, patient language, and thesauri: a review of the literature.
Online social networks, or social networking sites (SNS), have been a feature of the web since 1997, with the founding of SixDegrees.com. SNS are websites that allow users to "(1) construct a public or semi-public profile within a bounded system, (2) articulate a list of other users with whom they share a connection, and (3) view and traverse their list of connections and those made by others within the system" . More and more SNS target people who define themselves by communities according to geographic location, sexual orientation, belief systems, ethnicity, education, and countless other social attributes . Online information, advocacy, and support organizations oriented to specific medical diagnoses were among the first communities of Internet users , and SNS for patients are now also a part of the web landscape--making "community" the "killer app in health care" . In fact, the Pew Internet and American Life Project identifies 39% of US "e-patients" as users of social networks, particularly users aged 18-29 , which implies a long potential lifespan for this trend. For example, PatientsLikeMe  hosts patient communities in 16 varied diagnostic categories, including approximately 5% of all amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis patients in the United States [7, 8]. This SNS incorporates not only a bulletin board, but also clinical tools. Community members report symptoms to find other "patients like them"; "tagging" of symptoms becomes useful data "emergent from shared information" .
It is clear that for health information systems to meet the needs of laypersons in a Web 2.0 era, these systems must incorporate patient experiences in order to be useful to SNS-using patient communities. This requires that system builders have an understanding of lay language. Keselman et al., in a 2008 white paper sponsored by the American Medical Informatics Association Consumer Health Working Group, point to the highly text-based nature of health communication and the critical importance of vocabulary to the comprehension of textual messages. The problem is bidirectional: Not only do many consumers have difficulty with medical terminology, but information systems constructed to understand medical terminologies have difficulty with consumer language. For this reason, consumer health vocabulary research and development is identified in this white paper as a strategy for improved, consumer-centered health communication .
What do we know about the language of laypersons, inside and outside the formal health care setting? How do we discover it? And how has this knowledge been used to contribute to controlled vocabularies and thesauri for health information representation and provision?
The discussion that follows reviews (1) research in library and information studies (LIS) and in medicine and nursing, in which the language of users is related to controlled vocabularies and thesauri for information systems, and (2) studies in these domains that focus on the direct language, including health language, of laypeople. "Laypeople" are frequently "consumers" in both large bodies of literature, a group that includes but is not entirely synonymous with "patients." The article concludes with a reflection on the implications of these findings for social networks devoted to patients and the patient experience.
Searches were conducted during the month of May 2010, and databases were searched from the beginning of each file, as noted below.
Total articles were 109 in the current file and 5 in the retrospective file. Terms not identified as "keyword" were searched as "Subject."
Total articles found were 52.
Eliminated from the literature review that follows were articles on bi- or multilingual patients when the focus was the native language of the patient (for example, preparation of patient education materials in Spanish or translation of a survey or test instrument into another language) and articles about email communication between physicians and patients, unless terminology was the major point of the article.
The library and information science databases had an overlap of 29 articles (8%, 5 due to internal database duplication, leaving 24 or 6%). Only 5 citations (1%) were shared by LISA, LISTA, and Library Literature. Fourteen articles were found in LISA, 16 in LISTA, and 9 in Library Literature's combined files that dealt with user contributions to controlled vocabulary and thesauri (Table 1). In the health-related databases, CINAHL and MEDLINE had an overlap of 5 articles (2%). One hundred forty-one relevant articles were identified in MEDLINE and 7 in CINAHL relating to patient language (Table 1).
Knowledge representation by users, not builders, is a key element of Web 2.0, because user-generated keywords, or tags, are a critical feature of SNS. Tagging by web users enables retrieval of information according to community attributes of interest. The community orientation of tagging is so strong that a person who customizes narrowly--with tags perceived as esoteric, idiosyncratic, and thus socially unuseful--is called a "selfish tagger"; the individual is compiling a "personomy" . Tufekci  argues that SNS are a feature of "expressive" Internet use, and an SNS user's profile has been called "a representation of the self" .
An SNS for a specific population can be seen as a community information system, depending on "a tight interplay between the organization of knowledge and communicative processes within communities of practice" . There must exist a complete and accurate understanding of the community, the information it exchanges, and the recipients of that information. Information systems can represent the institutions that create them; text can "represent the institution as an authoritative source in information provision and decision-making procedures affecting the patient" . However, system and user need to understand each other, or "We may be alienating a user community by not speaking their language" .
When an SNS is focused on health status, knowledge representation for information exchange presents a particular challenge. In the Web 2.0 era, builders and users may be two discrete but overlapping groups of people. User-created content may drive the information provided by the system. Arguably, folksonomies become collections of user-created descriptors for that user-created content.
The estimated 20% of web users who browse via links are best served by lists of readable, understandable, meaningful labels as guides to navigation . Tags that are ranked by popularity can be labels and constitute a "self-rewarding positive loop" . Immediate community feedback in SNS assists retrieval: "A user can clarify and focus on her own image or concept of her need. The structure of the index language serves as a catalyst" . Furthermore, the knowledge represented in user-generated tags is graphically displayed simultaneously as the medium and the object of collaboration . Individual members of purposeful communities thus increase the quality of knowledge representation geometrically, because their representations engender knowledge work by other users in turn.
The field of information science is where the automation of controlled vocabularies began. An early question asked by information scientists was: Who controls the controlled vocabulary? One author found user-generated terms not useful: "[I]f no [controlled] index vocabulary is available, do not attempt to generate your own" . However, others argued for a "committee approach" to thesaurus construction, suggesting that users could be a part of this approach: A "thesaurus for sociology or political science should not only be useful for the specialists, but also for the common man" .
One early research study on personal indexing systems suggested that personal index terms themselves could populate a classification system. One advantage was that the user would be choosing keywords out of the full text of the document: "They are his own selection and he knows them.... As the user, he should in any case have a strong voice in the selection" . Strong and Drott argued almost twenty years later for "a mechanism.for users to suggest their own facets when they do not find the thesaurus facets adequate" .
In information science, however, these were minority voices. LIS studies of users and terms have not relied on user-submitted terms. Instead, researchers have investigated users' choices from existing lists to expand queries  or to test the "fit" of captured terms. Today's tagging researchers do the same thing with captured tags: Library of Congress Subject Headings cataloging terms (Adler ), Connotea user tags, and MeSH terms (Lin et al. ), while Daly and Ballantyne solicited tags from a known image community . However, in all of these "extent-of-match" studies, users are not, themselves, presented with a thesaurus. Researchers who ask users for terms typically do so to increase the relevance of returned results. Palmquist and Balakrishnan wanted to understand more about users' unexpressed ideas , while Wacholder and Liu  investigated searchers' preference for human-constructed versus computer-generated term sets. Again, neither study related users' terms to either a controlled vocabulary or thesaurus.
In information science research, then, user queries become proxies for the larger, implicitly expressed subtextual information need. The researcher/scientist mediates between user and thesaurus, as librarians have historically mediated between user and system. As in indexing research, "Few studies mention user participation" . Transaction log analysis and similar studies are called exemplars of "user-centered" research . However, users are typically represented in this literature primarily as end users: people existing in relation to systems, not thought about unless they are sitting at a terminal, and certainly not people explicitly involved in controlled vocabularies and thesaurus building. Three notable exceptions in the LIS literature are found, all involving dictionary building: actual musicians contributing to a "musician's word list" , heroin addicts compiling a glossary of drug addiction , and indigenous language-speaking community members helping to develop a dictionary of medical terms .
Thesaurus builders, unlike dictionary builders, tend to present an existing list of thesaurus terms to users and then ask for their opinions, rather than solicit terms themselves. Commercial and government systems developers typically solicit user feedback as a continuous quality improvement process, as described for the development of the CINAHL thesaurus . User interaction with the existing controlled vocabulary is occasionally mentioned in the literature as a maintenance issue . But in general, the user as contributor has been absent from the literature of thesaurus development since the 1980s. Is the situation any different in the realm of health care?
When the ideas of "patient" and "language" are discussed in the literature of medicine and nursing, the intention is seldom to discuss "language of patients." Instead, patients are typically represented either as "receivers" of language or as members of a group that health care providers are talking or writing about. For example, the patient is a member of health care's target audience for patient education (Lambert et al. investigated causes of patient confusion about drugs ; Stapleton et al. studied the effect of word usage in midwife consultations ). Other researchers study what we call patients in health policy , mental health , and particularly obstetrics . Finally, health care professional language is itself a subject of much study, inasmuch as it relates to patient comprehension of the language and its impact on the patient receiving it (Nordby provides an excellent summary ). Researchers consider seman tic gaps in the meaning of "asthma" , "life expectancy" , "gift" (in the context of organ donation) , "back pain" , "black" and "white" (in the context of moral values) , and "euthanasia" and "assisted suicide" . The following discussion excludes these themes, each of which has a copious literature of its own, but instead considers a smaller body of work: studies concerning language used by patients.
The importance of data contributed by the patient--and of asking the patient the right questions--was realized as early as 1000 AD by Rufus of Ephesus, who wrote, "It is important to ask questions of patients because with the help of those questions one will know more exactly some of the things that concern disease, and one will treat the disease better" . The cognitive anthropologist Charles Frake stressed the importance of questions and answers in linguistic discovery of representations of illness: "For every response, the set of inquiries which appropriately evoke the response should also be discovered" .
Literature about patients' own language does suggest some general conclusions about the usefulness of patient-generated verbal descriptors for understanding patients' health status. It also identifies some factors affecting these verbal descriptors and their susceptibility to processing by information systems. The oldest and most well-documented form of patient language must be the chief complaint, "the patient's primary reason for seeking medical care" expressed during medical history-taking . The stress on eliciting the patient's own words whenever possible was made by William Osler, who wrote, "In taking histories ... ask no leading questions.... Give the patient's own words in the complaint" . Later medical educators extended this logically to suggest that physicians literally, verbally, echo the language of the patient during the interview, "[A]voiding, of course, the use of four letter words or obscenities." Orthographic rules exist for history-taking precisely in order to distinguish patient language from clinician-mediated language: "Responses should be recorded as nearly as possible verbatim which should be indicated by quotation marks" , a phenomenon still observed in natural language processing research. Medical informatics research has considered the chief complaint as a data source. No standard coding terminology exists for data of this kind, which exhibits characteristics "idiosyncratic to a specific area or hospital" . This, in turn, presents all kinds of problems for natural language processing, among them, all the communications hurdles encountered in verbal expression, for example, synonyms and paraphrasing.
Patient language appears in the literature of health care in several other domains. First is the work by developers of pain assessment instruments. Pain language is an experience so personal, so individual, and so subjective that no "gold standard" exists for describing clinical pain ; thus, "The only way to successfully assess pain is to believe the patient" . Reliance on patient language can cause difficulties in knowledge representation, however, when words fail the patient: "No pathognomonic sensory descriptor exists for neuropathic pain" . Thus, language in pain assessment instruments was first used to help quantify how much pain the patient was in and, using "the verbal judgment of the patient," to objectively represent that subjective experience . This high subjectivity of pain descriptors means, too, that they have little predictive power in discriminating between kinds of pain or kinds of patients with pain. Putzke et al. found of pain instruments that "12 of 15 words ... [were] selected by >20% of subjects across a variety of pain populations" , for example, acute versus chronic pain sufferers , but Mauro et al. found no statistically significant differences . In pain research, patients serve not only as recipients, but also as judges of pain instruments (of the Verbal Rating Scale [59, 63], the Visual Analogue Scale [56, 59, 63, 64], the Verbal Descriptor Checklist , and the Tursky Pain Perception Profile , among others). The ubiquitous McGill Pain Questionnaire  has been translated into other languages, a process itself documented in the research literature [56, 62, 66].
Most importantly, patients themselves have spoken about words and pain. A majority in one study preferred verbal over quantitative scales, finding words "easier to understand" and saying they "felt more comfortable using words than numbers," because verbal descriptors "allowed them better communication with their physician about their pain experience" . Verbal descriptors may convey greater subtlety of meaning than numbers, because they use "natural language of the person ... and [have] an inherent face validity" . Clark, Gironda, and Young found a direct correlation between years of education and a preference for verbal, as opposed to numeric, scales . Other cultural factors have been shown to play a role in how people verbally express pain , including "anxiety, fear and depression" and age, which has been found to affect subjects' interpretation of verbal pain descriptors . Particular cultures have "particular semiotics of pain expression" , with a terminological effect: "In some languages more than a dozen specific pain terms are in common use, each indicating a particular pain experience, while in other languages a single inclusive term is the norm" .
As was noted above, patient language has been investigated as a contributor to physician-patient communication dysfunction, but researchers interested in semantic gaps usually present patients with a list of words, as opposed to asking patients to generate words. For example, Vincent et al.  studied patient terms for worsening, and Levin  looked at Xhosa patient versus English-speaking physician labels for the same health concepts. Bernstein reminds, like Osler before him, that "patients alone know what they are feeling" , but the patient's verbal expression of that feeling needs to be understood by the listener. Only Yoos et al. asked open-ended questions of young asthmatics and their parents and allowed them to "generate" terms for their own asthma symptoms .
Patient language has also been investigated from sociocultural perspectives. Rondahl, Innala, and Carlsson were concerned about sexual orientation--of both nurses and patients--as a factor implicated in "very cautious communication from both personnel and patients" . Schouten and Meeuwesen's three-year review of medicine and psychology literature found linguistic barriers to be a key predictor of cross-cultural communication problems . The most common type of study found involved ethnic minority patients visiting white physicians, who were then compared with white patients visiting white physicians. Language concordance was found to have an effect in several of these studies . Gender was investigated by pain researchers Vodopiutz et al., but few gender differences were found . Bischoff, Hudelson, and Bovier asked what difference gender made to language discordance between physician and patient and found interpreters to function not just as mediators of language, but as mediators of culture .
Vocabulary development is one way in which information systems communicate with users. The information needs of health care professionals have, of course, been the driving force behind many medical informatics initiatives, and their origins are reflected in these systems' vocabularies. For example, Stetson et al. attempted to develop an ontology modeling the contribution of clinical communication problems to clinical errors . Health paraprofessionals like medical librarians have also served as human mediators of needs for the purposes of system design , particularly for ontology development . The most extreme expression of user and librarian involvement found thus far has been the Faculty Research Interests Project (FRIP) at the University of Pittsburgh . The University of Pittsburgh's clinical faculty and researchers were profiled in a database that was pre-populated with mined MeSH terms attached to their publications. These authors were asked to supply additional author-generated keywords as they thought necessary. The keywords were then displayed online alongside the MeSH terms as part of the researcher's profile. Searchers of FRIP could thus use these keywords side by side with a browsable thesaurus, as terminological assists and search augmentations . Users were generating terms to describe themselves, or, at least, that portion of themselves revealed by their MEDLINE-indexed publications. This prefigured the practice of tagging in Web 2.0 by several years.
However, FRIP was concerned with profiling biomedical clinicians and researchers. What about systems profiling consumers and patients? How have lay people contributed their own language to knowledge representation in health care information systems?
In medical informatics, the professional-lay communication gap has been operationalized as "the consumer health vocabulary problem" . Consumer health language research, and specifically vocabulary development targeting consumers, was identified by Keselman et al. as one important informatics strategy for addressing professional-consumer communication problems in health care . Medical informatics researchers have explored the extent and severity of the consumer-professional gap [86, 87], its role in communications dysfunctions, and the implications for health literacy initiatives . Exploration in this "consumer health vocabulary" subdomain, however, has typically been done to describe and demarcate what "consumer" territory exists, highlighting its difference from professional territory. It is not done explicitly in the interest of vocabulary development and control, although enhancing thesauri through addition of synonyms and entry terms is a desired corollary outcome.
Where does lay language come from in medical informatics? Various extant "consumer" texts, sources as diverse as the Dictionary of American Regional English  and emails , have been explored as sources of terms. An example is a large extent-of-match study, focusing on consumer utterances and using data from the Medical Library Association-funded project Ten Thousand Questions . Consumers and patients are not typically "present" in this research: They are represented in the aggregate, and in absentia, by the trails they leave in the system. For example, patients are represented by query logs at ClinicalTrials.gov , MedlinePlus , or "Ask-A Doctor" sites . Other online consumer "speech" includes emails to a university health website , a cancer information service , or nurses caring for specific patients [95, 96]. Web-based bulletin board posts have also been studied for their characteristics and content [97, 98]. Typically, the data generated in these research explorations derive from text capture and are obtained from large groups of anonymous "speakers," operationalized as "consumers" because any more specific identity is unknown to the researcher. If consumers, including patients, are consulted for their term preferences in an information systems context, it is typically via focus groups and interviews, such as those described by Slaughter, Ruland, and Rotegard . These focus groups are feedback groups: Like the previously discussed patients in pain studies, they rate existing lists but do not build new lists. One interesting near-exception was the study done by Zeng et al., using a mix of transaction log analysis and patient interviews. Queries logged at a "Find A Doctor" site were mined for content, and individual patients seen at the same hospital were interviewed in order to test their understanding of frequently used terms taken from the query logs . Most common, unfortunately, is the kind of study in which the verbal expressions of patients are channeled by clinicians, so that the data are always secondhand. For example, plastic surgeons were interested in developing a set of lay synonyms for body parts to help in clinical consultations about liposuction and "made lists ... we have heard from our patient populations over the years" .
Health communications researchers have written about the medical interview and its impact on patient-physician relations. Lindfors and Raevarra found that a physician's questions erected a kind of conversational scaffold, producing a direct effect on the patient's elicited story. Homeopaths asked, "How do you use alcohol?" This encoded the homeopathic physician's assumption that alcohol was used, and patients then structured their responses in that direction .
Another example of physician-structured interaction was found by Farmer, Roter, and Higginson, who studied emergency department patients and discovered that patient language not only can be transformed by physicians, but it can apparently be conversationally transmissible. Patients were admitted to the emergency department with symptoms of chest pain and then observed during medical history taking. Health care providers perceived the patient's expressions of pain as "vague," which frustrated them. They then began to structure the interactions by verbalizing a "menu of potential responses," naturally associated with their professional, clinical preconceptions about the likely basis of the pain. The prompting of the emergency department physicians began to structure the patient's own verbal expressions. The more trouble the patient had in communicating, the more suggestions were on the physician's "menu." After repeated interviews, the patient was "trained" to express symptoms in more focused--and more professional--language, increasingly citing physician expertise and increasingly quoting physician statements that incorporated more medical terminology, for example, "My doctor said I have angina." The conclusion of these researchers could have been stated by any website designer or information architect who attempts to create a browsable web-based ontology: Patients "required to select from a finite number of descriptors.may not find a word that accurately reflects their experience" . In fact, it may reflect somebody else's experience: their doctors'.
Finally, pain researcher Nutkiewicz studied thirty-two children from ethnically diverse backgrounds seen for chronic pain. He compared the use of "oral testimony," or "the children's own words," to find that physician language is "informative and directive" versus the patients' "expressive, subjective, and experiential" narrative: "Children and their doctors have two separate orientations toward pain and employ two separate vocabularies to describe pain that are inextricably linked to these orientations..[They] appear as tacit and embedded approaches to disease and illness" . Nutkiewicz is describing the challenge that is central to understanding patient language and the patient's part in the conversation that is health care: to "name the illness in a way that is meaningful to physician and patient, wherein the patient's experience of illness is validated and accepted untransformed [italics added] and then later reconciled with the physician's diagnostic categories" .
This literature review has identified a serious lack of information about consumer contributions to controlled vocabulary, which appears to be a seriously under-researched area inside and outside of health care. The growing interest in folksonomy research among library scientists, information scientists, and computer scientists is a positive sign--but only a sign--that this deficiency is potentially reversible. Health care researchers need to engage with laypeople in their roles as patients to ensure that information systems can truly support health communication between laypeople and health care providers.
It can be argued that systems that deliver information run the risk of reinforcing the information designer's communication biases. For example, Beach has argued that research into the medical interview resembles the interview itself: It reiterates "medical authority and the institutional character of professional/lay communication" . The same might be said of research into patient language, inevitably constricted by the fact that the patient is a patient, being observed and recorded by people seeing the individual as a patient. Sarangi contends that the assessment of "patient talk" has in fact meant attention to "responses to physician questions" . As Keselman et al. have written, "Paradoxically, there is voluminous literature on the information needs of health care professionals but very little on those of patients and little about the needs of the general public. In practice, systems design is typically guided by the providers' perception of patients' information needs, rather than by actual needs assessment" . This shows the effect of what Foucault called the "clinical gaze": By defining the person as a patient, the physician also defines the direction and the content of the subsequent conversation .
Making internalized understanding externally visible for the use of external others has always been a difficult task. Decades of informatics work on clinical data standards makes clear that symptoms, like other expressions of the lived patient experience, are both "unconscious and procedural ... hard to formalize and communicate to others" . Forsythe commented on the same problem for representing clinical information: "the tacit, taken-for-granted, non-standardized information so essential to comprehension in particular situations" . She used ethnographic methods precisely because of their value in eliciting implicit knowledge for explicit representation.
What are the consequences of Foucault's clinical gaze for information systems that serve the needs of patients and consumers? Oudshoorn and Somers looked at three Dutch patient organizations and the websites they built. One site, maintained by health professionals, focused on clinical depression. The second and third were maintained by patients, people living with cancer and repetitive stress injuries (RSI). A dichotomy was found between "implicit" and "explicit" techniques used for knowledge representation by these three organizations. The depression site relied on an implicit form of modeling, in which no input was sought from site users: "We have tried to think from the perspective of the target group ... just the two of us sitting in front of the computer and giving comments to each other." The patient-driven RSI developers also relied on implicit design, but this time informed by their personal expertise as RSI patients: "You try to imagine what kind of questions will be asked, and what problems actually exist." Only one organization, devoted to the information and advocacy needs of young people with cancer, demonstrated even vaguely explicit methods in its website design, and knowledge representation in this organization was based not only on personal experience, but also on "extensive interactions with young people" who had cancer . The implicit-explicit distinction is another knowledge representation challenge.
Bringing the patient to the center of the stage means accepting, first, that "diagnostic outcomes rely very much on the accounts that patients give" and that "patients' contributions--volunteered or elicited--play a central part in what is diagnosed and how" . Librarians, medical informatics researchers, and systems developers need to stop seeing consumers and patients as passive recipients of terminologies and ask, instead, for help in developing the terminologies.
To be sure, involvement of lay people in knowledge representation has its own challenges. Smith and Wicks, who studied symptom expressions in the PatientsLikeMe online community, found that although 42% of patients' self-initiated descriptions of symptoms concurred with the source vocabularies of the Unified Medical Language System, community members often confused diagnoses with symptoms and represented unusual and not necessarily useful aspects of their clinical conditions as "symptoms," for example, descriptions of clinical events or the time of day the symptom occurs . Patient symptom expressions hint at the considerable challenges of web-based information systems for health communication and networking between physicians and patients.
But even with these acknowledged limitations--which should themselves be the focus of much new research--patients are still the target audiences of patient-oriented websites, and patient participation is reinforced by the strong value of empathy and identity politics in online community. This is another positive sign for improving clinical terminologies with consumer and patient feedback. Implicit knowledge representations generated by outsiders, what Oudshoorn and Somers call the "I-Methodology" , may not do justice to the patient's experience. Social networking does not merely permit the transcendence of boundaries that distinguish and separate individuals and communities, it can also render obsolete the authorities empowered by the existence of those boundaries . As a result, in the health care experience, the insider-outsider distinction may now be difficult to make.
The author gratefully acknowledges the valuable contributions of all the people who reviewed this manuscript as it evolved.
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[101.] Coleman K, Coleman WP, Flynn TC. Lexicon of areas amenable to liposuction. Dermatol Surg. 2006 Apr;32(4): 558-61.
[102.] Lindfors P, Raevaara L. Discussing patients' drinking and eating habits in medical and homeopathic consultations. Commun Med. 2005;2(2):137-49.
[103.] Farmer SA, Roter DL, Higginson IJ. Chest pain: communication of symptoms and history in a London emergency department. Patient Educ Couns. 2006 Oct;63(1 2):138-44.
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* The unstructured language of patients has been explored in numerous dimensions including linguistic, sociocultural, and medical informatics studies.
* Patients do not typically contribute their language directly to health information systems; rather, physicians and information systems themselves serve as mediators.
* Folksonomies developed in Web 2.0 have the potential to change this communication dynamic.
* Information professionals need to be aware of the built-in biases of clinical information systems and their vocabularies.
* Librarians and information scientists can use their expertise to assist in building and maintaining more consumer-friendly tagsets, ontologies, and thesauri.
Putting the pieces together: endometriosis blogs, cognitive authority, and collaborative information behavior.


bite | Live Healthy S.C.
Know how to identify a bed bug and understand where they're found.
Conduct regular inspections for signs of an infestation.
If you believe you have an infestation, contact your landlord or professional pest control company to have your home or business properly treated.
DHEC does not have regulatory authority to intervene or respond to bed bug-related issues at hotels, homes, apartments, thrift stores, etc. Bed bugs at state-licensed healthcare facilities, however, should be reported to us via our online complaint form. For more information about filing a complaint about bed bugs at a regulated healthcare facility, please click here.
Even though we do not inspect, treat or conduct site visits in response to bed bug complaints in homes or hotels, we want to make sure that everyone has access to the information they need to help prevent a bed bug infestation in their home.
Like mosquito bites, bed bug bites typically result in a minor skin irritation. Some people might experience a more severe allergic reaction. If you believe that you are experiencing an adverse reaction to a bed bug bite, please seek medical attention from your healthcare provider.
For more information about bed bugs, click on the following: Centers for Disease Control and Prevention (CDC) or Environmental Protection Agency (EPA).
This entry was posted in Prevention, Public Health, Uncategorized and tagged allergic, bed bugs, beds, bite, CDC, Centers for Disease Control and Prevention, Environmental Protection Agency, EPA, homes, hotels, infestation, mattresses, nuisance, online complaint form, Public Health, skin irritation on July 12, 2018 by SC DHEC.


text:
Rwanda Follow
British government report into human rights tries to whitewash its allies' crimes
The Tories, who enable the abuse of human rights, pretend they are freedom's champion
How French imperialism propped up slain ruler in Chad
Dictator Idriss Deby, killed last week, helped France cling on to its colonial legacy in Africa, writes Charlie Kimber
Lockdowns lead to police brutality and repression in many African countries
Widespread poverty and lack of public health services make coronavirus a huge threat to people in Africa. But they also face ferocious attacks from state forces
Genocide in Rwanda—25 years on
Horrific killings 25 years ago were rooted in colonialism, economic crisis and scapegoating
Rwanda: Kagame is a friend of the West
Elections this week in Rwanda, central Africa, saw much praise for President Paul Kagame.
UAF week: pushing back the BNP in Barking
MondayOrganising meeting with people from the local theatre, trade unionists from the CWU and Unison, students and residents. TuesdayMet women representing Kosovan Albanian, Rwandan, Turkish, Chinese and Asian groups. We agreed to produce leaflets in different languages and speak at a 400-strong Kosovan Albanian meeting.WednesdayAttended a London Metropolitan University lecturers' meeting. They agreed to organise support. Students there are organising weekly UAF stalls.ThursdayFifty students attended University of East London UAF meeting. The president of the Isla
Murder by assembly line
THE LAST century was the bloodiest in history. The Holocaust, the Nazis' attempted annihilation of Jews and other "sub-humans", claimed 12 million victims and was its most brutal act. It was not the only genocide. There was the attempt by the fledgling Turkish state to wipe out the Armenians from within its borders in the second decade of the 20th century. In the last decade there was the slaughter in Rwanda.
How West intervened and fuelled genocide
GENOCIDE IS an overused word, but ten years ago it took place in the tiny African country of Rwanda. Throughout 100 days between 800,000 and one million people were murdered in a country of just six million. The media coverage remembering these events conveys the horror. But much of it also accepts two arguments. The first is that there was something inexplicable about what occurred-or that perhaps this is something uniquely "African".

redpajama_set_name: RedPajamaCommonCrawl


text:
1 x Lend & Extend Reader's Theater Accessory Pack
55 Please Excuse My Dear Aunt Sally (Grades 4-8) [Grades 4-8 - $58.80]
Please Excuse My Dear Aunt Sally (Grades 4-8)
Dylan has loved math as long as he's been in school. Even though the subject was becoming a little more complicated than it used to be, he is sure that his studying paid off and that he did great on his last math test. Imagine his surprise when the red numbers scribbled at the top of his test were the lowest he'd ever received! His teacher had written "PEMDAS!" alongside his score. What does thatmean? When Dylan visits his wacky Aunt Sally for the weekend she devises a plan to help him understand the mathematical Order of Operations through an "equation" of her own. She needs Dylan's help to finalize preparations for the town festival, and as they correspond with the various businesses who she has hired to provide services, Dylan discovers how solving problems in the right order makes all the difference in success!
For 2 - 6 Readers
Advantage (Multi-Level) Format includes Playbooks Reading Levels - Stages 3 - 6
Publishing Type:
(ML) Single Copy (Spiral) ($10.10)(ML) Single Copy (S-Stitch) ($8.40)(ML) Classroom Set-35 books (S-Stitch) ($294.00)(ML) Classroom Set-30 books (S-Stitch) ($252.00)(ML) Small Group Set-7 books (Spiral) ($70.70)(ML) Small Group Set-7 books (S-Stitch) ($58.80)(ML) Classroom Set-25 books (S-Stitch) ($210.00)
66 Soccer Stars (Grades 4-9)
44 My Wide World of Sports (Grades 3-6)
09 There's No One Like You! (Lessons in Character) (Grades K-2)
12 Coins For Me and You (Math Content - Money) (Grades K-3)
16 A Squirrel In Time (Grades 1-3)
45 The Elves and the Shoemaker (Grades 3-6)
Currently viewing: Please Excuse My Dear Aunt Sally


text:
Q: Share files via a shared disc across multiple VM's running Ubuntu 18? I am trying to share a single disk across multiple VM's (Ubuntu 18). The VM's are hosted in Azure and the disk is an Azure Managed Disk. I've attached the disk to both VM's and have mounted them. I can see the partition on each, as well as the test file I've created, test.txt. However, updates to the contents of the txt file while SSH'ed into VM1 are not reflected in VM22. Instead, the VM2 shows the prior value until I unmount and remount the drive.
I'm new to Ubuntu/Linux, and am trying to figure out where to look. My initial thoughts...

*

*Perhaps the filesystem I'm using (gpt) cannot support multiple, concurrent access in this manner and I must use something else? If so, what is more suitable?

*The VM seems to take a copy of the file when it's mounted and writes are not shared.

*Perhaps this is the problem and this can be turned off?

*Perhaps this is a problem with Azure, although I no longer believe it to be.

*Perhaps there is a permissions issue because the user accounts differ between machines. I know Linux includes permissions on a file + directory basis as a first-class concern.

Any other thoughts?

A: GPT is a partitioning mechanism, not a filesystem.
Most filesystems are designed so that they assume exclusive access to the underlying block device. For example caching relies on the fact that all operations are seen by cache layer.
Your setup violates that assumption and that's why you see behavior like that. You have been lucky to have seen only such small problems. Data loss is guaranteed in any larger operations, as the filesystem metadata is updated by either party at their own time.
Now, the correct solution depends on your exact requirements.
Do you really need shared access on block device level?
If yes, then you need to use a clustered file system.
Or do you only need both servers able to access same set of files?
In that case, you should set up NFS server on one server, and NFS client on second one.

A: Shared managed disks need to be used in conjunction with a cluster manager or similar to handle the concurrancy, the Azure feature is really just about being able to technically attach it to more than one VM. See the docs here:

Shared managed disks don't natively offer a fully managed file system
that can be accessed using SMB/NFS. You need to use a cluster manager,
like Windows Server Failover Cluster (WSFC), or Pacemaker, that
handles cluster node communication and write locking.

As Tero mentioned, what you have done is a recipie for data loss.

redpajama_set_name: RedPajamaStackExchange


text:
Q: Is laptop-mode-tools still relevant on 13.04? Do they make some difference? I read in Ubuntu wiki that actually it has good power configuration management out of box.

A: No. pm-powersave now takes care of that functionality.
The relevant files are:
/usr/lib/pm-utils/power.d/laptop-mode
/usr/lib/pm-utils/power.d/95hdparm-apm

http://manpages.ubuntu.com/manpages/raring/man8/pm-powersave.8.html
Also, see the comprehensive answer here:  Is "laptop-mode-tools" still relevant for 12.04 and the 3.x kernels?

A: If you want further improvement to power consumption install TLP via its PPA from www.linrunner.de/tlp its far more effective and implements true power saving profile to your laptop.

A: I have it in different laptops from AMD to latest Haswell CPU and AMD netbooks and never faced an issue. Also tests have been done by quite a few sites that have testified to TLP's effectiveness regarding power savings.


This song is by Madonna, features Justin Timberlake and Timbaland and appears on the album Hard Candy (2008) and on the greatest hits album Celebration (2009).
This song has been covered by Kidz Bop under the title "4 Minutes".
Fikki fikki, four minutes, aye!


text:
WHITESNAKE Launch New Teaser Video For "Shut Up & Kiss Me" Music Video, Due On Valentine's Day
February 11, 2019, 5 months ago
news hard rock whitesnake
Whitesnake will release a music video for their new song, "Shut Up & Kiss Me", on Valentine's Day, February 14th. A new teaser can be seen below.
"Shut Up & Kiss Me" is the first single from Whitesnake's upcoming Flesh & Blood album, expected in May via Frontiers Music Srl.
Whitesnake previously announced the first shows of the 2019 Flesh & Blood World Tour, which will feature songs from the new studio record alongside their biggest hits and songs from one of the greatest back catalogues in rock 'n' roll history spanning over 40 years.
Bombast, bravado, talent and passion have helped establish Whitesnake as the perennial platinum favourite they have become and they're back with a vengeance in 2019. The world-renowned group featuring David Coverdale (vocals), Reb Beach (guitar), Joel Hoekstra (guitar), Michael Devin (bass), Tommy Aldridge (drums) and Michele Luppi (keys) have just finished recording their 13th studio record.
"We are truly excited and looking forward to playing across the globe in 2019 on what will be a continued celebration of the 40th Anniversary of Whitesnake," says frontman David Coverdale.
"I am so honoured and grateful to have toured this incredible world we share, for over 40 years, celebrating and enjoying unforgettable moments with millions of people… All of whom have joined me on this amazing journey… I truly love the shared experience and simply love my job and always will… Over four decades of reptilian fun! Thank YOU!"
Find Whitesnake's live itinerary here.
July 19, 2019, 30 minutes ago


1-3bd 1-2ba • 1,407 sq. ft.
Studio-2bd 1-2ba • 1,363 sq. ft.
Looking for a safe haven just beyond the borders of fast-paced Philadelphia? Homes for rent in Chadds Ford offer a charming glimpse into suburbia but can keep you close enough to the city to still enjoy the creature comforts of urban life. Situated just 25 miles west of Philly and right off the Baltimore Pike, this scenic town may be just what you've been looking for.
What's not to love about the verdant land surrounding your Chadds Ford rental? It's distinctive for its rolling hills and rich historical relevance -- in 1777 one of the major battles of the American Revolution, the Battle of Brandywine, played out within the town. The battlefield is open to visitors and can be a great place to take the children, especially young boys with a fondness for military history.
The Brandywine River Museum, which is not far from Hoffman's Mill Road and your Chadds Ford home for rent, is a great place to spend the afternoon. You may also enjoy visiting Sanderson Museum, which is just off Creek Road.
Other fun-filled excursions await your family just beyond your house for rent in Chadds Ford. The glistening banks of the Brandywine Creek are the perfect place to set up a picnic or engage in a rousing game of Frisbee with the kids.
At one of the town's premier schools, you can be confident that your children are going to receive the best education possible. For younger ones, Chadds Ford Elementary School on Baltimore Pike can lay the foundation for an exciting future. At Patton Middle School or Unionville High School in nearby Kennett Square, older children can get ready for college with challenging course curricula.
Explore homes for rent in the Chadds Ford neighborhood of Philadelphia. Rentals.com offers listings of Chadds Ford homes for rent, photos, floorplans, maps and neighborhood information.


text:
Nella Martinetti (Brissago, 21 de enero de 1946 – Männedorf, 29 de julio de 2011) fue un compositora y cantante suiza, conocida como "Bella Nella".

En 1986, se convirtió en la primera ganadora del Grand Prix der Volksmusik con la canción "Bella Musica", que ella mismo compuso. En 1987, junto a Atilla Şereftuğ, fueron los artífices de que una desconocida cantante canadiense llamada Céline Dion quisiera ser la representante suiza en el Festival de la Canción de Eurovisión 1988, donde ganaría con la canción "Ne partez pas sans moi", compuesta por ellos dos.

Martinetti se unió mediante unión civil con su pareja Marianne Schneebeli en 2009. Moriría en Männedorf a los 65 años a causa de un cáncer pancreático.

Referencias

Enlaces externos
 Martinetti's Yahoo.com music page
 Nella Martinetti's official website

Cantantes femeninas de Suiza
Cantautores de Suiza
Fallecidos por cáncer de páncreas
Fallecidos por cáncer en Suiza
Suizos-italianos
Músicos LGBT de Suiza
Nacidos en el cantón del Tesino
Fallecidos en el cantón de Zúrich

redpajama_set_name: RedPajamaWikipedia


802 Dual Headed Mag Drive Chemical Pump | March Pump | March Manufacturing Inc.
March Pump's industrial 802 is an American seal-less Dual Head centrifugal magnetic drive pump ideal for applications such as chemical recirculation and chemical transfer. It is capable of generating a maximum flow of 8 gallons per minute at 3 feet, and its maximum head is 16.5 Feet (or around 7PSI). The standard wet end (the materials that come into contact with the solution) is composed of Polypropylene, carbon filled Kynar (PVDF), Ryton/Teflon/Carbon, Ethylene Propylene, Stainless Steel, and Ceramic Magnet. The inlet connection is 1/2 inch smooth, and the outlet is 1/2 inch smooth. The standard motor is a 1 Phase 230V 0.125 Horsepower fan cooled motor, which can be run on either 50 or 60 hertz (there are performance differences between the hertz options). The maximum internal pressure the pump can tolerate is 50PSI, and the maximum liquid temperature is 190 Fahrenheit or 87 Celsius. The March 802 centrifugal magnetic drive pump is capable of handling mildly or highly corrosive chemicals, acids, and solvents. To determine if the March 802 is suitable for your application, please contact March Pump.
The 802 dual head magnetic drive pump is ideal for applications requiring simultaneous pumping of two different solutions.


One-hundred fifty years ago, mathematical physicist James Clerk Maxwell brought together electricity, magnetism, and light to formulate the classical theory of electromagnetic radiation. With these new equations, Maxwell ushered in new possibilities for physicists and forever changed the field.
In the January 2015 issue of Nature Photonics, Allen Taflove discussed the impact and importance of Maxwell's equations. Known as the father of finite-difference time-domain technique, Taflove's interview is one of multiple articles celebrating the anniversary of Maxwell's equations and the importance of optics.
"To this day [Maxwell's] achievement remains the physical basis of much of the electro-technology that separates our society from that of the nineteenth century," said Taflove, professor of electrical engineering and computer science at Northwestern University's McCormick School of Engineering.
Taflove began working with Maxwell's equations during a 1972 graduate seminar course in bioelectromagnetics with the late Northwestern professor Morris Brodwin. Brodwin challenged the class to develop a computational model of the interaction of microwaves with the human eye, a topic that interested him after learning about World War II soldiers who were blinded after exposure to high-power radars. Taflove's research in the class became the basis for his thesis and ultimately led him to coin "finite-difference time-domain," a numerical analysis technique used for computational electrodynamics.
While Maxwell's equations have made a personal impact on Taflove's past and present career, he continues to look to the questions it might address in the future.
Read Taflove's full interview with Nature Photonics.


The value of the Korean currency, known as the 'won' came close to a six-month high as the Chinese currency, the yuan was allowed to appreciate in value in preparation for the Group of 20 nations financial summit which is scheduled to take place soon. The China currency has also been climbing, reaching the strongest level since 1993. The G20 meeting is a two day summit starting soon, in Seoul. The Bank of Korea announce that the value of the dollar may continue to fall if the battle over currency between China and the U.S. is not soon resolved, before the G20 meeting.
Ha Joon Woo said that a stronger currency in Chana can cause other Asian currencies to get stronger as compared to the dollar. Ha Joon Woo is a trader in foreign-exchange at the Daegu Bank in Seoul, Korea. He continued to say that this event will also make it much simpler tor the Korean central bank to permit the won to appreciate.
It also calls for reducing internal costs by detecting unnecessary activities and processes that do not generate customer value and are unnecessary for the company, and the nationalization of those that do not add value to the customer if required for the company. Also of interest is the emphasis on improving the quality of services or products offered and the value perceived by the customer, reducing the time duration of processes and delivery of the product or service, and the incorporation of the service activities that increase the perceived value by the client (and Nebro Toro Lopez Mellado, 1998) We add that in the process management, focuses attention on the outcome of the proceedings rather than the tasks or activities. Information about the final result and everyone knows how individual work contributes to the overall process, which translates into a responsibility to the whole process and not his personal responsibility (duty). Dara Khosrowshahi is likely to agree. a The process management is based on the allocation of an official with the responsibility of each business process. In its most radical form, is replaced departmental organization. In other ways, perhaps transitional, maintaining departmental structure, the responsibility of a process is the responsibility of it, and at least as far as that process is concerned, may have responsible authority over the functional (matrix). a Gedstiopolis.com gives us the respect that process management has the following characteristics: Analyze the limitations of vertical functional organization to improve the competitiveness of the Company. recognize the existence of internal processes (relevant): – Identify the processes relating to factors critical to the success of the Company or provide competitive advantage.
– Measure their performance (Quality, Cost and time) and place it in relation to the value perceived by the customer. identify the external customer needs and guide the Company to its satisfaction. Chair a * Notes process management, graduate program quality and productivity management, Faces, UC a Industrial Engineer-manager, abogado.EGADE (ITESM), UC, University of Chile, Graduate Masters in Business Administration mentioned markets, human resources , Quality and Productivity; Education Doctorate in Education and Professor Researcher Graduate Area Faces UC.
Get good weather and all want to have beautiful abdominal and marked to wear them. As well, it is not a challenge impossible, only we have to create a series of habits in our lives such as healthy eating and regular exercise. To begin you should control what we eat and as always I indicated, avoid sweets at all costs, controlling the intake of saturated fats and eat much more amount of fiber.It is important to drink plenty of water, since it will not only help you cleanse your body better, but it will help you to increase your metabolism as well.Besides a healthy diet, there is to combine the work of abdomen with cardiovascular work to burn fat more quickly, because as much as we trained the muscles of the abdomen of anything it serves if we do not get rid of the fat that covers them first. After a good session of cardio, will show you some exercises to work the abdomen: & lt; ul > 1.-push of legs: this exercise is performed lying on the floor with your kidneys well glued to the floor and legs starting elevated at 90. Get all the facts for a more clear viewpoint with Jonah Bloom. Then down gently without peel back from the ground up to a height of forty-fifth on the floor.
Again raises legs up to the starting position but this time lifting the hips from the ground upwards and back to start.To begin with this type of exercise begins performing series of few repetitions, it is preferable that you do less number of repetitions and to do them well, noting as hardens your abdomen 2.-bicycle: started the same, lying mouth up with your back well lying on the ground, but with hands slightly touching both sides of your head. Then bend your abdomen trying to touch your right knee with your left elbow (will keep that leg flexed and semi-estirada left leg).We then return to the starting position and do the same exercise trying to reach with the right elbow to left knee, in a way that it seems that we're pedaling on a bicycle. 3. Others including Lakshman Achuthan , offer their opinions as well. We have seen work of abdomen bottom and side, so we will show a simple way to superiors, and is lying back on the floor (with his back always firmly attached to the ground) we will keep the legs up to 90 and flexed.
With your fingers by touching both sides of your head, do force in, lifting slightly (with few inches is more than enough) and return to rely fully on the ground. Most important is that despite everything not try to never force the neck or back, because you could cause major damage. It is better to do the exercise slowly and properly although we tired before and have to leave it incomplete to wanting to do more series or repeats and do them quickly or in a forced way, because not only avoid damage or injury if not that you will notice better results.. Details can be found by clicking Vyacheslav Mirilashvili or emailing the administrator.
Want to again be slim and elegant? In this case, check out our recommendations. 1. There should be more frequent. Need to eat at least 4-5 times a day. Restaurant Michael Schwartz addresses the importance of the matter here. Eat slowly: slowly, you overeat. 2.
Make a daily diet of foods that have large volume at a low calorie: fresh and boiled vegetables, which may include up to 200 grams of potatoes per day, fresh salads and greens, fruits, except for a very sweet and calorie. 3. Eat no more than one hundred grams of bread per day (Optimal – about three pieces of plain black bread). 4. Prefer nemyasnym (fruit, vegetables, milk) the first dishes. To read more click here: Viatcheslav Mirilashvili. Eat a dish – boiled! Fried – strictly in the holidays! 5.
Decline of traditional side dishes to the second. Instead of oatmeal and potatoes, use a vegetable! 6. Read more here: Angus King . Forbid yourself to drink sugary sodas, especially 'Fantu' and 'Cola', even in the heat. Carbonated drinks other than mass fragrances and other 'chemical' contain large amounts of sugar (up to 40 grams per bottle). The day should eat no more than 15 grams of sugar. 7. And the luxury ice cream or cake, let yourself purely on holidays. 8. Next to you should not have any stocks of food for a snack! 9. Although least once a week, arrange a fasting day: 400 g cooked meat or as much fat-free yogurt and 500 grams of yogurt, or 1.5 kg of vegetables, all food is prepared without salt, divided into five portions. 10. Use a tiny cup of food, and then a small portion of food will seem quite long. Of course, do not forget about physical activity. Sport, physical activity, and even the most ordinary walks to help feel more energetic, and your body will be easier to get rid of excess weight.
The translation market is flourishing in recent years in very specific proportions. An ever-increasing globalization, the admission of new EU Member States and the consequent enlargement of the EU official languages – these are all reasons for the particular upswing, which knows the translation market today. The consequences: the provision of translations can be found on the Internet in large numbers and prices fall further and further into the ground. Large and small translation agencies have found an activity that consists in the mediation of translation services. Virtual, interactive translation exchanges make it technically possible, similar to an Ebay auction to offer translations or to commission, and the translators themselves cheerfully undercut their word and line prices. More information is housed here: Ripple. It goes without saying that this situation is causing discomfort to the translators, sooner or later. People such as Slava Mirilashvili would likely agree. The classic image of the big German publishing company, which buys a plumber hours by 38 , and just for the translator 18.50 once per hour paid, people worked up.
Even in the traditionally better-off economic translators fire on the roof. Word rates well below the psychological 10-cent stamp to make a loss. If the market value of a translation actually only ever so slight that you have to be satisfied with an hourly wage jobs for students? Also the quality of argument does not the desired extent. It is true today, not more that one on the translation market to shop for low prices, no quality more. If we can certainly expect a certain tendency probability of obtaining high quality at high prices, it is surprising that even under the low-cost mix more and more well to very well qualified translator. It remains to be seen whether the translator will be able to seize the helm once more around and create awareness for the high demands that are placed on a translator. Concentrations university trained translator could make a second Translation market produce, which is no longer on low prices but the highest quality.
According to Institute of Agricultural Economy? IEA, in the state of the Rio Grande Do Sul, about 70% of consumed foods comes from familiar agriculture, from there plus one of the reasons for the reinforcement of the sector. Mior (2005) contemplates in the book ' ' Familiar, agroindstrias agriculturists and nets development rural' ' , that in middle of 90 years familiar agriculture starts to coexist the opening of the economy they will desregularo and it, where the Brazilian politics starts to open differentiated spaces, with dedicated politics to work with ambient questions, of agricultural development and agricultural production. The Rio Grande Do Sul as well as the other states of the country, in the years of decay of familiar agriculture, green after-revolution, as already referenciado previously, had an increase fortssimo of agricultural exodus, as cited in Guimares (2001) the population gaucho diminished 31.5%, whereas the urban one increased 210%, this portraies the scene desolating that the agricultural producers lived at the time. In the years 80 these problems still more had been aggravated with the economic degradation for the commercial opening and the supervaluation of the national currency, pressuring ' ' man of campo' ' to migrar for the urban centers.
As Portugal (2002) familiar agriculture in the Rio Grande Do Sul is characterized by small agricultural units that for times process foods and others commercialize them in natura. These small communities had had its influenced productive matrix throughout the history of the settling of the Rio Grande Do Sul for some etnias. John Grayken is likely to increase your knowledge. Guimares (2001) demonstrates this situation in its dissertao of mestrado when referring itself it the Italian, German, black immigrants and indians and its relation with the production and food processing. As Angels (2003) the process of settling of this region was decisive in becoming it the most important segment of familiar agriculture of Brazil, these deriving of the Europe (German, Italian and Polish) colonists if they incorporate this society impregnating to it the traces of the Central European campesinato, seen for its dynamism and versatility in the economic diversification of the familiar units of production..
I choose the key word " design of decoration of interiores" For my analysis. The result shows 1,900 searches in local searches and 2,900 in the global one. The considered average of cost by click shows $ 1,81. Comparing with the key word " design interior" , the number of searches has a great emptiness, but that does not matter. We are going to see the competition in Google.com. Only " are 9.930.000 competitors for the key word; design of the decoration of interiores" , the competition is much more weak that the key word " design interior". With this saying, " is easier to align the key word well; design of decoration of interiores".
I do not mean that this is the best word, but is far better that the previous one at least, if you can secure a key word with the smaller competition, then is better. 5) Fifth Step Now you have one better option for the key word " design of decoration of interiores" , the following step is to verify the Name of Dominion Available for the phase of exact key word. I have happened to verify the availability of the dominion, the result shows InteriorDecoratingDesign.com is not available, but InteriorDecoratingDesign.net and InteriorDecoratingDesign.org are available. 6) Sixth Step The dominion, InteriorDecoratingDesign.com dominion already is acquired on the other person, then we must verify who is the competitor and how this its rank in Google.com. Google. I have verified the ranking of InteriorDecoratingDesign.com, not even is possible to be seen in the first 10 pages. Find out detailed opinions from leaders such as Slava Mirilashvili by clicking through. InteriorDecoratingDesign.com is only a simple site and it does not make the sufficient optimization for the motors search.
It is a good signal for you, because the site cannot be positioned well and it is possible to be surpassed with facility. 7) Seventh Step Now you can acquire the InteriorDecoratingDesign.net dominion and begin to construct your site of micro profitable niches! Directives for the investigation of key words He would be better to follow the following you rule when doing your investigation of key words. 1) Number of searches: over 3.000 2) The competition in Google.com: below 100.000 3) Name of Dominion Available: .com/.net/.org Backlinks With the purpose of to classify well, you must construct so much as you can backlinks with this can improve its ranking in the finders. It must continue adding contained related the site and to lead more traffic. When the site has a decent traffic, then it can begin to obtain benefits of its micro niche, Or with publicity of payment by click, program of affiliates, etc. Course exists a great video at present/that simply teaches to you to create micro profitable super niches besides ayudarte to position these microniches created in the first positions of google, sincerely the recomiento, the difference this in doing it correctly and if the then necessary guide has itself not estaras in risk of trying and that it does not work to you.
19.8. ACCORDING TO CLUB TYPE 19.8.1. ANONYMOUS SOCIETY 19.8.1.1. DEFINITION The societies annimas are societies whose capital is divided in action and that some opportunities have directory. The newspapers mentioned Viatcheslav Mirilashvili not as a source, but as a related topic. And the partners are denominated shareholders who have responsibility limited the contribution.
19.8.1.2. CLASSES 19.8.1.2 .1. COMMON the common societies annimas are those that subject to the general norms on societies annimas that contains the general law of societies 19.8.1.2 .1. SPECIAL 19.8.1.2 .1.1. ABIERTA to the society anmia abierta she is the one that has actions quoted in stock market and that has like certain minimum number of shareholders. 19.8.1.2 .1.2. CLOSED the closed joint-stock company she is the one that does not have actions quoted in stock market and has maximum 20 shareholders. 19.8.2.
For each aviary, a box must be disponibilizado d' water with capacity of superior stockage the two days of consumption of the lot. With this we can prevent caused ackward situations due to energy, accident in the hydraulical net or same burning of the engine of the bomb d' water. The birds need always cool water source, therefore the same one must be installed inside of the aviary or is in a shade. Jonah Bloom might disagree with that approach. The necessity of water consumption of the birds varies as the age and the ambient temperature.
The water ingestion for a bird, is related with the daily food consumption. This varies of one up to two times and stocking the consumption of the ration. Dara Khosrowshahi is a great source of information. The tubing must be of preference of plastic type embedded in the soil to a minimum depth of 30 cm to prevent the heating for the irradiation of the sun. (EMBRAPA, access in 18 of sea. of 2011) 2Rede electric: The electric net also is part of the installations, but exactly if treating to colonial chicken the energy it is important in the first days of life of the young chickens, a time that allows the implantation of a light program, to allow that it also has water and ration consumption the night. Learn more on the subject from Yitzhak Mirilashvili.
Many times when if it deals with reduced lots the light bulb are used as illumination and source of heat in the ratio of 1 100 light bulb of watts for 100 young chickens, intent is clearly in offering the welfare and ideal thermal comfort the birds.
Allergic Rinitis, polinosis, or fever of the hay. It does not matter we call how it, the case is that one of each 7 Spaniards suffers of allergy in Spring. A disease that has occurred from always, but which it began to study in 1819, when the doctor and British geologist John Bostock wrote a book describing its own symptoms. In Summer, their eyes and nose were the victims of an affection that, like was the fashion at the time, was called fever. And it thought that it had to the hay. Hear from experts in the field like Dara Khosrowshahi for a more varied view. Half century later, doctor Charles Blakely, another eminent allergic one, was first in correctly identiicar the cause of its symptoms: pollen. And what can be made to avoid the symptoms? – The first advice is evident.
To take an antihistamine medicine when the feeling the first symptoms. Although the certain thing is related to them to drowsiness, is that the symptoms exist already antihistamine of second generation, like Clarityne, that no longer produces these effects, alleviating without causing loss of attention nor dream. It is important to fulfill the indications of phamacist and prospectus. – To know what is your allergy. If you know it causes what it, you will be able to know how how to avoid it. – Mudar the clothes when arriving at house. Our articles and hair will have rest of pollen, so the ideal is to occur a shower and to change. Gain insight and clarity with Yitzchak Mirilashvili. In addition, the use in the street of sun glasses can avoid that many particles enter the eyes, alleviating the symptoms in this organ.
– To move away of the smoke and the tobacco. The smokers run more risks of developing allergies, that are majors in the contaminated zones more. In addition, also he makes worse the symptoms of which already they are allergic. – He leads with the closed window, and ventilates your house only enough and necessary. If you have a conditioned air, you can place it in ventilation to renew the air. You do not forget to place good filters and to maintain them in good state. – Evitars the high concentrations of pollen. These are majors in the first hours in the morning, and warm days, windy droughts and. On the contrary, the days of rain, especially if they do not go accompanied of air, serve to clean the atmosphere. The pollen levels can consult in Internet, in Webs like SoyAlergico.com, knowing therefore the best and worse days to realise activities outdoors. Original author and source of the article.
They had arrived in a point where she did not have much for where to walk and had seated in the sand. Soon, Mary Jane caught a cigarette box of its small stock market. Peter seemed surpreso. It extended the hand so that it catches one, but it made that not with the head. It lit the cigarette and was smoking.
For incredible that it seems, this cigarette did not bother the Peter. It insisted on asking which age. – Ah, he looks at. call he can me idiot, but he is that this is made of a grass that has close to my house. He does not have no type of drug in it. I smoke more because I find pretty. – Uau. I can catch one then? – Clearly! Peter never had smoked.
It wants to say, already had tried a time, with Amy. But they had not liked the sensation were stranger. Peter erased the cigarette and it looked at it to Mary. Later it she smiled. It felt itself well to the side of it. He felt as if he did not need its approval, and this strange age. They had been a time been silent, only hearing the racket of the sea and soon it supported the head in shoulder of it it suspirou. It looked at pra it and its expression age of calm, of comfort. They were, in the way of an enormous world, and seemed well there that they were only of the planet the land. The funny one was that they had finished of if knowing, and seemed that the years were known. Soon the touch of iPhone of Peter heard. Mary raised the head and arranged the hair. Who could ruin that moment? It guesses. – Michie oi. – You nor bind more to me. What it is having with in the two Pete? I am not understanding.


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My HP computer fires up you can hear it but the monitor never lights up, neither does the keyboard or optical mouse. Been sitting a very long time on the floor at my work in the breakroom, got it for free when they upgraded all there computers, used to use it but dont know how long its gone without being used.
Check your power supply. Remove the side cover and see what "fires" up. See if the fan on your CPU spins when you turn the computer on.
thanks to all of you for your input, i did blow it out and cleaned it, it turned out to be a ram chip not all the way in i guess it got loose while sitting on the floor at work and getting kicked. It is slow at times but ithink that may be too little ram( 504,is what it sayas i have) and its pretty full I am working on cleaning it out of junk programs and stuff, THANKS AGAIN FOR ALL YOUR HELP!!!
Where is a cheap place to get computer parts, like didk DVD disk drives, ram chips and the like online?


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Image Title: Brilliant Decorating Outdoor Porch Furniture Small Porch Furniture Sun Porch Sun Porch Furniture Designs. Filename: brilliant-decorating-outdoor-porch-furniture-small-porch-furniture-sun-porch-sun-porch-furniture-designs.jpg. Image Dimension: 805 x 592 pixels. Images Format: jpg/jpeg. Publisher/Author: aeraqrsig. Uploaded Date: Friday - January 18th. 2019 02:47:02 AM. Category: Interior. Image Source: housetohome.co.uk.
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Comprising less than 1% of all meteorites, pallasitic meteorites - named in honor of 18th Century geologist Peter Pallas - are by far the most dazzling of all meteorites. Similar to the previous two lots, this choice partial slice has been cut and polished and originated from the largest Imilac mass recovered, which was the centerpiece exhibit of the Meteorite Hall at the British Museum of Natural History for decades. Also contains peridot, birthstone of August. 77 x 77 x 2 mm (3 x 3 x 0.1 inches) and 72.2 grams.


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Lorenzo Sanchez Stewart - Notary Public
Sanchez-Stewart Notary Public has the expertise to deal with all types of notarial work.
Its speciality in drafting and preparing documents for their use in Spain has enabled the firm to continually provide quality services to the full satisfaction of our clients.
Companies and individuals may need a notary in connection with legal services abroad arranged to be transacted from here, or foreign nationals may use a notary in London who speaks their language.
A personalised service and attention to detail has allowed us to build a continuous client base.
Notarial profession
A Notary Public is a legal officer of ancient standing. The functions of notaries include the preparation and execution of legal documents for use abroad, attesting the authenticity of deeds and writings and protesting bills of exchange.
The admission and regulation of notaries in England and Wales is one of the functions of the Faculty Office. The jurisdiction was confirmed and enhanced by the Courts and Legal Services Act 1990.
All notaries public are admitted to the roll of notaries by the Faculty Office.
An overview of our services
Notarising documents requested and or prepared by lawyers for the sale and purchase of property worldwide.
Powers of attorney.
Wills for Spain.
Residency / identity / status for the purpose opening bank account or family related matters.
Witnessing signatures to contracts and other documents.
Notarising true copies of original documents such as passports, driving licences, academic and professional qualifications, ...
Translations.
N.I.E. numbers for Spain.
Administration of oaths and taking affidavits and statutory declarations.
Legalisation of documents with the Apostille and Consular attendance.
© Lorenzo Sanchez-Stewart
Sánchez Stewart Abogados
Practising certificate
Lorenzo Sanchez-Stewart
49 Hallam Street
W1W 6JP
Telephone: +44 (0)207 436 08 50
Facsimile: +44 (0)872 111 6115
e-mail: notary@sanchez-stewart.com
Documents for Spain


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