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Mbak Is,… ada cita2 memilih salah satunya? bagi saya blogging cuma menuangkan pikiran, apapun itu,… semua pekerjaan mempunyai efek samping salah satunya menghasilkan uang. jadi bukan atas dasar uang, melainkan hobi dan ketrampilan. Kaget selesai posting Eh,… Pembaca Kalian Benci Iklan!
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Oh, he’s a uniter who will fix the economy.In a narrow sense, he’s done exactly that with the small arms industry and culture in this country.He’s going to do this country some good, even if by being nothing other than a catalyst for those of us not willing to hand the government the keys to our lives.
Apuesto por Ivrea.Siendo 3 tomos es perfecta. Y con la salida del anime, un combo increible, uno dara vendas de lo otro seguro. Bravo por selecta y la editorial que sea.
Dear Asela,My name is Lishan Perera and I am a freelance atvoiian journalist based inSri Lanka. The purpose of this e-mail is to request permission to use yourphotograph of the Mihin Lanka cabin crew to accompany one of my articles which is scheduled to bepublished in an international magazine. Due credit will of course be givento you and I guarantee that yours rights to the photograph will clearly bestated beneath the image. I was really fascinated by this photograph and Ibelieve that it will be do a perfect job of complementing my article (whichhappens to be on Mihin Lanka), therefore I hope that you will consider myrequest favourably.Thanking you in advanceBest RegardsLishan PereraJune 19, 2012
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**Cough** Red Dragon **Cough** The film is criminal for squandering some of the best actors working today:Philip Seymour HoffmanEdward NortonEmily WatsonMary-Louise ParkerHarvey Keiteland Ralph Feinnes(I won’t say Anthony Hopkins because I really don’t like much of his work, particularly his 3-pound ham “chianti and fava beans” performances in the two Lamb’s sequels…)
Du bekräftar vad jag (alltid) säger: Det är inte kameran som "gör" bra bilder, det är fotografen bakom. En härlig solig bild blev det med din "mini". Min lilla "Sonny" förjer alltid med mig.PS. Planeringsmöte – zzzzzhhhhhhh DS
SÃ¥ velkjent! Men supert nÃ¥r man greier Ã¥ snu det, slik som du gjorde her! Innimellom er det lett Ã¥ se alle gjøremÃ¥lene som et hinder; og sÃ¥ glemmer man at det er jo dette livet handler om! MÃ¥ bare prøve Ã¥ stoppe opp og tenke seg om av og til ;-)Lykke til med ny (travel) uke – nyt den!:-)
Sono praticamente certo si tratti di coreano (notare come tutti i "simboli" sembrino delle "adorabili" faccine)… detto questo, essendo il coreano una lingua a me sconosciuta punto a caso sul manuale per pervertiti.
pfff dur ca, je repasse tout à l’heure.Bon allez la seule reponse qui me vienne à l’esprit pour la 10 c’est le seul, le grand l’unique Thomas Muster je pense
Bill Cutting | January 30, 2011 at 8:21 pm |[Is Obama the secret son of Malcolm X?]NO !!!!!!!!!!!!!!!!!!!!!!!!_______________________________________________Bill, I won’t go so far as to say “no” as the timelines do match up, however I think that our time is better spent working on things that we can prove. That’s all.
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Saya telah terambil borang biru yang telah diberikan oleh pihak sekolah..Saya ingin menukarnya esok iaitu pada 11/11/11..Saya nak tanya,bila permohonan untuk ke Tingkatan 1/2012 akan ditutup?
thanks for telling it like it is. for some reason, a bunch of the beat writers, keep blowing sunshine up everyone’s asses. the fans have already figured out brown. at 0 and 7, i think the press would turn on brown. i still think brown can get us to 50 wins, but there’s no way brown gets us over the hump. we need phil and we need him now.
hey josh,i like what you write…(your blog layout is very cool too!)fun thing is, that it is easier as we always expect to get into this juicyness of now – and since i got i little taste of it…my body wants to go there, because it feels goooood…so i follow my body looking forward to hear more from you!all beststephanie.
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1d8Great article.You make a very good case to go short on the GPS purveyors however their technology is already in our cars which gives them a serious head start on market entrants,gives them an opportunity to up their game while Google is creating theirs and frankly it may focus their mind a little more on how they can monetise their platform ie use their technology to sell more service to their captive audience eg What restaurant options do i have in this area?3 dd 45
Goed gedaan mannen.Sportief op z’n best. Chapeau.Heb zelf ondervonden dat sporten een mens krachtiger,zelfzekerder,blijer …….maakt.Ook het positivisme groeit in de mens.Kortom, ga sporten ,beweeg…….sportieve grtn Rob
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I’m pretty sure I saw this in Boston’s chinatown, but I can’t be sure… all I know is a lot of people were shouting and a lot of other people were sittting in vans looking bored
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You mean there isn’t a ‘contented little baby book of playground mishaps’?! There so SHOULD be. I wouldn’t worry. Judging by your Silent Sunday he is a very brave boy so am sure he will be over it in no time. By the way I think your promise this week is my favourite one EVER! x
aylık 450 lirası olan evimden kira geliri almaktayım.ancak bu ev vefat eden eşimden benim ve 2 çocuğumun adına 3 hissli bir evdir. benim sormak istediğim kira vergisi ödeyip ödemeyeceğim. ödemeyecek isem vergi dairesine dilekçe verecekmiyim. şimdiden teşekkürler.
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I would be partial to number 2 myself, Shannon. It looks wonderful white. Maybe you have some fabric floating around {an old tablecloth, curtain panel, drop cloth?} as option 3, that you could use so that the chair can move around wherever you want to use it.
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eddy: i totally agree. i did just that when i was in the force, not wanting to be reprimanded by enciks like you. hahah. Especially audits. I bluffed my way through to questions i couldnt answer. that is why 4th div is the bestest!
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Economic, tu iti iei reducere exact de valoarea becului pe care il aduci. Daca faci comparatia cu sistemul buy-back de 15-30% care se practica la alte chestii, e cea mai buna afacere posibila. Mentionez ca e o afacere buna DOAR cand tu chiar vrei sa-ti schimbi becurile.
“NAN!!! I can do it myself!!” this made me laugh so much. cool workout though.Little question from Canada though. Is running in the winter cold bad for your lungs? Because it feels weird if it gets -10 and under.
mientras no haya nada oficial, pues solo debes preocuparte que los anuncios no se confundan con tus tÃtulos, algo difÃcil, pero mientras se note que es publicidad y que no, pues por ahora ningún problema.Y es como dices, son los anuncios de más rendimiento (alto CTR), tal vez por eso Google pueda ponerles más el ojo encima.Saludos.
Joice disse:Mi querida, amiga de tantos anos…me emocionei ao ver as fotos de voces, absolutamente lindas!Um beijao enorme no coracao desse casal e nos vemos em breve!!Joice
I swear, you never make a fashion 'don't', you know where they place a black bar over your eyes to hide your identity? Well, who would hide those eyes? Amazing. The dress is fab as usual.
Idiotic articles like this one are part of why I left Korea, but the Koreans I speak to now cannot understand why it was unpleasant for me to be part of a group that was constantly attacked in the press (nor could many of my more complacent colleagues back in Seoul.) I am not going to be damaging the Korean economy anytime soon, but the constant trickle of nasty, discriminatory articles is surely having an effect on Korea's reputation (if it ever had one.)
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Are you born with the right to vote? Are you born with the right to drink? No you are not.It says something fundamental about society that we believe ourselves better than others, and that we can make decisions about society.I would like to see what would happen if someone outlawed the right for Christians to get married. Imagine the outrage.
My most memorable gig this year in Melbourne, was Laura Marling at the corner hotel, Boy and Bear supporting and the whole thing feeling like a gypsy caravan. Lots of dancing and lots of different instruments including a piano accordion. Fantastic stuff.
Oh my – they always find the best place to ask the most awkward things – like they know you’re hiding something. Mine are 6&8 and still have roughly the same story. x
off topic: Deb, I can’t seem to get to “the inside of me” from your link list. I get to a completely different site (an italian newspaper…!!!)Just wanted to let you know.. don’t know what happened!!
Nice review dude. This is one of my all-time favourites. Between this in the 70s and To Live And Die In LA in the 80s, Friedkin had the best cop thrillers in two decades. As much as I love Heat, I do sometimes wonder what Billy Friedkin would’ve done with that script!
"Ma lo compilarono per scherzo dagli astronauti durante la quarantena post-volo". Forse va riscritto "Ma lo compillarono per scherzo gli" ecc. ecc., oppure "Ma fu compilato per scherzo dagli" ecc.ecc.; ad ogni modo, stasera strizzerò l'occhio alla luna, pensando ad Armstrong e canticchiando Armstrong (l'altro, quello di "What a wonderful World" ;o)
If ratings were really down it was because of two things: It was a bit underpublicized this year – I was surprised it was on when it was on – and it competed with NBA playoffs (all clinching games) and American Idol and whatever else you want to throw in there. Not so much “fan fatigue”.
hi wanderlass,Got confused as french embassy doesn’t want to reveal on how much will be the minimum requirements for bank statement will be. May you advise me about the bank requirements. Someone tells me it should atleast 200k. Does it really have to have a 200k on your account, as i only have minimal amount in my account Php50,000.00. My french friend will shoulder all expenses going to france and going back to manila.please help me.Thanks, romela Reply
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Great photos and great story!You know, there’s actually a race every summer that takes place in Norwegian mountains – Viking Tour. It’s totally stunning, epic and all that stuff. Best thing I’ve ever done on a bike.Can you imagine last year we rode up Stalheimskleiva? And then you have Dalsnibba, Djupvasshytta and much more..Norways is simply stunning.
Anti NWO / October 11, 2009Travel overseas? Mail the stick to where you are going and travel with your laptop without a hard drive in it and only a live puppy CD to boot with. Makes for some eybrow raisings at TSA.Reply
OMG! This is hysterical and some of it rings true for me too. Our big family dinners have gotten smaller as families have grown and moved on or away. Now it’s less than 10 people and it’s just not as much *fun* anymore. Enjoy it while it lasts!
Hi there I make a similar recipe. I make the salsa the cebolla (onion marinade) first. I make stock from the shrimp shells. When the stock is done I add a little bit of fresh pepper and about 1/4 cup of ketchup (for about 2 lbs of shrimp) and mix. I cook the shrimp let it cool then I combine the onion marinade & shrimp. Then I add about 1/2 cup – 1 cup of the stock (depending on how soupy you like it)to the ceviche mixture. Serve over white rice and add some of the fantastic juice on top! Yummy.
Alo all..Buat gw standar aj d… Itu di jalanan aj dh kaya raja… Ngapain di ganti macam2… Bikin banyak ngeluarin biaya, beda si kalo emang buat balapan..speed itu wajib.Tapi kalo harian mah, standar aj lo pasti bisa ya minimal ngekorin Ducati Monster he he he.. Kalo lo jago y lo pasti bs ngasepin tu motor… Safety riding bro…
I'm with you HelenI love the original Spice I Am in Surry Hills. I love that there are funky little designer furniture stores everywhere you look in the neighbourhood.LOOOVE the yum neu and will continue to do so!
Valkoinen kirahvi, katsotaan nyt että miten kauan tämä innostus kestää=)Sanna, sinulta just keksinkin tämän leffahaasteen. Tsemppiä maailmanvalloitukseen. Se vaikuttaa kiinnostavalta, mutta aika työläältä:)
Flagler Beach is the most perfect place to visit. Just a beautiful area. I have been visting this area since the late 60's. Next time I come up from Sarasota I will stop at your place. I've heard from people the food is excellent. Nice blog. All the best.
Puleeeeze. RC's logic, or rather lack of logic, is painful to follow.Witty is clearly speaking in regards to the Jewish community.Korean-Americans can be supportive of the Korean-American community and supportive of the larger American community, yes?
oh god, THANK YOU for voicing your disgust. these are positively heinous. they are like alien babies of cracked-out spice girl groupies. they are hideous and offensive. and everyone seems to love their trashiness! i hate this whole trash revival, this look people strive for – the glazey-eyed vague crackwhore look, complete with ridiculously expensive bits of ripped cotton which are supposed to make you look like a drunk slut. GAH IT MAKES ME SO ANGRY.
Could you send me an application form? I would always peek in on my gf’s sister when she lived with us.She would always masturbate with her skimpy little undies on and when She caught me watching her with my dick in my hand she rode me and pumped my load off in the crotch of her damp little panties
salut, je sui un garcon de 27 ans, je suis etudiant et j’abite a Croix. Je parle pas le francais bien parceque c’est n’est pas ma langue (je suis italian). si tu me veut contacter on peut exchanger des photos. mon email est
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No, the sun is getting hotter. That would heat things up a bit right? There is no evidence that our carbon footprint on the earth is affecting the globe. Al Bore is an idiot. The only reason they want us to buy into the idea of global warming is so that they can start a global, yes global carbon tax. The powers that be are already talking about it.
To Mr. Conrad–This is not about a particular photograph, but about your many photographs which I have been awre of for many years. Every time I see a photo I particularly like, I look and there it is: Fred R. Conrad. So I want you to know my appreciation. The most recent one was of feet walking with shadows. However, I have been watching your work, and I wanted you to know. I am a painter myself. .
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This is making me so excited for our session!!! I love the sisters on the bed and the ring around the rosie – such sister moments are so hard to capture, what a amazing memory to have.
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You have made some good points there. I checked on the internet to learn more about the issue and found most individuals will go along with your views on this website.
A friend posted an image of this. I cn't post it here but the underlying point is great."When someone tells you that Obama is destroying the economy, point out that share prices and corporate profits are at an all-tiem high.When they tell you that hasn't helped them any, remind them they've just admitted trickle-down economics doesn't work."
I love expos although i never get to go to many! By the way – you are looking fabulous! on a side note – i couldn’t get the blog hop button to stay in my post today – the second line (the image line) kept disappearing….getfitchick recently posted..
It is not surprising that employers tend to offer only superficial compliance when there is no follow up from regulatory agencies. Unsafe workplace practices are often habitual and can be difficult to break. It may take several visits, citations and fines to motivate permanent change. If the employer doubts the regulators will ever be back, why would he or she go to the trouble of making costly changes?
This is a lovely post. I wonder whether you would consider posting some of your memories on Writing the City. The current theme is 'Hidden Skyline' and is all about memories of the past.Please contact Kay at: writingthecity@civiclife.sg
The case you lay out is complete and I believe this is the single most important step BikeFed should take. It would be the last major hurdle to decriminalize the typical behavior of many cyclists. With the stroke of a pen it would eliminate a schism among cyclists and an argument often used against us by anticyclists, and I think just free up alot of energy for more important work. Bring it on, please!
By October 26, 2012 – 2:21 pmaw bless. It is traumatic having your costume ruined. But good save with Michangelo! We were huge fans of the Turtles and even watched the film last night. We’re actually tempted to go as them for Halloween, but don’t have time to make the awesome heads we have in mind.
Elis Flora comentou em 20 de agosto de 2011 às 04:08. Júlia amei a maquiagem!!! Queria saber se tem muita diferença, e qual, dos delineadores lÃÂquidos e esse em gel que você usa. Obrigada!
I’m shocked the day care would even *think* about putting a used, slobber covered bottle back into the fridge. The bacteria starts growing inside nipple the minute the baby starts sucking on it, and should be tossed completely if not used up after 30 minutes….so just imagine the colony of bugs that would develop after several hours in the fridge! Don’t they know this is a major health hazard?
What does he wish to debate? Why would anyone accommodate such an obvious idiot? It's like wrestling a pig. You both get dirty but the pig enjoys it.The SPLC has some interesting posts on their blog regarding April 19. No one can act surprised if these militia nutters act out. They call themselves "patriots". Maybe it is time to call a spade a spade and start calling them "hate-riots".My $0.02.
We added your video to our ‘wedding photographers’ playlist. We would love you to share your top 3 photography tips for successfully capturing one’s BIG day on our blog. Please connect with us here on youtube or on twitter.By the way, you might want to check out our ‘Top 50 Wedding Photographers on twitter’ on our blog. Should you be on the list?Cheers,C&K
Great post! I am always surprised (well, not so much anymore…) when people don’t make the diet and health connection. Food is medicine – for better OR worse. I will be particularly interested in your findings on the endocrine system. Often times overlooked and very misunderstood.Karen
Great point on the productivity vs gender equality vs social norms conundrum! working right now on two papers about female cash crop producers in Africa, it will be great to get your paper in our lit review… (and I’m sending your blog right now to the teams in the field to look into family dynamics)
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My respect for Michael just dropped down into the negatives. Seriously, he’s stepping out on her for Brooke??? Also, why in the name of taste and decorum is she engaged to HIS fake-baked butt? ::reaches for the love potions he swiped from the fairies to try and set Maddie up with Trevor::
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Nom,I heard her last night. Her slamming the gov for screwing up Cash For Clunkers and now asking us to rely on them for an extra 1/7 of the economy was classic.
pastel pink,blue and green are you best options in that order. Pastel yellow, and white will also go well with that just make sure that if you do wear a white shirt that you wear a tank top underneath so *nothing* shows through the shirt( they can be see through). -1Was this answer helpful?
1. Jag och mannen försöker alltid få till en powerwalk/långprommenad på julaftonsförmiddagen. I bästa fall en löptur. Detta satsar vi även på i år. Jag behöver få lite frisk luft, röra på mig och hämta kraft inför en intensiv dag med mat, tomtar och släktingar ;).2. Stl XS ( ev S om dom är små i storleken )3. Jag gillar Bodystore på FB
Oh, I wish. I have the hopefully-next-to-last revision with a beta reader now. Once I incorporate those comments and give it a final polish and intensive edit, I will query it.The concept is different. And different is risky, especially with an unknown author. If I can’t attract an agent in a reasonable amount of time, I will e-publish it.
25-30-35-40-42,5f-42.5 kg. Olen tyytyväinen ja happy. Syksyllä OHS- maksimi oli 32,5 eli parannusta aika huikeasti lyhyessä ajassa ja siisPR samalla. Päälle kuritukseksi dippailua, wallballia 9kg:llä , vatsoja, pystärivoimat. Kyykky alkaa olla mulle ihan painajainen. Tekniikka ja jalkavoimat pettää mut joka kerta
Si cum ramane cu handwriting recognition de la majoritatea ppc-lor ?doar dai enable pe acea optiune din meniu si astfel ” “mazgalind†literele cu ajutorul degetului ” putem face aceleasi functii
Luciana comentou em 1 de fevereiro de 2010 às 15:20. fui dar uma olhadinha na sombra que sugeriu (Malt, muito bonita, mas no computador me pareceu escura), e vi a Chamomile, o que vc acha desta cor Julia?
Ooo, I like that one. I'm also really partial to 10, but I think that's just because it's such a different scene to see for Pteranodons. You see them for so long as leathery winged reptiles that it's peculiar to see one posed like a pelican. I love it though, it's so naturalistic.
Life Coaching met Herman het vir my baie beteken. Dit het my tot nuwe denke geinspireer asook nuwe tegnieke geleer. Dit het op ‘n baie nodige tyd in my lewe gebeur en wat die beste van die hele ervaring is, is dat ek dit prakties kan toepas in my beroep en in my lewe. Ek kan dit vir enige iemand aanbeveel. Ons almal het een of ander tyd coaching nodig veral as mens die lewe voluit wil leef.Dankie Herman!!
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In actual fact for most individuals these ED medication are very secure and extremely effective .By serving to
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This is without doubt one of the extra frequent questions
I get from my male patients. Or typically its the numerous different who’s frightened that one of those medicine for
erectile dysfunction (ED) would possibly stress their partners coronary heart.
Actually for most individuals these ED medication are very protected and
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Bodily intimacy bonds us to our associate like nothing else,
and helps to cement and maintain an in depth, private and loving connection. An intimate
lengthy-time period relationship is certainly one of an important
predictors of somebody who will keep wholesome and comfortable regardless of the stresses and strains that life inevitably throws at us alongside our
journey. So by serving to to enhance sexual means in males, these
ED medicine will be useful to their coronary heart well
being and total effectively-being. A Curious Facet Impact. .
. These medication had been found by accident about 20 years in the past when scientists have been in search of a
drug to deal with coronary heart illness. This explicit drug
(ultimately named Viagra) turned out to dilate blood vessels notably nicely within the penis.
As they are saying, the remaining is historical past,
and this drug alone has turned right into a billion-dollar-per-yr blockbuster.
The take-dwelling message is that these medication dilate blood
vessels which typically is nice to your coronary heart.
Examine in along with your physician earlier than beginning one of many medicine simply to make sure.
And watch out to not take them with nitroglycerin or Flomax sort medications for the prostate, as a result of together with Viagra, Cialis, or Levitra they’ll decrease your blood strain a lot.
These erectile dysfunction medicines are comparatively costly, at about $14
per pill. However because the spouse of one in every
of my patients put it: Its about the identical as what we’d pay to go see a film,
and that is significantly better leisure.
My husband began taking Viagra and Cialis about three years in the
past. Since then, I’ve carried out a few of my very own analysis on the web.
It’s wonderful what number of articles there are about why
you want …
My husband began taking Viagra and Cialis about three years in the past.
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A lot of Males use Viagra or Cialis
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First, let’s get a little historical perspective on American health care. This is not intended to be an exhausted look into that history but it will give us an appreciation of how the health care system and our expectations for it developed. What drove costs higher and higher?
To begin, let’s turn to the American civil war. In that war, dated tactics and the carnage inflicted by modern weapons of the era combined to cause ghastly results. Not generally known is that most of the deaths on both sides of that war were not the result of actual combat but to what happened after a battlefield wound was inflicted. To begin with, evacuation of the wounded moved at a snail’s pace and this caused severe delays in treating the wounded. Secondly, many wounds were subjected to wound care, related surgeries and/or amputations of the affected limbs and this often resulted in the onset of massive infection. So you might survive a battle wound only to die at the hands of medical care providers who although well-intentioned, their interventions were often quite lethal. High death tolls can also be ascribed to everyday sicknesses and diseases in a time when no antibiotics existed. In total something like 600,000 deaths occurred from all causes, over 2% of the U.S. population at the time!
Let’s skip to the first half of the 20th century for some additional perspective and to bring us up to more modern times. After the civil war there were steady improvements in American medicine in both the understanding and treatment of certain diseases, new surgical techniques and in physician education and training. But for the most part the best that doctors could offer their patients was a “wait and see” approach. Medicine could handle bone fractures and increasingly attempt risky surgeries (now largely performed in sterile surgical environments) but medicines were not yet available to handle serious illnesses. The majority of deaths remained the result of untreatable conditions such as tuberculosis, pneumonia, scarlet fever and measles and/or related complications. Doctors were increasingly aware of heart and vascular conditions, and cancer but they had almost nothing with which to treat these conditions.
This very basic review of American medical history helps us to understand that until quite recently (around the 1950′s) we had virtually no technologies with which to treat serious or even minor ailments. Here is a critical point we need to understand; “nothing to treat you with means that visits to the doctor if at all were relegated to emergencies so in such a scenario costs are curtailed. The simple fact is that there was little for doctors to offer and therefore virtually nothing to drive health care spending. A second factor holding down costs was that medical treatments that were provided were paid for out-of-pocket, meaning by way of an individuals personal resources. There was no such thing as health insurance and certainly not health insurance paid by an employer. Except for the very destitute who were lucky to find their way into a charity hospital, health care costs were the responsibility of the individual.
What does health care insurance have to do with health care costs? Its impact on health care costs has been, and remains to this day, absolutely enormous. When health insurance for individuals and families emerged as a means for corporations to escape wage freezes and to attract and retain employees after World War II, almost overnight a great pool of money became available to pay for health care. Money, as a result of the availability of billions of dollars from health insurance pools, encouraged an innovative America to increase medical research efforts. More Americans became insured not only through private, employer sponsored health insurance but through increased government funding that created Medicare and Medicaid (1965). In addition funding became available for expanded veterans health care benefits. Finding a cure for almost anything has consequently become very lucrative. This is also the primary reason for the vast array of treatments we have available today.
I do not wish to convey that medical innovations are a bad thing. Think of the tens of millions of lives that have been saved, extended, enhanced and made more productive as a result. But with a funding source grown to its current magnitude (hundreds of billions of dollars annually) upward pressure on health care costs are inevitable. Doctor’s offer and most of us demand and get access to the latest available health care technology in the form of pharmaceuticals, medical devices, diagnostic tools and surgical procedures. So the result is that there is more health care to spend our money on and until very recently most of us were insured and the costs were largely covered by a third-party (government, employers). Add an insatiable and unrealistic public demand for access and treatment and we have the “perfect storm” for higher and higher health care costs. And by and large the storm is only intensifying.
At this point, let’s turn to the key questions that will lead us into a review and hopefully a better understanding of the health care reform proposals in the news today. Is the current trajectory of U.S. health care spending sustainable? Can America maintain its world competitiveness when 16%, heading for 20% of our gross national product is being spent on health care? What are the other industrialized countries spending on health care and is it even close to these numbers? When we add politics and an election year to the debate, information to help us answer these questions become critical. We need to spend some effort in understanding health care and sorting out how we think about it. Properly armed we can more intelligently determine whether certain health care proposals might solve or worsen some of these problems. What can be done about the challenges? How can we as individuals contribute to the solutions?
The Obama health care plan is complex for sure – I have never seen a health care plan that isn’t. But through a variety of programs his plan attempts to deal with a) increasing the number of American that are covered by adequate insurance (almost 50 million are not), and b) managing costs in such a manner that quality and our access to health care is not adversely affected. Republicans seek to achieve these same basic and broad goals, but their approach is proposed as being more market driven than government driven. Let’s look at what the Obama plan does to accomplish the two objectives above. Remember, by the way, that his plan was passed by congress, and begins to seriously kick-in starting in 2014. So this is the direction we are currently taking as we attempt to reform health care.
Through insurance exchanges and an expansion of Medicaid,the Obama plan dramatically expands the number of Americans that will be covered by health insurance.
To cover the cost of this expansion the plan requires everyone to have health insurance with a penalty to be paid if we don’t comply. It will purportedly send money to the states to cover those individuals added to state-based Medicaid programs.
To cover the added costs there were a number of new taxes introduced, one being a 2.5% tax on new medical technologies and another increases taxes on interest and dividend income for wealthier Americans.
The Obama plan also uses concepts such as evidence-based medicine, accountable care organizations, comparative effectiveness research and reduced reimbursement to health care providers (doctors and hospitals) to control costs.
The insurance mandate covered by points 1 and 2 above is a worthy goal and most industrialized countries outside of the U.S. provide “free” (paid for by rather high individual and corporate taxes) health care to most if not all of their citizens. It is important to note, however, that there are a number of restrictions for which many Americans would be culturally unprepared. Here is the primary controversial aspect of the Obama plan, the insurance mandate. The U.S. Supreme Court recently decided to hear arguments as to the constitutionality of the health insurance mandate as a result of a petition by 26 states attorney’s general that congress exceeded its authority under the commerce clause of the U.S. constitution by passing this element of the plan. The problem is that if the Supreme Court should rule against the mandate, it is generally believed that the Obama plan as we know it is doomed. This is because its major goal of providing health insurance to all would be severely limited if not terminated altogether by such a decision.
As you would guess, the taxes covered by point 3 above are rather unpopular with those entities and individuals that have to pay them. Medical device companies, pharmaceutical companies, hospitals, doctors and insurance companies all had to “give up” something that would either create new revenue or would reduce costs within their spheres of control. As an example, Stryker Corporation, a large medical device company, recently announced at least a 1,000 employee reduction in part to cover these new fees. This is being experienced by other medical device companies and pharmaceutical companies as well. The reduction in good paying jobs in these sectors and in the hospital sector may rise as former cost structures will have to be dealt with in order to accommodate the reduced rate of reimbursement to hospitals. Over the next ten years some estimates put the cost reductions to hospitals and physicians at half a trillion dollars and this will flow directly to and affect the companies that supply hospitals and doctors with the latest medical technologies. None of this is to say that efficiencies will not be realized by these changes or that other jobs will in turn be created but this will represent painful change for a while. It helps us to understand that health care reform does have an effect both positive and negative.
Finally, the Obama plan seeks to change the way medical decisions are made. While clinical and basic research underpins almost everything done in medicine today, doctors are creatures of habit like the rest of us and their training and day-to-day experiences dictate to a great extent how they go about diagnosing and treating our conditions. Enter the concept of evidence-based medicine and comparative effectiveness research. Both of these seek to develop and utilize data bases from electronic health records and other sources to give better and more timely information and feedback to physicians as to the outcomes and costs of the treatments they are providing. There is great waste in health care today, estimated at perhaps a third of an over 2 trillion dollar health care spend annually. Imagine the savings that are possible from a reduction in unnecessary test and procedures that do not compare favorably with health care interventions that are better documented as effective. Now the Republicans and others don’t generally like these ideas as they tend to characterize them as “big government control” of your and my health care. But to be fair, regardless of their political persuasions, most people who understand health care at all, know that better data for the purposes described above will be crucial to getting health care efficiencies, patient safety and costs headed in the right direction.
A brief review of how Republicans and more conservative individuals think about health care reform. I believe they would agree that costs must come under control and that more, not fewer Americans should have access to health care regardless of their ability to pay. But the main difference is that these folks see market forces and competition as the way to creating the cost reductions and efficiencies we need. There are a number of ideas with regard to driving more competition among health insurance companies and health care providers (doctors and hospitals) so that the consumer would begin to drive cost down by the choices we make. This works in many sectors of our economy but this formula has shown that improvements are illusive when applied to health care. Primarily the problem is that health care choices are difficult even for those who understand it and are connected. The general population, however, is not so informed and besides we have all been brought up to “go to the doctor” when we feel it is necessary and we also have a cultural heritage that has engendered within most of us the feeling that health care is something that is just there and there really isn’t any reason not to access it for whatever the reason and worse we all feel that there is nothing we can do to affect its costs to insure its availability to those with serious problems.
OK, this article was not intended to be an exhaustive study as I needed to keep it short in an attempt to hold my audience’s attention and to leave some room for discussing what we can do contribute mightily to solving some of the problems. First we must understand that the dollars available for health care are not limitless. Any changes that are put in place to provide better insurance coverage and access to care will cost more. And somehow we have to find the revenues to pay for these changes. At the same time we have to pay less for medical treatments and procedures and do something to restrict the availability of unproven or poorly documented treatments as we are the highest cost health care system in the world and don’t necessarily have the best results in terms of longevity or avoiding chronic diseases much earlier than necessary.
I believe that we need a revolutionary change in the way we think about health care, its availability, its costs and who pays for it. And if you think I am about to say we should arbitrarily and drastically reduce spending on health care you would be wrong. Here it is fellow citizens – health care spending needs to be preserved and protected for those who need it. And to free up these dollars those of us who don’t need it or can delay it or avoid it need to act. First, we need to convince our politicians that this country needs sustained public education with regard to the value of preventive health strategies. This should be a top priority and it has worked to reduce the number of U.S. smokers for example. If prevention were to take hold, it is reasonable to assume that those needing health care for the myriad of life style engendered chronic diseases would decrease dramatically. Millions of Americans are experiencing these diseases far earlier than in decades past and much of this is due to poor life style choices. This change alone would free up plenty of money to handle the health care costs of those in dire need of treatment, whether due to an acute emergency or chronic condition.
Let’s go deeper on the first issue. Most of us refuse do something about implementing basic wellness strategies into our daily lives. We don’t exercise but we offer a lot of excuses. We don’t eat right but we offer a lot of excuses. We smoke and/or we drink alcohol to excess and we offer a lot of excuses as to why we can’t do anything about managing these known to be destructive personal health habits. We don’t take advantage of preventive health check-ups that look at blood pressure, cholesterol readings and body weight but we offer a lot of excuses. In short we neglect these things and the result is that we succumb much earlier than necessary to chronic diseases like heart problems, diabetes and high blood pressure. We wind up accessing doctors for these and more routine matters because “health care is there” and somehow we think we have no responsibility for reducing our demand on it.
It is difficult for us to listen to these truths but easy to blame the sick. Maybe they should take better care of themselves! Well, that might be true or maybe they have a genetic condition and they have become among the unfortunate through absolutely no fault of their own. But the point is that you and I can implement personalized preventive disease measures as a way of dramatically improving health care access for others while reducing its costs. It is far better to be productive by doing something we can control then shifting the blame.
There are a huge number of free web sites available that can steer us to a more healthful life style. A soon as you can, “Google” “preventive health care strategies”, look up your local hospital’s web site and you will find more than enough help to get you started. Finally, there is a lot to think about here and I have tried to outline the challenges but also the very powerful effect we could have on preserving the best of America’s health care system now and into the future. I am anxious to hear from you and until then – take charge and increase your chances for good health while making sure that health care is there when we need it.
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“NAN!!! I can do it myself!!” this made me laugh so much. cool workout though.Little question from Canada though. Is running in the winter cold bad for your lungs? Because it feels weird if it gets -10 and under.
mientras no haya nada oficial, pues solo debes preocuparte que los anuncios no se confundan con tus tÃtulos, algo difÃcil, pero mientras se note que es publicidad y que no, pues por ahora ningún problema.Y es como dices, son los anuncios de más rendimiento (alto CTR), tal vez por eso Google pueda ponerles más el ojo encima.Saludos.
Joice disse:Mi querida, amiga de tantos anos…me emocionei ao ver as fotos de voces, absolutamente lindas!Um beijao enorme no coracao desse casal e nos vemos em breve!!Joice
I swear, you never make a fashion 'don't', you know where they place a black bar over your eyes to hide your identity? Well, who would hide those eyes? Amazing. The dress is fab as usual.
Hey, subtle must be your middle name. Great post!
Idiotic articles like this one are part of why I left Korea, but the Koreans I speak to now cannot understand why it was unpleasant for me to be part of a group that was constantly attacked in the press (nor could many of my more complacent colleagues back in Seoul.) I am not going to be damaging the Korean economy anytime soon, but the constant trickle of nasty, discriminatory articles is surely having an effect on Korea's reputation (if it ever had one.)
hi!,I like your writing so a lot! share we be in contact more approximately your post on AOL? I require a specialist on this area to unravel my problem. Maybe that is you! Looking ahead to peer you.
Are you born with the right to vote? Are you born with the right to drink? No you are not.It says something fundamental about society that we believe ourselves better than others, and that we can make decisions about society.I would like to see what would happen if someone outlawed the right for Christians to get married. Imagine the outrage.
My most memorable gig this year in Melbourne, was Laura Marling at the corner hotel, Boy and Bear supporting and the whole thing feeling like a gypsy caravan. Lots of dancing and lots of different instruments including a piano accordion. Fantastic stuff.
Oh my – they always find the best place to ask the most awkward things – like they know you’re hiding something. Mine are 6&8 and still have roughly the same story. x
off topic: Deb, I can’t seem to get to “the inside of me” from your link list. I get to a completely different site (an italian newspaper…!!!)Just wanted to let you know.. don’t know what happened!!
Coucou Olivier,Et bien, je vais trouver comme prétexte que je suis un peu fatiguée et que je n’arrive pas à me concentrer sur ta citation du jour…….. )Merci pour le nouveau lien de Léo Gobeil.Merveilleuse photo des bernaches du Canada.Merci pour cet autre lien. On découvre beaucoup de belle choses grâce à toi OlivierDis-donc, tu as une bien jolie pendule )Bon week-end Olivier.GROS BISOUS,Sylvie )
Nice review dude. This is one of my all-time favourites. Between this in the 70s and To Live And Die In LA in the 80s, Friedkin had the best cop thrillers in two decades. As much as I love Heat, I do sometimes wonder what Billy Friedkin would’ve done with that script!
"Ma lo compilarono per scherzo dagli astronauti durante la quarantena post-volo". Forse va riscritto "Ma lo compillarono per scherzo gli" ecc. ecc., oppure "Ma fu compilato per scherzo dagli" ecc.ecc.; ad ogni modo, stasera strizzerò l'occhio alla luna, pensando ad Armstrong e canticchiando Armstrong (l'altro, quello di "What a wonderful World" ;o)
If ratings were really down it was because of two things: It was a bit underpublicized this year – I was surprised it was on when it was on – and it competed with NBA playoffs (all clinching games) and American Idol and whatever else you want to throw in there. Not so much “fan fatigue”.
Ã¥þрþшðѠÑÂтðтьÑÂ! áÿðÑÂøñþ!Ãœýõ тþöõ ÃÂÃÂÃÂœÃÂÞÓÞ ñþûьшõ ýрðòøтÑÂÑ ÑÂðüþÑÂтþÑÂтõûьýыõ ÿутõшõÑÂтòøѠ— ñуôь-тþ Ñ LP, ñуôь-тþ ñуüðöýыù ÿутõòþôøтõûь, ñуôь-тþ ÿрþÑÂтþ úðртð — тþûьúþ ýõ тур Ñûðóþ, Ѡøýõтþü ÑÂõùчðѠòþ÷üþöýþ üýþóþõ!..ÃÂúÑÂúурÑÂøю ûучшõ ò÷ÑÂть ѠüõÑÂтýыü ÑÂúÑÂúурÑÂþòþôþü, ð õÑÂûø ÿþ÷òþÃȄÂõт ÷ýðýøõ ÑÂ÷ыúð, тþ ø Ѡúþрõýýыü öøтõûõü.
hi wanderlass,Got confused as french embassy doesn’t want to reveal on how much will be the minimum requirements for bank statement will be. May you advise me about the bank requirements. Someone tells me it should atleast 200k. Does it really have to have a 200k on your account, as i only have minimal amount in my account Php50,000.00. My french friend will shoulder all expenses going to france and going back to manila.please help me.Thanks, romela Reply
ol-91 Gourcuff n’était déjà pas le joueur à embaucher à Lyon dans le contexte difficile que nous connaissons, alors le garder à un prix exorbitant et en attendant d’hypothétiques prouesses !Maintenant, nous avons trois ou quatre joueurs qui se bousculent ! et un milieu de terrain qui peine à transparaître.
I can’t believe I’ve been going for years without knowing that.
his may be the outstanding weblog page for anyone who wants to know about this theme. You recognize a lot its virtually difficult to argue with you (not that I genuinely would want…HaHa). You definitely put a fresh spin on a subject matter thats been published about for many years. Wonderful issues, just exceptional!
Great photos and great story!You know, there’s actually a race every summer that takes place in Norwegian mountains – Viking Tour. It’s totally stunning, epic and all that stuff. Best thing I’ve ever done on a bike.Can you imagine last year we rode up Stalheimskleiva? And then you have Dalsnibba, Djupvasshytta and much more..Norways is simply stunning.
Beh, che dire, è tutto nel perfetto stile del loro padrone. È sempre lì che glorifica il liberismo e la concorrenza, finché fanno comodo a lui, poi quando fiuta che sta per pigliarsi una tranvata in culo di quelle solenni, ecco che invoca gli aiuti di stato, con leggi e leggine apposta (nonostante fino a cinque minuti prima spalasse merda sulla “sinistra statalista“).Quei pagliacci sono uguali.Brucia, eh, la propria stessa medicina, vero? Cazzoni!
I feel so much happier now I understand all this. Thanks!
If you wrote an article about life we’d all reach enlightenment.
Anti NWO / October 11, 2009Travel overseas? Mail the stick to where you are going and travel with your laptop without a hard drive in it and only a live puppy CD to boot with. Makes for some eybrow raisings at TSA.Reply
「å¨˜ç ²ä¸å¯æ¥，ä¸æ˜¯å¨˜ç ²å»åƒå¨˜ç ²æ‰å¯æ¥」這個推論我ä¸åŒæ„。如果說話者真的èªç‚ºå¨˜ç ²æ²’有貶æ„，那就ä¸æœƒå¦‚æ¤ä½¿ç”¨é€™å€‹èªžè©ž，就好比我們罵人「騙å」，我們當然èªç‚ºé¨™å是錯的。版主的立論看似åˆç†，但我èªç‚ºæœ‰æŸäº›æ¦‚念的錯置，我們罵人低能兒並ä¸è¡¨ç¤ºæˆ‘們真的æ§è¦–「æŸæŸä½Žèƒ½å…’」，但我們的確èªç‚º「低能是壞的」，åªæ˜¯「王å°æ˜Žé›–然低能，ä½†å› ç‚ºä»–æ˜¯å€‹å–„è‰¯çš„å¥½å©å，所以我ä¸æƒ³é€™æ¨£èªªä»–」。想想當一個開車的人罵å¦ä¸€å€‹äººæ˜¯woman driver時，當然他就是在說「ä½ å°±ä¸æœƒé–‹è»Š，跟個女人一樣」，哪怕那個人èªè˜çœŸæ£å¾ˆæœƒé–‹è»Šçš„女人，ä»–ä»ç„¶å¯èƒ½ç¹¼çºŒç”¨woman driver來罵人。é‡é»žæ˜¯，實例上我們就算ä¸æ˜¯æƒ³ç½µåœ¨é€™å€‹è«–域裡æ¯å€‹å…·æœ‰è©²å±¬æ€§çš„å°è±¡，我們ä»ç„¶æŠŠé€™å€‹å±¬æ€§ç•¶æˆæ§è¦–è©ž，而且罵到了這些å°è±¡。
OMG! This is hysterical and some of it rings true for me too. Our big family dinners have gotten smaller as families have grown and moved on or away. Now it’s less than 10 people and it’s just not as much *fun* anymore. Enjoy it while it lasts!
Hi there I make a similar recipe. I make the salsa the cebolla (onion marinade) first. I make stock from the shrimp shells. When the stock is done I add a little bit of fresh pepper and about 1/4 cup of ketchup (for about 2 lbs of shrimp) and mix. I cook the shrimp let it cool then I combine the onion marinade & shrimp. Then I add about 1/2 cup – 1 cup of the stock (depending on how soupy you like it)to the ceviche mixture. Serve over white rice and add some of the fantastic juice on top! Yummy.
Alo all..Buat gw standar aj d… Itu di jalanan aj dh kaya raja… Ngapain di ganti macam2… Bikin banyak ngeluarin biaya, beda si kalo emang buat balapan..speed itu wajib.Tapi kalo harian mah, standar aj lo pasti bisa ya minimal ngekorin Ducati Monster he he he.. Kalo lo jago y lo pasti bs ngasepin tu motor… Safety riding bro…
I'm with you HelenI love the original Spice I Am in Surry Hills. I love that there are funky little designer furniture stores everywhere you look in the neighbourhood.LOOOVE the yum neu and will continue to do so!
Valkoinen kirahvi, katsotaan nyt että miten kauan tämä innostus kestää=)Sanna, sinulta just keksinkin tämän leffahaasteen. Tsemppiä maailmanvalloitukseen. Se vaikuttaa kiinnostavalta, mutta aika työläältä:)
Flagler Beach is the most perfect place to visit. Just a beautiful area. I have been visting this area since the late 60's. Next time I come up from Sarasota I will stop at your place. I've heard from people the food is excellent. Nice blog. All the best.
At last! Someone who understands! Thanks for posting!
Puleeeeze. RC's logic, or rather lack of logic, is painful to follow.Witty is clearly speaking in regards to the Jewish community.Korean-Americans can be supportive of the Korean-American community and supportive of the larger American community, yes?
nichts anderes. und renéDas Buhlen um die goldfischartige Aufmerksamkeisspanne von anderen Leuten, die wie ich sind, macht die ausschweifende Version leider unmöglich. Außerdem sitze ich manchmal auf meinem Hirn und mir fallen keine weiteren Themen ein :)Faktenarm ist er. Aber vitaminreich wie Frühstückszerealien.Yep. Die war früher besser.
Awesome you should think of something like that
oh god, THANK YOU for voicing your disgust. these are positively heinous. they are like alien babies of cracked-out spice girl groupies. they are hideous and offensive. and everyone seems to love their trashiness! i hate this whole trash revival, this look people strive for – the glazey-eyed vague crackwhore look, complete with ridiculously expensive bits of ripped cotton which are supposed to make you look like a drunk slut. GAH IT MAKES ME SO ANGRY.
Could you send me an application form? I would always peek in on my gf’s sister when she lived with us.She would always masturbate with her skimpy little undies on and when She caught me watching her with my dick in my hand she rode me and pumped my load off in the crotch of her damp little panties
You’re a real deep thinker. Thanks for sharing.
salut, je sui un garcon de 27 ans, je suis etudiant et j’abite a Croix. Je parle pas le francais bien parceque c’est n’est pas ma langue (je suis italian). si tu me veut contacter on peut exchanger des photos. mon email est
That’s a mold-breaker. Great thinking!
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No, the sun is getting hotter. That would heat things up a bit right? There is no evidence that our carbon footprint on the earth is affecting the globe. Al Bore is an idiot. The only reason they want us to buy into the idea of global warming is so that they can start a global, yes global carbon tax. The powers that be are already talking about it.
To Mr. Conrad–This is not about a particular photograph, but about your many photographs which I have been awre of for many years. Every time I see a photo I particularly like, I look and there it is: Fred R. Conrad. So I want you to know my appreciation. The most recent one was of feet walking with shadows. However, I have been watching your work, and I wanted you to know. I am a painter myself. .
Many thanks for this article. I will also like to state that it can possibly be hard if you find yourself in school and simply starting out to initiate a long credit score. There are many scholars who are only trying to make it and have a good or positive credit history are often a difficult point to have.
This is making me so excited for our session!!! I love the sisters on the bed and the ring around the rosie – such sister moments are so hard to capture, what a amazing memory to have.
fofiedelly10 avril 2012merci pour les astuces!! en passant ton blog tombe à l’heure meme où je me met sous drupal et il est devenu une reference pour moi merci encore!!
You have made some good points there. I checked on the internet to learn more about the issue and found most individuals will go along with your views on this website.
A friend posted an image of this. I cn't post it here but the underlying point is great."When someone tells you that Obama is destroying the economy, point out that share prices and corporate profits are at an all-tiem high.When they tell you that hasn't helped them any, remind them they've just admitted trickle-down economics doesn't work."
Hey, that’s powerful. Thanks for the news.
I love expos although i never get to go to many! By the way – you are looking fabulous! on a side note – i couldn’t get the blog hop button to stay in my post today – the second line (the image line) kept disappearing….getfitchick recently posted..
It is not surprising that employers tend to offer only superficial compliance when there is no follow up from regulatory agencies. Unsafe workplace practices are often habitual and can be difficult to break. It may take several visits, citations and fines to motivate permanent change. If the employer doubts the regulators will ever be back, why would he or she go to the trouble of making costly changes?
This is a lovely post. I wonder whether you would consider posting some of your memories on Writing the City. The current theme is 'Hidden Skyline' and is all about memories of the past.Please contact Kay at: writingthecity@civiclife.sg
The case you lay out is complete and I believe this is the single most important step BikeFed should take. It would be the last major hurdle to decriminalize the typical behavior of many cyclists. With the stroke of a pen it would eliminate a schism among cyclists and an argument often used against us by anticyclists, and I think just free up alot of energy for more important work. Bring it on, please!
By October 26, 2012 – 2:21 pmaw bless. It is traumatic having your costume ruined. But good save with Michangelo! We were huge fans of the Turtles and even watched the film last night. We’re actually tempted to go as them for Halloween, but don’t have time to make the awesome heads we have in mind.
I really appreciate free, succinct, reliable data like this.
mael dit :VIVE SAMSUNG VIVE ANDROID, ET [modéré] AIIIIPHONE A LA NOIX ET APPLE A 2 BALLE AVEC SON OS6 DE [modéré] , DE TOUTE MAGNIERE APPEL NAN NA PLUS POUR TRES LONGTEMPS L ‘HEUR DE SA FIN ET PROCHE!!!! DANS LE [modéré] LULU !!!
Elis Flora comentou em 20 de agosto de 2011 às 04:08. Júlia amei a maquiagem!!! Queria saber se tem muita diferença, e qual, dos delineadores lÃÂquidos e esse em gel que você usa. Obrigada!
I’m shocked the day care would even *think* about putting a used, slobber covered bottle back into the fridge. The bacteria starts growing inside nipple the minute the baby starts sucking on it, and should be tossed completely if not used up after 30 minutes….so just imagine the colony of bugs that would develop after several hours in the fridge! Don’t they know this is a major health hazard?
What does he wish to debate? Why would anyone accommodate such an obvious idiot? It's like wrestling a pig. You both get dirty but the pig enjoys it.The SPLC has some interesting posts on their blog regarding April 19. No one can act surprised if these militia nutters act out. They call themselves "patriots". Maybe it is time to call a spade a spade and start calling them "hate-riots".My $0.02.
We added your video to our ‘wedding photographers’ playlist. We would love you to share your top 3 photography tips for successfully capturing one’s BIG day on our blog. Please connect with us here on youtube or on twitter.By the way, you might want to check out our ‘Top 50 Wedding Photographers on twitter’ on our blog. Should you be on the list?Cheers,C&K
Great post! I am always surprised (well, not so much anymore…) when people don’t make the diet and health connection. Food is medicine – for better OR worse. I will be particularly interested in your findings on the endocrine system. Often times overlooked and very misunderstood.Karen
Great point on the productivity vs gender equality vs social norms conundrum! working right now on two papers about female cash crop producers in Africa, it will be great to get your paper in our lit review… (and I’m sending your blog right now to the teams in the field to look into family dynamics)
Whoa, whoa, get out the way with that good information.
say that all native born citizens are not natural born citizens, but you have nothing to back you up.You wanting something badly doesn't make it law.
I loved as much as you’ll receive carried out suitable here. The sketch is tasteful, your authored material stylish. nonetheless, you command get got an nervousness over which you wish be delivering the following. unwell unquestionably come further formerly once more as exactly the same nearly a lot generally inside case you shield this increase.
fala ai amigo, gostei abeça do video bem explicativo, mas esse seu bravoo hd é o plus neh? pq a interface é difewrente do meu e ele parece bem mais rapido tb… vc ja teve algum problema de travamento que teve que desligar no botao traseiro? pq o meu aqui ta dando direto =( vlw
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That’s a smart way of thinking about it.
My respect for Michael just dropped down into the negatives. Seriously, he’s stepping out on her for Brooke??? Also, why in the name of taste and decorum is she engaged to HIS fake-baked butt? ::reaches for the love potions he swiped from the fairies to try and set Maddie up with Trevor::
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Nom,I heard her last night. Her slamming the gov for screwing up Cash For Clunkers and now asking us to rely on them for an extra 1/7 of the economy was classic.
pastel pink,blue and green are you best options in that order. Pastel yellow, and white will also go well with that just make sure that if you do wear a white shirt that you wear a tank top underneath so *nothing* shows through the shirt( they can be see through). -1Was this answer helpful?
1. Jag och mannen försöker alltid få till en powerwalk/långprommenad på julaftonsförmiddagen. I bästa fall en löptur. Detta satsar vi även på i år. Jag behöver få lite frisk luft, röra på mig och hämta kraft inför en intensiv dag med mat, tomtar och släktingar ;).2. Stl XS ( ev S om dom är små i storleken )3. Jag gillar Bodystore på FB
Oh, I wish. I have the hopefully-next-to-last revision with a beta reader now. Once I incorporate those comments and give it a final polish and intensive edit, I will query it.The concept is different. And different is risky, especially with an unknown author. If I can’t attract an agent in a reasonable amount of time, I will e-publish it.
25-30-35-40-42,5f-42.5 kg. Olen tyytyväinen ja happy. Syksyllä OHS- maksimi oli 32,5 eli parannusta aika huikeasti lyhyessä ajassa ja siisPR samalla. Päälle kuritukseksi dippailua, wallballia 9kg:llä , vatsoja, pystärivoimat. Kyykky alkaa olla mulle ihan painajainen. Tekniikka ja jalkavoimat pettää mut joka kerta
You make things so clear. Thanks for taking the time!
Si cum ramane cu handwriting recognition de la majoritatea ppc-lor ?doar dai enable pe acea optiune din meniu si astfel ” “mazgalind†literele cu ajutorul degetului ” putem face aceleasi functii
Comme nous n’avons testé la combi Agent18 que pour quelques sessions c’est difficile de déceler des défauts qui apparaissent plus tard, au bout de 10-15 sessions. Sur la combi ZION par contre on l’a surfé pas mal de fois et même si l’eau pénètre un peu dans la 3/2 comme nous l’avons signalé, la combi reste vraiment confortable et élastique en plus d’être chaude.
Luciana comentou em 1 de fevereiro de 2010 às 15:20. fui dar uma olhadinha na sombra que sugeriu (Malt, muito bonita, mas no computador me pareceu escura), e vi a Chamomile, o que vc acha desta cor Julia?
Ooo, I like that one. I'm also really partial to 10, but I think that's just because it's such a different scene to see for Pteranodons. You see them for so long as leathery winged reptiles that it's peculiar to see one posed like a pelican. I love it though, it's so naturalistic.
Stay informative, San Diego, yeah boy!
Life Coaching met Herman het vir my baie beteken. Dit het my tot nuwe denke geinspireer asook nuwe tegnieke geleer. Dit het op ‘n baie nodige tyd in my lewe gebeur en wat die beste van die hele ervaring is, is dat ek dit prakties kan toepas in my beroep en in my lewe. Ek kan dit vir enige iemand aanbeveel. Ons almal het een of ander tyd coaching nodig veral as mens die lewe voluit wil leef.Dankie Herman!!
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I believe that a worthwhile life is defined by a kind of spiritual journey and a sense of obligation.
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This effect usually achieved by zooming *out* while taking the
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Patients with erectile dysfunction (ED) typically fear and query in regards to the security of their coronary heart with medications like Viagra, Levitra or Cilais.
In actual fact for most individuals these ED medication are very secure and extremely effective .By serving to
to enhance sexual potential in males, these ED medicine will be useful to their coronary heart well being and total effectively-being.
This is without doubt one of the extra frequent questions
I get from my male patients. Or typically its the numerous different who’s frightened that one of those medicine for
erectile dysfunction (ED) would possibly stress their partners coronary heart.
Actually for most individuals these ED medication are very protected and
extremely efficient. Intercourse is designed by
nature to be one among lifes most exquisite pleasures.
Bodily intimacy bonds us to our associate like nothing else,
and helps to cement and maintain an in depth, private and loving connection. An intimate
lengthy-time period relationship is certainly one of an important
predictors of somebody who will keep wholesome and comfortable regardless of the stresses and strains that life inevitably throws at us alongside our
journey. So by serving to to enhance sexual means in males, these
ED medicine will be useful to their coronary heart well
being and total effectively-being. A Curious Facet Impact. .
. These medication had been found by accident about 20 years in the past when scientists have been in search of a
drug to deal with coronary heart illness. This explicit drug
(ultimately named Viagra) turned out to dilate blood vessels notably nicely within the penis.
As they are saying, the remaining is historical past,
and this drug alone has turned right into a billion-dollar-per-yr blockbuster.
The take-dwelling message is that these medication dilate blood
vessels which typically is nice to your coronary heart.
Examine in along with your physician earlier than beginning one of many medicine simply to make sure.
And watch out to not take them with nitroglycerin or Flomax sort medications for the prostate, as a result of together with Viagra, Cialis, or Levitra they’ll decrease your blood strain a lot.
These erectile dysfunction medicines are comparatively costly, at about $14
per pill. However because the spouse of one in every
of my patients put it: Its about the identical as what we’d pay to go see a film,
and that is significantly better leisure.
My husband began taking Viagra and Cialis about three years in the
past. Since then, I’ve carried out a few of my very own analysis on the web.
It’s wonderful what number of articles there are about why
you want …
My husband began taking Viagra and Cialis about three years in the past.
Since then, I’ve achieved a few of my very own analysis on the web.
It’s superb what number of articles there are about
why you want to purchase Viagra and Cialis. Nevertheless, a few of the data stands out to me as being essential greater than others.
A lot of Males use Viagra or Cialis
At first, I believed that possibly my husband was a part of a small group of individuals.
Nonetheless, I’m starting to understand
by means of studying that a big majority of males over the age of forty are utilizing Viagra and generic Cialis.
For males over 60, that quantity is as excessive as ninety% in some
locations! Its not onerous to consider that so many
individuals are utilizing a contemplating that the profound have an effect on that has on conquering erectile dysfunction. I do know from private expertise
that there was a major distinction in our relationship after he had used
Cialis for a couple of months.
Many Books Converse from A Doctors Perspective
Tlisted here are many fascinating books written from docs
in new prescribe this remedy. They’ve had virtually fifteen years
to hearken to man and get their experiences.
It’s fascinating to search out that many of those books go into
the upset about educating man how their our bodies work.
Relying on what technology youre from, you may want this data as a result of youre by no means taught it.
When you perceive how your physique works, you’ll perceive
how Viagra and Cialis work.
Tlisted here are Psychological Facets for Some Males
Some males are usually not conscious of how their psychological well being has affected their
our bodies. Sure folks will get sure bodily to situations primarily based on how a lot stress they’re below.
Everyone seems to be slightly completely different.
Nevertheless there are numerous males who discover that they dont must take Viagra or Cialis ceaselessly.
They discover their stress ranges altering and merely want to make use of generic Viagra and
Cialis much less.
Viagra and Cialis Enhance Intimacy
Anyone who has examine bettering relationships finally learns about emotional intimacy.
That is when your accomplice is your greatest pal too.
Many people suppose that taking somewhat blue pill goes to cure us of all our relationship issues.
Whereas it’d restore your capability to get an erection,
it won’t enhance your emotional relationship. Nevertheless, working collectively to enhance
your relationship over all actually will.
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First, let’s get a little historical perspective on American health care. This is not intended to be an exhausted look into that history but it will give us an appreciation of how the health care system and our expectations for it developed. What drove costs higher and higher?
To begin, let’s turn to the American civil war. In that war, dated tactics and the carnage inflicted by modern weapons of the era combined to cause ghastly results. Not generally known is that most of the deaths on both sides of that war were not the result of actual combat but to what happened after a battlefield wound was inflicted. To begin with, evacuation of the wounded moved at a snail’s pace and this caused severe delays in treating the wounded. Secondly, many wounds were subjected to wound care, related surgeries and/or amputations of the affected limbs and this often resulted in the onset of massive infection. So you might survive a battle wound only to die at the hands of medical care providers who although well-intentioned, their interventions were often quite lethal. High death tolls can also be ascribed to everyday sicknesses and diseases in a time when no antibiotics existed. In total something like 600,000 deaths occurred from all causes, over 2% of the U.S. population at the time!
Let’s skip to the first half of the 20th century for some additional perspective and to bring us up to more modern times. After the civil war there were steady improvements in American medicine in both the understanding and treatment of certain diseases, new surgical techniques and in physician education and training. But for the most part the best that doctors could offer their patients was a “wait and see” approach. Medicine could handle bone fractures and increasingly attempt risky surgeries (now largely performed in sterile surgical environments) but medicines were not yet available to handle serious illnesses. The majority of deaths remained the result of untreatable conditions such as tuberculosis, pneumonia, scarlet fever and measles and/or related complications. Doctors were increasingly aware of heart and vascular conditions, and cancer but they had almost nothing with which to treat these conditions.
This very basic review of American medical history helps us to understand that until quite recently (around the 1950′s) we had virtually no technologies with which to treat serious or even minor ailments. Here is a critical point we need to understand; “nothing to treat you with means that visits to the doctor if at all were relegated to emergencies so in such a scenario costs are curtailed. The simple fact is that there was little for doctors to offer and therefore virtually nothing to drive health care spending. A second factor holding down costs was that medical treatments that were provided were paid for out-of-pocket, meaning by way of an individuals personal resources. There was no such thing as health insurance and certainly not health insurance paid by an employer. Except for the very destitute who were lucky to find their way into a charity hospital, health care costs were the responsibility of the individual.
What does health care insurance have to do with health care costs? Its impact on health care costs has been, and remains to this day, absolutely enormous. When health insurance for individuals and families emerged as a means for corporations to escape wage freezes and to attract and retain employees after World War II, almost overnight a great pool of money became available to pay for health care. Money, as a result of the availability of billions of dollars from health insurance pools, encouraged an innovative America to increase medical research efforts. More Americans became insured not only through private, employer sponsored health insurance but through increased government funding that created Medicare and Medicaid (1965). In addition funding became available for expanded veterans health care benefits. Finding a cure for almost anything has consequently become very lucrative. This is also the primary reason for the vast array of treatments we have available today.
I do not wish to convey that medical innovations are a bad thing. Think of the tens of millions of lives that have been saved, extended, enhanced and made more productive as a result. But with a funding source grown to its current magnitude (hundreds of billions of dollars annually) upward pressure on health care costs are inevitable. Doctor’s offer and most of us demand and get access to the latest available health care technology in the form of pharmaceuticals, medical devices, diagnostic tools and surgical procedures. So the result is that there is more health care to spend our money on and until very recently most of us were insured and the costs were largely covered by a third-party (government, employers). Add an insatiable and unrealistic public demand for access and treatment and we have the “perfect storm” for higher and higher health care costs. And by and large the storm is only intensifying.
At this point, let’s turn to the key questions that will lead us into a review and hopefully a better understanding of the health care reform proposals in the news today. Is the current trajectory of U.S. health care spending sustainable? Can America maintain its world competitiveness when 16%, heading for 20% of our gross national product is being spent on health care? What are the other industrialized countries spending on health care and is it even close to these numbers? When we add politics and an election year to the debate, information to help us answer these questions become critical. We need to spend some effort in understanding health care and sorting out how we think about it. Properly armed we can more intelligently determine whether certain health care proposals might solve or worsen some of these problems. What can be done about the challenges? How can we as individuals contribute to the solutions?
The Obama health care plan is complex for sure – I have never seen a health care plan that isn’t. But through a variety of programs his plan attempts to deal with a) increasing the number of American that are covered by adequate insurance (almost 50 million are not), and b) managing costs in such a manner that quality and our access to health care is not adversely affected. Republicans seek to achieve these same basic and broad goals, but their approach is proposed as being more market driven than government driven. Let’s look at what the Obama plan does to accomplish the two objectives above. Remember, by the way, that his plan was passed by congress, and begins to seriously kick-in starting in 2014. So this is the direction we are currently taking as we attempt to reform health care.
Through insurance exchanges and an expansion of Medicaid,the Obama plan dramatically expands the number of Americans that will be covered by health insurance.
To cover the cost of this expansion the plan requires everyone to have health insurance with a penalty to be paid if we don’t comply. It will purportedly send money to the states to cover those individuals added to state-based Medicaid programs.
To cover the added costs there were a number of new taxes introduced, one being a 2.5% tax on new medical technologies and another increases taxes on interest and dividend income for wealthier Americans.
The Obama plan also uses concepts such as evidence-based medicine, accountable care organizations, comparative effectiveness research and reduced reimbursement to health care providers (doctors and hospitals) to control costs.
The insurance mandate covered by points 1 and 2 above is a worthy goal and most industrialized countries outside of the U.S. provide “free” (paid for by rather high individual and corporate taxes) health care to most if not all of their citizens. It is important to note, however, that there are a number of restrictions for which many Americans would be culturally unprepared. Here is the primary controversial aspect of the Obama plan, the insurance mandate. The U.S. Supreme Court recently decided to hear arguments as to the constitutionality of the health insurance mandate as a result of a petition by 26 states attorney’s general that congress exceeded its authority under the commerce clause of the U.S. constitution by passing this element of the plan. The problem is that if the Supreme Court should rule against the mandate, it is generally believed that the Obama plan as we know it is doomed. This is because its major goal of providing health insurance to all would be severely limited if not terminated altogether by such a decision.
As you would guess, the taxes covered by point 3 above are rather unpopular with those entities and individuals that have to pay them. Medical device companies, pharmaceutical companies, hospitals, doctors and insurance companies all had to “give up” something that would either create new revenue or would reduce costs within their spheres of control. As an example, Stryker Corporation, a large medical device company, recently announced at least a 1,000 employee reduction in part to cover these new fees. This is being experienced by other medical device companies and pharmaceutical companies as well. The reduction in good paying jobs in these sectors and in the hospital sector may rise as former cost structures will have to be dealt with in order to accommodate the reduced rate of reimbursement to hospitals. Over the next ten years some estimates put the cost reductions to hospitals and physicians at half a trillion dollars and this will flow directly to and affect the companies that supply hospitals and doctors with the latest medical technologies. None of this is to say that efficiencies will not be realized by these changes or that other jobs will in turn be created but this will represent painful change for a while. It helps us to understand that health care reform does have an effect both positive and negative.
Finally, the Obama plan seeks to change the way medical decisions are made. While clinical and basic research underpins almost everything done in medicine today, doctors are creatures of habit like the rest of us and their training and day-to-day experiences dictate to a great extent how they go about diagnosing and treating our conditions. Enter the concept of evidence-based medicine and comparative effectiveness research. Both of these seek to develop and utilize data bases from electronic health records and other sources to give better and more timely information and feedback to physicians as to the outcomes and costs of the treatments they are providing. There is great waste in health care today, estimated at perhaps a third of an over 2 trillion dollar health care spend annually. Imagine the savings that are possible from a reduction in unnecessary test and procedures that do not compare favorably with health care interventions that are better documented as effective. Now the Republicans and others don’t generally like these ideas as they tend to characterize them as “big government control” of your and my health care. But to be fair, regardless of their political persuasions, most people who understand health care at all, know that better data for the purposes described above will be crucial to getting health care efficiencies, patient safety and costs headed in the right direction.
A brief review of how Republicans and more conservative individuals think about health care reform. I believe they would agree that costs must come under control and that more, not fewer Americans should have access to health care regardless of their ability to pay. But the main difference is that these folks see market forces and competition as the way to creating the cost reductions and efficiencies we need. There are a number of ideas with regard to driving more competition among health insurance companies and health care providers (doctors and hospitals) so that the consumer would begin to drive cost down by the choices we make. This works in many sectors of our economy but this formula has shown that improvements are illusive when applied to health care. Primarily the problem is that health care choices are difficult even for those who understand it and are connected. The general population, however, is not so informed and besides we have all been brought up to “go to the doctor” when we feel it is necessary and we also have a cultural heritage that has engendered within most of us the feeling that health care is something that is just there and there really isn’t any reason not to access it for whatever the reason and worse we all feel that there is nothing we can do to affect its costs to insure its availability to those with serious problems.
OK, this article was not intended to be an exhaustive study as I needed to keep it short in an attempt to hold my audience’s attention and to leave some room for discussing what we can do contribute mightily to solving some of the problems. First we must understand that the dollars available for health care are not limitless. Any changes that are put in place to provide better insurance coverage and access to care will cost more. And somehow we have to find the revenues to pay for these changes. At the same time we have to pay less for medical treatments and procedures and do something to restrict the availability of unproven or poorly documented treatments as we are the highest cost health care system in the world and don’t necessarily have the best results in terms of longevity or avoiding chronic diseases much earlier than necessary.
I believe that we need a revolutionary change in the way we think about health care, its availability, its costs and who pays for it. And if you think I am about to say we should arbitrarily and drastically reduce spending on health care you would be wrong. Here it is fellow citizens – health care spending needs to be preserved and protected for those who need it. And to free up these dollars those of us who don’t need it or can delay it or avoid it need to act. First, we need to convince our politicians that this country needs sustained public education with regard to the value of preventive health strategies. This should be a top priority and it has worked to reduce the number of U.S. smokers for example. If prevention were to take hold, it is reasonable to assume that those needing health care for the myriad of life style engendered chronic diseases would decrease dramatically. Millions of Americans are experiencing these diseases far earlier than in decades past and much of this is due to poor life style choices. This change alone would free up plenty of money to handle the health care costs of those in dire need of treatment, whether due to an acute emergency or chronic condition.
Let’s go deeper on the first issue. Most of us refuse do something about implementing basic wellness strategies into our daily lives. We don’t exercise but we offer a lot of excuses. We don’t eat right but we offer a lot of excuses. We smoke and/or we drink alcohol to excess and we offer a lot of excuses as to why we can’t do anything about managing these known to be destructive personal health habits. We don’t take advantage of preventive health check-ups that look at blood pressure, cholesterol readings and body weight but we offer a lot of excuses. In short we neglect these things and the result is that we succumb much earlier than necessary to chronic diseases like heart problems, diabetes and high blood pressure. We wind up accessing doctors for these and more routine matters because “health care is there” and somehow we think we have no responsibility for reducing our demand on it.
It is difficult for us to listen to these truths but easy to blame the sick. Maybe they should take better care of themselves! Well, that might be true or maybe they have a genetic condition and they have become among the unfortunate through absolutely no fault of their own. But the point is that you and I can implement personalized preventive disease measures as a way of dramatically improving health care access for others while reducing its costs. It is far better to be productive by doing something we can control then shifting the blame.
There are a huge number of free web sites available that can steer us to a more healthful life style. A soon as you can, “Google” “preventive health care strategies”, look up your local hospital’s web site and you will find more than enough help to get you started. Finally, there is a lot to think about here and I have tried to outline the challenges but also the very powerful effect we could have on preserving the best of America’s health care system now and into the future. I am anxious to hear from you and until then – take charge and increase your chances for good health while making sure that health care is there when we need it.
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