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Lost Since 9
America has entered its third great era: the post constitutional one. In the first, in the colonial years,van cleef and arpels fake necklace, a unitary executive, the King of England, ruled without checks and balances, allowing no freedom of speech, due process, or privacy when it came to protecting his power.In the second, the principles of the Enlightenment and an armed rebellion were used to push back the king abuses. The result was a new country and a new constitution with a Bill of Rights expressly meant to check the government's power. Now, we are wading into the shallow waters of a third era, a time when that government is abandoning the basic ideas that saw our nation through centuries of challenges far more daunting than terrorism. Those ideas enshrined in the Bill of Rights are disarmingly concise. Think of them as the haiku of a genuine people's government.Deeper, darker waters lie ahead and we seem drawn down into them. For here there be monsters.The Powers of a Police State DeniedAmerica in its pre constitutional days may seem eerily familiar even to casual readers of current events. We lived then under the control of a king. (Think now: the imperial presidency.) That king was a powerful, unitary executive who ruled at a distance. His goal was simple: to use his power over American colonies to draw the maximum financial gain while suppressing any dissent that might endanger his control.In those years, protest was dangerous. Speech could indeed make you the enemy of the government. Journalism could be a crime if you didn write in support of those in power. A citizen needed to watch what he said, for there were spies everywhere, including fellow colonists hoping for a few crumbs from the king's table. Laws could be brutal and punishments swift as well as extra judicial. In extreme cases, troops shot down those simply assembling to speak out.Among the many offenses against liberty in pre constitutional America, one pivotal event, the Stamp Act of 1765, stands out. To enforce the taxes imposed by the Act,van cleef and arpel replica necklace, the king's men used "writs of assistance" that allowed them to burst into any home or business, with or without suspicion of wrongdoing. American privacy was violated and property ransacked, often simply as a warning of the king power. Some colonist was then undoubtedly the first American to mutter,van cleef and arpels replica clover necklace, if I have nothing to hide, why should I be afraid? He soon learned that when a population is categorically treated as a potential enemy, everyone has something to hide if the government claims they do.The Stamp Act and the flood of kingly offenses that followed created in those who founded the United States a profound suspicion of what an unchecked government could do, and a sense that power and freedom are not likely to coexist comfortably in a democracy. A balancing mechanism was required. In addition to the body of the Constitution outlining what the new nation's government could do, needed was an accounting of what it could not do. The answer was the Bill of Rights.The Bill's preamble explained the matter this way: order to prevent misconstruction or abuse of [the government's] powers, that further declaratory and restrictive clauses should be added. Thomas Jefferson commented separately, "[A] bill of rights is what the people are entitled to against every government on earth."In other words, the Bill of Rights was written to make sure that the new government would not replicate the abuses of power of the old one. Each amendment spoke directly to a specific offense committed by the king. Their purpose collectively was to lay out what the government could never take away. Knowing first hand the dangers of a police state and unchecked power, those who wrote the Constitution wanted to be clear: never again.It needs to be said that those imperfect men were very much of their era. They were right about much, but desperately wrong about other things. They addressed but ignored the rights of women and Native Americans. Above all, they did not abolish the institution of slavery, our nation Original Sin. It would take many years, and much blood, to begin to rectify those mistakes.Still, for more than two centuries, the meaning of the Bill of Rights was generally expanded, though especially in wartime it sometimes temporarily contracted. Yet the basic principles that guided America were sustained despite civil war, world wars, depressions, and endless challenges. Then, one September morning, our Post Constitutional era began amid falling towers and empty skies. What have we lost since? More than we imagine. A look at the Bill of Rights, amendment by amendment, tells the tale."Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."The First Amendment was meant to make one thing indisputably clear: free speech was the basis for a government of the people. Without a free press, as well as the ability to openly gather, debate, protest, and criticize, how would the people be able to judge their government's adherence to the other rights? How could people vote knowledgeably if they didn know what was being done in their name by their government? An informed citizenry, Thomas Jefferson stated, was "a vital requisite for our survival as a free people."That was how it was seen long ago. In Post Constitutional America, however, the government strives to "control the message," to actively thwart efforts to maintain a citizenry informed about what done in its name, a concept that these days seems as quaint as Jefferson's powdered wig. There are far too many examples of the post 9/11 erosion of the First Amendment to list here. Let's just look at a few important ones that tell the tale of what we have lost since 9/11.(Lack of) Freedom of InformationIn 1966, an idea for keeping Americans better informed on the workings of their government was hatched: the Freedom of Information Act (FOIA). Strengthened in 1974, it began with the premise that, except for some obvious categories (like serious national security matters and personal information), the position of the government should be: everything it does is available to the public. Like the Bill of Rights, which made specific the limits of government, FOIA began with a presumption that it was the government duty to make information available and quickly to the people, unless a convincing case could be made otherwise. The default position of the FOIA switch was set to ON.Three decades later, the FOIA system works far differently. Agencies are generally loath to release documents of any sort and instead put their efforts into creating roadblocks to legitimate requests. Some still require signatures on paper. (The State Department notes, for personal information cannot be submitted electronically and should be submitted by mail. Others demand hyper detailed information like the precise dates and titles of documents whose dates and titles may be classified and unavailable. The NSA simply denies almost all FOIA requests out of hand, absent a court order.Most federal agencies now regard the deadline mandated for a response as the time period to send out a received note. They tend to assign only a few staff members to processing requests, leading to near endless delays. At the State Department, most FOIA work is done on a part time basis by retirees. The CIA won directly release electronic versions of documents. Even when a request is fulfilled, copying is often denied and reproduction costs exaggerated.In some cases, the requested records have a way of disappearing or are simply removed. The ACLU experience when it filed an FOIA style request with the Sarasota police department on its use of the cell phone surveillance tool Stingray could be considered typical. The morning the ACLU was to review the files, Federal Marshals arrived and physically took possession of them, claiming they had deputized the local cops and made the files federal property.John Young, who runs the web site Cryptome and is a steadfast FOIA requester, stated, delay, brush off, lying are normal. It is a delusion for ordinary requesters and a bitch of a challenge for professionals. Churning has become a way of life for FOIA, costly as hell for little results. Lips and the WhistleblowerAll government agencies have regulations requiring employees to obtain permission before speaking to the representatives of the people that is, journalists. Even speaking about unclassified information is a no no that may cost you your job. A government ever more in lockdown mode has created what one journalist calls a where censorship is the norm. who does speak to Americans about their government? Growing hordes of spokespeople, communications staff, trained PR crews, and those anonymous officials who pop up so regularly in news articles in major papers.With the government obsessively seeking to hide or spin what it does, in the sunlight contact barred, and those inside locked behind an iron curtain of secrecy, the whistleblower has become the paradigmatic figure of the era. Not surprisingly, anyone who blows a whistle has, in these years, come under fierce attack.Pick a case: Tom Drake exposing early NSA efforts to turn its spy tools on Americans, Edward Snowden proving that the government has us under constant surveillance, Chelsea Manning documenting war crimes in Iraq and sleazy diplomacy everywhere, John Kiriakou acknowledging torture by his former employer the CIA, or Robert MacLean revealing Transportation Safety Administration malfeasance. In each instance, the threat of jail was quick to surface. The nuclear option against such truthtellers is the Espionage Act, a law that offended the Constitution when implemented in the midst of World War I. It has been resurrected by the Obama administration as a blunt tool for silencing and punishing whistleblowers.The Obama administration has already charged six people under that act for allegedly mishandling classified information. Even Richard Nixon only invoked it once, in a failed prosecution against Pentagon Papers whistleblower Daniel Ellsberg.Indeed, the very word couldn be stranger in the context of these cases. None of those charged spied. None sought to aid an enemy or make money selling secrets. No matter. In Post Constitutional America, the powers that be stand ready to twist language in whatever Orwellian direction is necessary to bridge the gap between reality and the king's needs. national security or benefit a foreign power. It could still be a part of an charge.A final question might be: How could a law designed almost 100 years ago to stop German spies in wartime have become a tool to silence the few Americans willing to risk everything to exercise their First Amendment rights? When did free speech become a crime?Each person charged under the Espionage Act in these years was primarily a source for a journalist. The press was necessary to question government officials directly, comment on their actions,van cleef and arpels fake butterfly necklace, and inform the citizenry about what its government was doing. Sadly, as the Obama administration is moving ever more fiercely against those who might reveal its acts or documents, the bulk of the media have acquiesced. Glenn Greenwald said it plainly: too many journalists have gone into a self censoring mode, practicing "obsequious journalism."
America has entered its third great era: the post constitutional one. In the first, in the colonial years,van cleef and arpels fake necklace, a unitary executive, the King of England, ruled without checks and balances, allowing no freedom of speech, due process, or privacy when it came to protecting his power.In the second, the principles of the Enlightenment and an armed rebellion were used to push back the king abuses. The result was a new country and a new constitution with a Bill of Rights expressly meant to check the government's power. Now, we are wading into the shallow waters of a third era, a time when that government is abandoning the basic ideas that saw our nation through centuries of challenges far more daunting than terrorism. Those ideas enshrined in the Bill of Rights are disarmingly concise. Think of them as the haiku of a genuine people's government.Deeper, darker waters lie ahead and we seem drawn down into them. For here there be monsters.The Powers of a Police State DeniedAmerica in its pre constitutional days may seem eerily familiar even to casual readers of current events. We lived then under the control of a king. (Think now: the imperial presidency.) That king was a powerful, unitary executive who ruled at a distance. His goal was simple: to use his power over American colonies to draw the maximum financial gain while suppressing any dissent that might endanger his control.In those years, protest was dangerous. Speech could indeed make you the enemy of the government. Journalism could be a crime if you didn write in support of those in power. A citizen needed to watch what he said, for there were spies everywhere, including fellow colonists hoping for a few crumbs from the king's table. Laws could be brutal and punishments swift as well as extra judicial. In extreme cases, troops shot down those simply assembling to speak out.Among the many offenses against liberty in pre constitutional America, one pivotal event, the Stamp Act of 1765, stands out. To enforce the taxes imposed by the Act,van cleef and arpel replica necklace, the king's men used "writs of assistance" that allowed them to burst into any home or business, with or without suspicion of wrongdoing. American privacy was violated and property ransacked, often simply as a warning of the king power. Some colonist was then undoubtedly the first American to mutter,van cleef and arpels replica clover necklace, if I have nothing to hide, why should I be afraid? He soon learned that when a population is categorically treated as a potential enemy, everyone has something to hide if the government claims they do.The Stamp Act and the flood of kingly offenses that followed created in those who founded the United States a profound suspicion of what an unchecked government could do, and a sense that power and freedom are not likely to coexist comfortably in a democracy. A balancing mechanism was required. In addition to the body of the Constitution outlining what the new nation's government could do, needed was an accounting of what it could not do. The answer was the Bill of Rights.The Bill's preamble explained the matter this way: order to prevent misconstruction or abuse of [the government's] powers, that further declaratory and restrictive clauses should be added. Thomas Jefferson commented separately, "[A] bill of rights is what the people are entitled to against every government on earth."In other words, the Bill of Rights was written to make sure that the new government would not replicate the abuses of power of the old one. Each amendment spoke directly to a specific offense committed by the king. Their purpose collectively was to lay out what the government could never take away. Knowing first hand the dangers of a police state and unchecked power, those who wrote the Constitution wanted to be clear: never again.It needs to be said that those imperfect men were very much of their era. They were right about much, but desperately wrong about other things. They addressed but ignored the rights of women and Native Americans. Above all, they did not abolish the institution of slavery, our nation Original Sin. It would take many years, and much blood, to begin to rectify those mistakes.Still, for more than two centuries, the meaning of the Bill of Rights was generally expanded, though especially in wartime it sometimes temporarily contracted. Yet the basic principles that guided America were sustained despite civil war, world wars, depressions, and endless challenges. Then, one September morning, our Post Constitutional era began amid falling towers and empty skies. What have we lost since? More than we imagine. A look at the Bill of Rights, amendment by amendment, tells the tale."Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."The First Amendment was meant to make one thing indisputably clear: free speech was the basis for a government of the people. Without a free press, as well as the ability to openly gather, debate, protest, and criticize, how would the people be able to judge their government's adherence to the other rights? How could people vote knowledgeably if they didn know what was being done in their name by their government? An informed citizenry, Thomas Jefferson stated, was "a vital requisite for our survival as a free people."That was how it was seen long ago. In Post Constitutional America, however, the government strives to "control the message," to actively thwart efforts to maintain a citizenry informed about what done in its name, a concept that these days seems as quaint as Jefferson's powdered wig. There are far too many examples of the post 9/11 erosion of the First Amendment to list here. Let's just look at a few important ones that tell the tale of what we have lost since 9/11.(Lack of) Freedom of InformationIn 1966, an idea for keeping Americans better informed on the workings of their government was hatched: the Freedom of Information Act (FOIA). Strengthened in 1974, it began with the premise that, except for some obvious categories (like serious national security matters and personal information), the position of the government should be: everything it does is available to the public. Like the Bill of Rights, which made specific the limits of government, FOIA began with a presumption that it was the government duty to make information available and quickly to the people, unless a convincing case could be made otherwise. The default position of the FOIA switch was set to ON.Three decades later, the FOIA system works far differently. Agencies are generally loath to release documents of any sort and instead put their efforts into creating roadblocks to legitimate requests. Some still require signatures on paper. (The State Department notes, for personal information cannot be submitted electronically and should be submitted by mail. Others demand hyper detailed information like the precise dates and titles of documents whose dates and titles may be classified and unavailable. The NSA simply denies almost all FOIA requests out of hand, absent a court order.Most federal agencies now regard the deadline mandated for a response as the time period to send out a received note. They tend to assign only a few staff members to processing requests, leading to near endless delays. At the State Department, most FOIA work is done on a part time basis by retirees. The CIA won directly release electronic versions of documents. Even when a request is fulfilled, copying is often denied and reproduction costs exaggerated.In some cases, the requested records have a way of disappearing or are simply removed. The ACLU experience when it filed an FOIA style request with the Sarasota police department on its use of the cell phone surveillance tool Stingray could be considered typical. The morning the ACLU was to review the files, Federal Marshals arrived and physically took possession of them, claiming they had deputized the local cops and made the files federal property.John Young, who runs the web site Cryptome and is a steadfast FOIA requester, stated, delay, brush off, lying are normal. It is a delusion for ordinary requesters and a bitch of a challenge for professionals. Churning has become a way of life for FOIA, costly as hell for little results. Lips and the WhistleblowerAll government agencies have regulations requiring employees to obtain permission before speaking to the representatives of the people that is, journalists. Even speaking about unclassified information is a no no that may cost you your job. A government ever more in lockdown mode has created what one journalist calls a where censorship is the norm. who does speak to Americans about their government? Growing hordes of spokespeople, communications staff, trained PR crews, and those anonymous officials who pop up so regularly in news articles in major papers.With the government obsessively seeking to hide or spin what it does, in the sunlight contact barred, and those inside locked behind an iron curtain of secrecy, the whistleblower has become the paradigmatic figure of the era. Not surprisingly, anyone who blows a whistle has, in these years, come under fierce attack.Pick a case: Tom Drake exposing early NSA efforts to turn its spy tools on Americans, Edward Snowden proving that the government has us under constant surveillance, Chelsea Manning documenting war crimes in Iraq and sleazy diplomacy everywhere, John Kiriakou acknowledging torture by his former employer the CIA, or Robert MacLean revealing Transportation Safety Administration malfeasance. In each instance, the threat of jail was quick to surface. The nuclear option against such truthtellers is the Espionage Act, a law that offended the Constitution when implemented in the midst of World War I. It has been resurrected by the Obama administration as a blunt tool for silencing and punishing whistleblowers.The Obama administration has already charged six people under that act for allegedly mishandling classified information. Even Richard Nixon only invoked it once, in a failed prosecution against Pentagon Papers whistleblower Daniel Ellsberg.Indeed, the very word couldn be stranger in the context of these cases. None of those charged spied. None sought to aid an enemy or make money selling secrets. No matter. In Post Constitutional America, the powers that be stand ready to twist language in whatever Orwellian direction is necessary to bridge the gap between reality and the king's needs. national security or benefit a foreign power. It could still be a part of an charge.A final question might be: How could a law designed almost 100 years ago to stop German spies in wartime have become a tool to silence the few Americans willing to risk everything to exercise their First Amendment rights? When did free speech become a crime?Each person charged under the Espionage Act in these years was primarily a source for a journalist. The press was necessary to question government officials directly, comment on their actions,van cleef and arpels fake butterfly necklace, and inform the citizenry about what its government was doing. Sadly, as the Obama administration is moving ever more fiercely against those who might reveal its acts or documents, the bulk of the media have acquiesced. Glenn Greenwald said it plainly: too many journalists have gone into a self censoring mode, practicing "obsequious journalism."
KKR thrash RCB
Asplendid opening wicket stand by the belligerent Manoj Tiwary (50) and Brad Hodge (50)ensured the Kolkata Knight Ridersa comfortable seven wicketwin in their IPLmatch againstthe Bangalore Royal Challengers at the Eden Gardens on Sunday.
Chasing just 136 to win, thelocal side cruised home with four balls to spare, withCheteshwar Pujara on five and Owais Shah on two.
Tiwary, out for a duck in the opening match against Deccan Chargers, made a maiden IPL fifty. His aggressive 29 ball knock comprised of six boundaries and two massive hits over it.
However, soon after he reached the landmark, he hit a Roelof van der Merwe delivery straight back to the bowler to give Bangalore their first wicket, albeit a tad too late.
Two balls later, Ganguly, also out for a golden duck again the Chargers, was dropped by Sreevats.
Hodge completed his fourth IPL half century soon after but was dismissed in the same over. The Australian's 45 ball knock was inclusive of seven hits to the fence.
Sourav Ganguly made an almost run a ball 23 before being dismissed with just trequired.
The KKR captain hit a Praveen Kumar delivery straight to Eoin Morgan at deep midwicket.
Earlier,van cleef zipper necklace replica, a superlative unbeaten 65 by veteran Jacques Kallis helped the Bangalore Royal Challengerspost atotal with a semblance of respectability.
The Bangalore team, afterstruggling at 35 for four in the eighth over,managed 135 for seven in their stipulated 20 overs.
Kallis' masterclass came off just 52 balls and consisted of seven hits to the fence and a huge one over it,van cleef and arpels magic alhambra necklace replica.
Angelo Matthews was the most successful Kolkata bowler with figures of four for19 in his four overs,van cleef and arpels sweet alhambra necklace replica. Murali Kartik impressed again with his two for 22.
The home team made most of their decision to bowl first.
Charl Langeveldt dismissed Sreevats Goswami in his second over to give Kolkata Knight Riders an early breakthrough.
Goswami (8) was caiught by Ishant Sharma at third man.
Two overs later, Manish Pandey (0)) dragged an Matthews delivery to his stumps to make it a double celebrations for the hosts.
Virat Kohli (2) was caught by Matthews off Kartik to ensure another setback for Bangalore and their woes were compounded when Eoin Morgan (10) dragged a Kartik delivery onto his stumps,magic alhambra necklace replica.
Rahul Dravid (21) and Kallis put on38 runs for the fifth wicket before another fatal inside edge (off Matthews) ended Dravid's innings.
Robin Uthappa (20) lasted 17 balls before edging an Matthews delivery straight to Saha behind the stumps.
Three balls later, a Roelef van der Merwe mishit was snapped up by Brad Hodge at backward point, giving Matthews his fourth wicket of the innings.
Asplendid opening wicket stand by the belligerent Manoj Tiwary (50) and Brad Hodge (50)ensured the Kolkata Knight Ridersa comfortable seven wicketwin in their IPLmatch againstthe Bangalore Royal Challengers at the Eden Gardens on Sunday.
Chasing just 136 to win, thelocal side cruised home with four balls to spare, withCheteshwar Pujara on five and Owais Shah on two.
Tiwary, out for a duck in the opening match against Deccan Chargers, made a maiden IPL fifty. His aggressive 29 ball knock comprised of six boundaries and two massive hits over it.
However, soon after he reached the landmark, he hit a Roelof van der Merwe delivery straight back to the bowler to give Bangalore their first wicket, albeit a tad too late.
Two balls later, Ganguly, also out for a golden duck again the Chargers, was dropped by Sreevats.
Hodge completed his fourth IPL half century soon after but was dismissed in the same over. The Australian's 45 ball knock was inclusive of seven hits to the fence.
Sourav Ganguly made an almost run a ball 23 before being dismissed with just trequired.
The KKR captain hit a Praveen Kumar delivery straight to Eoin Morgan at deep midwicket.
Earlier,van cleef zipper necklace replica, a superlative unbeaten 65 by veteran Jacques Kallis helped the Bangalore Royal Challengerspost atotal with a semblance of respectability.
The Bangalore team, afterstruggling at 35 for four in the eighth over,managed 135 for seven in their stipulated 20 overs.
Kallis' masterclass came off just 52 balls and consisted of seven hits to the fence and a huge one over it,van cleef and arpels magic alhambra necklace replica.
Angelo Matthews was the most successful Kolkata bowler with figures of four for19 in his four overs,van cleef and arpels sweet alhambra necklace replica. Murali Kartik impressed again with his two for 22.
The home team made most of their decision to bowl first.
Charl Langeveldt dismissed Sreevats Goswami in his second over to give Kolkata Knight Riders an early breakthrough.
Goswami (8) was caiught by Ishant Sharma at third man.
Two overs later, Manish Pandey (0)) dragged an Matthews delivery to his stumps to make it a double celebrations for the hosts.
Virat Kohli (2) was caught by Matthews off Kartik to ensure another setback for Bangalore and their woes were compounded when Eoin Morgan (10) dragged a Kartik delivery onto his stumps,magic alhambra necklace replica.
Rahul Dravid (21) and Kallis put on38 runs for the fifth wicket before another fatal inside edge (off Matthews) ended Dravid's innings.
Robin Uthappa (20) lasted 17 balls before edging an Matthews delivery straight to Saha behind the stumps.
Three balls later, a Roelef van der Merwe mishit was snapped up by Brad Hodge at backward point, giving Matthews his fourth wicket of the innings.
Lawn mower repair right at your doorstep
Huebner will drive to your home, load your lawn mower into his van and repair it right on the spot. He said the convenience of the service is a big selling point with customers.
"When you think about it, when you have to fix your broken lawn mower you have to figure out where you going to take it, load it up in your vehicle,van cleef pink necklace replica, it may take you 20 minutes to drive there and there may be a lineup when you get there," he said.
"If you leave it (at a repair shop) and if they really busy it could be a week to two weeks before you get it back, and then you have to bring it home again and clean your car after," he said.
"I come out right to your door, and you can still do the stuff that important to you. One time I went out and as I was fixing a lawn mower, this guy was playing with his kid. It gives you quality time instead of spending it driving somewhere."
Huebner said when a customer calls for a repair he can usually attend to it within a couple days. It usually takes him about an hour to fix a lawn mower.
"Usually (when a customer calls) it next day service, and it done. They don have to wait, and they can continue cutting their grass right away,van cleef arpel alhambra necklace replica," he said.
Huebner said his easily recognizable van has become his calling card.
"Since I switched to the bus, and had it all decaled up the way it is, I get lots of people calling me to say they saw it driving," he said.
Huebner used an enclosed trailer attached to his truck as a workshop when he started the business. It was a far from ideal situation, so he started looking around for a better option.
"I saw a Handi Transit van on the Internet and thought it might be cool (to use). I started looking around for one and found one and bought it. It was just a matter of taking some seats out,black van cleef necklace replica, and adding a work bench and a tool box. It been so much more convenient (than the trailer)," he said.
Huebner doesn just service lawn mowers. He also fixes snowblowers in the wintertime,van cleef necklace clover replica, and refurbishes and sells both types of machines.
"It really impressed me because I got a car but you can haul a lawn mower or snowblower that easily," Molinksi said.
Huebner will drive to your home, load your lawn mower into his van and repair it right on the spot. He said the convenience of the service is a big selling point with customers.
"When you think about it, when you have to fix your broken lawn mower you have to figure out where you going to take it, load it up in your vehicle,van cleef pink necklace replica, it may take you 20 minutes to drive there and there may be a lineup when you get there," he said.
"If you leave it (at a repair shop) and if they really busy it could be a week to two weeks before you get it back, and then you have to bring it home again and clean your car after," he said.
"I come out right to your door, and you can still do the stuff that important to you. One time I went out and as I was fixing a lawn mower, this guy was playing with his kid. It gives you quality time instead of spending it driving somewhere."
Huebner said when a customer calls for a repair he can usually attend to it within a couple days. It usually takes him about an hour to fix a lawn mower.
"Usually (when a customer calls) it next day service, and it done. They don have to wait, and they can continue cutting their grass right away,van cleef arpel alhambra necklace replica," he said.
Huebner said his easily recognizable van has become his calling card.
"Since I switched to the bus, and had it all decaled up the way it is, I get lots of people calling me to say they saw it driving," he said.
Huebner used an enclosed trailer attached to his truck as a workshop when he started the business. It was a far from ideal situation, so he started looking around for a better option.
"I saw a Handi Transit van on the Internet and thought it might be cool (to use). I started looking around for one and found one and bought it. It was just a matter of taking some seats out,black van cleef necklace replica, and adding a work bench and a tool box. It been so much more convenient (than the trailer)," he said.
Huebner doesn just service lawn mowers. He also fixes snowblowers in the wintertime,van cleef necklace clover replica, and refurbishes and sells both types of machines.
"It really impressed me because I got a car but you can haul a lawn mower or snowblower that easily," Molinksi said.
How a rogue trader crashed UBS
ZURICH/SINGAPORE Late last Friday afternoon, as Formula One teams readied their cars for a practice session ahead of the Singapore Grand Prix, the entrance hall of the nearby Ritz Carlton buzzed with activity.
One by one, senior executives of Swiss bank UBS entered the lobby, which is designed by Pritzker winning architect Kevin Roche and features a soaring glass ceiling, and made their way to the gold colored lifts that whisk guests up to rooms that overlook the Marina Bay street circuit.
As the bankers sped past works of art by the likes of Henry Moore, David Hockney and Frank Stella, some made their way straight to a lounge UBS had hired to entertain clients during the race weekend. At its entrance stood three Singaporean women wearing red and white polo shirts,fake van cleef alhambra necklace, each holding a sign emblazoned with the UBS logo and the slogan "Welcome, the race starts here".
For UBS chief Oswald Gruebel and perhaps for UBS as it is currently constituted it was more like the end of the road. The bank's board had met in Singapore that afternoon to discuss the loss of $2.3 billion by an alleged rogue trader in its London based investment banking arm. Though the board had not yet gone public with the news, it had decided to accept Gruebel's resignation and appoint an interim replacement.
Gruebel's decision to leave a year or so ahead of schedule was not just a response to the immediate crisis at UBS. It was also an admission that the bank's latest scandal has effectively undone all his efforts over the past two years to lobby against tougher bank regulations.
The alleged rogue trades have killed any remaining ambitions UBS might have to compete with the titans of Wall Street. They also cast a huge shadow across the entire industry and make tough new regulations far more likely,vintage alhambra necklace 10 motifs replica, as the 67 year old hinted in a memo to staff after he quit. This incident has worldwide repercussions, including political ones," he wrote.
In the aftermath of the scandal, the Swiss parliament narrowly rejected a bid to ban investment banking outright. Governments elsewhere are now more likely to push through regulations such as the Volcker rule,van cleef arpel alhambra necklace replica, which is under discussion in the United States and would ban proprietary trading by investment banks, and proposals in Britain that would force banks to "ring fence" their investment banking activities from their consumer banking side.
Global lenders such as UBS and Deutsche Bank have already cut the size of their balance sheets by at least a third since 2007, and are set to further shed risky assets to meet Basel rules on capital which will come into force in 2013. UBS said in August it would axe 3,500 more jobs to cut 2 billion Swiss francs ($2.2 billion) in annual costs, with almost half of those at the investment bank.
Interim CEO Sergio Ermotti, who until now ran UBS's European operations, told journalists on Saturday that his fellow bankers had to accept investment banking "is an industry that is due to shrink, not due to expand. Therefore anybody who wants to have a job and who is really keen to be in this industry will have to accept this new paradigm."
"This could not have happened at a worse time for the industry in general terms," said London based banking headhunter Jonathan Evans, Chairman of Sammons Associates. "Investment banking activities have been under the spotlight too much in recent times for all the wrong reasons and this news will just produce further negativity from the man in the street."
Most of the bank's executives decided to fly home early from the Singapore board meeting. Chief Operating Officer Ulrich Koerner gathered with a few colleagues in a corner of the hotel's Chihuly lounge, looking glum and speaking in hushed tones as they shared a bottle of white wine.
A lawyer, part of the UBS team, paced up and down the marble floored lobby muttering into his BlackBerry, "No . no golden parachute".
As the cars began to wail on the track below, Gruebel appeared in the lounge through a side door. He had changed into casual clothes, and was sporting a black polo shirt and slacks. His hair was slicked back in its trademark style. As he moved across the room toward the grand piano he noticed Koerner and looked visibly relieved. He walked over to his colleague, who was perched on a low slung three seater couch, and stood behind him chuckling.
Speaking in Gruebel's native German, the two men reminisced about what a momentous day it had been. Each tried to reassure the other, until eventually Kroener looked up and said, "It has to be said: You know how to make the best of it, don't you?"
Gruebel chuckled again, smiled and walked back toward the lifts, waving goodbye as he retreated down a corridor toward a green glass sculpture called "sunset."
Asked to comment on his future by Reuters that evening, Gruebel shook his head and walked away. on Wednesday, September 14. The German was in Zurich in UBS's four storey stone headquarters when Carsten Kengeter, who Gruebel had promoted less than a year earlier to head the investment bank, phoned from London.
UBS had only recently started to win back the trust of its wealthy private banking clients after risky bets on subprime mortgages came close to felling it in the financial crisis of 2008. Kengeter knew only that the trades had left it exposed to massive new losses, probably amounting to billions of dollars.
Lawyers and executives were already grilling 31 year old Kweku Adoboli,van cleef mother of pearl clover necklace replica, who had joined the bank five years earlier as a trainee and worked in the equities division. A UBS insider told Reuters that senior managers had been "flabbergasted" after discovering the alleged trades, which had come to light when controllers making routine checks demanded an explanation for positions that were due to settle on September 22. Another insider described the news as like a "meteorite strike".
Exposed, Adoboli had reported himself to his boss John Hughes who had alerted his bosses.
Gruebel and Kengeter, both seasoned former traders, knew they had no time to lose. They ordered a small taskforce dubbed "Project Bronze" by those involved to immediately close Adoboli's open positions. the next morning, as the extent of the problem became clearer, UBS informed City of London police who arrested the trader at around 3.30 at UBS's London headquarters, and then took him to the nearby Bishopsgate police station.
A couple of hours later, executives in Zurich were called in to a pre dawn crisis meeting to decide whether to go public with the news. Project Bronze was scrambling to unwind Adoboli's positions in Asian trading. The bank had to balance its regulatory requirements with concerns that alerting the market could exacerbate losses. With two thirds of Adoboli's open positions closed out overnight, the scale of the losses was clear and executives agreed they would have to say something, especially as it would be almost impossible to keep the arrest secret.
UBS's media department rushed to prepare a statement. Five minutes before European markets opened, the bank dropped its bombshell, first in German and minutes later in English. Chairman Kaspar Villiger said Kengeter and his team had done an "excellent job" to limit losses by moving so fast, contrasting their actions with the hesitation that compounded losses at Societe Generale after rogue trades by Jerome Kerviel three years ago.
ZURICH/SINGAPORE Late last Friday afternoon, as Formula One teams readied their cars for a practice session ahead of the Singapore Grand Prix, the entrance hall of the nearby Ritz Carlton buzzed with activity.
One by one, senior executives of Swiss bank UBS entered the lobby, which is designed by Pritzker winning architect Kevin Roche and features a soaring glass ceiling, and made their way to the gold colored lifts that whisk guests up to rooms that overlook the Marina Bay street circuit.
As the bankers sped past works of art by the likes of Henry Moore, David Hockney and Frank Stella, some made their way straight to a lounge UBS had hired to entertain clients during the race weekend. At its entrance stood three Singaporean women wearing red and white polo shirts,fake van cleef alhambra necklace, each holding a sign emblazoned with the UBS logo and the slogan "Welcome, the race starts here".
For UBS chief Oswald Gruebel and perhaps for UBS as it is currently constituted it was more like the end of the road. The bank's board had met in Singapore that afternoon to discuss the loss of $2.3 billion by an alleged rogue trader in its London based investment banking arm. Though the board had not yet gone public with the news, it had decided to accept Gruebel's resignation and appoint an interim replacement.
Gruebel's decision to leave a year or so ahead of schedule was not just a response to the immediate crisis at UBS. It was also an admission that the bank's latest scandal has effectively undone all his efforts over the past two years to lobby against tougher bank regulations.
The alleged rogue trades have killed any remaining ambitions UBS might have to compete with the titans of Wall Street. They also cast a huge shadow across the entire industry and make tough new regulations far more likely,vintage alhambra necklace 10 motifs replica, as the 67 year old hinted in a memo to staff after he quit. This incident has worldwide repercussions, including political ones," he wrote.
In the aftermath of the scandal, the Swiss parliament narrowly rejected a bid to ban investment banking outright. Governments elsewhere are now more likely to push through regulations such as the Volcker rule,van cleef arpel alhambra necklace replica, which is under discussion in the United States and would ban proprietary trading by investment banks, and proposals in Britain that would force banks to "ring fence" their investment banking activities from their consumer banking side.
Global lenders such as UBS and Deutsche Bank have already cut the size of their balance sheets by at least a third since 2007, and are set to further shed risky assets to meet Basel rules on capital which will come into force in 2013. UBS said in August it would axe 3,500 more jobs to cut 2 billion Swiss francs ($2.2 billion) in annual costs, with almost half of those at the investment bank.
Interim CEO Sergio Ermotti, who until now ran UBS's European operations, told journalists on Saturday that his fellow bankers had to accept investment banking "is an industry that is due to shrink, not due to expand. Therefore anybody who wants to have a job and who is really keen to be in this industry will have to accept this new paradigm."
"This could not have happened at a worse time for the industry in general terms," said London based banking headhunter Jonathan Evans, Chairman of Sammons Associates. "Investment banking activities have been under the spotlight too much in recent times for all the wrong reasons and this news will just produce further negativity from the man in the street."
Most of the bank's executives decided to fly home early from the Singapore board meeting. Chief Operating Officer Ulrich Koerner gathered with a few colleagues in a corner of the hotel's Chihuly lounge, looking glum and speaking in hushed tones as they shared a bottle of white wine.
A lawyer, part of the UBS team, paced up and down the marble floored lobby muttering into his BlackBerry, "No . no golden parachute".
As the cars began to wail on the track below, Gruebel appeared in the lounge through a side door. He had changed into casual clothes, and was sporting a black polo shirt and slacks. His hair was slicked back in its trademark style. As he moved across the room toward the grand piano he noticed Koerner and looked visibly relieved. He walked over to his colleague, who was perched on a low slung three seater couch, and stood behind him chuckling.
Speaking in Gruebel's native German, the two men reminisced about what a momentous day it had been. Each tried to reassure the other, until eventually Kroener looked up and said, "It has to be said: You know how to make the best of it, don't you?"
Gruebel chuckled again, smiled and walked back toward the lifts, waving goodbye as he retreated down a corridor toward a green glass sculpture called "sunset."
Asked to comment on his future by Reuters that evening, Gruebel shook his head and walked away. on Wednesday, September 14. The German was in Zurich in UBS's four storey stone headquarters when Carsten Kengeter, who Gruebel had promoted less than a year earlier to head the investment bank, phoned from London.
UBS had only recently started to win back the trust of its wealthy private banking clients after risky bets on subprime mortgages came close to felling it in the financial crisis of 2008. Kengeter knew only that the trades had left it exposed to massive new losses, probably amounting to billions of dollars.
Lawyers and executives were already grilling 31 year old Kweku Adoboli,van cleef mother of pearl clover necklace replica, who had joined the bank five years earlier as a trainee and worked in the equities division. A UBS insider told Reuters that senior managers had been "flabbergasted" after discovering the alleged trades, which had come to light when controllers making routine checks demanded an explanation for positions that were due to settle on September 22. Another insider described the news as like a "meteorite strike".
Exposed, Adoboli had reported himself to his boss John Hughes who had alerted his bosses.
Gruebel and Kengeter, both seasoned former traders, knew they had no time to lose. They ordered a small taskforce dubbed "Project Bronze" by those involved to immediately close Adoboli's open positions. the next morning, as the extent of the problem became clearer, UBS informed City of London police who arrested the trader at around 3.30 at UBS's London headquarters, and then took him to the nearby Bishopsgate police station.
A couple of hours later, executives in Zurich were called in to a pre dawn crisis meeting to decide whether to go public with the news. Project Bronze was scrambling to unwind Adoboli's positions in Asian trading. The bank had to balance its regulatory requirements with concerns that alerting the market could exacerbate losses. With two thirds of Adoboli's open positions closed out overnight, the scale of the losses was clear and executives agreed they would have to say something, especially as it would be almost impossible to keep the arrest secret.
UBS's media department rushed to prepare a statement. Five minutes before European markets opened, the bank dropped its bombshell, first in German and minutes later in English. Chairman Kaspar Villiger said Kengeter and his team had done an "excellent job" to limit losses by moving so fast, contrasting their actions with the hesitation that compounded losses at Societe Generale after rogue trades by Jerome Kerviel three years ago.
Looking At Business Opportunities In the Stop
Yeah, I'm not even one day into the nicotine free world and already thinking of how I can turn my misery into moola. There are hundreds of products and books and gizmos on the market that are stop smoking aids, but I don't think most of them work very well. If they did, by now the field of potential clients would have dried up, wouldn't it?
I know I will make my first chunk of money with my stop smoking handbook. I think I will title it "How to quit smoking in 40 years or less." It won't be too big a book, so maybe I will only charge $10. In the world of stop smoking paraphernalia, nothing is anywhere near that cheap,van cleef arpels alhambra replica bracelet, so it might sell.
I also plan to figure out how to inject nicotine into various foods that no one has thought of yet. Yes, there is nicotine gum, but there could be so much more. There could be nicotine lollipops, nicotine flavored beer I'll bet that will be a winner also steak, eggs, chicken, all with a nice dose of nicotine.
I will figure out how to freeze dry nicotine so a person can put it on their foods. I can just see restaurants with salt, pepper and nicotine shakers on all the tables. I'm sure eventually I can come up with a nicotine cookbook after people start trying my foods in various measures and ways.
I can see me holding seminars on how I quit. It might be several sessions long, as I will have to explain the 40 year process. I could come out with an abridged version,van cleef and arpels fake clover bracelet, I imagine. I could title it "The 40 steps to quitting cigarettes." It would be Step one, year one: smoke. Step two, year two: smoke. Step three, year three: smoke,van cleef replica bracelet alhambra, etc.; until I get to Step 40, year 40: quit.
I figure I might have to throw some comedy into that speech or it might get a little boring.
There are companies that make wooden fake cigarettes, and I can see how they can help with the hand to mouth habit of a smoker. The problem is, they are way overpriced. So I will start my own factory. All I need is a bunch of three eighths inch dowel rods and a saw to cut them into four inch long lengths. Then I spray paint them white and I can sell them for a buck apiece.
Now the companies that charge as much as $19.95 for these wooden cigs claim that they use a safe, nontoxic paint and that adds to their price, but that is bogus. Anyone who spent years sucking down methane isn't going to worry about a little paint here and there,bracelet alhambra fake van cleef, unless I use that old lead paint I still have around. I might even get fancy and offer non filter, filter and even menthol looking wooden cigs.
Maybe I should package them with some kind of signature stamp on the side like Mikey's Smokes. I could even have an ad campaign and go national, but I fear then the government might get involved if I become too well known. I can just see "60 Minutes" coming to the house because my wooden cigarettes have been found to cause splinters in laboratory rats.
All in all, I think I have found my chance at really hitting the mother lode of financial independence. Who knew all I had to do was quit a miserable habit that now is making me miserable since I quit.
I have to go now. The semi truck of dowel rods just pulled up. I also ordered a van of illegal immigrants to work the saws. I have to keep my costs down, you know.
Just because I will be saving almost three grand a year by not buying smokes doesn't mean I should just throw money away. I did that for 40 years, I guess. We will see eventually if I threw something else away in those years of smoking: me.
Yeah, I'm not even one day into the nicotine free world and already thinking of how I can turn my misery into moola. There are hundreds of products and books and gizmos on the market that are stop smoking aids, but I don't think most of them work very well. If they did, by now the field of potential clients would have dried up, wouldn't it?
I know I will make my first chunk of money with my stop smoking handbook. I think I will title it "How to quit smoking in 40 years or less." It won't be too big a book, so maybe I will only charge $10. In the world of stop smoking paraphernalia, nothing is anywhere near that cheap,van cleef arpels alhambra replica bracelet, so it might sell.
I also plan to figure out how to inject nicotine into various foods that no one has thought of yet. Yes, there is nicotine gum, but there could be so much more. There could be nicotine lollipops, nicotine flavored beer I'll bet that will be a winner also steak, eggs, chicken, all with a nice dose of nicotine.
I will figure out how to freeze dry nicotine so a person can put it on their foods. I can just see restaurants with salt, pepper and nicotine shakers on all the tables. I'm sure eventually I can come up with a nicotine cookbook after people start trying my foods in various measures and ways.
I can see me holding seminars on how I quit. It might be several sessions long, as I will have to explain the 40 year process. I could come out with an abridged version,van cleef and arpels fake clover bracelet, I imagine. I could title it "The 40 steps to quitting cigarettes." It would be Step one, year one: smoke. Step two, year two: smoke. Step three, year three: smoke,van cleef replica bracelet alhambra, etc.; until I get to Step 40, year 40: quit.
I figure I might have to throw some comedy into that speech or it might get a little boring.
There are companies that make wooden fake cigarettes, and I can see how they can help with the hand to mouth habit of a smoker. The problem is, they are way overpriced. So I will start my own factory. All I need is a bunch of three eighths inch dowel rods and a saw to cut them into four inch long lengths. Then I spray paint them white and I can sell them for a buck apiece.
Now the companies that charge as much as $19.95 for these wooden cigs claim that they use a safe, nontoxic paint and that adds to their price, but that is bogus. Anyone who spent years sucking down methane isn't going to worry about a little paint here and there,bracelet alhambra fake van cleef, unless I use that old lead paint I still have around. I might even get fancy and offer non filter, filter and even menthol looking wooden cigs.
Maybe I should package them with some kind of signature stamp on the side like Mikey's Smokes. I could even have an ad campaign and go national, but I fear then the government might get involved if I become too well known. I can just see "60 Minutes" coming to the house because my wooden cigarettes have been found to cause splinters in laboratory rats.
All in all, I think I have found my chance at really hitting the mother lode of financial independence. Who knew all I had to do was quit a miserable habit that now is making me miserable since I quit.
I have to go now. The semi truck of dowel rods just pulled up. I also ordered a van of illegal immigrants to work the saws. I have to keep my costs down, you know.
Just because I will be saving almost three grand a year by not buying smokes doesn't mean I should just throw money away. I did that for 40 years, I guess. We will see eventually if I threw something else away in those years of smoking: me.
Maggie Smith is glorious
The arrangements people have! The Lady in the Van is the now absurdly famous story of how a cantankerous, ungrateful, bigoted, smelly old bag called Miss Shepherd was allowed to live in a derelict van in Alan Bennett's driveway in increasingly posh Gloucester Crescent, NW1, for 15 years, prevailing upon him to do her shopping and clean up her shit.
Bennett's original motives may have been common human kindness, liberal guilt, the scent of good copy or raw fascination with obstreperous old ladies. Whatever the reason, it was a bargain: he extracted from this nuisance first many diary entries, then a more extended book, then successful stage and radio plays, and now a movie, directed once more by Nicholas Hytner, until recently the director of the National Theatre, the director of all Bennett's plays for the last 15 years,van cleef and arpels replica bracelets, also behind the films of The Madness of King George and The History Boys. The likes of Roger Allam, Dominic Cooper and James Corden play useful cameo roles and the great Bennett himself rolls up on his bike for the unveiling of a blue plaque to the sacred site at the end but the glory of the film is Maggie Smith. There's nobody like her: so wonderfully grande dame in any degree of squalor. All any of us can aspire to in the end, perhaps.
If the script plays up Miss Shepherd's distinction,van cleef and arpels perlee fake bracelet, as a pianist taught by Cortot, a discovery actually only made by Bennett after her death, in compensation it does, compared to his original prose memoir,bracelet replica van cleef, 'fess up much more comprehensively to the peculiarity of his interest in crazy old bats ("that appears to be my niche I'm stuck with old ladies") and to his awareness of her being, just like his mother, a mine of material, a treasure trove as well as a poo menace. "She'd be a good subject for you, one of your little plays" local grandee Mrs Vaughan Williams (Frances de la Tour) tells him, spotting his affinity with the van hag. She was.
After the premiere, Nicholas Hytner said that seeing it for the first time on a big screen with an audience made him realize it resonated with the great British toleration of strangers in our midst, however difficult "I hope that's who we are, that is who we want to be", obviously alluding to current circs, winning applause.
On Adblock click "Don't run on pages on this domain".
If you are Private Browsing in Firefox,van cleef replica bracelet alhambra, "Tracking Protection" may cause the adblock notice to show. It can be temporarily disabled by clicking the "shield" icon in the address bar.
The arrangements people have! The Lady in the Van is the now absurdly famous story of how a cantankerous, ungrateful, bigoted, smelly old bag called Miss Shepherd was allowed to live in a derelict van in Alan Bennett's driveway in increasingly posh Gloucester Crescent, NW1, for 15 years, prevailing upon him to do her shopping and clean up her shit.
Bennett's original motives may have been common human kindness, liberal guilt, the scent of good copy or raw fascination with obstreperous old ladies. Whatever the reason, it was a bargain: he extracted from this nuisance first many diary entries, then a more extended book, then successful stage and radio plays, and now a movie, directed once more by Nicholas Hytner, until recently the director of the National Theatre, the director of all Bennett's plays for the last 15 years,van cleef and arpels replica bracelets, also behind the films of The Madness of King George and The History Boys. The likes of Roger Allam, Dominic Cooper and James Corden play useful cameo roles and the great Bennett himself rolls up on his bike for the unveiling of a blue plaque to the sacred site at the end but the glory of the film is Maggie Smith. There's nobody like her: so wonderfully grande dame in any degree of squalor. All any of us can aspire to in the end, perhaps.
If the script plays up Miss Shepherd's distinction,van cleef and arpels perlee fake bracelet, as a pianist taught by Cortot, a discovery actually only made by Bennett after her death, in compensation it does, compared to his original prose memoir,bracelet replica van cleef, 'fess up much more comprehensively to the peculiarity of his interest in crazy old bats ("that appears to be my niche I'm stuck with old ladies") and to his awareness of her being, just like his mother, a mine of material, a treasure trove as well as a poo menace. "She'd be a good subject for you, one of your little plays" local grandee Mrs Vaughan Williams (Frances de la Tour) tells him, spotting his affinity with the van hag. She was.
After the premiere, Nicholas Hytner said that seeing it for the first time on a big screen with an audience made him realize it resonated with the great British toleration of strangers in our midst, however difficult "I hope that's who we are, that is who we want to be", obviously alluding to current circs, winning applause.
On Adblock click "Don't run on pages on this domain".
If you are Private Browsing in Firefox,van cleef replica bracelet alhambra, "Tracking Protection" may cause the adblock notice to show. It can be temporarily disabled by clicking the "shield" icon in the address bar.
Life Insurance Agency In Los Angeles
Los Angeles is a happening city and a dream destination for many. The city is popular among visitors for its night life. It has all kinds of service providers, with most of the global brands making sure that they mark their presence. Even the insurance agencies in the region provide insurance cover for almost every kind of possible risk, which one may face in the city. May it be life insurance, dental insurance, travel insurance, health insurance, or insurance for groups or businesses, every type of risk mitigation policy can be found in the city.
Considering the importance of life and insurance policies for the same, people in Los Angeles can avail different policies,bracelet replica van cleef and arpels, with each having its own unique features. From individuals to groups, or even the corporate,alhambra knock off bracelet van cleef, life insurance policies can be found suiting to one's requirements. Some Life Insurance agencies in Los Angeles even provide custom made insurance plans, to ensure their clients are able to reap maximum benefits,van cleef bracelet knock off alhambra, while ensuring the concerned risk is duly covered.
Most of the life insurance agencies in LA provide option of online insurance as well, to make sure that their clients do not have the trouble to visit the office every time. The process even makes the entire process hassle free and quick. There are many service providers too, who sell life insurance policies of reputed brands, either as a franchisee or as an independent dealer.
We have mentioned some of the service providers below:
Golden Life Insurance Agency
Sumitomo Life Insurance Agency
Lakhani Insurance Agency, Inc
However, it is always recommended that before buying any policy, individuals must get in touch with the representatives from the company,bracelet fake alhambra van cleef, and get information on minutest of details so as to avoid chances of frauds or misunderstandings. The best way to find the ideal policy and the service provider is to compare multiple policies and consult people who have already taken the policy. Information such as processing time for claims, and relevant intricacies involved, must all be clarified beforehand only to avoid any inconvenience at a later stage.
All this does not mean that life insurance is not required; in fact it has become a necessity to ensure security of family or dependents, in case of adversities. Thus, while taking such a critical decision, extensive research is the best and safe way out.
Los Angeles is a happening city and a dream destination for many. The city is popular among visitors for its night life. It has all kinds of service providers, with most of the global brands making sure that they mark their presence. Even the insurance agencies in the region provide insurance cover for almost every kind of possible risk, which one may face in the city. May it be life insurance, dental insurance, travel insurance, health insurance, or insurance for groups or businesses, every type of risk mitigation policy can be found in the city.
Considering the importance of life and insurance policies for the same, people in Los Angeles can avail different policies,bracelet replica van cleef and arpels, with each having its own unique features. From individuals to groups, or even the corporate,alhambra knock off bracelet van cleef, life insurance policies can be found suiting to one's requirements. Some Life Insurance agencies in Los Angeles even provide custom made insurance plans, to ensure their clients are able to reap maximum benefits,van cleef bracelet knock off alhambra, while ensuring the concerned risk is duly covered.
Most of the life insurance agencies in LA provide option of online insurance as well, to make sure that their clients do not have the trouble to visit the office every time. The process even makes the entire process hassle free and quick. There are many service providers too, who sell life insurance policies of reputed brands, either as a franchisee or as an independent dealer.
We have mentioned some of the service providers below:
Golden Life Insurance Agency
Sumitomo Life Insurance Agency
Lakhani Insurance Agency, Inc
However, it is always recommended that before buying any policy, individuals must get in touch with the representatives from the company,bracelet fake alhambra van cleef, and get information on minutest of details so as to avoid chances of frauds or misunderstandings. The best way to find the ideal policy and the service provider is to compare multiple policies and consult people who have already taken the policy. Information such as processing time for claims, and relevant intricacies involved, must all be clarified beforehand only to avoid any inconvenience at a later stage.
All this does not mean that life insurance is not required; in fact it has become a necessity to ensure security of family or dependents, in case of adversities. Thus, while taking such a critical decision, extensive research is the best and safe way out.
Kuching girl takes Miss Andaman World and Miss Malaysia Perak titles
The actress of television dramas on local television channels as well as Singapore Channel 5 also walked away with the subsidiary titles of Miss Catwalk and Miss Supermodel.While she has joined many other pageants since the age of 19, Kho had taken a break from them in the last year to concentrate on her acting career.Recording artiste Iqwal performing for the crowd.the chance to join the Miss Andaman World pageant was too good to give up.wasn expecting to win since some of the other contestants had nicer physique while some were more talented.so, you can imagine how happy and grateful I am to have won, said Kho, who also becomes Miss Malaysia Perak with her win in the pageant.Kho added that her win was especially precious since it also automatically qualifies her for the Miss Event World 2016 final.joined the Miss Andaman World pageant because unlike conventional pageants, this one incorporates elements of show business in the entire selection process.pageant looks for the person with a higher commercial value, which gives me a good platform to progress in the entertainment line, explained Kho, who is also brand ambassador of a contact lens company and several hair products.Zoe J (left) performing during the first round of catwalk by the 14 finalists.Another lass who was perhaps as happy as Kho was 19 year old college student Lee Weng Yee who won the grand prize of a brand new Perodua Axia car in the carnival lucky draw.Kho and her family members screamed out in excitement when her winning number was announced by Andaman managing director Datuk Seri Dr Vincent Tiew.never won anything that costs so much.so happy but since I already have a car, I give the prize to my dad.in our family has their own cars except my dad who either drives his goods van or rides his motorcycle.am very uncomfortable with my dad riding the motorcycle as I feel it is very dangerous.this car, he won have any more excuse about not having a car to get around in,imitation pour homme van cleef and arpels, said the business administration student studying at a university college in Petaling Jaya.A total of 88 lucky draw prizes were given out during the carnival, which was made more interesting with performances by Soul Eclipse, Zoe J the Dancing Violinist,pour homme van cleef and arpels replique, and recording artiste Iqwal Hafiz.The Regal Orchestra Fusion from Kuala Lumpur presented popular Chinese and English numbers with Z Yan on vocals accompanied by the erhu, guzheng and dizi, percussion and keyboard.The carnival ended with a spectacular fireworks display, which had the crowd transfixed for a good 10 minutes.The evening before,arpel and van cleef replique, Andaman feted the elderly from various old folks home to a dinner at the Grand China Restaurant.College student Lee (right) receiving the mock key to her brand new Perodua Axia from Tiew.Held in conjunction with its 10th anniversary, the 60 table dinner was also attended by business associates of Andaman.The night was made extra meaningful when Tiew handed over a donation for RM300,000 each to SJK (C) Sam Tet, SMJK Sam Tet and the John Moh Education Foundation.This is the fourth year that Andaman has contributed generously to the foundation and schools.The group executive chairman Datuk Dr Patrick Teoh Seng Foo and directors, Teoh Seng Aun and Kenneth Teoh Seng Kian,imitation van cleef arpel, were former students of Sam Tet.Tiew said Andaman was poised to become Perak best condominium project with a sales value of RM330mil to date, adding that buyers could expect to receive the keys to their units by next August, six months ahead of schedule.
The actress of television dramas on local television channels as well as Singapore Channel 5 also walked away with the subsidiary titles of Miss Catwalk and Miss Supermodel.While she has joined many other pageants since the age of 19, Kho had taken a break from them in the last year to concentrate on her acting career.Recording artiste Iqwal performing for the crowd.the chance to join the Miss Andaman World pageant was too good to give up.wasn expecting to win since some of the other contestants had nicer physique while some were more talented.so, you can imagine how happy and grateful I am to have won, said Kho, who also becomes Miss Malaysia Perak with her win in the pageant.Kho added that her win was especially precious since it also automatically qualifies her for the Miss Event World 2016 final.joined the Miss Andaman World pageant because unlike conventional pageants, this one incorporates elements of show business in the entire selection process.pageant looks for the person with a higher commercial value, which gives me a good platform to progress in the entertainment line, explained Kho, who is also brand ambassador of a contact lens company and several hair products.Zoe J (left) performing during the first round of catwalk by the 14 finalists.Another lass who was perhaps as happy as Kho was 19 year old college student Lee Weng Yee who won the grand prize of a brand new Perodua Axia car in the carnival lucky draw.Kho and her family members screamed out in excitement when her winning number was announced by Andaman managing director Datuk Seri Dr Vincent Tiew.never won anything that costs so much.so happy but since I already have a car, I give the prize to my dad.in our family has their own cars except my dad who either drives his goods van or rides his motorcycle.am very uncomfortable with my dad riding the motorcycle as I feel it is very dangerous.this car, he won have any more excuse about not having a car to get around in,imitation pour homme van cleef and arpels, said the business administration student studying at a university college in Petaling Jaya.A total of 88 lucky draw prizes were given out during the carnival, which was made more interesting with performances by Soul Eclipse, Zoe J the Dancing Violinist,pour homme van cleef and arpels replique, and recording artiste Iqwal Hafiz.The Regal Orchestra Fusion from Kuala Lumpur presented popular Chinese and English numbers with Z Yan on vocals accompanied by the erhu, guzheng and dizi, percussion and keyboard.The carnival ended with a spectacular fireworks display, which had the crowd transfixed for a good 10 minutes.The evening before,arpel and van cleef replique, Andaman feted the elderly from various old folks home to a dinner at the Grand China Restaurant.College student Lee (right) receiving the mock key to her brand new Perodua Axia from Tiew.Held in conjunction with its 10th anniversary, the 60 table dinner was also attended by business associates of Andaman.The night was made extra meaningful when Tiew handed over a donation for RM300,000 each to SJK (C) Sam Tet, SMJK Sam Tet and the John Moh Education Foundation.This is the fourth year that Andaman has contributed generously to the foundation and schools.The group executive chairman Datuk Dr Patrick Teoh Seng Foo and directors, Teoh Seng Aun and Kenneth Teoh Seng Kian,imitation van cleef arpel, were former students of Sam Tet.Tiew said Andaman was poised to become Perak best condominium project with a sales value of RM330mil to date, adding that buyers could expect to receive the keys to their units by next August, six months ahead of schedule.
Diwali snoep verspreiding zoetheid en vreugde
Diwali het festival van lichten is ook populair voor fireworks en Diwali snoep. De viering is niet compleet zonder passende Diwali snoepjes die de volksmond bekend als Diwali Mithai in India. Het is de ideale tijd om te genieten en fijnproevers van in de hele natie kijken uit naar de feestelijke maand kloof op heerlijke Diwali mithai. Feestgangers verzenden vaak Diwali snoep naar India voor geliefden. Er zijn speciale recepten die bekendheid tijdens het festival krijgen. Diwali snoep hebben daarom een prominente plaats in Diwali feesten.
De Diwali snoepjes zijn zo divers als het festival zelf,imitation van cleef arpel, en hoewel er specifieke recepten voor de festiviteiten apt, mensen over het algemeen authentieke recepten met de hedendaagse om te komen met exclusieve Diwali snoep mix. De meest populaire Diwali mthai omvatten Kaju Brafi, Kaju Katli, Bundi Ladoo en amandel Seera. Ze maken ideale giften, met name als u overweegt om te verzenden Diwali snoep naar India. Traditionele zoetigheden zoals kheer en maava gunjiya ook krijgen bekendheid hebben zoals de populairste Diwali snoep.
Naast firecracker winkels en kleding winkels krijgen zoete winkels ook bekendheid tijdens Diwali. Ze zijn beladen met heerlijke zoete,bijou van cleef et arpels replique, gegarneerd met zilver folie, gehakte noten en de extra vleugje aroma vooral voor Diwali. Diwali mithai zijn vaak verpakt in prachtige zoek zoete vakken die bevorderlijk zijn voor de aantrekkingskracht van geschenken. Ja, Diwali mithai in exclusieve zoete vakken uitstekende Diwali giften maken. Online marts hebben een indrukwekkende verzameling van Diwali snoep en andere giften van de keuzelijst met invoervak. Trouwens, de online bestemmingen naar voren zijn gekomen als de ideale inzet voor het verzenden van Diwali snoep naar India.
Diwali snoep voor de gezondheid bewuste:
Gezondheid bewuste mensen vormen een aanzienlijk deel van het zoete consumeren bevolking. Niet alleen zijn ze gezondheidsbewuste maar ze willen ook een calorie evenwicht handhaven tijdens de feestdagen. Fijnproevers zijn extra voorzichtig zijn over wat ze eten en liever binge op smakelijke nog gezonde Diwali mithai. Minder vet, zonder suiker of kunstmatig gezoet Diwali Mithai aandacht voor de gezondheid bewuste krijgt. Knippen naar beneden voor vetten, suiker en extra conserveermiddel en voedsel kleur is de mantra voor gezonde Diwali snoep.
Droog fruit schotel A beter weddenschap?
Diwali is belangrijk voor feestgangers en niet feestgangers als het is een van die zeldzame festivals die de hele natie in harmonie omarmen. Corporate organisaties omvatten Diwali feesten als een belangrijk onderdeel van de agenda en na te gaan dat alle medewerkers met verschillende achtergronden die betrokken zijn bij de festiviteiten zijn. Rangoli wedstrijd of uitwisseling van geschenken, de gebeurtenissen versterken de solidariteit van de beroepsbevolking. Collectieve giften zijn een integraal onderdeel van de Diwali viering in India en zijn onmisbaar voor elke organisatie. Droge vruchten en Diwali snoepjes zijn een integraal onderdeel van corporate gifting. Naast fysieke winkels zijn online marts ook de ideale halte om Diwali snoep verzenden naar India. De indrukwekkende collectie van droog fruit dozen en andere giften van de keuzelijst met invoervak verbetert het winkelen ervaring.
Hoewel wij vragen ons af dat als droge vruchten hebben vervangen Diwali mithai, de huidige ontwikkelingen bewijzen anders. De ontluikende trends in Diwali mithai, de nieuwere recepten en specifieke snoep voor de gezondheid bewuste, organische snoepjes en andere uitvindingen hebben genegeerd de mythe over de droge vruchten ter vervanging van snoep. Diwali mithai erin geslaagd te houden hun stand, zelfs onder de obesitas en diabetes bevolking vechten. Ze worden begeleid met elke gift, groot of klein en hebben een prominente plaats in de vieringen Diwali. Diwali zoetigheden zijn daarom bijna synoniem geworden voor Diwali,imitation van cleef arpels pour homme, het festival van liefde, vreugde, gelach en verlichting.
Verwante artikelen in snoepjes
Mensen die genteresseerd zijn in het bovenstaande artikel zijn ook genteresseerd in de aanverwante artikelen hieronder:
De geschiedenis van Chupa Chups lollies
Chupa Chups behoren tot de meest verbazingwekkende lollies gemaakt vandaag. Het bedrijf begon als een idee van een Spaanse burger genaamd Enric Bernat in 1958. Mr. Bernat begon zijn carrire in een fabriek jam appel. Hij benaderde beleggers over een lolly bedrijf maar ze snel verliet,van cleef bijoux replique. Hij nam het bedrijf zelf en bouwde de eerste productiemachines met zijn eigen handen.
Een korte geschiedenis van Skittles en Laffy Taffy
Een van de meest populaire snoepjes beschikbaar in Amerika is Skittles terwijl Lafffy Taffy is ook een van Amerika's meest bekende een candy merken hield door kinderen en beschikbaar in een verscheidenheid van fruit smaken. Skittles is heeft een chocolade centrum met een kleurrijke snoep shell en kauwtabletten in de mond. Een kleine "s" wordt afgedrukt op elke snoep. Laffy Taffy is een moderne vorm van kauwtabletten toffee en verpakt in een verscheidenheid van formaten.
Diwali het festival van lichten is ook populair voor fireworks en Diwali snoep. De viering is niet compleet zonder passende Diwali snoepjes die de volksmond bekend als Diwali Mithai in India. Het is de ideale tijd om te genieten en fijnproevers van in de hele natie kijken uit naar de feestelijke maand kloof op heerlijke Diwali mithai. Feestgangers verzenden vaak Diwali snoep naar India voor geliefden. Er zijn speciale recepten die bekendheid tijdens het festival krijgen. Diwali snoep hebben daarom een prominente plaats in Diwali feesten.
De Diwali snoepjes zijn zo divers als het festival zelf,imitation van cleef arpel, en hoewel er specifieke recepten voor de festiviteiten apt, mensen over het algemeen authentieke recepten met de hedendaagse om te komen met exclusieve Diwali snoep mix. De meest populaire Diwali mthai omvatten Kaju Brafi, Kaju Katli, Bundi Ladoo en amandel Seera. Ze maken ideale giften, met name als u overweegt om te verzenden Diwali snoep naar India. Traditionele zoetigheden zoals kheer en maava gunjiya ook krijgen bekendheid hebben zoals de populairste Diwali snoep.
Naast firecracker winkels en kleding winkels krijgen zoete winkels ook bekendheid tijdens Diwali. Ze zijn beladen met heerlijke zoete,bijou van cleef et arpels replique, gegarneerd met zilver folie, gehakte noten en de extra vleugje aroma vooral voor Diwali. Diwali mithai zijn vaak verpakt in prachtige zoek zoete vakken die bevorderlijk zijn voor de aantrekkingskracht van geschenken. Ja, Diwali mithai in exclusieve zoete vakken uitstekende Diwali giften maken. Online marts hebben een indrukwekkende verzameling van Diwali snoep en andere giften van de keuzelijst met invoervak. Trouwens, de online bestemmingen naar voren zijn gekomen als de ideale inzet voor het verzenden van Diwali snoep naar India.
Diwali snoep voor de gezondheid bewuste:
Gezondheid bewuste mensen vormen een aanzienlijk deel van het zoete consumeren bevolking. Niet alleen zijn ze gezondheidsbewuste maar ze willen ook een calorie evenwicht handhaven tijdens de feestdagen. Fijnproevers zijn extra voorzichtig zijn over wat ze eten en liever binge op smakelijke nog gezonde Diwali mithai. Minder vet, zonder suiker of kunstmatig gezoet Diwali Mithai aandacht voor de gezondheid bewuste krijgt. Knippen naar beneden voor vetten, suiker en extra conserveermiddel en voedsel kleur is de mantra voor gezonde Diwali snoep.
Droog fruit schotel A beter weddenschap?
Diwali is belangrijk voor feestgangers en niet feestgangers als het is een van die zeldzame festivals die de hele natie in harmonie omarmen. Corporate organisaties omvatten Diwali feesten als een belangrijk onderdeel van de agenda en na te gaan dat alle medewerkers met verschillende achtergronden die betrokken zijn bij de festiviteiten zijn. Rangoli wedstrijd of uitwisseling van geschenken, de gebeurtenissen versterken de solidariteit van de beroepsbevolking. Collectieve giften zijn een integraal onderdeel van de Diwali viering in India en zijn onmisbaar voor elke organisatie. Droge vruchten en Diwali snoepjes zijn een integraal onderdeel van corporate gifting. Naast fysieke winkels zijn online marts ook de ideale halte om Diwali snoep verzenden naar India. De indrukwekkende collectie van droog fruit dozen en andere giften van de keuzelijst met invoervak verbetert het winkelen ervaring.
Hoewel wij vragen ons af dat als droge vruchten hebben vervangen Diwali mithai, de huidige ontwikkelingen bewijzen anders. De ontluikende trends in Diwali mithai, de nieuwere recepten en specifieke snoep voor de gezondheid bewuste, organische snoepjes en andere uitvindingen hebben genegeerd de mythe over de droge vruchten ter vervanging van snoep. Diwali mithai erin geslaagd te houden hun stand, zelfs onder de obesitas en diabetes bevolking vechten. Ze worden begeleid met elke gift, groot of klein en hebben een prominente plaats in de vieringen Diwali. Diwali zoetigheden zijn daarom bijna synoniem geworden voor Diwali,imitation van cleef arpels pour homme, het festival van liefde, vreugde, gelach en verlichting.
Verwante artikelen in snoepjes
Mensen die genteresseerd zijn in het bovenstaande artikel zijn ook genteresseerd in de aanverwante artikelen hieronder:
De geschiedenis van Chupa Chups lollies
Chupa Chups behoren tot de meest verbazingwekkende lollies gemaakt vandaag. Het bedrijf begon als een idee van een Spaanse burger genaamd Enric Bernat in 1958. Mr. Bernat begon zijn carrire in een fabriek jam appel. Hij benaderde beleggers over een lolly bedrijf maar ze snel verliet,van cleef bijoux replique. Hij nam het bedrijf zelf en bouwde de eerste productiemachines met zijn eigen handen.
Een korte geschiedenis van Skittles en Laffy Taffy
Een van de meest populaire snoepjes beschikbaar in Amerika is Skittles terwijl Lafffy Taffy is ook een van Amerika's meest bekende een candy merken hield door kinderen en beschikbaar in een verscheidenheid van fruit smaken. Skittles is heeft een chocolade centrum met een kleurrijke snoep shell en kauwtabletten in de mond. Een kleine "s" wordt afgedrukt op elke snoep. Laffy Taffy is een moderne vorm van kauwtabletten toffee en verpakt in een verscheidenheid van formaten.
international comparisons of electronic health record cohorts in England and New Zealand
AbstractObjectives Electronic health records offer the opportunity to discover new clinical implications for established blood tests, but international comparisons have been lacking. We tested the association of total white cell count (WBC) with all cause mortality in England and New Zealand. High WBC within the reference range (8.65 10.05109/L) was associated with significantly increased mortality compared to the middle quintile (6.25 7.25109/L); adjusted HR 1.51 (95% CI 1.43 to 1.59) in CALIBER and 1.33 (95% CI 1.06 to 1.65) in PREDICT. WBC outside the reference range was associated with even greater mortality. The association was stronger over the first 6months of follow up, but similar across ethnic groups.
MortalityLeukocyte countElectronic health recordsCohort studiesStrengths and limitations of this studyThe main strength of this study is that we showed similar associations of total white cell count with mortality in two ethnically different populations from different countries.
Both cohorts were large and population based, avoiding the selection bias inherent in bespoke cohorts with low response rates.
A limitation of this study is that white cell count and other covariates were measured only when thought to be clinically necessary, so some covariate data were missing.
As this is an observational study it can be used to infer association but not causation, and residual confounding may partly account for the observed association between total white cell count and mortality.
IntroductionA fundamental question in clinical medicine is 'what does this blood test result mean?' Relevant evidence in answering this question may come from examining the prognostic significance of blood tests recorded in usual clinical care. The direct clinical applicability, large sample sizes and population base of electronic health record cohorts, which are increasingly available for research in different countries, might provide opportunities to discover and replicate associations between clinically recorded measurements and patient outcomes. However, to date there have been few international comparisons of the prognostic validity of blood tests performed in primary care, partly because of the challenge of accessing such data, and harmonising the structure and coding of electronic healthcare records between countries. Nevertheless, such international comparisons might help to evaluate the robustness of associations among patients with different ethnic backgrounds and different profiles of risk.
We chose to compare England and New Zealand because they have different healthcare systems and ethnically different populations (the English population is predominantly Caucasian, with small proportions of South Asian or black ethnicities1 whereas New Zealand contains a sizeable proportion of Mori, Pacific, Chinese and South Asian people2). However, both countries have pseudonymised primary care data linked with other data sources available for research on a large scale,replique arpels and van cleef, making this type of study feasible. Despite the ubiquity of this test, it is unclear how strongly a clinically recorded 'normal' value in the general population is associated with subsequent short term and long term mortality. White cell counts vary between ethnic groups3 and are associated with inflammation, smoking, obesity and high systolic blood pressure.4 Previous bespoke cohort studies with white cell counts measured under research conditions suggest a link between high white cell count and increased risk of coronary disease5 ,6 and long term mortality (see online supplementary table S2).7 17 The largest previous study involved 438500 government employees and their families in South Korea and accrued 48757 events,7 but the largest study to compare ethnic groups was much smaller, with only 1062 events (Reasons for Geographical and Racial Differences in Stroke (REGARDS) study).8 As far as we are aware, there are no general population studies of white cell counts and mortality that used clinical rather than research measures of white cell counts. However, it is important to know the prognostic significance of white cell counts measured for diverse indications in usual clinical care. White cell count even within the normal range can be affected by a range of chronic and acute illnesses18 which prompts the question, not answered in previous studies, as to whether it is more strongly associated with short term than long term prognosis.
Our objectives were (1) to use clinically recorded white cell counts in diverse populations to replicate previous observations of the association of white cell count with mortality and (2) to extend these observations by comparing short term and long term associations, and investigating interactions with ethnicity, age, sex and smoking. This study was a new collaboration between the CALIBER (ClinicAl research using LInked Bespoke studies and Electronic health Records) programme in England19 (primary care data linked to hospitalisation, mortality and acute coronary syndrome registries) and PREDICT in New Zealand20 (cardiovascular risk assessments from primary care linked to hospital admissions, mortality,van der cleef arpels replique, dispensed medication and laboratory results).
MethodsWe carried out a cohort study using information recorded in usual clinical care in electronic health records in England and New Zealand. Characteristics of data sources analysed in two countries are summarised in online supplementary table S1.
CALIBER study population (England)The study population was drawn from the CALIBER,19 which links four sources of electronic health data in England: primary care health records (coded diagnoses, clinical measurements, laboratory results and prescribed medication) from general practices contributing to the Clinical Practice Research Datalink (CPRD),21 coded hospital discharges (Hospital Episode Statistics, HES), the Myocardial Ischaemia National Audit Project (MINAP)22 and death registrations. CALIBER contains data from 244 general practices which consented to the data linkage; these practices contained 3.9% of the population of England in 2006. The linkage was carried out in October 2010 by a trusted third party, using a deterministic match between National Health Service number, date of birth and sex. CALIBER studies have demonstrated associations of age, sex,23 blood pressure,24 neutrophil,van cleef and arpels replique, eosinophil and lymphocyte counts,25 ,26 and type 2 diabetes27 with initial presentation of cardiovascular diseases.
The study period was January 1997 to March 2010, and patients were eligible for inclusion when they had been registered for at least 1year with a practice meeting research data recording standards.
PREDICT study population (New Zealand)In New Zealand, approximately one third of general practitioners use PREDICT, a web based clinical decision support application to assess cardiovascular risk for primary prevention, and the PREDICT software captures this information centrally including commonly measured risk factors for cardiovascular disease (smoking status, diabetes status, gender, age, systolic blood pressure).20 ,28 These risk assessment records are linked to national databases of hospital admission data and mortality using an encrypted New Zealand National Health Index (NHI) number. Records were also linked with the New Zealand Pharmaceutical Information database,29 a national register of community dispensing, and TestSafe, a repository of laboratory test results for the Auckland and Northland region of the North Island of New Zealand. TestSafe contains community and hospital laboratory results from July 2006 onwards; prior to this date only hospital test results were available from this source, or community tests which were also copied to hospital services. White cell count results were linked to PREDICT information using the encrypted NHI. In PREDICT, prior cardiovascular disease was ascertained by the cardiovascular risk assessment questionnaire and hospitalisation records; in CALIBER prior cardiovascular disease was identified in primary care (Read codes for diagnoses) or hospitalisation records (International Classification of Diseases, Tenth Revision (ICD 10) codes) or an entry in the acute coronary syndrome registry.
In CALIBER, patients entered the study on the date of the first white cell count measurement after study eligibility. In PREDICT,imitation van cleef, patients entered the study on the date of the cardiovascular risk assessment. The most recent measure of total white cell count up to 5years before or 2weeks after cardiovascular risk assessment was chosen. If no white cell count was available during this period, it was considered missing.
OutcomesThe primary outcome of the study was all cause mortality. We identified patients who had died by linkage to the relevant national death registry, with follow up in New Zealand until 26 July 2012 and in CALIBER until 25 March 2010.
Other covariatesCardiovascular risk factor information such as smoking status, blood pressure and total:high density lipoprotein (HDL) cholesterol ratio were collected in PREDICT as part of the cardiovascular risk assessment and were largely complete. In CALIBER, we derived smoking status (current smoker or non smoker, to match the PREDICT categories) using primary care records prior to study entry, and extracted the most recent value of continuous risk factors (blood pressure, total cholesterol and HDL cholesterol) up to 1year prior to study entry.
Total white cell counts can be affected by factors such as infections, autoimmune diseases, medication and haematological conditions. Similar to our recent CALIBER studies on differential white cell counts,25 ,26 we sought to differentiate between a patient's long term 'stable' white cell count, and values obtained when the patient had an 'acute' condition which may alter white cell counts. We adapted a set of validated criteria published by the eMERGE consortium30 (electronic Medical Records and Genomics) for studying genetic determinants of the stable white cell counts, which takes into account cancer diagnoses, haematological diagnoses, use of steroids or immune modulating medication, recent vaccination and recent symptoms or diagnoses of infection. We used prescription, symptom, diagnosis and hospitalisation data in the primary care and secondary care records in CALIBER to assess whether the patient was clinically 'acute' or 'stable' at the time of the blood test; see online supplementary material methods for more details.
Diabetes status was assessed in CALIBER by a diagnosis of diabetes recorded prior to study entry in primary care (as a Read code) or in a hospital admission (as an ICD 10 code in Hospital Episode Statistics).27 In PREDICT, diabetes status was entered by the general practitioner into the web based cardiovascular risk assessment form. In addition, we considered patients to be diabetic if they had been dispensed an oral hypoglycaemic agent or insulin in the 6months before assessment, or if they had been hospitalised with a primary diagnosis of diabetes within the previous 5years.
New Zealand ethnicity data were recorded in PREDICT and national data sources, and were classified according to a standardised protocol,31 which prioritises Mori then Pacific ethnic groups if more than one ethnic group is recorded. Individuals were coded as Mori, Pacific, Indian or other. 'Others' were mainly of New Zealand European descent. In CALIBER, we classified ethnicity as white, black, South Asian (comprising Indian, Pakistani or Bangladeshi) or 'other', according to ethnicity recorded in primary care or during a hospital admission.1
AbstractObjectives Electronic health records offer the opportunity to discover new clinical implications for established blood tests, but international comparisons have been lacking. We tested the association of total white cell count (WBC) with all cause mortality in England and New Zealand. High WBC within the reference range (8.65 10.05109/L) was associated with significantly increased mortality compared to the middle quintile (6.25 7.25109/L); adjusted HR 1.51 (95% CI 1.43 to 1.59) in CALIBER and 1.33 (95% CI 1.06 to 1.65) in PREDICT. WBC outside the reference range was associated with even greater mortality. The association was stronger over the first 6months of follow up, but similar across ethnic groups.
MortalityLeukocyte countElectronic health recordsCohort studiesStrengths and limitations of this studyThe main strength of this study is that we showed similar associations of total white cell count with mortality in two ethnically different populations from different countries.
Both cohorts were large and population based, avoiding the selection bias inherent in bespoke cohorts with low response rates.
A limitation of this study is that white cell count and other covariates were measured only when thought to be clinically necessary, so some covariate data were missing.
As this is an observational study it can be used to infer association but not causation, and residual confounding may partly account for the observed association between total white cell count and mortality.
IntroductionA fundamental question in clinical medicine is 'what does this blood test result mean?' Relevant evidence in answering this question may come from examining the prognostic significance of blood tests recorded in usual clinical care. The direct clinical applicability, large sample sizes and population base of electronic health record cohorts, which are increasingly available for research in different countries, might provide opportunities to discover and replicate associations between clinically recorded measurements and patient outcomes. However, to date there have been few international comparisons of the prognostic validity of blood tests performed in primary care, partly because of the challenge of accessing such data, and harmonising the structure and coding of electronic healthcare records between countries. Nevertheless, such international comparisons might help to evaluate the robustness of associations among patients with different ethnic backgrounds and different profiles of risk.
We chose to compare England and New Zealand because they have different healthcare systems and ethnically different populations (the English population is predominantly Caucasian, with small proportions of South Asian or black ethnicities1 whereas New Zealand contains a sizeable proportion of Mori, Pacific, Chinese and South Asian people2). However, both countries have pseudonymised primary care data linked with other data sources available for research on a large scale,replique arpels and van cleef, making this type of study feasible. Despite the ubiquity of this test, it is unclear how strongly a clinically recorded 'normal' value in the general population is associated with subsequent short term and long term mortality. White cell counts vary between ethnic groups3 and are associated with inflammation, smoking, obesity and high systolic blood pressure.4 Previous bespoke cohort studies with white cell counts measured under research conditions suggest a link between high white cell count and increased risk of coronary disease5 ,6 and long term mortality (see online supplementary table S2).7 17 The largest previous study involved 438500 government employees and their families in South Korea and accrued 48757 events,7 but the largest study to compare ethnic groups was much smaller, with only 1062 events (Reasons for Geographical and Racial Differences in Stroke (REGARDS) study).8 As far as we are aware, there are no general population studies of white cell counts and mortality that used clinical rather than research measures of white cell counts. However, it is important to know the prognostic significance of white cell counts measured for diverse indications in usual clinical care. White cell count even within the normal range can be affected by a range of chronic and acute illnesses18 which prompts the question, not answered in previous studies, as to whether it is more strongly associated with short term than long term prognosis.
Our objectives were (1) to use clinically recorded white cell counts in diverse populations to replicate previous observations of the association of white cell count with mortality and (2) to extend these observations by comparing short term and long term associations, and investigating interactions with ethnicity, age, sex and smoking. This study was a new collaboration between the CALIBER (ClinicAl research using LInked Bespoke studies and Electronic health Records) programme in England19 (primary care data linked to hospitalisation, mortality and acute coronary syndrome registries) and PREDICT in New Zealand20 (cardiovascular risk assessments from primary care linked to hospital admissions, mortality,van der cleef arpels replique, dispensed medication and laboratory results).
MethodsWe carried out a cohort study using information recorded in usual clinical care in electronic health records in England and New Zealand. Characteristics of data sources analysed in two countries are summarised in online supplementary table S1.
CALIBER study population (England)The study population was drawn from the CALIBER,19 which links four sources of electronic health data in England: primary care health records (coded diagnoses, clinical measurements, laboratory results and prescribed medication) from general practices contributing to the Clinical Practice Research Datalink (CPRD),21 coded hospital discharges (Hospital Episode Statistics, HES), the Myocardial Ischaemia National Audit Project (MINAP)22 and death registrations. CALIBER contains data from 244 general practices which consented to the data linkage; these practices contained 3.9% of the population of England in 2006. The linkage was carried out in October 2010 by a trusted third party, using a deterministic match between National Health Service number, date of birth and sex. CALIBER studies have demonstrated associations of age, sex,23 blood pressure,24 neutrophil,van cleef and arpels replique, eosinophil and lymphocyte counts,25 ,26 and type 2 diabetes27 with initial presentation of cardiovascular diseases.
The study period was January 1997 to March 2010, and patients were eligible for inclusion when they had been registered for at least 1year with a practice meeting research data recording standards.
PREDICT study population (New Zealand)In New Zealand, approximately one third of general practitioners use PREDICT, a web based clinical decision support application to assess cardiovascular risk for primary prevention, and the PREDICT software captures this information centrally including commonly measured risk factors for cardiovascular disease (smoking status, diabetes status, gender, age, systolic blood pressure).20 ,28 These risk assessment records are linked to national databases of hospital admission data and mortality using an encrypted New Zealand National Health Index (NHI) number. Records were also linked with the New Zealand Pharmaceutical Information database,29 a national register of community dispensing, and TestSafe, a repository of laboratory test results for the Auckland and Northland region of the North Island of New Zealand. TestSafe contains community and hospital laboratory results from July 2006 onwards; prior to this date only hospital test results were available from this source, or community tests which were also copied to hospital services. White cell count results were linked to PREDICT information using the encrypted NHI. In PREDICT, prior cardiovascular disease was ascertained by the cardiovascular risk assessment questionnaire and hospitalisation records; in CALIBER prior cardiovascular disease was identified in primary care (Read codes for diagnoses) or hospitalisation records (International Classification of Diseases, Tenth Revision (ICD 10) codes) or an entry in the acute coronary syndrome registry.
In CALIBER, patients entered the study on the date of the first white cell count measurement after study eligibility. In PREDICT,imitation van cleef, patients entered the study on the date of the cardiovascular risk assessment. The most recent measure of total white cell count up to 5years before or 2weeks after cardiovascular risk assessment was chosen. If no white cell count was available during this period, it was considered missing.
OutcomesThe primary outcome of the study was all cause mortality. We identified patients who had died by linkage to the relevant national death registry, with follow up in New Zealand until 26 July 2012 and in CALIBER until 25 March 2010.
Other covariatesCardiovascular risk factor information such as smoking status, blood pressure and total:high density lipoprotein (HDL) cholesterol ratio were collected in PREDICT as part of the cardiovascular risk assessment and were largely complete. In CALIBER, we derived smoking status (current smoker or non smoker, to match the PREDICT categories) using primary care records prior to study entry, and extracted the most recent value of continuous risk factors (blood pressure, total cholesterol and HDL cholesterol) up to 1year prior to study entry.
Total white cell counts can be affected by factors such as infections, autoimmune diseases, medication and haematological conditions. Similar to our recent CALIBER studies on differential white cell counts,25 ,26 we sought to differentiate between a patient's long term 'stable' white cell count, and values obtained when the patient had an 'acute' condition which may alter white cell counts. We adapted a set of validated criteria published by the eMERGE consortium30 (electronic Medical Records and Genomics) for studying genetic determinants of the stable white cell counts, which takes into account cancer diagnoses, haematological diagnoses, use of steroids or immune modulating medication, recent vaccination and recent symptoms or diagnoses of infection. We used prescription, symptom, diagnosis and hospitalisation data in the primary care and secondary care records in CALIBER to assess whether the patient was clinically 'acute' or 'stable' at the time of the blood test; see online supplementary material methods for more details.
Diabetes status was assessed in CALIBER by a diagnosis of diabetes recorded prior to study entry in primary care (as a Read code) or in a hospital admission (as an ICD 10 code in Hospital Episode Statistics).27 In PREDICT, diabetes status was entered by the general practitioner into the web based cardiovascular risk assessment form. In addition, we considered patients to be diabetic if they had been dispensed an oral hypoglycaemic agent or insulin in the 6months before assessment, or if they had been hospitalised with a primary diagnosis of diabetes within the previous 5years.
New Zealand ethnicity data were recorded in PREDICT and national data sources, and were classified according to a standardised protocol,31 which prioritises Mori then Pacific ethnic groups if more than one ethnic group is recorded. Individuals were coded as Mori, Pacific, Indian or other. 'Others' were mainly of New Zealand European descent. In CALIBER, we classified ethnicity as white, black, South Asian (comprising Indian, Pakistani or Bangladeshi) or 'other', according to ethnicity recorded in primary care or during a hospital admission.1