Monthly Archives: March 2018

Major Study Shows Dissatisfaction Following Robotic Prostatectomy

Major Study Shows Dissatisfaction Following Robotic Prostatectomy

A major study of patient satisfaction and regret following open prostatectomy and robot-assisted laparoscopic prostatectomy provides some important lessons for surgeons.*
The research, recently published in the European Journal of Urology, shows 19 per cent of patients regretted their treatment choice and patients who had robot-assisted surgery were most likely to be dissatisfied.

The authors suggest the regret is “possibly because of higher expectation of an ‘innovative procedure'”.

Their conclusion is one for all urological surgeons to note. “We suggest that urologists carefully portray the risks and benefits of new technologies during preoperative counselling to minimise regret and maximise satisfaction.”

In recent years, the treatment of prostate cancer has been a rapidly developing field, providing patients with a wide range of different choices.

Brachytherapy and HIFU offer non-surgical options and for those who want surgery, there are open, laparoscopic and nerve-sparring options, depending upon your diagnosis and treatment provider.

At the same time, patients are becoming increasingly proactive, using the internet to research and consider the different options themselves, as well as the traditional consultation with the urologist.

Increased choice is without doubt a positive benefit for patients, but as urology centres – both private and NHS – seek to attract patients, we have a responsibility to carefully counsel them about the advantages and disadvantages of treatments.
There is a distinctive risk when a procedure is perceived to be new and especially “innovative”. The media will always be interested in the next “pioneering operation”, particularly one which involves robots.

A newspaper article will tend to portray the new procedure as an immaculate solution, which corrects all the risk and disadvantages of other procedures.
As surgeons, we have a responsibility to provide patients with a more sober and informative picture, acknowledging limitations as well as benefits.

The patient satisfaction study was based on the responses of 400 men who had undergone retropubic radical prostatectomy (RRP) or robot-assisted laparoscopic radical prostatectomy between 2000 and 2007 in the US.

The report’s authors also examined patients urinary domain scores, hormonal domain scores and found scores were independently linked with regret.

It is still early days for robotic surgery in the UK. In prostate cancer surgery, there are currently six Da Vinci robotic machines in the UK, compared with 350 in America.

There is no current evidence that robotic surgery provides better outcomes for patients, in terms of urinary symptoms, post operative sexual function or post-operative risks and complications.
It seems certain that robotic surgery will increase within the UK during the next decade, with NHS and private centres purchasing the Da Vinci machines.

This will provide even more choice for patients, which is in principle, a positive development.

It is however vital that patients are given accurate and comprehensive information to enable them to make an informed choice, rather than simply being over-sold a new product.

Christian Dating and Waiting

Christian Dating and Waiting

Waiting for that perfect Christian dating partner can be a difficult and faith stretching experience. Many singles suffer from depression just thinking about how long it’s been since they’ve had a meaningful date.

If you’re a single Christian, no doubt the hardest part has been waiting on the Lord for that special soulmate. This is especially true as you see your single friends meet their dream dates, get married and move on. Loneliness and anxiety starts to creep in as we wonder when God will bless us.

Although King David did not have Christian dating in mind when he wrote Psalms 13, many single people waiting for a mate can certainly identify with his feelings in verse 1: ” How long O Lord? Will you forget me forever?”

Are you a single Christian girl or guy struggling with your faith in the area of “waiting on the Lord” for a husband or wife? Be encouraged and recall that David, whom God described as a man after His own heart, also struggled. Yet, it’s interesting that during the time he wrote Psalms 13, he also penned Psalms 62:1: “My soul waits in silence for God only.”

If you read the rest of Psalms 62, you’ll see David could wait upon the Lord because he had a calm, confident expectation that God would do exactly what He promised: He would meet David’s needs.

Recently, I had a single woman come up to me quite confused over the Christian dating issue. Although she wanted so much to be married to a godly man, she was torn over whether using Christian dating services meant she was no longer waiting on God for His provision.

How about you? Are you confused over how you should approach Christian dating and waiting on God? If so, consider these questions to guide your actions and test your heart motives:
Does God’s word and/or uncontrollable circumstances preclude you from taking action toward entering a dating relationship? If so, this may be the time to silently wait on Him, resting in His promises to provide.
Have you done all that you could do in your particular situation? Remember, God wants us to take faith-filled risks as we ask, seek and knock (Matthew 7:7). Many times we claim to be “waiting on God” before making a move on a matter, but God has already given permission to simultaneous take action while honouring him as well.
Do your attitude and actions show that your soul is submitted to God’s will and resting on His promises? Or are you hell bent on taking your Christian dating life into your own hands because you fear losing out on that single man or woman?As you meander through the Christian singles dating scene, remember that waiting on God and taking proactive steps toward your dating goal need not be an either/or proposition. Just make sure as a Christian single, your heart is aligned with God’s each step of the way.

Obama’s mom’s Return To School Government Grant Scholarship

Obama’s mom’s Return To School Government Grant Scholarship

Did you know that the new US government is committed to helping single moms return to school? Many mothers are not aware that the Obama’s ‘Moms Return to School’ Government Grant Scholarship is available, but there are big benefits to finding out as much as you can about this offer.

Given the state of our economy this is a great time to be finishing or furthering your education; even more so if you are a single mother. When the economy bounces back (which it always does), qualified workers are going to be in big demand. Having that degree will make you qualified for that job you have always wanted.

Here are some of the important things to know about Obama’s “Mom’s Return To School” grants and scholarships.

Federal Pell Grants

One of the first bills introduced by Obama, the Federal Pell Grants are being increased for low income students. That means the maximum grant allowed now is $5100 instead of $4050. There is even talk of raising it more. If you are a single mother then is one of the very best grants that you can get.

You can apply for this grant by choosing a college or university that you wish to attend. Make sure they are running your chosen program or course first.

You then fill out a deferral FAFSA form and have it submitted.

Tax Benefits for Studying Moms

The first four thousand dollars of money applied toward higher education is tax free according to the American Opportunity Tax Credit.

Grants for Online Study

If you are planning on attending an online school then be aware that Obama’s “Mom’s Return To School” government grant program is still an option for you . If you think about it studying using an online school just makes a lot of sense for a single mother who wants to be available for her kids.

You can also look for additional grants and scholarships you qualify for. You may be surprised to find that some are even suited for single mothers and may offer more money.

latest JN0-360 study materials

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Wedding Rings And Wedding Bands Can Be Purchased Anywhere

Wedding Rings And Wedding Bands Can Be Purchased Anywhere

Wedding rings are an important part of a couples planned event. These rings symbolize the union of two people in marriage and vows. These ring symbols are very popular and can be found anywhere.

Traditionally, wedding bands were simply plain metal circles. These rings are sold by a local jeweler or a local jewelry store. Before recent times, a blacksmith made the Wedding rings for a couple.

Today, wedding bands can be found and purchased almost anywhere. Rings are offered at local stores and even online via the Internet. Some individuals even sell rings themselves through consignment.

Jewelry stores are perhaps the most logical place to buy rings. These stores have a wide selection and knowledge about wedding rings. A jewelry store obtains rings to sell to couples in two main ways.

The primary way a jewelry store gets the rings is by a designer. Some stores have an in house designer who makes all the jewelry. A designer has knowledge and experience in jewelry designing.

This dedicated person may have studied precious metals or gemstones. A designer knows the best materials to use in designing jewelry. A designer can adapt materials to fit within particular pieces.

A benefit to using a designer is that wedding bands can be custom. This designer can meet and talk with couples to get their ideas. Then for an additional charge can create custom made rings for them.

Other jewelry stores obtain wedding bands through suppliers. These jeweler suppliers have their own selection of jewelry pieces. A jewelry store reviews the selections and purchases them to display.

It is the hope of the store that the pieces selected are well liked. Buying from a supplier gives a lot more variety of ring design. However, this takes away the ability for custom design of rings.

Online stores also sell wedding bands for a couples big day. These online stores typically have much less overhead and cost. Thus, these stores obtain wedding bands by a designer and supplier.

This means online stores have a much greater variety in ring choices. Wedding rings can be found online in all designs, styles, and sizes. One can search for bands of certain metals or gemstones in the design.

These online stores offer much better pricing than local jewelers. Wedding bands sold online are cheaper and save a couple money. This is one reason to explore the selection of wedding rings online.

Childrens Duvets Duvet Covers for Every Child

Childrens Duvets Duvet Covers for Every Child

A stunning variety of covers for childrens duvets are available for parents who want to add color and interest to their childrens bedrooms. Duvet covers come in all colors, sizes, and themes. Solid colored duvet covers can complement the color scheme in your childs bedroom. Patterned covers that reflect themes related to your childs interests and activities can make going to bed an experience your child actually looks forward to.

Whether you have a boy or girl, there is a duvet cover out there that will appeal to your child. It is easy to find childrens duvets that appeal to both genders and to kids of all ages. Every parent knows that it is important to enable children to express their identities through the objects they surround themselves with, especially the dcor of their bedrooms and their bedding. Selecting a duvet cover of an appropriate color and style can allow your child to show off his or her personality. Little girls who love pink will enjoy duvet covers in colors such as BeBop Pink and Tickled Pink. Little boys may prefer covers in Pistachio and Blueberry Cordial Aqua. For older children, who may want their duvet covers to reflect their new maturity, covers in more subdued colors such as Quilt Blue or Tartan Red may be more appropriate

In addition to a variety of color schemes, you will find a multitude of themes available in covers for childrens duvets. For the dinosaur enthusiast in your family, you can choose duvet covers in Dino Lime and Jurassic Dinosaur. The budding athlete in your house will love Old Ball Game, Grand Slam, and Soccer World. Girls who love to play “dress-up” will be thrilled with such offerings as Rhinestone Cowgirl and Glitter Princess. Themed duvet covers are not only functional but entertaining. They will engage and occupy your childs imagination in those moments before falling asleep. It will no longer be a chore to get your children to wind down at the end of the day. They will be clamoring to go to bed.

Covers for childrens duvets also offer convenience and versatility. When one duvet cover is being laundered, simply zip another one on over your childs duvet. If your child becomes bored with his African Safari duvet cover, switch to the Pirate Map cover and he will be happy again. Changing the duvet cover in your childs bedroom is a simple way to vary the dcor and reignite his or her interest in the nighttime ritual of going to bed.

Indian Wedding Catering- Tickling those taste buds

Indian Wedding Catering- Tickling those taste buds

If you are planning to have Indian Catering for your big day, you will require completing a fairly large range of tasks; you will need to organise, your guest list, the venue, the menu and the services you require (buffet, table, waiter). This all requires a lot of work, and most people could get overwhelmed, in this article we aim to help you manage and organise the tasks. Before we get started it’s important to do your homework, know what you want and the budget you have in mind.

Firstly, before you speak to or hire an Indian Wedding Caterer, do some research. Google is the best source to find Indian Wedding Caterers around your local area. It’s important to browse their websites and look for any testimonials and view their menu. It’s crucial to ask friends and family for references, this will ultimately minimise the risk of unpleasant surprises on the wedding day itself.

We have made a few suggestions below, to help you on your quest for hiring a suitable Indian Wedding Catering Company and choosing a suitable menu, whilst maximising your budget:

– Wedding Essentials – Ensure that the venue allows external Indian Wedding Caterers, and that they can provide a suitable kitchen where they can cook/prepare the menus on-site. Ensure they have a loading bay for ease of access into the kitchen.

– The Menu: A mouth-watering menu that will satisfy your guests. It’s important that on your wedding day everything is perfect, especially the menu catered for, we suggest you get a balance of the freshest, flavourful, and the least expensive menu from the budget available, not forgetting a menu which pleases your personal taste, as it is your dream day in the end.

-Food Tasting: Once you have made a shortlist of potential wedding caterers, it would be advised to book a food tasting session with them. This will give you an indication of which caterers can meet and fulfil your menu requirements and provide you with a platform to make a direct comparison on which company can deliver you with value for money menus.

Comfort Snacks: An important factor to considerer when selecting your menu is to choose one which serves high calorie foods, this as a result will satisfy guests with reasonably small portions, helping you to stay within the budget.

– Catering Extra’s: Ask the catering company, if they will provide the table linen, chair covers and the cutlery within budget. Centrepiece- If you’re planning on having a centrepiece, but budget is limited, you can ask the Indian Wedding Caterer to organize fruits in vases, rather than flowers, this will not only offer great colour but they are a less cost-effective option.

This article is in reference to Gulshan Iqbal, Indian Wedding Catering Specialists. Visit their website for a full menu of Indian Catering and Indian Caterers dishes.

Chilean Wedding Customs

Chilean Wedding Customs

Usually, in Chile, weddings go like this:

The man proposes and (so long as the lady accepts), he offers her an engagement ring which she places on her ring finger, just like in England and most of Europe.

Then they usually do alternate wedding ceremony rings and wear them on their proper ‘ring’ fingers.

Then, each time they set the marriage date, they have the Civil Service, which is the authorized aspect of things. This normally includes going to a Registry Office and having the authorized whys and wherefores read out in entrance of a few of your closest family and friends. That is when the couples transfer their wedding ceremony ring to the left ring finger in the event that they want. Plenty of Chileans put on their rings on their right ‘ring’ fingers too – it doesn’t matter to them. This service is then followed by an enormous dinner and a small occasion for aforementioned shut household and mates and a few presents are given.

The wedding takes place after some time (say, a month at the very least) after this authorized occasion. The wedding is a non secular ceremony. And a ceremony it definitely is.

You invite hundreds of individuals – from the furthest of your loved ones members and associates and their relations and pals, and your boss and their household and pals together – and squeeze them into the hugest and grandest church you will discover and afford. Then the wedding happens. The vows, the readings, the blessings from the priest and all other follows. Then they’ve a giant outdated band (yes, on the church ‘stage’) and a tremendous singer after which the bride and groom leave together to plenty of clapping and outside have a bit of rice throwing and images flashes, as is the norm in western cultures.

They’re then whisked away, followed by their guests, to a lavish celebration. Typically there are several hundred tables full with elaborate centerpieces with candles of their crystalline candle holders in every single place and flowers all around, twisted and twined by way of the chairs. Champagne is liberally handed out by tuxedo waiters as is caviar and pisco sours and different culinary and taste buddy delights, earlier than sitting right down to a full-service dinner. Throughout the reception, the groom, bride, and their dad and mom will cease by every table to say thank to their guests. The visitor in return, will give envelopes containing wedding ceremony cards and cash gifts (Chilean spurs was the standard wedding gifts within the olden days) to the newly wedded couples along with their blessing. Dinner is followed by an enormous Latino disco and a dancing party, which is opened by the groom and the bride’s first dance and the place everyone wears masks and has streamers and joke store child’s get together things. The social gathering does not recess until very late at night. The newly wedded couples then depart for his or her honeymoon.

Rise above the lonely weekends and try dating agencies

Rise above the lonely weekends and try dating agencies

You have got this life just for once, and thus it is always suggested to make complete use of it by enjoying it to the fullest. A lonely weekend and busy professional life will lead you nowhere after a while. You definitely need a companion with whom living life would become more worthwhile. No matter how many unsuccessful relationships you had, it is never too late for trying for love-if not love at least a fun friendship that will make you smile always. The online dating agencies were established with the same purpose of helping individuals like you who are optimistic to find a good companion soon.

Instead of spending those lonely Friday evenings, you can register your name to some of the reliable dating websites and see if you are able to know an individual that ignites a spark in you again. The irish dating agencies are the only way to meet a special one just by sitting in your home or office. There is no harm in talking to a person online as long as both of you are getting along and spending a good time. Once you are sure that both of you have same needs, set up a face to face meeting to take things forward. In case, you remain unsatisfied then you can unregister your name, but at least you can try this new technological advancement once.

Before taking things to the next level, you should first make sure that both of you want to experience the same things i.e. Just being friends, casual dating, or a long term relationship. This will ensure that you do not have to undergo any confusion or heartbreak later on. Professional dating agency Ireland is also a great help for people who are shy inherently and find it difficult to approach people face to face. Through these online sites it will be easier for you to display your charming side without feeling too overwhelmed or conscious. This is the reason that online dating agencies are so popular amongst people of almost every age group. All you are expected to be during the entire process is having a realistic expectation and practical approach.

Do not start expecting a serious relation within few online chats itself because it takes significant time to build a strong relationship. Moreover, do not share your deep details with someone if you are only looking for casual dating relationships. Fill up your profile with genuine information and be straightforward about your expectations. After all, you are here to have a good time and not invite further complications in your life. The website would not compel or persuade you to do anything so that the entire dating process remains an experience out of your own decisions. So, register your name to these dating sites and give yourself that dignity and freedom to search out a partner who can suit your lifestyle and expectations.

Daylight And Fresh Air Within School Lecture Rooms

Daylight And Fresh Air Within School Lecture Rooms

The unfavorable impact associated with bad interior o2 quality (IAQ) and also a not enough sun light on the health and productiveness associated with building occupants are generally well known, and can be particularly damaging to small children which spend roughly 12% of their day time in school buildings, more than in any building type besides their particular homes. Within the school, children are subject to a selection of contaminants that originate from interior sources, for instance furnishings, IT components, along with bio-effluents, and from those that are usually introduced from outside, for instance nitrogen dioxide and carbon monoxide. The chance of small children to experience long-lasting damage is increased simply because most of the tissue and bodily organs tend to be still growing, they will breath more air compared to their own body mass as compared to adults, and air-flow rates within university classrooms in many cases are discovered to be under those that are recommended. Furthermore, low levels of daylight are usually linked to depression, inadequate vitamin D synthesis, along with lessened productivity.

New school buildings are built to stringent criteria plus this is relatively easy to perform when starting with a blank canvas. It is usually more difficult to meet UK specifications whenever retro fitting existing school structures or even when renovating existing non-domestic buildings to use as educational institutions. However, all school buildings should meet government specifications and here expertise matters. Monodraught happen to have been developing natural ventilation and daylight strategies for brand new and also pre-existing school properties for nearly 15 years and in that time period the company has quickly responded to completely new and improved procedures and methods, and also to the numerous modifications that have been made to the Building Bulletin guidelines (there are currently more than 30 documents) for school design from the 8 Secretaries of State for Education who’ve held office. In addition Monodraught has representatives on the management committee with the Chartered Institute of Building Services (CIBSE) Schools Design Group that aims to improve the structure, procedure, as well as environmental quality regarding education structures by disseminating info relevant to their designers and operators.

Monodraught natural ventilation systems are already installed in in excess of 1100 schools and daylight systems in more than 3,000 colleges. Moreover, the overall performance associated with the ventilation and daylight systems has been thoroughly researched by Brunel as well as Nottingham Universities and the conclusions printed throughout peer reviewed publications. Monodraught is committed to the study and development of its products for them to be used as part of a system of procedures to provide healthy and productive interior surroundings in restored and also remodelled school classrooms.