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|Reviews for A Question of Loyalty|
| Alia92 chapter 4 . 8/7/2011
The ending was awesome:) oh please write more!
| Alia92 chapter 3 . 8/7/2011
:) hell yea! I been lookin for someone to do a "welcome back and thank you for totally savin my ass" chap after the collector base to honor Shep, niicely done lol I however take my hot ass drell lover with me everywhere:) anyways think this us my favorite chap, lived the Thane bit 0.0 ahhh I just love him...
| Alia92 chapter 2 . 8/7/2011
Hey ;( too short!
| Alia92 chapter 1 . 8/7/2011
Lol that Is what I was thinking the other day when I was talkin to her "Wrex would totally hit that" XD anyways niice writing!
| amaretto and coke chapter 4 . 3/23/2011
Lovely. Very nice to see another side of Miranda that isn't hyper-sexualized, and I love the way that you characterized Jacob.
| PadawanMage chapter 4 . 6/6/2010
Very nice! Love to see Miranda care about other things besides her sister.
| BetaReject chapter 4 . 5/19/2010
Oh gosh wow that first scene was so incredibly touching! I normally don't ship these two as a pair but you've done such a wonderful job of portraying their relationship. The silent understanding that surpasses words. I like how you show through his actions the affections these two share, how he knows just what she needs and when to give it.
Oh wow the second deleted scene was equally powerful. Though I admit I had to smile upon hearing Jacob's nickname for Shepard heh 'Miss Lazarus' very appropriate. Equally powerful was the fact that once more you show without showing how deep Jacob's feelings for Miranda runs. How well he knows her, how he can read her with a mere glance.
I liked too how you show Miranda's strength and her vulnerability. How she is this powerful woman capable of doing some serious damage, but she's also a human being with doubts, regrets and insecurities. It was equally powerful too how she chooses to recall Jacob's kindness his unspoken support instead of falling back onto the easy way out of keeping everyone at arms length. I think that moment where she's reminicising the good time instead of the bad really shows how far she has come and how much she has grown.
Equally powerful was the fact that as muhc as she wants to break down she doesn't. She knows that what she has with him is almost if not equally fragile as the friendship she shares with Shepard. How there is that promise that one day she will fully remove her guards, its just not today.
Oh gosh that ending was so perfect too how through his simple statement he says so much more than either are ready to admit. How in his own way he expresses his own loyalties and his support of her decisions.
Honestly this was amazing I do hope you will continue to do tales that explore these characters in further detail as you have me completely hooked! m(_ _)m
| Paladins chapter 4 . 5/19/2010
I very much liked this story. I like that Miranda had an issue changing sides. She didn't just flop over with a cheesy grin. I also liked your approach to Miranda as a whole. She's a fun character, because you can make her a Cerberus bitch (quoting Jack) or she can change sides to Shepard. Which gives you a lot of room with her. Other characters as well are fun in a similar way (Jack and Zaeed come to mind just off the bat), but she has more pull than them.
Anyway, I got off topic. This was a sweet story, and it does make me want to go play just to see if I can get something sweet out of Miranda (not counting playing as a guy... ya know).
| OmegaCrusader chapter 3 . 5/7/2010
Now, it's definitely one thing to write a fanfiction portraying a MShep ROMANCING Miranda.
It's another thing entirely to portray a FShep BEING FRIENDS with Miranda.
Let me begin once again by saying that you essentially captured Miranda's essence and character perfectly. She's been psychologically abused by her father, isolated from the rest of the world, and, quite possibly, the extent of social interaction for her, for her standards, was simply with her contacts (which I don't think she considers 'friends', simply allies), and Niket was probably the only true friend she ever had. She believes that close relationships can break more than it can make, friend or lover. For example:
Imagine if a MShep romancing Miranda died during Omega-4. You can essentially imagine how heart-broken she would be (especially if Shepard chose the 'I promise I won't die' line), because she feels that Shepard is the only person she can actually look to as an equal, that Shepard is THAT type of person, the type of person that can breach her emotional barriers that had been erected due to her early childhood and seeing herself as merely a tool to be used and thinking that no one sees past that facade either.
I'd continue, but my take on Miranda's character is an essay of several pages long xD
So, all in all, well done, very well done. We don't see a lot of Shep/Miranda friendship fics (In all honesty, I haven't seen any besides yours o_0), and it's nice to see something different from the norm of MShep/Miranda romance fics.
I would like to see a bit of bonus content, if only for flavor. :D
| kiwibliss chapter 3 . 5/7/2010
The Miranda/Shep relationship is a difficult one and I think you did an excellent job of illustrating that. Some of the slightly renegade choices in game (like Veetor) can really leave the darker side of Miranda exposed. I think that she legitimately does change through association with Shepard though, again as evidenced by you.
| BetaReject chapter 3 . 5/6/2010
Oh wow I really love how you show Miranda's reaction to the Illusive man. How she terminated the two who had tortured Veetor. I really loved how she handled the Illusive man as well. I love how you show through her actions how she has matured and grown as a person.
Oh my goodness wow I really love how you show this human side to Miranda. My goodness I never thought I'd say this but you have completely sold me on Miranda. I think I actually respect and like her now. Damn.
I really love how she stands up to the Illusive Man, the very person she once believed she owed everything to. This is the Miranda I wish i could have seen in the game. Just seeing her defending Veetor like tht was so powerful. How even she doesn't recogonise her own strength. How she's starting to find herself, and becoming the woman she should have bene allowed to be all along.
Aww I love how Jacob is like a big bro to Shepard. I love how she tries to keep the mood light but you can still feel the weight of hte moment. Equally powerful is how she still is unaware of what Miranda has done. How she still remains distrustful of her though for now they are both bound together by duty. That moment where Thane and her exchange expression was really well done. No weakness, no faltering, just that mutual understanding. That was seriously powerful.
Holy wow just when I thought this couldn't get any better you have Shepard and Miranda facing TIM down! Oh that was just brilliant! Beautiful job there! I loved how Miranda shuts him down right after Shepard tells him off. I relaly loved too how you show without showing that Miranda has entered a new phase of her life. That for the first time, the very first time she is truly free, that she can finally follow her heart's desire without the control or shadow of another ruling her every action.
That silent nod Shepard gave her in reply was just so poignant too. How it says so much without ever saying a word m(_ _)m
Oh gosh this ending was so well done too. I love how each and every person handles the events of the day so to speak each in their own way. I loved Zaeed's reaction heh that is so him, same with Thane's silent presence how he offers support in his own way. But I thikn it was Shepard's response to Miranda that was by far the most powerful. How she returns the spying device that small symbol of gratitude and he unspoken understanding that there is hope yet for the future of their friendship. Her closing words too was really sweet. I just love their friendship!
Oh my goodness what a beautiful ending! Seriously this was such a lovely tale I do hope that you continue on with the addendum bits as I'd love to read anything that explores this friendship and sisterhood further!
| BetaReject chapter 2 . 5/5/2010
Woah that was such a sharp contrast from the last chapter. Like Miranda I'm completely at a loss. Wow whatever she did it really set her off my word!
O.O OMG poor Veetor! ;_; I've never taken the option of leaving him with Cerebrus but upon reading this I've only found one more reason why I knew I made the righ decision. I can oly imagine the horrors that poor man went through during his interrogations (
I loved the fire of this piece, the control Shepard shows even in her rage (if that option was available I would have had Shepard space her for that.)
I liked how you showed Miranda's mask in place, how we never really see what's going through her mind though the detachment seems to reveal in its own way her reaction. The fact she needs to distance herself from the matter, the fact she never argues the point or even defends herself tells me that the jury is still out. Miranda isn't really known for her silence when something irks her so I really found it powerful how in her silence she is saying so much.
Beautiful job here I really do hope you continue in the future!
| PadawanMage chapter 2 . 5/4/2010
Wow, very powerful! I never allowed him to be taken by Cerberus...and now I know why.
| payroo chapter 2 . 5/3/2010
! I had no idea that would happen to Veetor if you handed him over to Cerberus... I think this is one renegade option I won't be able to choose.
The second part was all the more painful after the first one where they bonded and whatnot. I like your Miranda voice!
| BetaReject chapter 1 . 4/17/2010
Wow you know this tale has really given me a new respect for Miranda, the struggles she has gon ethrough and is going through. It can't be easy to learn how to be your own person when your entire life was built to fulfil another's dreams and greed.
I like how you show this human side of her that is so rarely seen in the games or even in fanfiction for that friendship she shares with shepard was equally powerful and endearing. Its not often you see Shepard's human side either in teh tales. Usually she's angsty or too bad ass (not that I mind but I love this down to earth woman you can imagine is approachable and is capable of friendship).
I have to say it once more I really love the friendship between Miranda and Shepard here. Just seeing them as two women as opposed to soldiers, warriors or heroines. Its so refreshing to say the least!
Wow that ending just blew me away. No pretense no warning just Miranda taking that first step into finding her own person. Making her first real friend and finally finding that place where she belongs all along.
Please tell me that you'll be writing more on their friendship in the future i would love to read it!


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Momentum aim to oust Tom Watson for ‘disloyalty’ following anti-Brexit speeches
- Credit: PA Archive/PA Images
Momentum is attempting to remove Tom Watson from his role as deputy leader of the Labour Party for 'disloyalty' over the party's Brexit position.
At a meeting of Labour's National Executive Committee (NEC) Jon Lansman, the founder of left-wing group Momentum, proposed a motion to scrap the role of deputy leader.
The chair of the NEC said the motion was out of order before 17 members to 10 voted to hear it.
As it failed to meet a two-thirds majority it was not discussed but will end up on Saturday's agenda with an expectation it will pass.
Supporters of the motion included Diane Abbott and Rebecca Long-Bailey - the only shadow cabinet members present.
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Tom Watson was not present at the meeting - he had given apologies due to childcare commitments.
Lansman claimed that Tom Watson's overall Remain position - and recent calls for a People's Vote to take place before a general election - were reasons for removing him.
- 1 Nigel Farage loses nearly 50,000 followers after Twitter suspends QAnon accounts
- 2 Michel Barnier tells UK to be 'very careful' in Brexit diplomatic status row
- 3 Fifteen ways to fix Britain
- 4 This chumocracy is costing our country
- 5 Holyrood in talks with EU to extend Erasmus scheme to Scottish students
- 6 Susanna Reid takes on Priti Patel over government's gaslighting of public on coronavirus
- 7 Independent SAGE adviser gives scathing assessment of Priti Patel's £800 Covid fines
- 8 An actor whose politics were a touchy subject
- 9 Bob Geldof takes swipe at No 10 saying 'lying is second nature' to them
- 10 Brexiteer says he'd never have voted for Brexit 'if we knew we'd lose our jobs'
Momentum are confident that they have the votes to abolish the position.
A Momentum statement said: "No one person is more important than beating Boris Johnson, ending austerity and tackling the climate emergency. We just can't afford to go into an election with a deputy leader set on wrecking Labour's chances.
"Labour members overwhelmingly want a deputy leadership election, but our outdated rulebook won't let it happen. You need 20% of Labour MPs to trigger an election, and they just won't let the members have a fair and open election."
The moves appeared to provoke outrage from the parliamentary Labour party.
Ex-minister Yvette Cooper tweeted: "This is completely mad and incredibly destructive. Country faces serious challenges & General Election could be imminent. @UKLabour conference shd be about country & about pulling together. Instead we get this."
Former Cabinet minister Ben Bradshaw said the attempt to "purge" Mr Watson was "totally f***ing insane".
Tottenham MP David Lammy said: "Tribal infighting in the middle of a Boris Johnson-inspired national emergency makes me want to weep.
"My constituents and millions of others across the country desperately need the Labour party united right now. The Tories, not Tom Watson, are our opponents. Let's fight them."


text:
|Title:||Analysis of the awareness and popularity of the brand of a selected education and research library in the Czech Republic: A Case Study|
|Citation:||HOMMEROVÁ, D., ŠRÉDL, K., DBALÁ, K. Analysis of the awareness and popularity of the brand of a selected education and research library in the Czech Republic: A Case Study. Information (Switzerland), 2020, roč. 11, č. 8. ISSN 2078-2489.|
|Keywords in different language:||brand;branding;image;library;positioning;strategy;sustainability|
|Abstract in different language:||This article aims to show the significance of branding in achieving set marketing goals and ensuring the sustainable development of a selected education and research library as a non-profit organization. The research is based on available data from foreign research studies concerning the image of a brand and the branding of non-profit organizations, and expands on them by utilizing other methods of brand image measurement. A survey involving a sample of 220 respondents was conducted at the particular site, taking into account the library’s target segments. Also utilized in evaluating the library’s image was an analysis of the awareness and favorability of its brand. The library has recently undergone a rebranding process and is applying a new visual style. The new visual style of the library resulting from the rebranding was met with a positive response in 69 % of cases. Branding and appropriate marketing communication that reflects the latest trends can have a positive influence on the sustainability of libraries. The research results have contributed to the adoption of corrective measures in planning the strategy of the selected library and the case study results can be applied across the board to other contributory organizations in the Czech Republic.|
|Appears in Collections:||Články / Articles (KMO)|
Please use this identifier to cite or link to this item:
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

domain: library


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domain: entertainment


text:
Larval Development of Callinectes Similis Reared in the Laboratory
Abstract:Freshly hatched larvae of Callinectes similis Williams, the lesser blue crab, were reared to the first crab stage. Eight zoeal stages and one megalopa stage are described with particular reference to types of setae on appendages. Updated information on the development of the commercial blue crab, Callinectes sapidus Rathbun, is also given, as well as similarities and differences between C. similis and C. sapidus. The zoeae of C. similis and C. sapidus are so similar that they can only be separated by a number of minor differences. The dorsal spine of C. similis is significantly longer than that of C. sapidus in all zoeal stages. Other structures, such as the rostrum and antennae, are either longer in early zoeal stages of C. sapidus than in C. similis, or the structures of the two species are not significantly different. In later stages, however, structures measured were generally significantly longer in C. similis than in C. sapidus. Also in later zoeal stages, there are generally small differences in setation of appendages.
There are diagnostic differences in lengths of parts of the claw of the first leg and setation of pleopods of the megalopa of the two species. There are also minor differences in the setae of the scaphognathite, in seta of the epipodite of the 3rd maxilliped and in aesthetascs of antennules of the two species.
Document Type: Research Article
Publication date: October 1, 1977
More about this publication?
- The Bulletin of Marine Science is dedicated to the dissemination of high quality research from the world's oceans. All aspects of marine science are treated by the Bulletin of Marine Science, including papers in marine biology, biological oceanography, fisheries, marine affairs, applied marine physics, marine geology and geophysics, marine and atmospheric chemistry, and meteorology and physical oceanography.
- Editorial Board
- Information for Authors
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- Ingenta Connect is not responsible for the content or availability of external websites

domain: biology


text:
The benchmark FTSE 100 has so far added about 7 points to yesterdays gains to take the index to 4,466 after UK stocks commenced trading on a mixed note.
BHP Billiton, one of the world's biggest mining companies, rose 5p to 451p.
Severn Trent lost 32p to 799p after the water company’s stock changed hands without giving investors buying the shares today the right to the second- half payout of 29.27 pence.
In Asia, Tokyo's Nikkei 225 index gained 254.02 points to 11,641.72 earlier today, and Hong Kong's Hang Seng index advanced 47.04 points to 12,097.73.
In the US, the Dow Jones Industrial Average index rose 45.70 points to 10,380.43 yesterday and the S&P 500 index gained 6.72 points to 1,132.01.
Nasdaq's Composite index advanced 25.61 points to 1,995.60.IFAonline
FCA checked files
Properties do not exist
Follows active fee cuts in June

domain: news


text:
Too much of a good thing is awesome, don’t let anyone tell you different. And it is for this very reason that Testament, Anthrax, and Death Angel have announced a third leg to their tour. This leg will focus almost entirely on Canada with some select dates in a few Northern US States. Check out all the tour dates below (more to be added over the next few weeks). This tour will see Testament supporting their upcoming album, Dark Roots Of Earth, which comes out July 31st. More details for that album can be found here.
14 Ace of Spades, Sacramento, CA
15 Roseland Theatre, Portland, OR
16 Toyota Arena, Kennewick, WA
17 Knitting Factory, Spokane, WA
20 Vogue Theatre, Vancouver, BC
21 MacEwan Hall Ballroom, Calgary, AL
22 Events Center, Edmonton, AL
24 The Odeon, Saskatoon, SK
25 Burton Cummings Theatre, Winnipeg, MB
29 Danforth Hall, Toronto, ON
30 Capitole du Quebec, Quebec City, QC
2 Metropolis, Montreal, QC
3 State Theatre, Portland, ME
5 Wellmont Theatre, Montclair, NJ
Got any thoughts/questions/concerns for Jonny B.? Shoot him a message on Twitter!

domain: artistic


text:
NPA’s Electronic Cargo Tracking System will curb illicit activities in the petroleum sector – Tampuli
The Chief Executive Officer of the National Petroleum Authority, Mr Alhassan Tampuli says he is confident that the introduction of the command centre for the bulk road vehicle & electronic cargo tracking system will go a long way to curb the incessant illicit activities in the downstream petroleum sector.
Speaking at the official commissioning of the command centre at the NPA’s head office in Accra on Tuesday, January 14, Mr Alhassan Tampuli said this new innovation is the sort of game-changer which will sanitize the sector, increase revenue for the state and improve standards for all stakeholders.
In Ghana, the dominant mode of petroleum product transportation is by road using Bulk Road Vehicles. Currently, about 98% of the volume of petroleum products moved within the country are done using BRVs.
This mode of transportation is however associated with many challenges including transit product shortages and false haulage claims.
Addressing stakeholders at the event commission Mr Tampuli revealed that due to the absence of an effective tracking system, transport service providers exploited the lack of capacity of the NPA to independently confirm the delivery of petroleum products to retail outlets, thereby subjecting the Petroleum Fund to abuse by presenting false claims for costs incurred for the transportation of petroleum products.
To address the challenge, he said, the NPA opted for a technological approach that would enable it to have visibility on the movement of bulk road vehicles and the locations where petroleum products were loaded, hence the introduction of the tracking system.
“The introduction of the BRV Tracking and Cargo Tracking Systems is a demonstration of our commitment to improving standards and controls in the distribution of petroleum products in the country.
“There is no doubt that all sectors of the economy stand to benefit from an efficiently managed downstream oil sector that delivers petroleum products in the right quantity and, the required quality at least cost at all times.
“Adequate controls and reliable distribution service for the petroleum downstream sector is very essential for economic development and this sits well with the NPA’s vision which is to be a catalyst for economic transformation and growth” he added.
The event was graced by the Vice President of Ghana, Dr Bawumia who praised
and commended the NPA and its stakeholder agencies for their efforts at improving operational standards and efficiency in the petroleum downstream industry, adding that energy was critical to the survival of mankind and, therefore, its sustainability had become a very important and burning issue around the globe.
The petroleum downstream sector, according to him, was a critical component in meeting the energy requirements of the country, since an efficient and effective petroleum products distribution system was important and essential to the economic growth of the country.
About the NPA
The NPA was established by an Act of Parliament (NPA Act 2005, ACT 691) to regulate the petroleum downstream industry in Ghana. As a Regulator, the Authority has endeavoured to ensure that the industry remains efficient, profitable and fair while ensuring that consumers receive value for money.
Since the establishment of the NPA in 2005, the Authority has supervised the acceleration of the petroleum downstream deregulation process by facilitating the removal of restrictions on the establishment and operations of facilities, and importation of crude oil and petroleum products.
In June 2015, the NPA successfully implemented the final phase of the deregulation process, which is price liberalization. This process involves full decontrol of prices of petroleum products from the government, private importers, distributors and retailers are empowered to set ex-refinery and ex-pump prices with no intervention from the government.


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13 Imaginative Craft Show Display Ideas to Get You Inspired
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text: All parents, teachers, and students should know by now that a school is no place for weapons including but not limited to knives and guns. Of course, a 9 mm semi-automatic handgun should not be brought to school. The presence of this gun around children can be a recipe for danger, personal injuries, and wrongful death. A 6th grader went to his middle school in west Orlando with a 9 mm handgun. Officers were called to the school and went to the classroom where the student was attending class. The officer safely separated the student from his backpack where they located the gun. The student acknowledged that there was a stolen gun in his back pack. The school along with police responded in a manner that was swift and controlled. Fortunately, nobody was hurt by the presence of this dangerous gun on school premises. I commend the police and school officials for taking care of this situation for the protection and safety of the students including the one that brought the gun to school. You can read more about this story at West Orlando Middle School Student Arrested for Bringing Gun to School.

domain: sociology


WCSS maintains a fleet of response vessels specifically designed to respond and deploy containment and recovery equipment in surface water. These boats are strategically placed throughout Western Canada and are available to WCSS Members in Good Standing. Boats can only be operated by personnel who have certified in the Small Commercial Vessel Operator and WCSS Boat Handling courses. The airboats and barges require additional certification prior to operating. All boats are equipped with Transport Canada and WCSS standard safety equipment, including two-way radios capable of transmitting and receiving on a set frequency of 159.48000mhz.
There are three different classifications for response vessels:
**Please note that the full scope of WCSS Airboat use is currently under review and that interim use is restricted to ice assessment only.**
Airboats are propeller driven V-8 engine, flat bottomed boats capable of working in shallow water, ice and broken ice, muskeg, swamps, and on dry ground. These boats can be used as safety boats or to deploy equipment and carry 500kg of personnel and equipment. Require at least a 3/4 ton or 1 ton truck with a 2-5/16″ ball.
The barges are 8m long X 2.5m wide response vessels which are ideal for hauling heavy equipment and personnel to remote locations on a river and provide a stable working platform. They have twin V-8 engines with jet drives and can operate in as little as 30cm of water. Barges weigh about 4000kg and require at least a 1 ton truck with a 2-5/16 ball.
There are numerous single engine response vessels in the fleet, ranging from 16 ft flat bottom boats with outboard jet drives, to 22 ft inboard engines with jet drives. Although handling characteristics vary with each design, all are capable of hauling equipment and personnel and deploying equipment. The workboats can be hauled with a 1/2 ton truck with a 2″ ball.


text: American Press Travel News–January 1st, Bob and Barb “On the Road Again” this time dining at Little Italy Restaurant. we love pizza, who doesn’t? Well, beside pizza, we enjoy about everything covered in melted mozzarella. Little Italy in Port St Lucie does this well. Anything, chicken, veal, eggplant covered with melted mozzarella with added garlic knots and spaghetti and the right tomato sauce, rules with us. The best garlic knots have great flavor even without garlic, but when drenched a bit in butter/garlic sauce, the knots are even more spectacular. Why do I recommend this Italian Restaurant? Its consistently good!! Located next to a Publics in Port St Lucie, West.

domain: food


text:
- Please select a date to see the proper prices!
- No meal
Description of the accommodation:
Rooms, services Are you looking for a remarkable trip to Belgium? Take a look at what Bed and Breakfast Coupure Bruges has to offer! The pension is offering three nicely furnished rooms to stay in to those seeking accommodation in Bruges. The pension has an own parking lot, enabling you to park your car on the spot. If you have a suitable portable device, you can connect to the Internet for free via a wireless network (WiFi) available in the rooms. The exact equipment and the exact list of available services of Bed and Breakfast Coupure Bruges can be read on the information sheet below.
Payment For the reservation you may need to provide advance payment by credit card or credit card guarantee, depending on the exact date, room and price.
Arrival, opening hours The earliest time of check-in is 16:30, the latest time of check-out is 11:00.
Bed and Breakfast Coupure Bruges rooms Rooms
On site parking
Free WiFi in shared places
Default services: Garden
WiFi, Restroom, No elevator, Pets and service animals not allowed
No baby cot

domain: travel


text:
That One Time
My life has been full of beautifully unique moments. In the world of live performance, and especially improvisation, this is common. I remember that one performance, that one rehearsal, that one time in the studio, that one audience, that one reaction.
This kind of thinking is often thought of as nostalgic; head-in-the-clouds. Today’s culture also pushes back against the value of singular experiences. Science demands replicability. Dizzy Gillespie, the famed jazz trumpet player, is quoted as saying that the professional is the cat who can do the same thing twice. Many of us yearn for some consistency.
But what if we were put here on this earth for a singular moment? Would that not be enough? Would that not be fulfilling? What if there where many singular moments? What would it look like if all those moments strung together? Wouldn’t that be what we call a life?

domain: literature


text:
STEPHANIE Davis showed off her growing baby bump in a pink velour tracksuit as she celebrated finally moving into her first home.
The mum-to-be looked the picture of happiness as she shared a snap of her sitting at the bottom of the stairs in her new pad.
She captioned the snap of her in the cosy looking ensemble: "Moving in day outfit 👶🏻 baby and mummy very happy thank you @lasulaboutique we both feeling so comfortable #mumtobe #cosy #jobdone."
The Celebrity Big Brother star has been keeping her fans updated on the details of her house move and recently said her "life has turned around" in the past few months.
Steph then shared an old sonogram picture of her baby boy writing that "time has gone so fast" and she's "grown up so much" since the start of her pregnancy.
She wrote: "Old photo...How different to what he will be now even though he's so cute and a proper baby there...growth scan is so soon!
"Can't wait to see his little face again. Then I can't wait to hold him in my arms.
"Times flying but loving every minute of carrying him and feeling him play is honestly... amazing words can't describe how incredible it is!
"I've grown up so much, 23 is a lovely age, I've my house, baby , priorities and absolutely LOVE being a mummy!
"My baby's made my dreams come true, I'm so lucky to have him and to love him and have this extra special bond with him every day.
"Count down....my little best mate, my boy, happy."
Meanwhile, Steph, 23, hinted that she moved on from her ex boyfriend Jeremy McConnell as she posted a picture of her relaxing next to a mystery man on the couch.
The actress was enjoying some chill time after a sun-soaked holiday and uploaded an image of her legs next to his, while her arm cuddled across his chest.
Meanwhile the guy, who was wearing shorts and had two packs of sweets on his knee, placed a protective hand on her body.
Guessing gameStephanie Davis DENIES her secret boyfriend is pro golfer James McDowall in straight to the point tweet
MYSTERY MANPregnant Stephanie Davis teases picture of rumoured new boyfriend in cosy snap on Instagram
little princeStephanie Davis plans to dress her baby like Prince George as she reveals she has picked a name
'IT WAS SO REAL'Steph Davis claims she was visited in a dream by dead David Gest who's been 'dyeing his own hair in heaven'
'My life has turned around'Stephanie Davis says her life 'couldn't be better' as she officially buys her first home
The TV star's adorable pet pooch can be seen staring at their PDA from a spot by the fire.
The identity of Steph's first boyfriend since her CBB ex Jez, who she claims is the father to her child, remains shrouded in secrecy yet his legs and wrist - with his easily-recognisable Apple watch - have featured on her profile before.
She captioned the cosy picture with the words: "Nothing better than family times ... house full of people," followed by an emoji love heart.
She then went on to talk about her baby, who is thought to be due in December, and added: "So relaxed. My baby boy kicking to us.
"He knows our voices too well, it's mummy ... and us X" teasing her closeness with her male mate.
While she has kept her new beau's identity a secret, Steph did take to Twitter to deny she is dating pro golfer James McDowall.
Fans speculated James was her mystery man because they wear the same apple watch but she put those rumours to bed writing: ""I do not know who @jamesmcdowall90 is or how I've been linked to him. Thank you.x"
Got a story? email email@example.com or call us direct on 02077824220

domain: celebrity


D*F*D or Dumb Founded Drifting parts is a small company who produced drift specific parts for drifters who wish to use custom parts for their chassis. We started any products with intensive Planning, Engineering drawing, Testing and Marketing. These are not mass produce, very limited quantity, highest quality assurance and we only take pre orders. Normal turnaround time 7 days. Inner shaft diameter 4mm. 2 secure screws for long lasting use!
Price: RM115/piece. Call me at 0163310258 for orders. Dealers are welcome.
Units sold and delivered 10. Units on queue 15 (another week to be delivered)


Mike Pence to meet with Trump this weekend amid VP talk
INDIANAPOLIS — Indiana Gov. Mike Pence's re-election campaign announced Friday that he will meet with presumed Republican presidential nominee Donald Trump over the weekend amid speculation that Pence is under consideration as his vice presidential running-mate.
The move raises questions about what it would mean for his gubernatorial re-election campaign at home. While the Republican governor's embrace of social issues has brought considerable criticism from Democrats and business leaders, he is well regarded among national conservatives and brings with him the support of the party's evangelical wing. If Pence were to become Trump's vice presidential nominee, state law dictates that he could not run for both offices.
Pence campaign spokesman Marc Lotter characterized the meeting as nothing out of the ordinary though he declined to comment on the exact purpose, or if Pence was being considered as a potential vice presidential pick.
"Gov. Pence has accepted an invitation to spend a little time with Mr. Trump this weekend," Lotter said. "That is consistent with meetings that Mr. Trump is scheduling with many key party leaders."
Pence was once viewed as a possible presidential candidate and served in Congress for 12 years before he was elected Indiana's governor in 2012 in a narrow victory over Democrat John Gregg. His popularity has since fallen.
Under Pence, who has described himself as "a Christian, a conservative and a Republican, in that order," Indiana has marched to the front lines of the nation's culture wars. In 2015 he drew mostly negative attention to the state after signing a law that critics say would have allowed businesses to deny service to gay people for religious reasons. Groups threatened boycotts, late-night television shows mocked the policy and a coalition of gay rights supporters and business interests successfully demanded that lawmakers approve changes.
While speculation that Pence could be a vice presidential pick for Trump created significant buzz in national political circles, it drew a mixed response in Indiana.
Curt Smith, an influential Indiana evangelical figure, said Pence would be an excellent choice for Trump, who is viewed skeptically by evangelicals and movement conservatives.
"He would be extremely reassuring to conservatives in general and evangelicals in particular," Smith said. "He had a leadership role in Congress and would be able to be the president's lead on Capitol Hill."
Devin Anderson, a longtime Indiana Republican said Pence has done a good job presiding over an improving economy and plummeting unemployment rate, which Republicans credit to the state's low taxes and limits on regulation.
"It seems to me that the governor should continue to press his case to Hoosier voters in this governor's race, which is still a tight race," said Anderson, a businessman who previously worked for GOP members of the state's congressional delegation. "It's critical that Mike Pence remains governor and keep Indiana on a good path."
Gregg's campaign seized on the news.
"Mike Pence has always put his own political agenda ahead of everything and everyone else. For him running for governor was never about serving Hoosiers, it has always been about using the office to get into even higher office," Gregg campaign spokesman Jeff Harris said. "Just look at the extreme social agenda he's pushed as governor. It's been more focused on establishing his conservative credentials and building a national profile than on improving the lives of everyday Hoosiers."


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Easter Island (Rapa Nui) is a remote volcanic island located in the Pacific Ocean. The island is made famous by its giant stone statues called ‘moai’. This tour provides the chance to explore the myths and legends of this intriguing island. In addition you have the opportunity to visit the ceremonial city of Orongo and the worship centre of Tangata Manu. Furthermore, enjoy the best that Rapa Nui has to offer with daily excursions.
On arrival at Mataveri (Easter Island Airport) you will be met and transferred to your HOTEL.
Day 2Easter Island
Today you will visit Rano Kau, Orongo, Ana Kai Tangata and Ahu Akivi Puna Pau. (B)
Day 3Easter Island
After breakfast, you will be taken on a full day tour to the ruins of the temple of Ahu Akahanga where the hats of the moai are the outstanding feature, scattered where they fell when the platform was destroyed. Continue to the volcano of Rano Raraku, where all of the moai on the island were carved out of the rock. You will then have the opportunity to climb to the edge of the crater of the volcano to appreciate the lake inside and moai scattered about the inner slopes in various stages of construction. Your day will end at Anakena Beach where you will have the opportunity to swim before returning to your HOTEL. (B, L)
Day 4Trip concludes
Today you will be met and transferred from your hotel to Easter Island Airport. (B)


Automotive recalls have been one of the staples of ConsumerAffairs’ Recall Roundup, and this week is no different. Our feature story this week is connected to a recall of over 85,000 Volvo vehicles.
Earlier this month, the automaker announced that it would be recalling several 2019 and 2020 model year light vehicles because of a fuel pump issue that could cause the engine to stall. A loss of power while these cars are being driven could increase the risk of a crash.
Volvo has already contacted dealers and plans to contact owners at the beginning of August. The automaker said dealers will replace a 15-amp fuse with a 20-amp fuse in affected vehicles free of charge. Consumers can contact the company for more information at 800-458-1552.
Nissan also recalls vehicles for stalling issue
In a strange twist, Volvo was not the only automaker facing a stalling issue this week. Nissan North America is recalling over 24,000 of its own INFINITI vehicles because of an impeller that can swell and bind within the fuel pump module and cause it to fail.
The automaker said it will be sending out notification letters to owners by mid-July and that dealers will be replacing fuel pump modules in affected vehicles free of charge.
Consumers can contact Nissan for more information at 800-662-6200 and reference recall number R21A2 for more information.
Voltage testers recalled for shocking users
Klein Tools is recalling nearly 1.7 million of its non-contact voltage testers because the devices can shock the people who are using them.
In a posting on the Consumer Product Safety Commission (CPSC) website, the company explained that the on/off button can remain pushed in during the power on or power off cycle. This issue could lead some users to be unaware that there is live voltage being channeled through the device, causing a shock.
Klein received two reports of its voltage testers not working properly, including one incident in which a shock occurred. The devices were sold at Home Depot stores and other hardware stores and electrical wholesalers across the U.S. between January 2020, and March 2021.
Consumers are being asked to stop using the affected devices immediately and to contact Klein Tools for more information on how they can be sent a free replacement tool.
Peppa Pig Chocolate Chip Cookies recalled
Parents of young children who love Peppa Pig may want to make sure that any themed snacks they bought are safe to eat.
Primary Colors Design, the company that makes the Peppa Pig Chocolate Chip Cookies Gable Box, is recalling the product because of the presence of undeclared eggs. While this might not be harmful to some children, those with an egg allergy could unknowingly consume the product and become ill.
Customers who purchased one of the recalled products and have an allergy or sensitivity to eggs are being urged not to consume the cookies. Primary Colors Design can be contacted at 419-903-0403 or by email at firstname.lastname@example.org for more information.


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News from the Geoblogosphere
New from Snet:
, a new tool to create lithological/sedimentological logs online..
Blog post recommendation
Losing Humanity's Heritage by Fire, But Not From Burning
Mt. Konocti and Clear Lake, an archaeological treasure in Central California I read this article by Madeleine Thomas in the Pacific Standard, and it was disturbing to say the least. It discusses the looting of archaeological sites in the Clear Lake area, in part by meth addicts. It's truly sad how low some people can go on their life's journey, and meth addiction is one of the worst ways to go


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Light switch pulling dull 2
Light switch, string pull. Basement.
Turn on the switch of a black light
Pull switch on a television, change the channel, turn dial, antique
Whoosh. Low and thick, created by swinging a wooden rod.
Switch on off neon lights.
Large clunking switch click with TV tube electric buzz
Old bakelite light switch with spring mechanism - Switched on with sproingy clunk
TV switched off. Small spring noise of switch release.


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Narjis Rizvi ( Community Health Sciences Department, The Aga Khan University Hospital, Karachi )
Stephen Luby ( Diarrheal Diseases Epidemiology Unit,Food borne and Diarrheal Diseases Mail stop A-38 Centers for Disease Control*, Atlanta. )
Vaginal discharge is one of the most common symptoms of gynecological morbidity.1 Vaginitis is the most prevalent cause followed by cervicitis2, however vaginal secretions also increase physiologically during mid-cycle and pregnancy.
Sexually Transmitted Diseases (STDs) and Reproductive Tract Infections (RTIs) often present with vaginal discharge.3 Presence of an STD increases the likelihood of contacting HIV as these diseases facilitate HIV transmission.2,4-6 In order to restrain HIV and AIDS, control of other STDs is imperative.2,7 Though STD infection rates are similar in both sexes, women bear the major burden of complications and serious sequelae.4,5,8 Hence, STD management in women is particularly important.9
The two important components of STD control program are case identification and appropriate management. STD case identification is extremely difficult in most parts of the world as these diseases are considered social problems and are frequently surrounded by prejudices and poor information.8,10 Social barriers in STD control are particularly pronounced in rural sectors of developing countries where the majority of population lives.11 Because of fear and shame victims commonly hide their conditions.
In India and Nepal STDs remained one of the commonest disease next to Malaria and Pulmonary Tuberculosis12 and its incidence is increasing in Nepal.13 Vaginal discharge was the most frequently reported symptom in gynecology. STD and ante-natal clinics14,15 in Nepal. In these patients it is usually difficult to differentiate between physiological and pathological discharges only on the basis of history and clinical examination.
Pathological discharge can be caused by more than twenty different organisms.4,16 WHO recommends algorithms for the treatment of this symptom in developing countries. These algorithms are poor predictors of an STD.10 If the management is based on these algorithms then patients having only one etiology are treated for several diseases. Laboratory test can sometimes be required to identify the specific micro-biological agent which can be treated effectively with specific anti-microbial agents.5,17-19 Given the general poor correlation observed between client symptoms, clinical signs and laboratory findings, the identification of appropriate, simple and low cost diagnostic test will be an effective strategy for better management of vaginal discharge and hence STDs.
This study was conducted to know Nepalese women's perceptions about vaginal discharge and STDs in the context of causes, routes of transmission, characteristics of normal and abnormal discharge and health seeking practices so that services can be geared towards patients needs. The study also aimed to correlate client symptoms, clinical signs and laboratory findings so that appropriate test can be identified for vaginal discharge management in the local context.
Subjects and Methods
We conducted the study at the outdoor patient department of Thapatali Maternity Hospital, Katmandu, Nepal in May and June 1997. This is a public hospital which provides gynecological, obstetric and STD treatment services to patients from the city and surrounding villages. The study included focus group discussions, quantitative in-depth interviews and laboratory evaluations
Focus Group Discussions
We conducted five focus group discussions, three with ante-natal clients and two with gynecological patients in the outdoor patient departments of Thapatali Maternity Hospital. In each discussion six to eight women participated. Consent was taken for participation. A trained research assistant, who held a masters degree in sociology, facilitated the discussions in Nepali. The facilitator encouraged active participation. An observer documented the whole process of group discussion and took notes. The objectives of these discussions were to comprehend women's perceptions about characteristics of normal and abnormal vaginal discharge, and the causes, routes of transmission and health seeking behavior for vaginal discharge and STDs. Another objective of these focus groups was to develop the structured questionnaire for the in-depth quantitative interviews.
In-depth structured interviews
The quantitative interview questionnaire was based on the information collected through focus group discussions. A research assistant administered a filtering questionnaire to all newly registered outdoor patients. This questionnaire included basic demographic information and one question to find out if vaginal discharge was the presenting complaint. Study personnel encouraged women who presented with vaginal discharge as their chief complaint to see the specific study physician for gynecological examination and laboratory investigations. Women were, however free to bypass the research physician and consult the regular outpatient staff.
Study personnel interviewed patients presenting to the study physician using a structured questionnaire. This questionnaire included questions on duration, causes, associated symptoms, knowledge about normal and abnormal discharge and health seeking behavior in relation to vaginal discharge. The study physician performed gynecological examination, including vaginal, bimanual and speculum examinations, collected samples for laboratory investigations and sent the patient to the laboratory for blood examination. For the clinical diagnosis, vaginal secretions were classified in two ways, quantity and quality. Quantitative categories were normal or large in amount. On the basis of quality, vaginal discharge was categorized as floccular, homogenous and curd-like and endo-cervical as normal or muco-purulent.
The research assistant interviewed each case using a structured questionnaire. This questionnaire included questions on duration, causes, associated symptoms, knowledge about normal and abnormal discharge and health seeking behavior in relation to vaginal discharge. Based on laboratory results, the study physician provided appropriate treatment to all cases on the follow-up visit.
All patients with vaginal discharge gave consent for laboratory investigations. Vaginal fluid from the posterior vaginal fornix was tested for pH and then used to prepare a wet mount and KOH specimens and examined microscopically for Trichomonads, Lactobacilli, the proportion of clue cells present and fungal elements (the slide was gently heated and re-examined if fungal elements were not seen initially). It was also subjected to an amine ("whiff") test. A smear was made from an endo-cervical swab and subjected to Methylene blue stain and microscopy examination for intracellular diplococci. Endocervical swabs were also taken for Gonorrhoea culture (immediate inoculation onto Thayer Martin and choclate agar media) and culture for Chlamydia. Blood samples were also collected to diagnose Syphilis through Venereal Disease Research Laboratory (VDRL) test and to confirm through Treponema Pallidum Haemagglutination (TPH) test.
|Table. Etiological agents in vaginal discharge patients (n=73). |
|Type of infection ||No. ||% |
|Candidiasis ||55 ||78|
|Bacterial Vaginosis ||18 ||25|
|Trichomonas ||12 ||17 |
|Gonorrhoea ||2 ||3|
|Syphilis ||2 ||3|
|Chlamydia ||0 ||0|
All women were assessed according to both sets of diagnostic criteria i.e., clinical and laboratory (Table) adapted from the work of Amsel et a120, Eschenbach et al21 and Spliegal et al.22
Focus group discussions were transcribed and coded. Later the themes were identified by analyzing the coded information. The analysis of qualitative data was done manually. The data collected through structured interviews, review of medical records and laboratory investigations was entered into EPI-Info version 6.0. The data was analyzed as frequency distribution of selected variables.
Focus Group Discussion
The mean age of focus group participants was 26 years. Local terms used to describe vaginal discharge were Setho Pani, Haritho Pani, Khola fancho, Dhatu Rog, Harm Palli and Setho Pani jani. Vaginal discharge was identified as a disease which is common but distinct from STDs. Participants emphasized that women clearly understand the difference between normal and abnormal vaginal secretions. Women consider the discharge as abnormal if it continues for more than 2-3 months, large in amount, contain pus or blood, has foul smell and or associated with systemic symptoms.
Abnormal vaginal discharge was believed to be caused by weakness of the body in general and genital organs in particular. Women believed that it is transmitted by direct contact with infected articles e.g. clothes, food and furniture, etc. Any woman could have this problem irrespective of her age, marital status and education.
Women expressed that a number of topical home remedies are used for the treatment of vaginal discharge e.g. mustard, or coconut oil alone or in turmeric powder, burn ointments and eczema and antiseptic powders and crèmes. One of the group mentioned that a special food made up of flour, butter and dry fruits is used as a home remedy.
Participants also reported that vaginal discharge patients do not seek treatment unless it interferes with daily routine work, the reason being shame and fear. Women believed that approaching the health institution is tantamount to publicizing that they have a sexual illness. Women reported that health providers in biomedical institutions are not very friendly and there is a lack of privacy. Women believed that vaginal discharge and STD patients prefer traditional healers or pharmacist as they are more welcoming and polite, and observe confidentiality and privacy. If this treatment failed then only did patients approach the qualified biomedical system.
Women clearly distinguished between vaginal discharge and sexually transmitted diseases. Vaginal discharge is considered as a disease which though shameful, yet socially acceptable in contrast STD is regarded as a substantial social stigma. The characteristics of STDs are described as heavy vaginal discharge associated with genital ulcer or vesicle. Participants reported that women are the primary sufferer and contact the disease through multiple sexual partners. These women later transmit infection to their husbands. Women consistently reported that STDs can only be transmitted if women have sexual relationship with multiple partners but not through her husband even if he had sexual contacts with other women. Women reported that a woman with STD has to live in social isolation. Because of fear of transmission of infection to others, women having STD are not allowed to get treatment from local traditional health providers.
Out of 333 newly registered gynecology outpatients at Thapatali Maternity Hospital, Katmandu, Nepal, between May 5 and June 10, 1997, 54% reported vaginal discharge. Among these women with vaginal discharge, 40% went to the study physician while the remaining 108 followed the routine outpatient procedure and went to the hospital doctors. The study physician performed gynecological examination and ordered laboratory investigations for all these (n=73) patients. The research assistant interviewed 70 of these patients while three did not come back for the interview.
Among the 70 women interviewed 58 (80%) had vaginal discharge for more than one month duration. The majority (92%) of women reported associated symptoms. The most common associated symptom was lower abdominal pain (83%), followed by dysmenorrhea (60%), irregular menstruation (53%), dysuria (50%) and dyspareunia (29%). More than half (51%) of the women believed that vaginal discharge was not a normal condition. The most common characteristics of abnormal discharge mentioned were increase in amount (67%), itching (55%), change in color (53%) and foul smell (52%). The most commonly reported cause of vaginal discharge was weakness (77%) which was also identified as one of the sequalae of vaginal discharge (75%). The other consequences mentioned were lower abdominal pain (67%) and backache (64%).
All women believed that they should seek advice from a family member. In the current episode, majority of patients (83%) took advice and consulted their husbands (80%). All those who did not take advice (20%) mentioned that shame was the main reason. The majority of women came to the hospital either with their husband (45%) or friend (36%). Most of the women (83%) knew that patients should approach hospital as their first choice. However, most (90%) of these patients in the current episode, had been to two or more health providers before they finally reached the hospital. The first place of contact with health system was the pharmacy by urban women and traditional healers by rural women. Three main criteria used by women for the selection of health provider or institutions were reputation of the provider (60%), distance of the health facility (30%) and the cost of treatment (10%).
Diagnostic findings in vaginal discharge cases
The gynecological history suggested presence of symptoms in all cases (n=70). Physical examination revealed abnormal clinical signs in 66 (91%) patients while in four patients examination was normal. Among these 66 patients with abnormal clinical signs, the laboratory tests confirmed reproductive tract infection and/ or STD in 64 while in the remaining two, no etiology was identified. Of those four patients who had normal internal examination findings, laboratory test identified an etiological agent in two patients. The most common clinical signs were vaginal discharge (91%), vaginal hyperemia (61%) and cervical excitation (40%).
Laboratory results confirmed that 91% (66) of patients had reproductive tract infection. Out of these 66 patients 15 (23%) had an STD. Most of the patients (72%) had a single etiology. Candida was the most common infection followed by Bacterial Vaginosis (Table 2).
Vaginal discharge and STDs are considered shameful and sharing the symptom even with health providers is uncomfortable. Hence, treatment is not sought until the symptoms severely affect the quality of these women's lives. This view was supported by quantitative interviews as most of the patients had vaginal discharge for more than one month. An STD/HIV project working in Nepal has also reported that most of the symptomatic STD patients had symptoms for more than three months.14 Furthermore, women believed that traditional healers or pharmacist are preferred for vaginal discharge and STDs, as these providers are more approachable and observe confidentiality.
Out of seventy women who presented with vaginal discharge 91% suffered from either Reproductive Tract Infection or an STD. STD in women was identified as a social taboo. Therefore women with these infections try to hide their symptoms as long as possible even from health providers. In this social context vaginal discharge can be used as a risk marker for early identification of STDs and HIV by primary health workers so that these patients can be referred to secondary level for further work up. This may reduce gynecological morbidity and can also be a cost effective intervention for HIV prevention. A randomized clinical trial conducted in Tanzania has demonstrated that improved treatment of STDs has resulted in reduction of the incidence of the HIV infection.23
In the present study, symptoms were suggestive of infection in all patients. The clinical examination was positive in 91% cases, but it was inconclusive for the type of infection. Laboratory investigations were the only means to confirm etiology. In 72% of patients a single etiological agent was identified. The three most common infections were Moniliasis (55), Bacterial Vaginosis (l8) and Trichomoniasis (l2). These three reproductive tract infections are found to be the commonest in other studies also.13 These infections can easily be diagnosed by microscopic examination of simple wet preparation of vaginal secretion and Gram stain. Once etiology is confirmed, specific drugs can be prescribed for each of these infections. On the other hand if syndromic approach is used, then these women who suffer either from Moniliasis, Trichomoniasis or Bacterial Vaginosis would also have received drugs against all six common STDs i.e., Trichomonads Vaginalis, Chlamydia Trachomatis, Gonorrhea, Bacterial Vaginosis and Moniliasis. This clearly indicates over treatment which may result in non-compliance and ultimately drug resistance. Additionally being treated for all six potential organisms would markedly increase drug costs in a setting where essential drugs are in short supply.
Women believed that they are the primary victim and the main source of transmission for STDs. The role of males in STD transmission is considered insignificant. As a result of these misconceptions women are blamed to be mainly responsible for STD transmission. Since South-East Asian culture does not allow women to use their right for safe sexual practices, women without multiple partners get STDs from their husbands but do not report and remain neglected and untreated. This results in a continuous increase in the incidence of STDs in South-East Asia.8 Hence, for prevention and control of STDs, it is imperative that women understand that husband could be the source of STDs, if he has multiple sexual partners. Moreover, awareness need to be created among both genders about the increasing number of STD cases, the sources and routes of transmission and the importance of safe sex practice.
In the current study and also in Africa, STD patients preferred to go to the non-formal health system.10,29 Therefore there is a need to nurture constructive relationship with front line health providers e.g. pharmacists and traditional healers. In addition qualified biomedical facilities should also develop a more supportive and humane environment for communities.These public institutions should be remodeled as a place where patients can comfortably communicate their sufferings. If the formal health systems become sensitive to the needs of the communities in relation to STDs and RTIs then patients may quickly and directly seek care from these institutions.
The major limitation of this study was that the subjects were selected from the hospital and may be non-representative of the general population.These women might be different from others in respect to the disease severity and or health seeking behavior. However, these women were from the lower socio-economic strata and hence represent the majority of the population. Therefore their viewpoint may help us in understanding the socio-cultural context and its influence on the health seeking behavior in relation to vaginal discharge and sexually transmitted diseases. The study has also suggested that vaginal discharge can be used as a risk marker for identification of STD cases. Although, there is a possibility that the accurate estimation of the predictive value of this risk factor might have been affected by the likelihood that mostly those women had landed at the hospital who had STDs. However, in the South East Asian cultural milieu it is worthwhile to utilize this risk marker for identification, appropriate management and control of STDs.
The most striking finding in this study is that STDs are not well understood by people and misconceptions pertaining to the etiology, transmission and appropriate management of vaginal discharge and STDs exist at the level of potential sufferers. Culture specific health education messages and strategies need to be designed to meet the local information needs. Another essential conclusion is that the quality of health care in terms of accuracy of diagnosis and treatment of vaginal discharge is essential for decreasing the incidence of STDs. The study also highlights that institutional environment in terms of client/patient respect, privacy and confidentiality, plays important role in modifying health seeking behavior of the communities. The programme planners and managers specifically involved in the control of sexually transmitted diseases should design interventions sensitive to clients' perceptions and practices.
1. Loretta B. Reproductive tract infection and abortion among adolescent girls in rural Nigeria. Lancet 1995;345:300-4.
2. World Bank, World Development Report 1993. Investing in Health. New York: Oxford University press, 1993.
3. Tswana SA. Hospital based study of sexually transmitted diseases at Murewa, Zimbabwe. Sexually Transmit Dis 1995;22:1-6.
4. De Schryver A. Epidemilogy of STDs: the global picture. Bull WHO 1990;68:639-54.
5. Laga M. Epidemiology and control of sexually transmitted diseases in developing countries. Sexually Transmit Dis 1994; 21: S45-50.
6. Adler MW. Sexually transmitted diseases control in developing countries. Genitourin Med 1996;20: 83-8.
7. Grosskurth H. STD research in Africa. Lancet. 1993;342:1415-6.
8. Cameron DW. Female to male transmission of human immuno-deficiency virus type I: risk factors for seroconversion in men. Lancet 1989;2:403-7.
9. Fransen L. Health policies for controlling AIDS. Health Policy and Planning: 1991;6:148-56. 13. IMMS. Sexually transmitted diseases. Mexico City, Mexico: IMSS, 1983, p. 13.
10. Osoba AO. Syphilis and gonorrhea have company. Geneva: WHO, 1986.
11. Shakya G.R. Patterns of sexually transmitted diseases at mid and far-west regions of Nepal and behavioral study of certain high risk groups-A ten years profile. J Nepal Med Assoc 1993;31:352-60.
12. WHO. Pandemic: A capsule summary, Geneva: WHO 1992, p.15.
13. Odugbemi T, Onile BA. Sexually transmitted diseases: a 19 month clinic experience at the Horin University Teaching Hospital. Niger Med Pract 1986;11:95- 9R.
14. Results of the study conducted on STD/HIV patients in Nepal (unpublished). Report of STD/HIV project, a joint project of the University of Heidelberg and National Center for AIDS and STD control, Nepal, 1996.
15. Wang X Assessment of STD case management in a gynaecological outpatient department - a case study from Thapatali maternity hospital, Nepal, 1996 (unpublished).
16. Pollangyo KJ. Sexually transmitted diseases. Health and disease in Tanzania. London. England, Harpercollins Academia, 1991, pp. 17-28.
17. Levett PN. Etiology of vaginal infections in pregnant and non-pregnant women in Barbados. West Indian Med J 1995; 44:96-8.
18. Bogaerts I. Simple algorithm for the management of genital ulcers, an evaluation in a primary health care center in Kigali, Rwanda. Bull WHO 1995;73:761-7.
19. Oates JK. The management of vaginal discharge. Br J Fam Plan 1985;11:80-6.
20. Amsel R, Totten PA, Spiegel CA, et al. Non-specific vaginitis: diagnostic criteria and microbial and epidemiological association. Am J Med 1983;74:14-22.
21. Eschenbach DA, Hillier S, Critchlow C, et al. Diagnosis and clinical manifestation of bacterial vaginosis. Am J Obstet Gynecol1988;158:819-27.
22. Spiegel CA, Amsel R, Holmes KK. Diagnosis of bacterial vaginosis by direct gram stain of vaginal fluid. J Clin Microbiol 1983;18:170-7.
23. Grosskurth H. Impact of Improved Treatment of STD on HIV Infection. Lancet, 1995;346: 530-6.
24. Population Reports. Issues in world health, series L, No.9, Geneva: WHO 1993.
Objective: To understand women's perceptions and health seeking behavior and the association between vaginal discharge, clinical signs and laboratory findings as a presentation of sexually transmitted diseases (STD).
Methods: We conducted five focus group discussions with women attending the outpatient department in a large public hospital in Katmandu, Nepal, during May-June 1997. We also interviewed seventy women presenting with vaginal discharge to the same hospital, through structured questionnaire. Women presenting with discharge were also examined and investigated for six common sexually transmitted diseases and reproductive tract infections.
Results: In the focus groups vaginal discharge was identified as a common disease distinct from STDs, for which women can seek treatment. STDs were considered as social diseases transmitted to women through multiple sexual partners and not from husband. Patients with vaginal discharge preferred traditional healers and pharmacist. Clinical signs were inconclusive for type of infection. Simple laboratory tests identified etiologic agent in 64 (91%) patients and the three commonest infections were Moniliasis (78%), Bacterial Vaginosis (25%) and Trichomoniasis (17%).
Conclusion: Vaginal discharge may be used as a risk marker for identification of STDs by Primary Health Workers. Low cost investigations should be made available at the secondary care level for identification of most common Reproductive Tract Infections. Communication campaigns should target the misconceptions that exist in the communities local context related to the prevention, treatment and control of vaginal discharge and STDs (JPMA 54:620;2004).

domain: medical