After breakfast, you will drive southwards to Egypts first capital, Memphis where you will visit the ruins of the temple of Ptah, the fallen colossal statue of King Ramses the 2nd and the Alabaster Sphinx of King Amenophis the 2nd. A short drive from Memphis lies the oldest, ancient cemetery of Sakkara. The worlds first monumental stone building, the Step Pyramid of King Zoser, built by the engineer Imhotep almost 5,000 ago, still stands. After visiting the complex you continue to one of the Mastabas (tombs) built nearby, such as those of Ptah Hotep, Mereruca, Idut or Ti for an inside visit. Then proceed to the National Museum housing underwater photographs and statues from the ongoing operation to salvage artifacts from the sunken palace of Cleopatra. A scenic drive along the beachfront boulevard will take you to the Montaza Gardens where the summer palace of King Farouk is located. Stroll through the palm covered grounds and view the palace, still used today for official state functions. Next, proceed to the Bibliotheca Alexandria, one of the most unusual architectural masterpieces of the 21st century. Marvel at the ultra modern interiors as a library guide takes you through Alexandrias crown jewel. Then proceed to your hotel in Alexandria for check In and overnight stay. After breakfast, check out from hotel to start your journey to Rosetta, It is 60 kilometer from Alexandria. You will get to take a motor boat in the Nile and visit an island, the meeting point of the Nile and the Mediterranean as well as the castle where Rosetta stone was found. In 1799, the famous Rosetta Stone was discovered here a granite stele with texts incised in three languages, which made a major contribution to deciphering the hieroglyphs, and then starts your way back to your hotel to Cairo. Important Notes: Comfortable walking shoes recommended. The sequence of visits may vary however all tour features and inclusions will remain unchanged. Access to the Catacombs of Shawqafa is through a spiral staircase around an open central well with approximately 100 wide steps. Due to the musty and humid conditions in the catacombs, guests suffering from asthma and/or claustrophobia may experience discomfort on this tour and should take this into consideration. At the museum, guests must go through two (2) security checks before entering. No cameras or videos are allowed in the museum. The museum is not air conditioned but natural ventilation produces cooling breezes. There is an elevator in the museum, but at times it is not in operation. Many vendors sell all sorts of souvenirs at the Pyramids, especially at the Western Plateau. What is being sold as papyrus at extremely cheap prices is nothing but painted banana leaves. Guests must be aware of great bargains at great prices! Please consult and seek the advice of your tour guide if you are not sure. Shoulders and knees must be covered while visiting the Mosque. Shoes must be removed while in the mosque. Everyone can learn more about traveling. Find out what you don't already know in the article that follows. Once you know where you are going, put in some time to learn y . Learning about new cultures, architectural wonders and sampling new cuisines are great benefits when you travel. The article ahead holds many suggestions on bettering your travel plans and making it right for you. 543390 439 Air Jordan 6 Game Royal 2014 Women Size ,646701 300 Kobe 9 EM 653996 146 Nike KD 7 USA Air Jordan 3 Retro True Blue 2011 Nike Air Foamposite Pro Air Jordan 5Lab3 Black Air Jordan 3 Black History Month Black Metallic Gold Air Jordan 11 Low IE Black Varsity Red 646701 700 Kobe 9 EM 646701 001 Kobe 9 EM In today's bilingual world of international trade, knowing a second language is a definite plus. Learning a second language for personal reasons has also become a popular hobby especially for travel enthusiasts. Those interested in mastering the Dutch language, with its high number of diphthongs and gravelly sounding vowels, have several options. From traditional university settings to private instruction to the comfort of in home online classes, the venues for learning Dutch are as unending as Holland's tulip fields. Various options exist at Oxford in England, which offers distance learning and evening classes, as well as courses geared toward quickly grasping Dutch language essentials for business. The school also offers private instruction on a one on one basis or for up to five students at a time. Prices vary according to how many students enroll in the class and how many hours of instruction they desire. 543390 439 Air Jordan 6 Game Royal 2014 Women Size,Vitamins and minerals can be applied directly to the skin or taken orally. If you have acne problems, dry skin, skin that is oily or skin that is blotchy, there are over the counter vitamins available to improve the quality of your skin. Before seeing a dermatologist, consider taking vitamin supplements and see how much your skin can improve. With a few daily supplements, a healthy diet and lots of water chances are your skin will improve and you'll never need to see a dermatologist. If you are still experiencing skin problems after taking vitamins or you experience an allergic reaction, see a dermatologist as soon as possible. Vitamins can help your body from the inside and the good results are reflected to the inside. If you have drab, aging skin or lingering skin problems, it is probably a reflection of what is going on inside of your body. Although eating certain foods has been proven not to trigger acne specifically, those with healthy, rejuvenating diets will see a reflection in the quality of the skin not only on the face, but on the entire body. In order to reap the benefits of these vitamins, drinking at least eight glasses of water a day and eating a diet of organic fruits and vegetables is a great way to improve your skin as well as your overall well being. If you are experiencing particularly severe skin problems like burns, severe acne, cysts, or other serious skin conditions, see a dermatologist. They will put you on prescription medication in addition to your vitamin regime. For individuals with mild to moderate skin problems, try taking only vitamins for at least a month before turning to prescription medications from a dermatologist. If you have any questions about the severity of your skin disorder, check with a dermatologist or doctor in your area.
Where Can We Buy The 543390 439 Air Jordan 6 Game Royal 2014 Women Size,Air Jordan 6 Rings Black Dark Charcoal Two jaw dropping papers from The Lancet 1 and BMJ 2 published in the past month should have a major effect on the practice of sports medicine. They have clearly demonstrated that radiating scans in young people actually do lead to an increased risk of cancer later in life. Perhaps until 2012 this was a theoretical risk, but as of the publication of these landmark papers 1 3 we can be certain that the increased risk is not zero. There will be much more to come in this field over the next few years and it will dramatically change the landscape of radiology and all medical practice. Pearce and colleagues' study in The Lancet looked at the excess risk of leukaemia and brain tumours for children and young people exposed to CT scans. They found that children exposed to cumulative doses of 50mGy in CT scans may have triple the risk of leukaemia, and doses of 60mGy may have almost triple the risk of brain tumours1. They are clearly cause for concern, as indicated by the fact that 12 other groups from 15 countries are studying the risk of scans on children3. These Lancet findings are more striking when combined with the findings of Pijpe and colleagues' GEN RAD RISK paper published last week in the BMJ2. This study showed that when women who carry a specific mutation associated with breast cancer (BRCA1/2), and who were exposed to diagnostic radiation before the age of 30, had almost twice the risk of breast cancer (with a dose response pattern). 4mGy from a single mammogram or shoulder x ray). Therefore, BRCA1/2 carriers, with an already increased risk of a very common cancer, would be particularly at risk from exposure from radiating scans at a young age. Why does this matter for sports and exercise medicine? Sports and exercise medicine is a field in which most patients have many years of life expectancy remaining; it is also a field in which diagnostic imaging is very common. Imaging is often confined to the limbs but also involves the spine. Importantly, the GEN RAD RISK paper showed, for example, that shoulder X rays in women with the BRCA1/2 mutation can increase the risk of breast cancer. This does not prove that a shoulder X ray is unsafe for the entire female population, but because it is quite plausible, we need to reassess the use of radiating scans. bowel, ovarian) after lumbar spine CT scan, but again we have to presume from the existing knowledge that the increased cancer risk is not zero. In this case, the unknown is the size of the increase in cancer risk (and not whether there actually is one). All tests (and treatments) in medicine need to consider benefits, risks and costs. On the benefit side, the test which gives the best information relevant to management needs to be identified. This can't be done in isolation of the increased cancer risk of radiating scans, particularly in young or middle aged patients. There will still be cases where a test that involves radiation is going to give preferred information to a non radiating one a classic example being in the knee of a 70 year old, where X ray will tell what needs to be known in 95% of cases and MRI scan is generally an excessive use of imaging. CT and bone scan to investigate for suspected pars stress fracture in an adolescent) we may need to quickly change to a recommendation of first line MRI scan to avoid increasing the risk of cancer. Health systems are going to need to change in scenarios where radiating tests are funded but non radiating tests aren't, because clearly it would raise ethical questions for a health system to be funding (offering a financial incentive) to have a test which can increase a patient's risk of cancer when a non risky test is available but unfunded. Up to fifty years ago, some shoe stores used to perform X rays on the spot to show whether a kid's shoe was fitting well4 this practice is now considered archaic. Sensibly there is now an attitude in medicine that a pregnant woman should not receive an X ray or CT scan if the information could be obtained in any other fashion. We are probably heading into an era where the same attitude needs to apply to all children and young people, for CT scan and even X ray. Modalities such as MRI and ultrasound (and good old fashioned clinical examination) will need to become more prominent in sports and exercise medicine, at the expense of radiating examinations. These studies highlighted in the blog will generate a demand for consensus meetings involving sports physicians, radiologists, radiation physicists, and epidemiologists among others to provide guidance for clinicians, professional bodies and patients. His sometimes controversial views are personal and not necessarily representative of organisations he is affiliated with. Her views in blogs are also personal and not necessarily representative of her affiliated organisations. Making the decision of when an athlete should return to play after an injury is one of the most challenging parts of a sports clinician's role. This is especially so when working with professional sporting teams, where the pressures can be immense. Ideally, a clear decision making process should be combined with reliable clinical objective markers to reduce the potential for the 'personality bias' of the clinician leading to error in these decisions. Being aware of personality bias Rehabilitators working with elite athletes may have their own 'personality bias' that can expose them to the risk of two opposing yet equally significant errors. On the one hand, the clinician may tend to be overly aggressive. This could be an internal compulsion (the 'Gambler' clinician) or may be the result of external pressures leading them to rush a player back in to competition before it is reasonably safe for them to do so (the 'Weak' clinician). Premature return to competition can lead to athletes breaking down with re injury or simply performing below expectations. If however, an injury does recur in the early stages of a return to competition, then it (perhaps reasonably) exposes that clinician to direct blame for a poor outcome. Any poor performance related to physical deficits may also negatively affect the clinician's relationship with the player and or their coach / manager. Both of these outcomes may in fact put that clinician's career at a club in jeopardy, and this is a fact of which most clinicians are well aware. On the other hand, the clinician may tend towards to being overly conservative. This may also be due to internal compulsion (the 'Conservative' clinician) or because of fear of the consequences described above (the 'Cynical' clinician). If athletes are kept out for longer than necessary to reduce the risk they might break down or perform below expectations on their return, it will mean they miss valuable competition time. This second type of error is not as immediately obvious to the coach / athlete and therefore it is less likely to bring direct blame to the clinician. Naturally if there is a pattern of consistently delayed recovery over a long period of time then it may reflect poorly on those involved. However, it is much more difficult to blame them directly, as it is never really clear as to when any individual athlete could have returned from a particular injury. Perhaps contrary to expectations then, it is likely many clinicians default to the position of being overly conservative. Unfortunately this means some will make a conscious choice to be overly conservative, not in the best interests of the player or the team, but rather in the hope of reducing any risk of being held liable for the more 'obvious' poor result (re injury or poor performance). What is the cost of 'delayed' return to play? To highlight the true cost of unnecessary conservatism from the cynical clinician to a club, consider the following example. If a football team that plays once a week was to have 30 injuries over the course of a season and all those injuries were given just one extra week of rehabilitation more than was really necessary, that would cost the club a total of an extra 30 missed games. Consider then if all those players actually came back 1 week earlier as perhaps many of them could, but this caused 5 players (17% of injuries) to re injure the same area. In the case of each of those 5 re injuries, if the athlete missed a further 4 weeks, the club would lose players for an extra 20 games. This means that despite those recurrences, the club would have cut their total number of games lost to injury by 30% (from 30 to 20 games lost). From his analysis at the time he concluded 'at this stage it may be a sensible strategy to allow earlier return to play in team sports and accept a low moderate re injury rate' after having seen such a pattern in the reported data. In reality, of course, there any many modifying factors that would need to be considered in each individual case. For example, is there extra risk of recurrence with an earlier return for that particular injury, and how long recovery likely will take after re injury? Also, other factors such as the point of the season, the particular game, and the position being played etc. will influence whether or not a risk is worth contemplating for an individual athlete at a particular time. The reality is that clinicians working with high level athletes must recognise that it may be equally as negative to have a bias towards conservatism as it is to have bias towards aggression in rehabilitation. Although most clinicians working in an elite environment would probably deny that they ever knowingly act overly conservatively, in reality most would (if being honest) admit there have been times when they have taken longer to return a player to competition than was perhaps essential because they feared the repercussions of any re injury. Conversely, most would also accept that there have probably been times when they allowed issues that don't directly relate to the injury into the thought process that ultimately allowed a player to return prematurely. Sports clinicians must be brave in the sense that they must be able to withstand the outside forces which might encourage a rushed return to play, but they must be equally brave in backing their own ability and judgement in getting a player back when the relative risk is reasonable, rather than waiting for the risk to be nil, which of course it will never actually be. The judgement of what is a reasonable risk is where the real skill of a sports rehabilitator lies. The ability to make this judgment correctly in a more consistent fashion, relies firstly utilising a clearly defined decision making process. The actual process of that return to play decision making was well outlined by Matheson et al (2011). They described a thorough model for considering all the factors that may affect our clinical judgement when deciding on the return to play of an athlete. The first two steps are to evaluate the athlete and the risk of returning to sport. This involves assessing the health status of the athlete and then considering that against risks particular to that sport and in that athlete. This is where improved objective markers would be particularly useful. Having decided that someone may return based on these principles, they acknowledge that there are still many 'modifiers' to your final decision which must be considered, and so ultimately clinical reasoning remains paramount. These modifiers would include consideration of issues such as the timing and season, the stage of an athlete's career, the importance of athlete to the team, the importance of a particular game to the athlete, any conflicts of interest at play (such as financial reward to the player or therapist), any chance of masking occurring, and risks of litigation etc. What objective measures are there? The ability to make return to play decisions objectively will help to decrease the potential of clinician personality bias to lead to error. For this reason I contend that developing improved objective markers that may predict a safe return to play is perhaps the greatest research need for rehabilitators working in high level sport. Unfortunately there are not yet many proven objective markers for sport specific return to play, but there are certainly some clinical tests that may be considered to reliably assess for known risk factors to injuries. Consider these examples. (1)The Hamstring active flexibility and apprehension test developed by Asking et al (2010) is a reliable test which is more sensitive to picking up on going Hamstring deficit than traditional assessment methods. Considering that hamstring recurrences are such a problem in the football codes it would be reasonable to suggest a normalisation on that test along with all other traditional clinical signs is essential before endorsing a return to play. (2) A decrease in adduction power as measured by a squeeze test may predict the onset of groin pain in AFL players (Crow 2010). Perhaps therefore after any groin injury a reasonable objective milestone that must be met during rehabilitation before being allowed to progress to full loading is that an athlete must have reached at least their pre morbidity levels on that squeeze test. (Per Holmich podcast on groin pain is here; his short YouTube video is here). In summary, to clear an athlete to return to play there needs to be confidence that the rehabilitation has been complete, and that a clear decision making process was followed. You must be aware of the dangers of 'personality bias' among clinicians and we should attempt to minimise this through the use of objective clinical testing wherever possible. Perfect judgement is impossible but clinicians and managers should appreciate that being overly conservative can be an equally significant and perhaps more common error as being overly aggressive. They should also accept that using objective markers is the way to minimise this. If the current markers fail us or do not exist in the sport specific detail we would like, it does not mean we should shy away from using objective markers, it means we should dedicate time to developing more accurate ones. 543390 439 Air Jordan 6 Game Royal 2014 Women Size Hi, I am 5'2" so I understand why you said a little heel. I am sure you could find something that would work at DSW. If you're able to get some slacks that are petite, or at least, aren't hanging on the ground, you could get away with a flat. I bought a few pairs of super cute, work approrpriate flats from DSW. They are both by Steve Madden, one is his Luxe line. Both of them are super duper comfortable and would be easy to wear all day while on your feet. Also, I love Born shoes, their soles are so comfy, would definitely be easy on your back while standing. For being on your feet all day, I would recommend a short boot. I've done retail and I can't think of any heeled shoe that would be comfy for a full day on my feet. If you don't want a boot, maybe try a low wedge heel or a loafer. Some loafers are really cute now. Also, if your work wants a professional dress, I would stay away from the informal mary jane styles simply because I know my job (business professional) has given people shit for wearing them (No offense intended for the people that listed them though, It just depends on the dress code). GL.
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