text:
Research | Volume 36, Article 363, 28 Aug 2020 | 10.11604/pamj.2020.36.363.17866
Socio-demographic, pattern of presentation and management outcome of breast cancer in a semi-urban tertiary health institution
Julius Gbenga Olaogun, John Adetunji Omotayo, Joshua Taye Ige, Abidemi Emmanuel Omonisi, Olusoga Olusola Akute, Olufunso Simisola Aduayi
Corresponding author: Julius Gbenga Olaogun, Deparment of Surgery, Ekiti State University, Ado-Ekiti, Nigeria
Received: 07 Dec 2018 - Accepted: 25 Jun 2020 - Published: 28 Aug 2020
Domain: General surgery
Keywords: Breast cancer, clinical presentation, socio-demographics, treatment outcome
©Julius Gbenga Olaogun et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Julius Gbenga Olaogun et al. Socio-demographic, pattern of presentation and management outcome of breast cancer in a semi-urban tertiary health institution. Pan African Medical Journal. 2020;36:363. [doi: 10.11604/pamj.2020.36.363.17866]
Julius Gbenga Olaogun1,&, John Adetunji Omotayo2, Joshua Taye Ige1, Abidemi Emmanuel Omonisi2, Olusoga Olusola Akute1, Olufunso Simisola Aduayi3
1Department of Surgery, Ekiti State University, Ado-Ekiti, Nigeria, 2Department of Anatomic Pathology, Ekiti State University, Ado-Ekiti, Nigeria, 3Department of Radiology, Ekiti State University, Ado-Ekiti, Nigeria
Julius Gbenga Olaogun, Department of Surgery, Ekiti State University, Ado-Ekiti, Nigeria
Introduction: breast cancer is the most common malignancy in females worldwide and a major cause of cancer-related deaths in both developing and developed countries. The objective of this study was to determine the socio-demographics, pattern of presentation and management outcome of breast cancer patients.
Methods: clinical records of confirmed breast cancer patients between January 2011 and December 2015 at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria were reviewed.
Results: eighty two breast cancer patients were seen. Their ages ranged from 26-95 years (mean 48.9 ± 14.9 years, median 47.5 years). Eighty one (98.8%) were females and the majority (65.4%) were premenopausal. The peak age of incidence was in the 4th decade. All patients presented with breast lump with mean duration of 9.49±6.1 months and size ranging from 2 to 16cm (mean 7.9±3.4 cm). Ten (12.2%) patients presented early, 61 (74.4%) were locally advanced while 11 (13.4%) had distant metastases. Fifty one (62.2%) patients had mastectomy. Only 38 (46.3%) patients completed six courses of chemotherapy. None had immunohistochemistry but they all routinely took tamoxifen. Only 4 (4.9%) had radiotherapy. Nineteen (23.2%) died within a year of presentation. The follow-up period ranged between 1 and 44 months (mean, 10.3 months). Thirty one (37.8%), 19 (23.2%) and 8 (9.8%) patients were seen during the first, second and third year of follow up respectively.
Conclusion: breast cancer mostly affects young premenopausal women presenting in advanced stage in our setting. The generally poor outcome is not unconnected with late presentation and inadequate diagnostic and treatment facilities.
Breast cancer is the most common malignancy in females worldwide and a major cause of cancer-related deaths in both developing and developed countries. Over 1.4 million women are diagnosed of breast cancer every year [1, 2]. About 32% of all cancer cases and 18% of all cancer deaths in women are reportedly due to breast cancer [3]. There has been a steady increase in the incidence of breast cancer in Nigeria from 15.3 per 100,000 in 1976 to 33.6 per 100,000 in 1992 to 52.0 and 64.6 per 100,000 in 2012 in Ibadan and Abuja respectively [4, 5]. This may not be unconnected with the recent increase in women´s level of awareness and knowledge of breast cancer disease making them to seek medical intervention in many health institutions.
The hallmark of breast cancer disease in Nigeria, like other developing African countries, is late presentation and this among other factors is majorly responsible for poor treatment outcome in terms of survival. In this advanced stage, there is less than 10% five-year survival rate in Nigeria [4, 6-8]. The reverse is the case in the United States where the overall 5-year survival is more than 90% and still continues to rise even with the rising incidence of breast cancer [9]. This study was carried out to evaluate the socio-demographics, pattern of presentation and management outcome of breast cancer patients in Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria.
This was a descriptive retrospective study carried out at the Ekiti State University Teaching Hospital, Ado-Ekiti (EKSUTH), Ado-Ekiti. The hospital is a 350-bed tertiary institution located in a semi-urban area of Ekiti and serves as a referral center for the primary and secondary health facilities in Ekiti State and other neighbouring States like Osun, Kwara, Ondo, Kogi, and Edo in Southern Nigeria. This study evaluated all patients with histologically confirmed breast cancer who were managed in our hospital between January 2011 and December 2015 and who received at least one form of treatment. All cases with benign breast lesions, suspected breast cancers that were not histologically confirmed and those who defaulted after the first clinic presentation were excluded from the study. The authors obtained ethical clearance for this study from the EKSUTH Ethics and Research Committee.
During this study period, we reviewed surgical outpatient clinic, emergency department and theatre registers to extract the names and hospital numbers of patients managed for breast cancer. The list generated was used to retrieve patients´ case notes that met the inclusion criteria from the medical records department. The information sought from the case notes using a proforma designed for the study included: patients´ socio-demographics, clinical stage at presentation, obstetrics/ gynaecology history, diagnostic methods, treatment modalities and outcome in terms of survival and mortality. All patents routinely had abdomino-pelvic scan, plain chest radiograph and histological diagnosis within 6 weeks of presentation. According to the American Joint Committee on Cancer (AJCC 2002) TNM stage groupings, the patients were categorized into early stage (stages 1, IIA and IIB), locally advanced (IIIA-C) and metastatic (stage IV). The data generated were entered into a spread sheet and analyzed using the statistical package for social sciences (SPSS) version 21.0. (IBM incorporated).
A total number of 654 patients with breast lesions were seen during the period of which 82 (12.5%) were confirmed breast cancer by either needle or open surgical biopsy. Their ages ranged between 26 and 95 years (mean, 48.9 ± 14.9 years). The median age was 47.5 years. The age distribution of the patients is shown in Figure 1 below. The peak age of incidence was seen in the fourth decade followed by 6th decade. The socio-demographic profiles of the patients are shown in Table 1. Eighty one (98.8%) of the patients were females, 53 (64.6%) at least had secondary education, 63 (76.8%) were multiparous while 53 (64.6%) were premenopausal.
Table 2 shows the symptoms at presentation. All the patients (100%) had history of breast lump. The duration of breast swelling ranged from 1 to 36 months with a mean duration of 9.49 ± 6.1 months. The mean lump size was 7.9 ± 3.4 cm (range, 2-16cm). The left breast was affected in 44 (53.7%), right breast in 36 (43.9%) while 2 (2.4%) patients had bilateral breast cancer. The most common histological diagnosis of the breast tumour was invasive ductal carcinoma (91.5%). Other histological variants are seen in Table 3. According to the American Joint Committee on Cancer (AJCC) Stage Groupings (Table 4), only 10 (12.2%) patients presented early, the vast majority 61 (74.4%) of the patients presented with locally advanced disease while 11 (13.4%) had distant metastases involving the pleura, lung, liver, bone and brain presentation.
Modified radical mastectomy was performed on 45 (54.9%) patients while 6 (7.3%) had simple mastectomy. Thirty six (70.6%) received neo-adjuvant chemotherapy ranging from 1 to 6 courses while the rest only had adjuvant chemotherapy. All patients received at least a dose of anthracycline based chemotherapy regimen (cyclophosphamide, doxorubicin/epirubicin and 5-fluorouracil) but only 36 (43.9%) completed six courses while the rest were not regular on medications mostly for financial constraints. The immunohistochemistry of the breast tissue could not be determined for lack of facility. However, all the patients were routinely placed on tamoxifen but none received biological therapy. Of the 26 patients referred for adjuvant radiotherapy, only 4 (15.4%) had it done. Nineteen (23.2%) died within a year of presentation. The follow-up period ranged between 1 and 44 months (mean, 10.3 months). Thirty one (37.8%), 19 (23.2%) and 8 (9.8%) patients were seen during the first, second and third year of follow up respectively.
There has been an increase in the incidence of breast cancer worldwide and it is presently the most common female malignancy in Nigeria. In our study, 12.5% of patients seen had breast cancer. Breast cancer affects younger population of women with a mean age of 48 years. This was similar to studies from different parts of Nigeria and Africa [10-12]. In a study by Bowen et al. [13] in UK, the British black women also presented younger at a median age of 46 years than white patients at median age of 67 years. The peak incidence was in the 4th decade closely followed by 6th decade in what looks like bimodal distribution of the disease. Most breast cancers are found in the females. Our finding of 1.2% of breast cancer in the male conforms to what has been documented by many studies in the literature. About two-thirds of the women were premenopausal or perimenopausal at presentation. This finding was similar to 66.7% and 69% reported by Adesunkanmi et al. [10] and Anyanwu [14] in South-Western and South-Eastern parts of Nigeria respectively. This further lends credence to the fact that breast cancer affects younger population of women in African countries. However, this was contrary to what obtains in Europe and America where the majority of the women are postmenopausal [15-17]. Nulliparity or low parity increases the risk of developing breast cancer. Although this study did not seek to find the risk factors for breast cancer in our locality, we found that the majority (76.8%) of our patients were multiparous and this was similar to previously published studies [10, 14].
Most of our patients were Christians. As much as this does not have any bearing on the aetiopathogenesis of this disease, it sometimes negatively impacts presentation to the hospital. A significant number of these people live in self-denial and would want to seek help from their spiritual leaders thereby delaying presentation. The most common symptom at presentation was breast lump. All our patients presented with breast lump with a mean duration of 9.5 months and lump size of 7.9 cm and the majority (64.6%) were having clinically palpable axillary lymph nodes. Rambau et al. [12] in their study reported that the tumor size greater than 6 cm in diameter and presence of necrosis within the tumor was significantly associated with high rate of lymph node metastasis. A quarter of our patients also presented with breast ulceration. All these are in keeping with late presentation which is the hallmark of breast cancer presentation in Nigeria and other developing countries. Since breast lump is the most common symptom, this should be emphasized during health awareness programs for women and the health professionals should play a vital role in educating women during their hospital visits even for other health problems. It is said that more than 90% of cases of breast cancers are detected by women themselves, stressing the importance of breast self - examination for early detection and treatment of cancer [10, 18, 19].
According to AJCC, the majority, 72 (87.8%) of patients, presented in stages III and IV disease. Studies from different parts of Nigeria and most developing countries showed that most patients presented in stages III and IV [10, 12, 14, 20-22]. However, the percentages of patients who presented with metastatic disease in the studies by Ntekim et al. [20] and Agbo et al. [21] were abysmally higher than our findings. Different reasons have been adduced to late presentation in Africans among which are illiteracy or low education, fear of diagnosis, ignorance, denial, belief in unorthodox therapies and faith healing [23]. The predominant histological type of invasive ductal carcinoma in our setting was similar to what have been reported in different studies [12, 14, 20, 21] The majority (64.6%) of patients in this setting had at least a secondary school education but was not found to have positively impacted the presentation. Adisa et al. [24] in Ile-Ife and Ntekim et al. [20] in Ibadan reported higher rates of 73.8% and 85% of at least a secondary formal education in their patients but the former noted that the high educational level however did not influence the duration of symptoms before presentation as only (34.7%) presented within 3 months of noticing breast lump. Ideally, one would expect good education to translate to patients´ better awareness and knowledge of the symptomatology of breast cancer. The paradox of a highly educated individual presenting late to the hospital may not likely to change when there is lack of required funds for treatment and patients are unwilling to have a mastectomy [25].
The management of breast cancer is multimodal and this could be very challenging to physicians in the developing countries considering the advanced stage at presentation and the inadequacy of the diagnostic and treatment facilities. The choice of therapy is more often than not dictated by the local availability of resources [26]. The majority (54.9%) of our patients had modified radical mastectomy. This still remains the standard surgical operation most frequently performed for operable breast cancer in most parts of the world. Different surgical rates have been reported across Nigeria and different parts of Africa [11, 19, 25, 27]. The role of surgery for the loco-regional clearance cannot be over-emphasized as it represents the most popular option when there is limited infrastructure and access to chemotherapy and radiotherapy [28]. None of the patients in our setting had breast-conserving surgery because they mostly presented in advanced stages. Even in early breast cancer, this surgical option will remain largely impracticable due to limited availability of radiotherapy facilities across Nigeria and for the fact that most patients are usually lost to follow-up [10, 21]. About two-fifth completed six courses of anthracycline-based chemotherapy and there were high rates of interruptions and abrupt termination of cycles. This could be due to financial constraint as most patients in our settings are poor. Taxane based regimens were not used either because of non-availability or high cost. In a setting where late presentation is the norm, chemotherapy becomes an ideal for both treatment and palliation. The government has a vital role to play in ensuring that drugs are highly subsidized, readily available and affordable to guarantee a standard of care and better outcome.
All patients in this review routinely had tamoxifen. It is still a common practice to give anti-oestrogen blindly in Nigeria without recourse to oestrogen/progesterone receptor (ER/PR) status. This trend was also reported by Scherber et al. [29] in Ghana. This might have been done as a cover up for adequate treatment of patients in the face of limited diagnostic facilities. However, this falls short of international best practices of evidenced based medicine and should be discouraged. For the same reasons of lack of facility for determination of tumour markers and high cost, none of our patients benefitted from targeted therapy. Only 4 (4.9%) patients benefitted from radiotherapy. This may not be unconnected with few facilities often unevenly distributed in private or tertiary hospitals thereby limiting accessibility to many segments of the population, prohibitive cost, long waiting times and inconsistency of services due to high patients´ load at those centres. Two of our patients were given three months appointments and could not have radiotherapy on their scheduled dates as a result of faulty machine. The death of almost a quarter of patients within a year of presentation is a pointer to the fact that advanced stage of breast cancer is associated with poor prognostic outcome mostly reported in the low and middle income countries [10, 24, 30]. The follow-up is also generally poor among Nigerian patients with breast cancer [10, 21, 25]. Only 8 (9.8%) patients were seen in the third year of follow-up in this study. Considering the late presentation and numerous barriers to adequate treatments, it is not unlikely that the majority of these patients could have died. Various interventions and strategies to improve follow-up should be instituted during the initial contact with the patients.
Breast cancer is seen in the young premenopausal women usually presenting in the advanced stage of the disease in our locality. The generally poor outcome is not unconnected with late presentation, inadequate diagnostic facilities and various treatment barriers. There is a need for more awareness to encourage early presentation and provision of adequate diagnostic and treatment facilities for improved outcome.
The hallmark of breast cancer disease in Nigeria, like other developing African countries, is late presentation when patients hardly benefit from any form of therapy;
Advanced stage of presentation is what is majorly responsible for poor treatment outcome in terms of survival.
This study highlights the bimodal distribution of breast cancer disease in our setting with peaks at the 4th and 6th decades;
High educational level does not necessarily translate to patients´ better awareness and knowledge of the symptomatology of breast cancer; the paradox of a highly educated individual presenting late to the hospital may likely persist;
The generally poor outcome is not only due to late presentation but inadequate diagnostic and treatment barriers.
JGO, JAO, and OOA conceived the study and were involved in the design and data collection. JTI, AEO and OSA were involved in collation and statistical analysis. JGO and AEO made the final draft of the manuscript. All the authors read and approved the final manuscript.
Table 1: socio-demographic profiles of patients
Table 2: symptoms at presentation
Table 3: histologic types of the breast cancer
Table 4: AJCC group stage of patients
Figure 1: age distribution of the patients
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Julius Gbenga Olaogun
John Adetunji Omotayo
Joshua Taye Ige
Abidemi Emmanuel Omonisi
Olusoga Olusola Akute
Olufunso Simisola Aduayi
Socio-demographics


text:
Q: Install Windows 10 on an EFI / hybrid MBR Macbook? I have an 2011 macbook which has been updated to EFI 1.7.
Bootcamp sets up a hybrid MBR to support Windows 7.
I need to install Windows 10 on this hybrid MBR setup instead of an EFI/GPT setup because the Cirrus audio chip doesn't register itself on an EFI/GPT setup for whatever reason.
The problem is that Windows 10 prefers (U)EFI GPT hard disks and refuses to install on a hybrid MBR citing that it can't install on an MBR partition in an EFI system.
How can I force Windows 10 to install on a hybrid MBR setup and bypass the EFI/MBR error it gives upon install?

redpajama_set_name: RedPajamaStackExchange


text:
If Stockholm Open 2013 byl tenisový turnaj pořádaný jako součást mužského okruhu ATP World Tour, který se hrál na krytých dvorcích s tvrdým povrchem v aréně Kungliga tennishallen. Konal se mezi 14. až 20. říjnem 2013 ve švédské metropoli Stockholmu jako 45. ročník turnaje.

Turnaj s rozpočtem 530 165 eur patřil do kategorie ATP World Tour 250. Nejvýše nasazeným hráčem ve dvouhře byl třetí tenista světa David Ferrer ze Španělska, kterého ve finále zdolala bulharská turnajová sedmička Grigor Dimitrov.

Dvouhra

Nasazení hráčů

 1) Žebříček ATP k 7. říjnu 2013.

Jiné formy účasti na turnaji
Následující hráči obdrželi divokou kartu do hlavní soutěže:
  Markus Eriksson
  Benoît Paire
  Milos Raonic

Následující hráči postoupili z kvalifikace:
  Marius Copil
  Joachim Johansson
  Nils Langer
  Milos Sekulic

Odhlášení
Před začátkem turnaje
  Brian Baker
  Marin Čilić
  David Goffin
  Sam Querrey
  Michail Južnyj
v průběhu turnaje
  Fernando Verdasco

Skrečování
  Jürgen Zopp

Čtyřhra

Nasazení párů

 1) Žebříček ATP k 7. říjnu 2013.

Jiné formy účasti
Následující páry obdržely divokou kartu do hlavní soutěže:
  Isak Arvidsson /  Andreas Siljeström
  Jonas Björkman /  Robert Lindstedt

Následující pár do soutěže nastoupil z pozice náhradníka:
  Patrik Rosenholm /  Milos Sekulic

Odhlášení
Před začátkem turnaje
  Marcelo Melo

v průběhu turnaje
  Fernando Verdasco

Přehled finále

Mužská dvouhra

  Grigor Dimitrov vs.  David Ferrer, 2–6, 6–3, 6–4

Mužská čtyřhra

  Ajsám Kúreší /  Jean-Julien Rojer vs.  Jonas Björkman /  Robert Lindstedt, 6–2, 6–2

Reference

Stockholm Open
ATP World Tour 2013
Tenis ve Švédsku v roce 2013

redpajama_set_name: RedPajamaWikipedia


text:
Protesters Claim Victory After Eric Holder Cancels Appearance in Oklahoma City (Video)
by Jim Hoft April 24, 2014
Eric Holder cancelled an appearance today in Oklahoma City amid angry protests.
News 9 reported:
News9.com – Oklahoma City, OK – News, Weather, Video and Sports |
The Washington Times reported:
Attorney General Eric Holder canceled his appearance before the Oklahoma City Police Department's graduating cadet class Thursday amid angry protests over his scheduled visit.
Mr. Holder was scheduled to deliver remarks at the graduation ceremony at 2:30 p.m. ET, according to his official itinerary sent out by the Justice Department Thursday morning.
But an early meeting at the Justice Department delayed Mr. Holder's departure from Washington, causing him to miss the graduation ceremony, spokesman Brian Fallon said in an e-mail.
"The Attorney General had been looking to addressing the cadets, and regrets he cannot attend in person," Mr. Fallon said. "He extends his heartfelt congratulations to the cadets and their families."
Mr. Holder's scheduled visit to Oklahoma City drew the criticism of several conservative lawmakers who planned the protest anticipating his arrival, including state Rep. Paul Wesselhoft, Moore Republican, who has stated he believes that Mr. Holder should be impeached.
"Our protest has turned into a victory celebration because we frankly didn't want him here — and we succeeded," Mr. Wesselhoft said in an interview. "This man has used his position to advance his own political agenda and that's not right. He swore to uphold the U.S. Constitution and defend it for all of us — not some of us."

redpajama_set_name: RedPajamaCommonCrawl


text:
#ifndef MSGRAPHSERVICEUSERFETCHER_H
#define MSGRAPHSERVICEUSERFETCHER_H

#import "MSGraphServiceModels.h"
#import "api/api.h"
#import "core/core.h"
#import "core/MSOrcEntityFetcher.h"

@class MSGraphServiceAssignedLicenseCollectionFetcher;
@class MSGraphServiceAssignedPlanCollectionFetcher;
@class MSGraphServicePasswordProfileFetcher;
@class MSGraphServiceProvisionedPlanCollectionFetcher;
@class MSGraphServiceDirectoryObjectCollectionFetcher;
@class MSGraphServiceDirectoryObjectFetcher;
@class MSGraphServiceMessageCollectionFetcher;
@class MSGraphServiceMailFolderCollectionFetcher;
@class MSGraphServiceCalendarFetcher;
@class MSGraphServiceCalendarCollectionFetcher;
@class MSGraphServiceCalendarGroupCollectionFetcher;
@class MSGraphServiceEventCollectionFetcher;
@class MSGraphServiceContactCollectionFetcher;
@class MSGraphServiceContactFolderCollectionFetcher;
@class MSGraphServiceProfilePhotoFetcher;
@class MSGraphServiceDriveFetcher;
@class MSGraphServiceDirectoryObjectCollectionFetcher;
@class MSGraphServiceDirectoryObjectFetcher;
@class MSGraphServiceMessageCollectionFetcher;
@class MSGraphServiceMailFolderCollectionFetcher;
@class MSGraphServiceCalendarFetcher;
@class MSGraphServiceCalendarCollectionFetcher;
@class MSGraphServiceCalendarGroupCollectionFetcher;
@class MSGraphServiceEventCollectionFetcher;
@class MSGraphServiceContactCollectionFetcher;
@class MSGraphServiceContactFolderCollectionFetcher;
@class MSGraphServiceProfilePhotoFetcher;
@class MSGraphServiceDriveFetcher;
@class MSGraphServiceDirectoryObjectFetcher;
@class MSGraphServiceMessageFetcher;
@class MSGraphServiceMailFolderFetcher;
@class MSGraphServiceCalendarFetcher;
@class MSGraphServiceCalendarGroupFetcher;
@class MSGraphServiceEventFetcher;
@class MSGraphServiceContactFetcher;
@class MSGraphServiceContactFolderFetcher;
@class MSGraphServiceUserOperations;

/** MSGraphServiceUserFetcher
 *
 */
__deprecated_msg("This SDK is deprecated. Please review the README for further information (https://github.com/OfficeDev/Microsoft-Graph-SDK-iOS).")
@interface MSGraphServiceUserFetcher : MSOrcEntityFetcher

@property (copy, nonatomic, readonly) MSGraphServiceUserOperations *operations;

- (instancetype)initWithUrl:(NSString*)urlComponent parent:(id<MSOrcExecutable>)parent;
- (void)readWithCallback:(void (^)(MSGraphServiceUser *, MSOrcError *))callback;
- (void)update:(MSGraphServiceUser *)user callback:(void (^)(MSGraphServiceUser *, MSOrcError*))callback ;
- (void)delete:(void(^)(int status, MSOrcError *))callback;
- (MSGraphServiceUserFetcher *)addCustomParametersWithName:(NSString *)name value:(id)value;
- (MSGraphServiceUserFetcher *)addCustomHeaderWithName:(NSString *)name value:(NSString *)value;
- (MSGraphServiceUserFetcher *)select:(NSString *)params;
- (MSGraphServiceUserFetcher *)expand:(NSString *)value;
@property (strong, nonatomic, readonly, getter=ownedDevices) MSGraphServiceDirectoryObjectCollectionFetcher *ownedDevices;

- (MSGraphServiceDirectoryObjectFetcher *)ownedDevicesById:(id)identifier;

@property (strong, nonatomic, readonly, getter=registeredDevices) MSGraphServiceDirectoryObjectCollectionFetcher *registeredDevices;

- (MSGraphServiceDirectoryObjectFetcher *)registeredDevicesById:(id)identifier;

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redpajama_set_name: RedPajamaGithub


text:
School of Histories and Humanities
History (Theses and Dissertations)
The Tithe War in Ireland, 1830-1838
Reid, David Patrick
David Patrick Reid, 'The Tithe War in Ireland, 1830-1838', [thesis], Trinity College (Dublin, Ireland). Department of History, 2013, pp 441
Reid TCD THESIS 9992 The Tithe.pdf (PDF) 275.4Mb
The arguments and narrative contained in this thesis were mainly constructed from a detailed examination of four broad categories of primary sources. Firstly, it was necessary to research the mass of state paper material generated by the Dublin Castle administration in the years between 1830 and 1838. The state papers contain the most important manuscript material relating to the Tithe War, and their extent, variety, veracity and pertinence meant that their comprehensive reading, assessment and forensic examination forms the basis of the arguments contained in this thesis. Parliamentary Papers proved to be a second set of invaluable sources in providing information relative to, and perspectives on, the Tithe War.
Author: Reid, David Patrick
Dickson, David
Qualification name:
Doctor of Philosophy (Ph.D.)
Trinity College (Dublin, Ireland). Department of History
TARA (Trinity's Access to Research Archive) has a robust takedown policy. Please contact us if you have any concerns: rssadmin@tcd.ie
Trinity College Dublin Theses & Dissertations
History, Ph.D., Ph.D. Trinity College Dublin


text:
New Establishment With 3 Asian-Inspired Drink and Dessert Vendors Opens in Long Island City
A new establishment consisting of three different drink and dessert vendors has opened in the Queens Plaza section of Long Island City (Photo: Michael Dorgan, Queens Post)
Aug. 25, 2022 By Michael Dorgan
A new establishment consisting of three different Asian-inspired drink and dessert vendors has opened in the Queens Plaza section of Long Island City.
The new establishment, called House of Sweet, opened Saturday on the ground floor of 42-15 Crescent St., an 11-story apartment building near the Queensboro Plaza subway station.
One-Zo, a Taiwanese-based bubble tea franchise, opened at the premises Saturday with the remaining two businesses expected to open next month.
The One-Zo franchisees have signed a lease on the 2,200 square foot premises that previously housed a fitness studio called SLT fitness.
The leaseholders, who are originally from Taiwan and live in Long Island City, are still renovating the rear of the space.
The establishment has one long counter area along the left-hand side of the premises with each business having its own serving space. One-zo is occupying the front area of the counter while Snow Show, an Asian-inspired frozen dessert company, and Coconut Jelly King, which serves coconut jelly desserts, will take up the rest of the counter space once the refurbishing work is complete.
House of Sweet has one long counter area along the left-hand side of the premises (Photo Michael Dorgan, Queens Post)
The One-Zo franchisees say they want House of Sweet to be a community space where residents can come together, hang out and enjoy a variety of beverages and desserts.
The entire space seats around 60 people with the seating areas located directly across from the counter, as well as at the front and rear of the premises.
There are a number of bubble tea stores already in Long Island City, however, the One-Zo franchisees say there is still a big market for the beverage among residents.
"Long Island City is rapidly growing and there is a lot of unfilled demand [for bubble tea]" one of the owners told the Queens/LIC Post.
"There are three other [bubble tea] stores in the neighborhood but there is room for even more," adding that bubble teas are becoming more mainstream and are consumed by people of all backgrounds.
They said they are excited to be bringing more variety of the brew to the neighborhood and that the One-Zo brand appeals to bubble tea lovers. One-Zo has more than 20 stores across the U.S. and the Crescent Street location is the company's first in Queens.
The shop makes the bubble teas from scratch by mixing a tea base with chewy tapioca balls, which are often referred to as "pearls" or "boba." All of its teas and boba bases are imported from Taiwan. The store then makes the balls in-store, something the franchisees say is not common within the industry.
One-Zo beverages (Photo Michael Dorgan, Queens Post)
The store's most popular tea base since opening has been the roasted rice milk tea while its fruit teas have also been selling well, they said. One-Zo also offers smoothies.
The One-Zo location will add to the growing list of Asian-inspired tea stores to open in Long Island City.
Teazzi Tea Shop, which specializes in bubble teas, opened in April 2021 on the ground floor of the Hayden residential building—a 51-story complex in Court Square located at 43-21 Hunter St.
Meanwhile, Möge Tee, a global bubble tea chain, opened in June 2021 on the ground floor of The View at East Coast condominium building – a 184-unit complex located at 46-30 Center Blvd. The chain also has a store at 42-38 Crescent St., which is less than a block away from House of Sweet.
House of Sweet opening hours are from 11:30 a.m. to 10 p.m. Mondays through Thursdays and from 11:30 a.m. to 10:30 p.m. on Fridays through Sundays.
The front area at House of Sweet (Photo Michael Dorgan, Queens Post)
The rear wall at Sweet House of sweet has paintings of some New York City landmarks (Photo Michael Dorgan, Queens Post)


I've been trying to figure this out today. I get how to navigate through midiox. I'm unclear if I'm actually doing the sending & loading part correctly.
On the Midi button menu of the ESQ-1, I set the channel to 01, and Enable-keys+ct+pc+ss+sx.
Then I go to the Storage menu button, midi, send, and send to Mirage (?), which the ESQ will say target System Not Responding, but midiox recieves some hex code.
But I'm unure if it works, idk where the patch loads exactly, if I'm supposed to do something onboard the ESQ-1 or not.


text:
Доњи Гаљиповци су насељено мјесто у општини Прњавор, Република Српска, БиХ. Према попису становништва из 1991. у насељу је живјело 426 становника.

Географија

Историја
Ово место се раније називало Галиповци српски. Према попису становништва из 1879. у овом месту је живело 246 становника грко-источне (православне)вероисповести. По попису становништва из 1910. године у њему су живела 334 становника српске националности, а према попису становништва из 1921. год. у њему је живело 338 Срба, 79 Русина и 40 Пољака.

Становништво

Референце

Види још

 Општина Прњавор

Општина Прњавор
Насељена мјеста у Републици Српској
Википројект географија/Насеља у Босни и Херцеговини


What would Halloween be without power tools? A little more trick than treat, I say.
Our front stoop isn't the only thing that was decorated.
(Yes, that is a farmer, his wife, and a very sleepy little chicken).
ok... I have to admit at first I said, "oh! how cuuuute!" and then I saw the mice and got squeemish. That is a great idea. I love how you used your power tools!
Love your pumpkins ... and your little "punkin".
You guys look so cute! and I really like your pumpkin. great idea.
Great job on the pumpkins and love your costumes!
Very cute...the pumpkins and the family!
So so so creative. Love your pumpkin....and your costumes are awesome!
LOVE, LOVE, LOVE the baby chicken costume!!
Our pumpkin was also completed in ten minutes flat, just in time for the trick or treaters.
Great idea with the mice/power tools. Very creative!
Excellent, excellent on all counts. You all look adorable.
Love the costumes and handy way to decorate a pumpkin!!
Love love love the pumpkins. You guys are so stinkn' cute! Thanks for your sweet words, I feel pretty good.
Wanderluster, do you have any recommendations on upholstery shops downtown that are reasonably priced?
Looove the pumpkins, but that family picture is awesome! I love that you figured out a way to incorporate your little clucker!
that is genious! I'll have to do this next year!
Lovely Lovely Lovely! What beautifully carved pumpkins! So beautiful!
OMG! i LOOOOVE the powertool pumpkin idea!! I think I have some thoughts for next year!! :) Thanks for sharing!


ZINEDINE ZIDANE could be willing to sell Real Madrid talisman Gareth Bale this summer.
The former Tottenham star had a hit-and-miss season at the Bernabeu this campaign.
Injuries hampered the winger's season, limiting his game time under Zidane.
However, Bale still helped his side to complete the Champions League and La Liga double.
Bale, 27, has been linked with a move away from Real this season.
Manchester United are said to be keen on the Wales international.
WHICH Manchester United players are entering the final year of their contract and could be available on the cheap this summer?
The Independent claimed Bale is willing to move to Old Trafford if Real decide to sell the attacker.
And according to Spanish outlet Diario Gol, Zidane is thinking about life without Bale.
They say Real will splash the cash this summer, with club president Florentino Perez desperate to bring Monaco sensation Kylian Mbappe to the Bernabeu.
And to do that, the Spanish giants will have to sell Bale or Karim Benzema.
Diario Gol add that Zidane is in favour of keeping Benzema and the Frenchman could be open to selling Bale.
Zidane is frustrated with Bale's injury struggles and knows the winger would command a huge transfer fee - which can go towards a new Galactico.


As part of the series on achievers from SJMSOM, IIT Bombay, we bring you the second instalment on winners of corporate competitions. Team Visionaries consisting of Daksh Gupta, Venkata Hareesh Kodi and Swetha Thomson won the prestigious Nestle Plan-o-Chain 2018.
Here, we have Swetha Thomson writing about the team's journey and the emotional roller coaster they went through in the run-up to the win.
"I should have prepared more". In the halls of Nestlé House, seated with a cup of coffee, thoughts kept rushing through my mind as I was waiting for the announcement of the results. I looked back at the set of events that had led me to that moment.
"An essential part of MBA life is Corporate Interaction and participation in Corporate Competitions." Seniors and most MBA graduates I met had told me that. I did not understand the true meaning of this until I entered SJMSOM. There were multiple opportunities to attempt developing strategies and structured thinking by participating in various competitions.
Plan-o-Chain by Nestlé was a competition I was looking forward to taking part, owing to its renowned legacy. As soon as the competition was announced, we formed a team of three, called Visionaries and were eager to approach the case.
The case was about the launch of a new product in the adult nutrition segment. The solution was to be provided along with the marketing plan, go-to-market strategy and entire supply chain design. The first round consisted of the submission of the presentation. We contacted several faculty members and they were of immense help for evaluation of various perspectives and directing us towards the most logical approach. Amidst a busy schedule of classes and other submissions, we took the time to make a presentation that reasonably represented our solution idea. I was delighted that my team's presentation was among the top six from our campus to be selected.
There was an additional requirement of the inclusion of the income statement and working capital for the Campus Round presentation. On the day of the Campus Round, we were the last team to present. There were judges from the Nestlé office evaluating the presentations. After rounds of rigorous practice, we presented our solution to the judges and were met with gruelling questions during and after the presentation. We tackled all the questions to the best of our knowledge and waited for the announcement of results. I was thrilled when the judges announced that our team had been declared the Campus Winners and had qualified for the national round.
A total of three teams from three colleges had qualified for the National Round. In this round, the stakes were much higher. We worked hard on our presentation, unaware of the preparation levels of other teams. We focused on providing an end to end complete solution for the case so that all possibilities are factored in.
The day before the National Round, we reached Gurgaon and stayed at the accommodation provided. We were anxious and eager to give our presentation. Our team was the second to be presenting, after the presentation by the team from NITIE. The presentation was 20 minutes long with an additional 10 minutes for questions.
We elaborated on the marketing initiatives and strategies in the supply chain and were met with a round of intense questioning. We answered the questions to the best of our knowledge.
My cup of coffee was almost empty as three presentations were completed, and we were waiting eagerly for the results. We were escorted to meet the Head of Human Resources, Mr. Amit Narain and other members from the management team of Nestlé.
"And the National Winners are Team Visionaries from SJMSOM", they announced. We were ecstatic as we rushed to receive the cheque and the certificates. Photographs clicked and greetings exchanged, we rejoiced thinking about the long hours and sleepless nights that we spent editing and improvising our presentation that had finally paid off. The entire experience provided me with numerous learning opportunities and introduced me to the process of analyzing multiple perspectives before deciding on the optimal solution.


Director Maruthi Counter to Review Writers..
Noted Director Maruthi participating in director's talk with Allu Arjun, as Arjun's new film Na Peru Surya Na Illu India has got mixed response from the audience, said he watched the film and enjoyed it. He continued that he usually watches a film two times, including 8:45 show in Imax. Maruthi termed 8:45 show as judges show as everyone sits holding pads to write on. He said their family members enjoyed watching the film. Maruthi said the film has reached all categories, including children.


text:
Magnus Carlsen is FIDE World Chess Champion 2014!
Relieved Carlsen at the press conference
Magnus Carlsen is FIDE World Chess Champion 2014! He retained the title after defeating the challenger Viswanathan Anand 6,5 – 4,5 in a match played at the Winter Olympic City of Sochi.
Carlsen took the lead in game 2, with Anand immediately returning the blow in game 3. The Norwegian took the lead again in game 6 and managed to hold all difficulties in further games, in what turned out to be one of the most exciting matches of the century.
Vishy went "all-in" in game 11, but he did not find the precise continuation in a better position. The game went from won to lost, Magnus Carlsen took the full point and with it the title World Chess Champion 2014. (final standings and statistics)
Related Items:anand, carlsen, championship, match, russia, sochi, world
BREAKING: Magnus Carlsen will not defend his World Champion title (VIDEO)
Anand wins the Rapid stage of Grand Chess Tour Poland 2022
Anand remains convincing in Poland; GCT Poland Day 2 recap


In my Steeden-esque world, the countdown to this season's opening round was shaping up like any other.
As the preseason rolls into February even some of the biggest names pause to assess the tailgating talent.
Aussie Test cricket fans might be hurting but plenty have shown the heart to keep the turnstiles spinning. If only Justin Langer could say the same about his fragile top order.
Melbourne Cricket Ground curator Matthew Page was on a hiding to nothing despite his positive spin leading into day one of the Boxing Day Test.
David Morrow had lost his lollies; my tiny Corolla speakers throbbed on life support in tune with his booming venom. It was 2010 and Steve Matai had just smeared Michael Ennis across the Brookvale turf with a callous high-shot.
The frustration in Matt Nable's voice said it all, "this is rubbish".
As a global collective all red-heads reckon they have more fun. And, if you're like me, then who's to argue? I'll drop anything to watch red-heads for fun.
Imagine if rugby league hall of fame nomination was based on attributes aligned to the game's head-down, bum-up blue-collar building blocks.
No one wears their heart on their sleeve better than Sam Burgess. And mixed with adrenaline-fuelled mayhem, there's none more explosive.
How do you reckon you would have gone at Allianz Stadium last Thursday night trying to convince a rugby league novice the Rabbitohs vs Roosters match they were about to witness is the NRL's oldest and most bitter rivalry?
If I supported the Canberra Raiders, I'd want the ballistic Ricky Stuart and his busted plastic chairs over his apologetic alter ego every day of the week.
Which NRL walk-up starts are now on the outer?
If players knew then what they know now, how many would rip up their contract for an opportunity to play elsewhere?
In just over a month you'll be punching holes in the air as your team cross for their opening try of the season. Chances are though, your precious moment will be shattered by a needless hearing before Judge Bunker.
Is the Australian cricket captain switched on and, more importantly, what is his message?
Waxheads with years of salty repute reckon the quest for the perfect ride never ends. It's why they keep suiting up, just like the thirsty and desperate hypnotised by the sign, 'Free beer tomorrow'.
It's another dog-eat-dog off-season, so who can you trust?
Sadly, last Sunday morning's lazy league read was soured by the news of Malcolm Young's passing – the unsung AC/DC guitarist whose thumping chords struck with the ferocity of a Trevor Gillmeister shoulder.
So the World Cup match review committee found Aaron Woods had no case to answer. Well, wax my '70s mo and turf player safety under the bus.
What would you do if State of Origin was on your watch? Seriously, the behemoth cash cow couldn't fit through the gate even if it wanted to watch itself.
It's a lopsided NRL draw, so whose ladder position is bogus?
With Round 16 of the NRL kicking off tonight, the similarities between now and 12 months ago offer a useful insight in the race to this year's finals.
Gday Nat. My opinion of McGuire is based on what I've seen. Munster was clearly upset and offended, it crossed the line of friendship.
I think the judiciary got it right with AFB. Contact with the head isn't tolerated these days. Sure it was reflex and Pearce ducked, defenders need better judgement even if it means taking the conservative option.
McGuire's gouge was intentional, no reflex, he thought about it and carried out the task. He deliberately attacked the head of an opponent, the most sensitive part. Yet the NRL not only let him off they don't even bother putting it to a judiciary. It's not right.
Thanks for the update EJ. Pity the Bulldogs in a few weeks when he's refreshed.
All good Papi, no offence taken, it makes for an awkward mouthful.
I'd like to think the game has moved on from inter-state bias. Speaking of Gal, I recall he was once found guilty of gouging or was he cleared??
Yeah I really enjoyed Addin's battle with Klemmer. Klemmer deserved all he got after letting Blake cruise under the sticks. And Klemmer's salute as Blake made his way off, brilliant – better than a poke in the eye with a blunt finger.
Hey Papi, the freedom to come up with your own headline is one of the best parts of the Roar.
Manly are fighting it, db. Addin has been named to take on the Dragons.
It would be pretty rough but has Munster brought the game into disrepute. Did he lie on field to protect a mate and come clean post match? That's pretty much taking the yellow water out of the game.
In any event, how long do friendships last when gouging is involved?
I don't follow racing but that was a good read. Be worth posting as an article.
Take me through the Sydney Olympics scenario? Scratching my head there.
I'll always watch league but it's far easier on the eye when my team's in front.
That's a fair point Paul, all I can say is, it's not in my top 10 favourite songs.
Paul, he was talking in praise of the Indig All Stars mature approach to the topic compared to confrontational alternatives, and reckons the NRL with their high profile couldve assisted in promoting further conversation. I don't think the NRL need an opinion either way but they are well placed to open more doors for blokes like Preston Campbell to state their case.
Business goals was a good chat. Primarily involving expansion. Does the game try and dominate the east coast or spread further, does it dilute suburbia…one way or another a clear approach is needed.
Fair enough Super and i'll always keep watching regardless of the distractions too. But the game has to be sustainable, so the grass roots case is a good example of where plenty of noise needs to be made. It's a bleak future for league the less and less kids are involved as time ticks by.
To be fair to Anthony in the article though, do you reckon his negativity is justified?
I'm hearing you loud and clear Super, the only bus I caught on the weekend went to Brookie.
Ahhhh, go to the top of the class, Wiki…The Rock!!
All good Scott. Don't fall into the trap of listening glowing Manly fans. Mate, I'll still be hunting positive Manly news until the next round starts.
The only other Rueben I can thick of is the ex Rooster prop 15 years back but his was a Ruben and a surname.
Good one Scotty, so we're not even gonna talk about the Turbo in the room.
From spoon favourite to rounding out the 8. Yep, a week's along time in footy, that's why every day until Thursday should be about the best 8 try romp in NZ since the Scott Donald days.
And before I forget Saints, how quick is poached Dragon Rueben Garrick?
First person to name the last Rueben to play NRL wins Corey's signed left boot!!
Here's hoping for more of the same at Leichhardt this arvo kk. Similar drizzly conditions a few years back saw the Tigers roar from the gates before my Eagles knew what hit them. So let the unpredictable madness you touch on swing the Eagles' way today.
Rain, ponchos and sodden Pluto-pups…I cant wait to plant my Grosbys on Mary St.
And Manly scored a try on the 7th tackle in the '78 semi finals – we should look at taking the premiership off them too.
What's done is done for me. I'm through with league inequities, especially on the opening day of a new season. Cap…check, flag…check, ticket…check. Let's GO!!!
All good points Tim, and while the shovel is deep, lets question South Sydney's reinstatement.
The Gabba will always host an Ashes Test. Day-1 of an Ashes series in Brisbane a must, it's the only long form game Queenslanders mark on the calendar.


A pioneering agreement between the U.S. Department of Energy (DOE) and NASA guaranteed that NERSC, at Berkeley Lab, would provide the high performance computing support essential to the mission's success.
Oak Ridge National Laboratory is once again officially home to the fastest supercomputer in the world, according to the TOP500 List, a semiannual ranking of the world's fastest computing systems.
LIVERMORE, Calif. — Jacqueline Chen, at Sandia National Laboratories, elected to the National Academy of Engineering . Chen is among the 99 new members from around the globe in the 2018 class .
Sixteen women from various Lab areas have been selected as "Women @ The Lab" honorees, sponsored by the Women Scientists and Engineers Council and the Diversity, Equity, and Inclusion Office.
The Advanced Scientific Computing Research (ASCR) program mission is to discover, develop, and deploy computational and networking capability to analyze, model, simulate and predict complex phenomena important to the Department of Energy and the advancement of science.
The American Academy of Arts and Sciences announced the election of 228 members, five of whom are scientists at the Department of Energy's Lawrence Berkeley National Laboratory (Berkeley Lab).


text:
Printers' Pulse
Burton, UConn Make Amends
A few weeks back, Cenveo Chairman and CEO Bob Burton made national headlines (including on Yahoo! and ESPN) when he voiced his displeasure with the University of Connecticut's hiring of a new football coach and threatened to rescind a $3 million donation to the program. He also asked that his name be removed from the Burton Family Football Complex.
There's good news for UConn football. Bob dropped me a note the other day, indicating that both his family and the university have mended their fences. He will continue to back the university and the gridiron program.
Burton—a longtime, major donor and a passionate supporter of Huskies football—was incensed that his family was not consulted during the process that led to the eventual hiring of coach Paul Pasqualoni. Burton wasn't seeking veto power, but noted that his family had been consulted by the university on a number of issues related to the football program. The rift seemed to indicate a disconnect between the Burton family and the UConn athletic department.
The Burton family was visited by UConn Board of Trustees Chairman Larry McHugh and Vice Chairman Tom Ritter on Feb. 9.
"The Burton family has been very generous to the university with its time, energy and resources," McHugh said in a statement released by UConn. "I felt that it was important to pay a visit to them and have a dialogue. I am very pleased that in a very short period of time he and his family were able to reconnect with UConn, recognizing all the good that UConn does for its students and our state. The UConn community is grateful for all of the contributions the Burton family has made to enhance our academic and athletic programs, and the support they have provided to so many UConn students."
As for Burton, he chose to look at the big picture when it comes to his family's relationship with the university and its football program.
Cenveo


This year in Ukraine as well as in the world we celebrate World Day of Palliative and Hospice Care on October, 11.
NGO "Ukrainian Palliative and Hospice Care League " is implementing International Renaissance Foundation Project under the Agreement on Cooperation between the League and Kiev Department of Health.
This day we were happy to make a first part of charitable donation amounting 119.636.00 UAH to Kiev City Hospital №2 .


text:
class PHYA_API paUserFun : public paFun
{
private:

public:
	paUserFun(){}	// Initially even mark/space.

	void tick(paFunContactGen*);

};

#endif


If you like to sew, and are ready to take it to the next level and start making your own patterns, this is a great book.
The author assumes that you know the very basics of sewing, how to thread your machine, and do straight and zig zag stitches. If you don't, that information will be in your owner's manual. After that, she teaches you from the ground up. She explains how to get your fabric on grain, how to finish seams nicely, what slopers are, how to take proper measurements and customize one to fit, and how they are used in pattern creation. She takes you step by step through all the processes in a nice, organized way that's easy to read with lots of pictures. The introduction also talks about body types and gives suggestions from projects in the book for the best silhouettes to flatter those types.
Three basic slopers are included for 3 dress styles- sheath, shift and princess seamed. A shift fits loosely, and is more fitted to the shoulders and bust than to the waist and hips, a sheath is fitted more closely, princess seams are the dresses with 2 fitted seams in the front for a very nice and very feminine fit.
Each dress style has 3 variations in the projects. The author explains how to create the patterns using the slopers you made to fit you just perfectly. A lot of the dresses maybe on the short side for some people, but lengthening is fairly simple, just remember to buy more yardage than recommended if you are lengthening the dress. The styles have a wonderful range, there are very tailored pieces and dresses that are more flowing and softer. All the instructions with the diagrams are clear and understandable. For techniques you may not have used before like applying interfacings- there are instructions in the book.
The last chapter is designs made from thrifted clothing, remaking the old into something new. It's got some great ideas for that formal dress you found at a thrift store that had a fabulous retro fabric and not so fabulous lines, or even turning a couple pairs of jeans into a very cute dress for summer.
One of my favorite things about this book is that dress styles themselves are classic. They take a note from the past and you can see the influence of other decades in the lines. They are made from more contemporary colors and trimmings, but the fact that a wrap dress is just as wearable now as it was in the 80s, or a shift with lines that wouldn't have looked out of place in the 60s would be cute at a party today proves the timelessness of the designs.
Absolutely recommended, and it's going up on my shelf with my vintage Vogue sewing books and other favorite references for sewing.
Check out Storey Publishing on FB for giveaways, ideas, recipes and projects!


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This is not a good combination for mutual involvement in occult, mystical or financial affairs. The Jupiter person may resent the tendency of the Pluto person to use what they consider unethical coercive tactics or their effects at reforming them. The Pluto person could resent the attempts of the Jupiter person at indoctrination in the Jupiter person own brand of religious ethics. There will be differences of opinion in the handling of finances, resources, education and there can be conflict over inheritance. If you have occult tendencies, you can be involved in dangerous or questionable practices. Mutual travel could be dangerous.