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TC49-TG4 - Eiffel Language
Scope - Programme of work - TC49
Upcoming meetings
Regular teleconferences are held monthly. The last face-to-face meeting took place on 25-27 August 2011 in Orinda (CA), USA.
Items of interest (click here for the scope and the programme of work)
Prof. Bertrand Meyer have won the Software System Award which is one of the most prestigious awards in computer science. For more information, you may consult the press release from the Association for Computing Machinery (ACM).
For more information, you may consult the Ecma TC49-TG4 community website for the standardization of Eiffel.


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FunSkool Walk and Drive Truck
Product Details
Brand: |
This Walk & Drive Truck is great for encouraging your little one to walk and have lots of fun doing it.
Your toddler can hold the steering wheel and turn it left and right for the car to move in that direction as they walk. The truck also grows with your toddler as it has an adjustable steering shaft. J.S
- Flexible steering shaft
- Rotating steering wheel
- Rotating front wheels
- For 18 months+
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Please check the stock availability notice on your item when placing your order. This item is: Sold out
Please remember to add postal time (3-5 working days) to obtain a complete estimate of delivery to your door.
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You will receive an email to confirm when your item has been sent.
You can also check the status of your order and individual items by accessing My Account details and following the prompts.
Please allow 10 working days from dispatch of your order before notifying us of any late deliveries.
It may be advisable to check with your neighbours to see if a parcel has been left with them, check any outhouses you might have where it may be left if it cannot fit through your letterbox and contact your local sorting office to see if the item has been returned to the depot as undelivered and awaiting collection.
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Product Recall: One SKU of Velveeta Cheesy Skillet Singles Due to Undeclared Soy: Click Here
COOK pasta as directed on package, omitting salt.
MEANWHILE, heat oil in Dutch oven or deep large skillet on medium heat. Add chicken, garlic and black pepper; mix well. Cook 5 min., stirring occasionally. Add mushrooms and green peppers; stir. Cook 5 min. or until chicken is done. Stir in marinara sauce; simmer 5 min., stirring occasionally.
DRAIN pasta; place in large bowl. Add half the chicken mixture; mix lightly. Top with remaining chicken mixture and cheese.


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More copies of this ISBNAmerican Sniper: The Autobiography of the Most Lethal Sniper in U.S. Military Historyby Chris Kyle
Synopses & ReviewsPublisher Comments:He is the deadliest American sniper ever, called "the devil" by the enemies he hunted and "the legend" by his Navy SEAL brothers . . .
From 1999 to 2009, U.S. Navy SEAL Chris Kyle recorded the most career sniper kills in United States military history. The Pentagon has officially confirmed more than 150 of Kyles kills (the previous American record was 109), but it has declined to verify the astonishing total number for this book. Iraqi insurgents feared Kyle so much they named him al-Shaitan ("the devil") and placed a bounty on his head. Kyle earned legendary status among his fellow SEALs, Marines, and U.S. Army soldiers, whom he protected with deadly accuracy from rooftops and stealth positions. Gripping and unforgettable, Kyle's masterful account of his extraordinary battlefield experiences ranks as one of the great war memoirs of all time. A native Texan who learned to shoot on childhood hunting trips with his father, Kyle was a champion saddle-bronc rider prior to joining the Navy. After 9/11, he was thrust onto the front lines of the War on Terror, and soon found his calling as a world-class sniper who performed best under fire. He recorded a personal-record 2,100-yard kill shot outside Baghdad; in Fallujah, Kyle braved heavy fire to rescue a group of Marines trapped on a street; in Ramadi, he stared down insurgents with his pistol in close combat. Kyle talks honestly about the pain of war—of twice being shot and experiencing the tragic deaths of two close friends. American Sniper also honors Kyles fellow warriors, who raised hell on and off the battlefield. And in moving first-person accounts throughout, Kyles wife, Taya, speaks openly about the strains of war on their marriage and children, as well as on Chris. Adrenaline-charged and deeply personal, American Sniper is a thrilling eyewitness account of war that only one man could tell. Review:"In the community of elite warriors, one man has risen above our ranks and distinguished himself as unique. Chris Kyle is that man. A master sniper, Chris has done and seen things that will be talked about for generations to come." Marcus Luttrell, former USN SEAL, recipient of the Navy Cross for extraordinary heroism under fire, #1 bestselling author of Lone Survivor
Review:"The raw and unforgettable narrative of the making of our country's record-holding sniper, Chris Kyle's memoir is a powerful book, both in terms of combat action and human drama. Chief Kyle is a true American warrior down to the bone, the Carlos Hathcock of a new generation." Charles W. Sasser, Green Beret (US Army Ret.) and author of One Shot, One Kill
Review:"American Sniper is the inside story of what it's like to be in war. A brave warrior and patriot, Chris Kyle writes frankly about the missions, personal challenges, and hard choices that are part of daily life of an elite SEAL Sniper. It's a classic!" Richard Marcinko (USN, Ret.), First Commanding Officer of SEAL Team Six and #1 bestselling author of Rogue Warrior
Review:"Eloquent....An aggressively written account of frontline combat, with plenty of action." Kirkus Reviews
Review:"Reads like a first-person thriller narrated by a sniper. The bare-bones facts are stunning....A first-rate military memoir." Booklist
Synopsis:Gripping, eye-opening, and powerful, American Sniper is the astonishing autobiography of SEAL Chief Chris Kyle, who is the record-holding sniper in U.S. military history. Kyle has more than 150 officially confirmed kills (the previous American record was 109), though his remarkable career total has not been made public by the Pentagon.
In this New York Times bestselling memoir, Kyle shares the true story of his extraordinary decade-long career, including his multiple combat tours in Iraq (Operation Iraqi Freedom) and elsewhere from 1999-2009. Kyles riveting first-person account of how he went from Texas rodeo cowboy to expert marksman and feared assassin offers a fascinating view of modern-day warfare and one of the most in-depth and illuminating looks into the secret world of Special Ops ever written. About the AuthorSEAL Team 3 Chief Chris Kyle served four combat tours in Operation Iraqi Freedom and elsewhere. For his bravery in battle, he was awarded two Silver Stars, five Bronze Stars with Valor, two Navy and Marine Corps Achievement Medals, and one Navy and Marine Corps Commendation. Additionally, he received the Grateful Nation Award, given by the Jewish Institute for National Security Affairs. Following his combat deployments, he became chief instructor for training Naval Special Warfare Sniper and Counter-Sniper teams, and he authored the Naval Special Warfare Sniper Doctrine, the first Navy SEAL sniper manual.
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Course Number
JD Graduation Requirements
This course typically satisfies all or some of the following JD graduation requirements:- Writing
Strategies in Employment Discrimination
Strategies in Employment Discrimination Practice. This seminar applies the legal principles studied in Employment Discrimination Law (Law 232) to a semester-long, simulated practice problem. The goal of the seminar is to reinforce legal concepts studied in the basic course, and to introduce through task-oriented exercises the real-world dimensions of an employment discrimination practice, including decisions about which cases to take, what facts must be gathered, what steps must precede the filing of a lawsuit, and what legal theory or theories should be pursued. Students will engage in interviews, negotiations and strategy sessions, and will prepare various file memos, letters, and an agency complaint. The course is co-taught with an experienced practitioner. Class meets every other week for two hours. Students must either have previously taken, or be concurrently enrolled in, Law 232.
Please note that course organization and content may vary substantially from semester to semester and descriptions are not necessarily professor specific. Please contact the instructor directly if you have particular course-related questions.
Prerequisite Information
232: Employment Discrimination
Katharine T. Bartlett
Strategies in Employment Discrimination 748.01
Fall 2010
E-mail List • Blackboard Site
Jedediah Purdy
Strategies in Employment Discrimination 748.01
Fall 2007
E-mail List • Blackboard Site
Jedediah Purdy
Strategies in Employment Discrimination 748.01
Fall 2005


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Our $150 Visa gift card giveaway
We've participated in a lot of contests, and we like it when it's quick and easy to enter. So we've made it super-easy to enter our latest contest: just complete the form below between October 1, 2013 and March 31, 2014 for a chance to win a $150 Visa gift card!
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Itsa Me, Mario! Now Why Am I In A Petri Dish?
This is a picture of Mario that was created in a petri dish at the University of Osaka in Japan. It's proof positive that the cure for cancer is just around the corner. So, how do you create a picture of Mario in a petri dish? It ain't paint by numbers! (It might actually be paint by numbers).
By genetically engineering bacteria to express fluorescent proteins and carotenoid pigments.
Oh-ho! So now you know. Reminds me of when i used to get my agarose gel electrophoresis on back in the day. You know what I'm talkin' about? I'm talking DNA. Dynamic nuclear acetates. What? Don't question me, I AM science!
Mario Recreated In Petri Dish [kotaku]
Thanks to Ford, who may or may not rock one of those stickers of Calvin pissing on the Chevy emblem.
Truthfully, we've seen some pretty stunning Mario edibles in the past, but this one might very well take the cake (I'm a stupid a-hole!). At first glance I thought this was a Super Mario Galaxy themed cake, but it's actually Mario Kart (the interplanetary scene is Rainbow Road... / Continue →
Remember Super Mario Crossover -- the Super Mario Bros you can play as different characters? Well like all great things, there's always some stuff that has to be cut out of the final product. Take the book I wrote for example: it's nothing but a dust jacket. But did that sto... / Continue →
DeviantARTist Anafuji went and made this Mario-themed chess cake for somebody's birthday. Or maybe a retirement party. Or just for fun. I don't actually know, but I felt guilty when I realized I might be lying to you. I want you to know I wouldn't do that because I really b... / Continue →


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As you've been listening these past few days, you've heard a couple things you wouldn't typically hear this time of year on KEXP. The first is the hullabaloo about Amplifiers Love Week. All donors play a crucial role in KEXP's ability to bring you great music and new artists on a daily basis. The sustained, ongoing monthlyRead more...
Listen Live:
iTunes and KEXP
You can now find KEXP under "Eclectic" in iTunes after the demise of the "Public" category, to better represent the diversity of our daytime variety shows and numerous specialty programs.KEXP Suggests


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Plumasnews.com includes a sampling of stories that are featured in the weekly editions of Feather Publishing newspapers plus important breaking news as it happens. To get all the news that is important to Plumas County, subscribe to one of our weekly newspapers by calling 530-283-0800. |
Please update your Flash Player to view content. |
As 2012 draws to a close, Feather Publishing presents a review of Plumas County's most interesting stories of the year. For the complete Year in Review, see this week's paper.
- Vintage Gardens owner dies in tree-falling accident
- Lassen National Forest OHV grant proposal available for review and comment
- Feather River College notified of $418,000 windfall
- PUSD revises emergency action and armed intruder plans
- Donated groomer brings ski hill closer to completion
- Supervisor wants to clarify stance on LAFCo fee issue
- CalFire to inspect Plumas homes before fire season
- 3 million-plus California students set to take modern assessments next month
- Chester ski team finishes season on top
- Remember When for the week of 2/28/2014
Sports Headlines
Volcanoes to play for Northern Section Championship
James Wilson
Sports Editor
David Estracio makes his move during the semifinals at Chester High School on March 4. The Volcanoes fell behind in the...
Chester ski team finishes season on top
Members of the Chester High School ski and snowboarding team show off the medals they won for excellence in their league at Boreal on Feb. 17. Pictured from left...
Read More...Lady Tigers end regular season with 19-7 mark
Portola's Alli Ramelli charges through Quincy's defence during the Tigers 48-46 sin Feb.18. Photo be James Wilson James Wilson Sports Editor 2/28/2014 In...
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Intro to Firefighting Annual Report (2008) (2007)
Performance Measures Photo Gallery Tell Us What You Think
SAFD History
How It All Began The San Antonio Fire Department had a very humble beginning. On June 6, 1854, a group of 20 young San Antonians met and organized the first volunteer fire department. They called it the Ben Milam Company. The company was comprised of only a bucket brigade, but with a lot of vim and vigor and determination to do something about protecting life and property against the demon "Fire."
In 1858, the Ben Milam Company purchased the first hand operated fire engine which made the local fire department one of the best in the entire Southwest. However, around 1859, with the burning of Eckenroth's store, it became apparent that the city's firefighting facilities were still not sufficient to cope with conflagrations.
In 1891, San Antonio boasted a population of 37,363 people. In March of that year, a permanent, paid Fire Department was organized. Two 700 gallons-per-minute steam pumpers, 5 hose carriages, 2 hook-and-ladder trucks, and assorted wagons and carts were provided. Some 45 firefighters were hired. The Fire Chief was paid $100 per month, double-team drivers were paid $55, and privates earned $45 per month.
Since our founding in 1891, the San Antonio Fire Department has built a strong reputation for serving the citizens of San Antonio. From that first hand operated fire engine, the department has continued to be innovative and aggressive in keeping up with firefighting trends, using the best technology, and finding more efficient and effective ways to provide service to the community. SAFD has been a vital part of the city's past and will play an even greater role in addressing the changing issues facing San Antonio into the future.
An in-depth article on the early history of the San Antonio Fire Department is available. Meet the special individuals that helped to shape the direction of SAFD in The Hall of Fire Chiefs.
Interested in a career with the San Antonio Fire Department? Find out what it takes to Join Our Team!


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Jay-Z's Roc Nation has launched a new sports management company, Roc Nation Sports, and signed New York Yankees all-star second baseman Robinson Canó as their first client.
"Because of my love of sports, it was a natural progression to form a company where we can help top athletes in various sports the same way we have been helping artists in the music industry for years," Jay-Z said in a statement.
Hackers Expose Jay-Z, Beyonce's Financial Info
The MC will help run the new agency along with Juan Perez, who will serve as president. Roc Nation Sports has partnered with Creative Artist Agency's sports division, which will co-represent Canó.
"At this point in my career, I am ready to take a more active role in my endeavors both on and off the field," Canó said. "I am confident that the pairing of Roc Nation Sports and CAA Sports will be essential in helping me accomplish my short- and long-term goals. I am making this important decision now so I can keep my focus on helping the Yankees succeed in 2013, while minimizing any distractions for me and my teammates."
This article originally appeared on Rolling Stone: Jay-Z Launches Roc Nation Sports Agency, Signs Robinson Cano- Sports & Recreation
- Arts & Entertainment
- Robinson Canó
- Roc Nation
- New York Yankees


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KELVIN© Intro to Electronics Lab
AN ECONOMICAL VALUE! The amazing variety in this lab makes it an accessible introduction to electronics for a wide range of grades; from elementary school to high school.
Students can explore electronics and circuitry at their own pace as they complete hands-on activities with the KELVIN© Belly Bear II Trainer, the KELVIN© 1st Breadboard Lab Trainer and the KELVIN© BASIC 3 Trainer. No computer required.
Major Items
Software, Video & Books
Additional Items
Activity Resources
MAIL: KELVIN®, 280 Adams Blvd., Farmingdale, NY 11735 USA PHONE: 1-800-535-8469 or 1-631-756-1750 FAX: 1-800-756-1025 or 1-631-756-1763 EMAIL: firstname.lastname@example.com• Request A Catalog
Copyright ® 2013 • KELVIN L.P. Registered trademarks of KELVIN L.P include, but are not limited to: KELVIN®, Kelvin Electronics®, Kelvin Technology™, Hands-On Science®, Build A Better Mousetrap Racer®, Join the Rat Racer®, And the Winner Is…®, New Standards® Modular Labs, and SUMO® Car.


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An ideal replacement wired chime, this model is either battery or transformer operated allowing a choice of any 8 downloadable MP3 sound files
*Free delivery over £50 refers to home delivery orders placed on diy.com only. Charges refer to the value of goods being delivered and excludes delivery from stores or services. Excludes bulk delivery.
B&Q accepts the above cards and also offers a range of in-store financial services. Learn more
© B&Q 2014 - Terms & Conditions


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We're sorry, but we currently have no tickets available for this event.
Check out our full selection of NBA Basketball tickets or sign up to be notified when tickets for this event are available.
It's the annual competition that features the best from the Western and Eastern Conferences and Vividseats.com has NBA All Star Game tickets to get you there to witness the top basketball talent in the world. When you buy tickets to the NBA All Star Game from Vividseats.com, you're going to get the quality seating guaranteed to let you view all the amazing action from a game that only features the best players of the year. To make it a more convenient ticket-buying process, we have added an NBA All Star Game schedule on our website so you can know when and where the event will take place. Additionally, when you purchase these cheap NBA All Star Game tickets from our website, you are in control of where you get to sit because we allow you to choose your seating. So get ready to enjoy the marvelous nature of the NBA All Star Game and order your NBA basketball tickets right now from Vividseats.com.
For the second time since 2008, the city of New Orleans will play host to the NBA All-Star Game on Sunday, Feb. 16. The 63rd annual event is poised to be much different this time around, not only because of the personnel involved, but because it will be hosted by the Pelicans rather than the Hornets, as the franchise underwent a complete makeover in the offseason. As usual, several fan-friendly NBA All-Star Game Weekend events will take place in the days leading up to the contest.
The West has prevailed in each of the last three NBA All-Star Games with Chris Paul, Kevin Durant, and Kobe Bryant all earning MVP honors in those respective years, though it was LeBron James who captured the award the last time it was held at New Orleans Arena (now called the Smoothie King Center). Looking ahead to future sites, it's looking like New York will win the bid, but plans are still in works regarding co-hosting duties for both the New York Knicks and Brooklyn Nets. Having just opened in 2012, the Nets' Barclays Center has never hosted the All-Star Game, while Madison Square Garden last put on the event in 1998.


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A product doesn't have to be expensive or ground breaking to leave a lasting impression. Case in point, some of my favorite gadgets at the CEDIA Expo were simply those that happened to strike my fancy at the moment… that made me smile … that made me wish a had some cash on hand to buy it right then and there, for no other reason than pure impulse.
Black speakers, white speakers, even red speakers are so ho-hum. But hot pink? Those I have to have. They'd look awful in my living room, I'm sure, but what a conversation starter. There's even an iPod dock on the top. From Earthquake Sound. $499/pair
I don't own an iPad … yet, but when I do, I'd like it to live on this bean bag mount from Salamander. About $100
I can't hang a picture straight, so a flat-panel TV? No way. This nifty mount features a built in bubble level so that even unstable hanger-uppers like me can their flat-panel TVs situated perfectly straight. From Level Mount, starts at $19.95.
An edible 7-foot remote—who can resist that? Especially when it's made by Buddy Valastro, the Cake Boss from TLC. Elan Home Systems celebrated at its booth at CEDIA with a cake made to resemble its H2 handheld remote. The touchscreen part of the remote was fully operational, and when we were done admiring it, we ate it.
Here some of the most common and practical lighting scenes used in homes with lighting control or automation systems.
High-performance audio upgrades topped this homeowner's renovation and home automation to-do list.
Owners of these high-tech basketball courts celebrate March Madness in style.


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This the last episode of Talking Red, a New Jersey Devils podcast, for the 2013 offseason. David Sarch and John Fischer discuss the final touches the team needs to make; and David interviews Timo Seppa of Hockey Prospectus about the Devils.
This is a good post by Timo Seppa of Hockey Prospectus about the New Jersey Devils season so far. It touches on the same issues discussed at length here. I think the only major factor missing is just a horrible run of luck (it's touched on by the scoring part). But it's a recommended read. (Disclosure: I did contribute to the 2010-11 Hockey Prospectus with Seppa on the Devils chapter.) Note to Burnside and other outside journalists writing about the 10-11 Devils: this is how you do it.
During the first intermission of last night's 3-1 loss to the Nashville Predators, I had the pleasure of speaking with Timo Seppa of Hockey Prospectus. He had a few questions, I gave him a few answers while attempting to explain the sometimes inexplicable performance of the 2010-11 New Jersey Devils.
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The need to download music is now obsolete. |
Post Reply |
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Platinum Member Official Box Hoister Joined: 28 June 2004 Status: Offline Points: 9201 |
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Posted: 05 July 2010 at 11:13am |
I now have last.fm on pretty much every single electronic thing I have.
I have last.fm on my xbox, ipod, phone(droid), and laptop. I have like 30,000 plays on it so now when I use the recommended radio, or my library it plays music I like. There is no point to this thread other than to profess my love for last.fm. Plus I have morals now I don't steal as much music. |
Que pasa?
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Navy seeks 'kamikaze' robot to clear mines
One contender for that task is the Transphibian, a 3-foot-long autonomous underwater vehicle (AUV) created by Durham, N.C.-based Nekton Research. The Transphibian is designed to identify mines and map the seabed by swimming and crawling through places where troops or ships are likely to follow. Soon, the company hopes to field a type of &… Read more


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Five percent of menstruating women have severe premenstrual symptoms and impairment of functioning defined as premenstrual dysphoric disorder (PMDD). Clinically significant premenstrual symptoms occur in at least an additional 20% of menstruating women. The diagnosis of PMDD should be confirmed by prospective symptom charting over 2 menstrual cycles to confirm the timing of the symptoms and to rule out other diagnoses. The burden of illness of PMDD includes disruption of parenting and partner relationships and decreased productivity in work roles. In addition, women with PMDD have increased use of health care services such as clinician visits and increased use of prescription medications and over-the-counter preparations. The etiology of PMDD is multifactorial. In particular, dysregulation of the serotonin and allopregnanolone systems is implicated. Several effective treatment options exist, including serotonergic antidepressant medications and an oral contraceptive that contains ethinyl estradiol and drosperinone. In addition, other hormones that suppress ovulation, anxiolytics, cognitive therapy, chasteberry and calcium may be helpful.
(Reprinted with permission from J Psychiatry Neurosci 2008; 33(4):291–301 )
About 80% of women report at least mild premenstrual symptoms, 20%–50% report moderate-to-severe premenstrual symptoms, and about 5% report severe symptoms for several days with impairment of functioning (1). The 5% of women with the severest premenstrual symptoms and impairment of social and role functioning often meet the diagnostic criteria for premenstrual dysphoric disorder (PMDD). The diagnostic criteria for PMDD are listed in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) (1), and women who meet criteria for PMDD receive a DSM-IV-TR diagnosis code 311 (i.e., depressive disorder not otherwise specified). To meet the PMDD criteria, at least 5 of 11 possible symptoms must be present in the premenstrual phase, these symptoms should be absent shortly after the onset of menses, and at least 1 of the 5 symptoms must be depressed mood, anxiety, affective lability or irritability. Other symptoms include decreased interest in usual activities, difficulty concentrating, low energy, changes in appetite, changes in sleep, a sense of being overwhelmed or out of control, headaches, joint or muscle pain, breast tenderness or swelling and abdominal bloating (1). Women with fewer or less severe symptoms are considered to have premenstrual syndrome (PMS). The American College of Obstetrics and Gynecology Practice Guidelines (2) and the International Classification of Diseases, 10th revision (3) both suggest diagnostic criteria for PMS that require a minimum of 1 premenstrual symptom.
Prospective daily rating of the PMDD criteria symptoms over 2 menstrual cycles is required to confirm the PMDD diagnosis. The daily ratings should document the timing of the symptoms during the premenstrual phase and the absence of symptoms or a chronic underlying disorder during the follicular phase. The retrospective reporting of premenstrual symptoms may amplify the woman's recall of the severity and frequency of symptoms. Reporting of symptoms can be influenced by the phase of the menstrual cycle when queried, the phrasing of questions, expectations and cultural issues (4). Studies conducted over the past 2 decades have used various scoring methods and different instruments for daily ratings to measure the premenstrual increase of symptoms. Recent studies have used visual analog scales (5) and Likert scale daily rating forms such as the Daily Record of Severity of Problems (6) or the Penn Daily Symptom Report (7). Various scoring methods compare the average of symptom scores during the premenstrual days with the average of symptom scores postmenses. The DSM-IV-TR PMDD criteria state that the premenstrual symptoms should not be an exacerbation of an underlying disorder but that PMDD could be superimposed on an axis I or II disorder (1).
Three studies in which subjects prospectively rated their symptoms reported PMDD prevalence rates of 4.6%–6.4% (8–10). Two studies of women who retrospectively rated their premenstrual symptoms according to PMDD criteria reported similar prevalence rates of 5.1%–6.7% (11, 12). These 2 studies reported that 18.6%–20.7% of women have "subthreshold PMDD," in which the full criteria are not met because they have fewer than 5 symptoms or because they fail to meet the functional impairment criterion. Even though premenstrual symptoms are described in women from menarche to menopause, it is unclear whether symptoms remain stable or increase in severity with age (12, 13). Irritability has been identified as the most common premenstrual symptom in US and European samples (13–15). Some cultures emphasize somatic rather than emotional premenstrual symptoms (16). Symptom severity peaks on or just before the first day of menses (4, 10, 15). Studies examining age, menstrual cycle characteristics, cognitive attributions, socioeconomic variables, lifestyle variables and number of children have not identified these variables as predisposing factors (13, 17). An elevated lifetime prevalence of major depressive disorder (MDD) in women with PMDD has been reported in several studies, (18) as has an elevated lifetime prevalence of postpartum depression (19).
A recent study is the first to demonstrate allelic variation on the estrogen receptor α gene in women with PMDD when compared with control women (20). In addition, the allelic variation was only significant in women who had a valine/valine genotype for the catechol-O-methyltransferase enzyme. This significant study may identify a source of abnormal estrogen signalling during the luteal phase that leads to premenstrual affective, cognitive and somatic symptoms (20). Previous studies had failed to identify gene polymorphism differences between women with PMDD and control subjects in regard to the serotonin transporter (21, 22), the transcription factor activating protein 2 (23), tryptophan hydroxylase and monoamine oxidase A promoter (22) genes. Overlap of PMDD with genetic liability for MDD, seasonal affective disorder and personality characteristics has been suggested (24, 25).
The diagnosis of PMDD requires the confirmation of luteal-phase impairment of social and/or work functioning that is due to premenstrual symptoms. The functional impairment reported by women with PMDD is similar in severity to the impairment reported in MDD and dysthymic disorder (26, 27). One study identified anxiety, irritability and mood lability as the premenstrual symptoms most associated with functional impairment (28). The burden of illness of PMDD results from the severity of symptoms, the chronicity of the disorder and the impairment in work, relationships and activities (29). It has been estimated that women with PMDD cumulatively endure 3.8 years of disability over their reproductive years (26). A study of 1194 women who prospectively rated their symptoms reported that women with PMDD were more likely to endorse hours missed from work, impaired productivity, role limitations and less effectiveness (30). Borenstein and colleagues (31, 32) have published studies examining functioning and health service use in 436 women who prospectively charted their symptoms for 2 cycles. Women with confirmed PMS reported significantly lower quality of life, increased absenteeism from work, decreased work productivity, impaired relationships with others and increased visits to health providers, compared with control women. These authors also reported that, given a 14% absenteeism rate and a 15% reduction in productivity, PMDD was associated with US$4333 indirect costs per patient per year (33). The economic burden associated with PMDD is more related to self-reported decreased productivity than to direct health care costs (30, 33). However, women with PMDD do report increased health services use, with visits to health care providers and use of prescription medications and alternative therapies (30, 32). Small studies of women with prospectively confirmed PMDD have also reported decreased interpersonal and work functioning and reduced quality of life in comparison with women without PMDD (34–36). Larger studies of women diagnosed retrospectively according to PMDD criteria have also reported substantial functional impairment in work and interpersonal roles (11, 12, 37, 38).
Because most PMDD symptoms are affective or anxiety-related, PMDD should generally not be diagnosed when an underlying depression or anxiety disorder is present; many such women are considered to have premenstrual exacerbation of their underlying depression or anxiety disorder. A recent study reported that 64% of the first 1500 women with MDD enrolled in the STAR*D study retrospectively reported premenstrual exacerbation of their depressive symptoms (39). Dysthymia, MDD, panic disorder and generalized anxiety disorder are the most common axis I psychiatric disorders that may be concurrent and exacerbated premenstrually, with less clear evidence for bipolar disorder, posttraumatic stress disorder, social phobia, eating disorders and substance abuse (12, 18, 40–43). Personality disorders do not have elevated prevalence in women with PMDD (19), but women with PMDD and a personality disorder may demonstrate premenstrual phase amplification of personality dysfunction (44). Schizophrenia may be an example of an underlying disorder that does not have premenstrual exacerbation of psychotic symptoms but may have superimposed affective and anxiety symptoms of PMDD (45). The prevalence of premenstrually exacerbated axis I disorders is unknown. It is generally recommended that clinicians treat the underlying disorder first, and if premenstrual symptoms persist, subsequent daily ratings can identify PMDD (46).
Symptoms of endometriosis, polycystic ovary disease, thyroid disorders, adrenal system disorders, hyperprolactinemia and panhypopituitarism may mimic symptoms of PMS. Medical disorders that may demonstrate a premenstrual increase in symptoms include migraines, asthma, epilepsy, irritable bowel syndrome, diabetes, allergies and autoimmune disorders (42, 47). It is presumed that the menstrual cycle fluctuations of gonadal hormones influence some of the symptoms of these medical conditions.
Several reviews exist of pathophysiological hypotheses of PMS and PMDD and the evidence for them (48–52). Most studies do not identify consistent abnormalities in hormones of the hypothalamic-pituitary-gonadal (HPG) axis, although a few studies have suggested altered luteinizing hormone (LH) pulse (53). As well, studies have not identified clear abnormalities in thyroid hormones, cortisol, prolactin, glucose, prostaglandins, β-endorphins, vitamins or electrolytes (49, 50). Since specific abnormalities in the HPG axis have not been identified in women with PMDD when compared with control subjects, it is thought that premenstrual symptoms occur as a result of a differential sensitivity to the mood-perturbing effects of gonadal steroid fluctuations in women with PMS and PMDD (54). It is probable that the etiology of the "differential sensitivity" is multifactorial and in part genetically determined (55). The recently identified allelic variation in the estrogen receptor α gene in women with PMDD may underlie the neurotransmitter and neuropeptide differential sensitivity owing to estrogen receptor influence on synthesis, receptors, transporters and cell signalling (20).
Although the specific neurotransmitter, neuroendocrine and neurosteroid abnormalities in women with PMDD are not known, serotonin, norepinephrine, γ-aminobutyric acid (GABA), allopregnanolone (ALLO, an anxiolytic metabolite of progesterone that acts at the GABAA receptor), endorphins and factors involved in calcium homeostasis may all be involved. Women with PMDD are more sensitive to the anxiogenic properties of carbon dioxide inhalation, lactate infusion, cholecystokinin tetrapeptide and flumazenil (49). Increased adrenergic receptor binding may reflect abnormal noradrenergic function (49). Women with PMDD have abnormal melatonin secretion and other circadian system abnormalities (56). It has been proposed that women with PMDD have altered affective information processing and regulation during the luteal phase, with abnormal activation patterns in specific brain regions (55). Imaging studies have demonstrated altered functional magnetic resonance imaging responses to negative and positive stimuli in the orbitofrontal cortex, amygdala and ventral striatum in women with PMDD compared with control subjects (57). A recent study reported significantly increased negative bias in the recognition of emotional facial expressions during the luteal phase in women with PMDD when compared with control women (58).
Many studies have identified various abnormalities in the serotonin system in women with PMS and PMDD. These include abnormal levels of whole blood serotonin, serotonin platelet uptake and platelet tritiated imipramine binding; abnormal responses to serotonergic probes such as l-tryptophan, buspirone, metachlorophenylpiperazine and fenfluramine; and exacerbation of premenstrual symptoms after metergoline or tryptophan depletion (49, 51, 59). Several studies have also suggested that women with PMDD have decreased luteal-phase levels of GABA, abnormal ALLO levels and decreased luteal-phase sensitivity of the GABAA receptor, as shown by flumazenil challenge and the sedative and saccadic eye velocity responses to benzodiazepines and alcohol (48, 49, 52, 60). Imaging studies have reported altered serotonin function (61, 62) and altered GABAergic function (63, 64) in women with PMDD when compared with healthy control subjects. It is possible that the rapid efficacy of selective serotonin reuptake inhibitors (SSRIs) in PMDD may be due in part to their ability to increase ALLO levels in the brain and enhance GABAA receptor function (65). Alternative hypotheses for the fast action of SSRIs in PMDD include enhanced function of 5-HT2C receptors (66) and inhibition of the serotonin transporter with resulting decreased LH production (67). It has also been hypothesized that the increase in ALLO after SSRI administration underlies the improvement in depressive symptoms of MDD in both sexes (68–70).
The most systematically studied treatments have been the elimination of hormonal fluctuations with ovulation suppression treatments or the "correction" of neurotransmitter dysregulation with antidepressant or anxiolytic medications. Other treatments have targeted putative vitamin or mineral deficiencies or the improvement of specific premenstrual symptoms (Box 1). Different treatment modalities may differentially treat specific symptom profiles, but treatment studies have rarely evaluated efficacy for specific anxiety, mood, behavioural and somatic symptom profiles (71).
Treatment Options for Premenstrual Dysphoric Disorder
Oral contraceptives (OCs) have been commonly prescribed by gynecologists and primary care clinicians for the treatment of PMS even though there were few studies demonstrating their efficacy until recently. Two older randomized controlled trials (RCTs) in samples of women with prospectively confirmed PMS reported a lack of efficacy with monophasic and triphasic OCs (72, 73). Surveys of population cohorts without defined PMS or PMDD have reported that OCs do not alter mood in most women, but a subset of women report improvement of premenstrual symptoms, and another subset of women report the production of negative premenstrual symptoms (74, 75). After the introduction in the late 1990s of an OC containing ethinyl estradiol 30 μg and a unique progesterone, drospirenone 3 mg, improved mood and quality of life during the luteal phase began to be reported in nonclinical population cohorts (60, 76, 77). In addition, a 6-month extended regimen of this OC was reported to be associated with fewer premenstrual emotional and physical symptoms than the normal 21/7 monthly administration in women not seeking care for problematic premenstrual symptoms (78). An RCT comparing the OC containing ethinyl estradiol 30 μg and drospirenone 3 mg with placebo in 82 women with PMDD reported that both the OC and placebo improved most premenstrual symptoms and that the OC was significantly more effective than placebo in decreasing food cravings, increased appetite and acne only (79). However, 2 recent studies of YAZ (Bayer HealthCare), an OC containing ethinyl estradiol 20 μg and drospirenone 3 mg, administered as 24 days of active pills followed by a 4-day hormone-free interval (24/4), have reported superiority in reducing premenstrual emotional and physical symptoms when compared with placebo (80, 81).
Yonkers and colleagues (80) reported on a parallel design study in which YAZ or placebo was administered to 450 women with PMDD over 3 months. Pearlstein and colleagues (81) reported on a crossover design study in which YAZ or placebo was administered to 64 women with PMDD over 7 months with a middle washout cycle. Both studies reported that self-rated symptom, functioning and quality of life measures, along with clinician-rated symptom and functioning measures, all significantly improved with YAZ in comparison with placebo. In both studies, adverse effects that were more common with YAZ, compared with placebo, included nausea, intermenstrual bleeding and breast pain (80, 81). In 2006, YAZ received United States Food and Drug Administration (FDA) approval for the treatment of PMDD in women desiring oral contraception. The efficacy of this particular OC for reducing premenstrual symptoms may be due to its administration in a 24/4 regimen, which provides more stable hormone levels and reduces adverse symptoms that can occur during withdrawal bleeding (82, 83). Differential efficacy of this OC may also be due to the unique antimineralocorticoid and antiandrogenic properties of drospirenone (77, 80, 81).
Gonadotropin-releasing hormone (GnRH) agonists suppress ovulation by downregulating GnRH receptors in the hypothalamus, leading to decreased follicle-stimulating hormone (FSH) and LH release from the pituitary resulting in decreased estrogen and progesterone levels. GnRH agonists are administered parenterally (e.g., subcutaneous monthly injections of goserelin, intramuscular monthly injections of leuprolide, daily intranasal buserelin). GnRH agonists have been reported to be superior to placebo in 8 of 10 published RCTs in women with PMS or PMDD (48, 84). A meta-analysis of 5 of these studies reported an odds ratio of 8.66 that GnRH agonists will lead to improvement in premenstrual emotional and physical symptoms, compared with placebo (85). "Add-back" hormone strategies have been investigated to counteract the undesirable medical consequences of hypoestrogenism resulting from prolonged anovulation induced by GnRH agonists. The meta-analysis concluded that add-back estrogen and progesterone did not reduce the efficacy of GnRH agonists (85) even though it had been reported that the add-back of estrogen and progesterone to goserelin (86) and leuprolide (54) led to the reappearance of mood and anxiety symptoms in some women with severe PMS. Since women with severe PMS and PMDD have an abnormal response to normal hormonal fluctuations (54), it is not a surprise that some women may experience the induction of mood and anxiety symptoms from the addition of gonadal steroids, which reduces the benefit of the replacement strategy. Suggested replacement strategies have also included low-dose pulsed progesterone (87) and tibolone, a synthetic steroid with estrogenic, androgenic and progestogenic properties (88). The safety of the long-term use of GnRH agonists and replacement hormones is unknown.
Oophorectomy and prolonged anovulation from danazol, estrogen or progesterone administered throughout the cycle are not common treatments, largely because of the medical risks attendant on a prolonged hypoestrogenic state, which leads to the same long-term health issues as those arising from use of GnRH agonists. Danazol, a synthetic steroid, alleviates premenstrual symptoms when administered at dosages that induce anovulation (200–400 mg/d) (89). When danazol 200 mg daily was administered during the luteal phase only, which did not lead to anovulation, breast tenderness improved, but other premenstrual symptoms did not improve (90). The few studies on estrogen or progesterone administered for most of the cycle have yielded mixed reports (48, 91). Two small studies reported relief of intractable PMS with hysterectomy and bilateral oophorectomy (92, 93). Hysterectomy with oophorectomy should be considered a last-resort treatment option for women with severe PMDD that has not responded to standard treatments (94, 95).
The administration of luteal-phase progesterone (oral micronized tablet, sublingual tablet, vaginal suppositories) is one of the older treatments studied for PMS and is largely due to the early hypothesis that PMS might be caused by a progesterone deficiency. However, abnormal hormone levels have not been demonstrated in women with PMS or PMDD. A recent systematic review concluded that, owing to the methodological shortcomings of previous studies, it is not possible to establish whether progesterone is helpful or not helpful for PMS or PMDD (96). A previous systematic review of published RCTs of luteal-phase progesterone and progestogens reported that there was no clinically meaningful difference between all progesterone forms and placebo, although progesterone had a small statistically significant superiority over placebo (97). A slight advantage for oral micronized progesterone was noted, and the authors postulated that this might be due to the increase in ALLO levels derived from this form of progesterone.
Treatment studies of SSRIs and PMDD have suggested efficacy rates similar to those found in treatment studies of SSRIs and MDD, with 60%–70% of women responding to SSRIs in comparison with about 30% of women responding to placebo, depending on how response is defined (71, 98). The SSRI dosages that are effective for PMDD are similar to or slightly lower than the dosages recommended for the treatment of MDD. A systematic review of RCTs of SSRIs reported that, compared with placebo, women with severe PMS or PMDD were about 7 times more likely to respond to SSRIs (99, 100). This review included 12 trials with continuous dosing (daily for the full cycle) of fluoxetine (101–107), sertraline (108, 109), paroxetine (110), citalopram (111) and fluvoxamine (112) and 4 trials with intermittent dosing (daily during the luteal phase, i.e., from ovulation to menses only) of sertraline (113–115) and citalopram (111). The systematic review of these 15 studies concluded that continuous and intermittent dosing had equivalent efficacy (99). Since this systematic review, one study of 167 women with severe PMS and PMDD reported that continuous and intermittent dosing of sertraline had equivalent efficacy and that each was superior to placebo (116). However, another study of 167 women with PMDD recently reported that, although both continuous and intermittent paroxetine were both superior to placebo for irritability, affect lability and mood swings, intermittent paroxetine was less effective than continuous paroxetine for depressed mood, low energy, food cravings and somatic premenstrual symptoms (117). A recent meta-analysis of 29 SSRI studies in 2964 women concluded that continuous dosing is more effective than intermittent dosing for treatment of PMS and PMDD (118).
The seminal studies involving continuous dosing of SSRIs in PMDD involved relatively large samples. One RCT compared fluoxetine 20 mg daily, fluoxetine 60 mg daily and placebo in 277 women over 6 months (101). Both fluoxetine 20 mg daily and 60 mg daily were more efficacious than placebo in reducing premenstrual emotional, behavioural and physical symptoms; however, the 20-mg dosage was better tolerated than the 60-mg dosage. This study was one of the first to note a fast onset of action and improvement in physical premenstrual symptoms with an SSRI (101). Another large RCT involved flexible-dose sertraline, up to 150 mg daily, over 3 months, and the average dose of 110 mg daily was more effective than placebo in reducing premenstrual symptoms (108) and improving psychosocial functioning in 243 women (27). Since this review, 2 large RCTs have demonstrated that, when compared with placebo over 3 months, continuous dosing of paroxetine controlled release (CR) 12.5 mg or 25 mg daily had superior efficacy in reducing premenstrual mood and physical symptoms in 313 (119) and 359 (120) women with PMDD. In both studies, paroxetine CR 25 mg daily was more effective than 12.5 mg daily in the improvement of premenstrual functioning and the reduction of premenstrual physical symptoms.
RCTs conducted subsequent to the review by Dimmock and colleagues (99) have also further established the efficacy of intermittent dosing of fluoxetine, sertraline and paroxetine. Luteal-phase fluoxetine 20 mg daily was superior to placebo in reducing premenstrual emotional and physical symptoms in 252 women with PMDD, whereas fluoxetine 10 mg daily during the luteal phase only was superior to placebo in reducing emotional but not physical symptoms (121). An RCT in 200 women with PMDD demonstrated that luteal-phase sertraline 50–100 mg daily was superior to placebo for improving premenstrual emotional symptoms and impaired functioning but not premenstrual physical symptoms (122). Another RCT, in 366 women with PMDD, reported that luteal-phase dosing of both paroxetine CR 12.5 mg and 25 mg daily was superior to placebo in reducing premenstrual symptoms and improving functioning (123). Studies involving intermittent dosing have reported the absence of discontinuation symptoms when fluoxetine, sertraline and paroxetine CR at the given dosages were abruptly stopped on the first day of menses. It has been hypothesized that the lack of withdrawal effects when the SSRI is discontinued at menses may be due to the lack of prolonged exposure (98). Even when the SSRI is abruptly discontinued on the first day of menses, the therapeutic action of intermittent dosing continues to relieve symptoms that extend into the first few days of menses (124). The FDA has approved the use of both continuous and intermittent dosing of fluoxetine, sertraline and paroxetine CR for women with PMDD, with specific dosage recommendations (Box 1). The first placebo-controlled RCT conducted with escitalopram recently reported that intermittent dosing with escitalopram 20 mg daily was superior to placebo in 158 women with PMDD (125).
The improvement of symptoms within the first treatment cycle in most continuous-dosing SSRI trials, as well as the efficacy of intermittent dosing, suggests a more rapid and different mechanism of action for SSRIs in PMDD as compared with MDD, where SSRIs may take 3–6 weeks to be effective. An increase in ALLO is one hypothesis to explain the rapid improvement of premenstrual symptoms with SSRIs. If an increase in ALLO is what makes an SSRI helpful for reducing symptoms, it may not be necessary to start the SSRI before or at ovulation. The few studies that have examined SSRI administration during the luteal phase, but after ovulation, have yielded mixed results. One study suggested that the administration of an SSRI the second luteal week only was not sufficient for efficacy. Fluoxetine 90 mg administered once 1 week before the expected onset of menses was not superior to placebo, but fluoxetine 90 mg administered 2 weeks and 1 week before the expected onset of menses was reported to be superior to placebo in reducing premenstrual emotional symptoms and improving premenstrual functioning but not premenstrual physical symptoms in 257 women with PMDD (126). Recently published RCTs have reported the efficacy of SSRIs for symptom-onset dosing of SSRIs, that is, administering SSRIs from the postovulatory day that premenstrual symptoms appear until menses. Preliminary studies in women with PMDD have suggested the superiority of symptom-onset paroxetine when compared with placebo (127) and the efficacy of both symptom-onset and luteal-phase escitalopram dosing, although luteal-phase dosing was found to be more effective for women with severe symptoms (128). Symptom-onset dosing of low-dose sertraline (25–50 mg/d) was reported to be superior to placebo in reducing premenstrual symptoms in 296 women with prospectively confirmed PMS (129).
Other antidepressants have also been studied in women with PMS and PMDD. Early RCTs reported efficacy with clomipramine (a tricyclic antidepressant with largely serotonergic action) in daily dosing (130) and in luteal-phase dosing (131). The dosages of clomipramine reported to be effective for PMS (25–75 mg/d) are lower than the expected effective doses for MDD. Daily dosing of immediate-release venlafaxine was reported to be superior to placebo in the reduction of the emotional and physical symptoms of PMDD in 157 women (132). One RCT reported that nefazodone was not superior to placebo for PMS (133). However, in a small crossover study, increasing nefazodone in the luteal phase was reported to improve premenstrual exacerbation of MDD (134). Three RCTs have compared SSRIs to nonserotonergic antidepressants and placebo, and each has reported specific efficacy of the SSRI over both placebo and the nonserotonergic antidepressant. Sertraline was compared with desipramine and placebo in 167 women with severe PMS or PMDD (109). Two smaller studies compared paroxetine to maprotiline and placebo (110) and fluoxetine to bupropion and placebo (107). The selective superiority of serotonergic antidepressants for PMDD is compatible with the postulated serotonin dysfunction in PMDD.
Many women report the recurrence of premenstrual symptoms after SSRI discontinuation, and many women choose to take SSRIs over the long term. Most SSRI trials have been 3 months in duration, and although a few open studies suggest maintenance of SSRI efficacy over 1–2 years, evidence-based long-term treatment recommendations do not exist. Studies are needed to identify whether or not some women develop tolerance to the SSRI over time, necessitating increases in dosage or switch to another medication, and whether or not some women stay in remission for a period of time after SSRI discontinuation. The short duration of most treatment studies has also not yielded information about potential adverse effects with long-term SSRI use. Anecdotally, many women report weight gain and sexual dysfunction after long-term antidepressant use for PMDD. Intermittent dosing may improve sexual function during the weeks that the SSRI is not taken, but it is not clear whether or not there is less weight gain with intermittent dosing. Systematic studies are needed of semi-intermittent dosing ('bumping up') of SSRIs in women with premenstrual exacerbation of an underlying depressive or anxiety disorder. In these women, the SSRI dosage is increased during the luteal phase and decreased back to the usual dosage at menses (46). Future studies are also indicated to systematically compare the efficacy and predictors of response to symptom-onset, luteal-phase and continuous daily SSRI dosing in women with PMDD.
Alprazolam 0.25 mg daily or twice daily (administered during the luteal phase only) has been reported to be more effective than placebo in most studies (135–138) but not all (139). It is primarily effective for premenstrual tension and irritability, and overall, it has a lower efficacy rate than the SSRIs. If alprazolam has been taken for more than 1 luteal-phase week, it should be tapered over the first couple of days of menses. Some efficacy has been reported with buspirone (133, 140). Studies reporting initial efficacy with nonsteroidal anti-inflammatory drugs (141), doxycycline (142), naltrexone (143) and atenolol (144) deserve replication. Bromocriptine has been reported to decrease premenstrual breast tenderness (145), and one study reported that spironolactone decreased premenstrual emotional symptoms as well as physical symptoms (146).
Lifestyle modifications that may alleviate premenstrual symptoms can be obtained through self-help materials or professional-led psychoeducation programs. A 4-session group intervention over 18 weeks emphasizing diet, exercise and a positive reframing of a woman's perceptions of her menstrual cycle was superior to a control condition in reducing premenstrual symptoms (147). In another intervention, 4 weekly peer support and professional guidance groups that included diet and exercise changes, environment modification, self-monitoring and other cognitive techniques were reported to be superior to a waitlist control condition in reducing premenstrual symptoms (148). It is unclear which lifestyle modifications are most helpful because few studies have been conducted on specific lifestyle modifications or psychosocial treatments.
Common dietary recommendations include increased consumption of complex carbohydrates, frequent snacks or meals, reduced consumption of refined sugar and artificial sweeteners and decreased caffeine intake. It is hypothesized that the ingestion of complex carbohydrates may maintain a steady serum glucose level that may decrease premenstrual food cravings and increase the availability of tryptophan in the brain for serotonin synthesis (84). Two RCTs that compared a beverage containing simple and complex carbohydrates with an isocaloric placebo beverage that did not increase tryptophan availability reported that the beverage containing simple and complex carbohydrates was superior in reducing premenstrual dysphoria and other symptoms (149, 150). These 2 studies are the only published RCTs of a specific dietary regimen.
Cognitive therapy (CT) is consistently reported to be an effective treatment for women with PMS. Two studies in women with prospectively confirmed PMS reported superiority of individual CT for reducing premenstrual symptoms when compared with a waitlist control condition (151) and when compared with information-focused therapy (152). Another RCT examined the relative efficacy of fluoxetine 20 mg daily, 10 individual CT sessions or their combination in women with PMDD (153, 154). Efficacy rates at 6 months were comparable between the 3 treatments; however, at 1 year women who had received CT were coping better than those who had received fluoxetine alone. Relaxation has had little systematic study in PMS; a single RCT reported that relaxation therapy was superior to both symptom charting and leisure reading (155). Exercise has not yet been tested in a sample of women with PMS or PMDD, but it is a frequently recommended treatment. Negative affect and other premenstrual symptoms improve with regular exercise in women in general (156, 157). Both aerobic and nonaerobic exercise may be helpful.
Calcium 600 mg twice daily was compared with placebo in 466 women with PMDD (158). Calcium was reported to have a 48% efficacy rate for reducing premenstrual emotional and physical symptoms (except for fatigue and insomnia), compared with 30% for placebo. However, women with concurrent psychiatric illness were not clearly excluded and concurrent medications were allowed, except for analgesics. The efficacy of calcium was somewhat reduced in women who were taking OCs. The results of this study were notable, and calcium deserves further study.
A review of early studies of vitamin B6 reported a lack of efficacy for PMS (159). A meta-analysis of 9 controlled trials that included 940 women with PMS indicated only weak support for the efficacy of vitamin B6 (50–100 mg/d) in reducing premenstrual symptoms (160). A recent study reported that 80 mg daily of pyridoxine was superior to placebo in relieving anxiety and mood premenstrual symptoms but not physical symptoms (161). Two small RCTs have suggested the efficacy of magnesium (162, 163), but other studies have failed to document magnesium deficiency in women with PMDD or improvement of premenstrual symptoms with supplemental magnesium when compared with placebo (164). An RCT reported superior efficacy for trytophan, compared with placebo, in women with PMDD (165), and an early study that suggested efficacy for vitamin E deserves replication (166). Some trials have been conducted with multinutrients containing several vitamin and mineral components. Several of the supplements contained quantities of vitamins that exceeded daily recommended levels, and as reviewed, results from these studies have been mixed (167, 168). Physical premenstrual symptoms have been reported to improve with fish oil (169) and soy isoflavones (170).
Reviews of complementary treatments have reported that the strongest evidence exists for the benefit of chasteberry, or V. agnus castus (168, 171–174). It has been hypothesized that the benefit of chasteberry for premenstrual symptoms could be due to its being a dopamine agonist that possibly reduces FSH or prolactin levels (174). Chasteberry was recently reported to reduce premenstrual symptoms in an open study of 118 women with PMDD (175). Chasteberry and fluoxetine were both reported to be effective in an RCT of 41 women with PMDD; however, fluoxetine was better for emotional symptoms and chasteberry was better for physical symptoms (176). The evidence-based reviews concluded that RCTs have not suggested consistent benefit for Ginkgo biloba, evening primrose oil and homeopathic treatments but that initial positive RCTs suggest further study of massage (177), reflexology (178), chiropractic manipulation (179) and biofeedback (180). Small RCTs have reported that saffron (181) and Qi therapy (182) were each superior to placebo in women with prospectively confirmed PMS. There have been positive open reports, but no RCTs, with Hypericum (183, 184), yoga (185), guided imagery (186), photic stimulation (187) and acupuncture (188). It has been proposed that sleep deprivation and light therapy may decrease premenstrual dysphoria by correcting abnormal circadian rhythms found in women with PMDD (56). Although a crossover study reported that evening bright light for 2 premenstrual weeks decreased depression and tension (189), a meta-analysis of the few existing trials suggested a small effect size for bright light therapy (190).
Five percent of menstruating women meet criteria for PMDD, and about 20% of menstruating women have "sub-threshold PMDD" or severe PMS. Thus, in each menstrual cycle, 1 in 4 women have emotional, behavioural and physical premenstrual symptoms that can lead to disruption in interpersonal relationships and role functioning. Recent studies of the burden of illness of PMDD identify a high economic indirect cost, mostly from reduced productivity and effectiveness at work, in addition to disturbed parenting and marital relationships. Once the diagnosis of severe PMS or PMDD is confirmed by prospective symptom charting for 2 menstrual cycles, lifestyle modifications, cognitive therapy, chasteberry and calcium are reasonable initial nonpharmacologic options. If medication is necessary, SSRI medication is considered the first-line treatment (2, 46, 191). SSRI medication may be effective when administered continuously or intermittently (from ovulation to menses). With the recent FDA approval of the oral contraceptive YAZ for women with PMDD desiring oral contraception, there may now be an alternative first-line treatment. Second-line pharmacologic treatment options include changing to a second SSRI, switching to YAZ, extended OC regimens, considering GnRH agonists or adding adjunctive anxiolytics or other medications targeted to specific symptoms (2, 77, 191). Future studies are needed to determine predictors that will identify which women will benefit from SSRIs versus hormonal strategies and to determine the optimal duration for medication treatment.
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(except Bank Holidays)
Monday to Thursday from 5pm,
All day Friday to Sunday and Bank Holidays
In cinema
In cinema
12 years and under
Ages 13-17
Valid student card required
Ages 60+
Ages 18+
1 adult, 3 children or 2 adults, 2 children
3D Films=
+ £2.00 Adult / + £6.40 Family / + £1.60 Others
3D Glasses=Reusable
+ £1.00 Per Pair
Premier Seat=
+ £2.30 Each / £9.20 Family. Note: The Wolf of Wall Street +£2.80 Each/ +£11.20 Family
Special prices for adults and kids.
Watch current film releases without worrying about your little one making any noise.
Treat yourself to a wide selection of snacks from one of our retail counters, from traditional favourites such as popcorn, nachos and pop to a varied selection of sweets and ice cream!
General Manager: Rapinder Khabda
ODEON Gerrards Cross is situated just off the high street. The cinema has 2 screens (Premier Seats) 1 ATM which is located in the main foyer.
Local restaurants
Italian - Santucci, Packhorse Road
Chinese - The Good Life, Packhorse Road
Indian - Bawachi, Packhorse Road
Thai- Thai Rack, Oak End Way
Local entertainment
Chalfont Leisure Centre (1 mile)
The Ethorpe- Pub/Restaurant (1 minute walk)
Wildwood restaurant/bar (2 minute walk)
Nearest cash dispenser
HSBC- opposite cinema on the same road
Many current and forthcoming film releases have a strong relevance to subjects covered in the national curriculum, provoking discussion and debate in an inspirational way. With media and communication becoming ever-popular choices, the cinema can provide a useful and relevant study aid for further and higher education. It's a real treat too, making a visit to ODEON Cinemas the perfect reward for good behaviour or record levels of attendance.
For more details and our special booking rates please contact us via email by clicking here.
Location Of Cinema
ODEON Gerrards Cross is located just off the high street on Ethorpe Close, just off of Ethorpe Crescent. The nearest bus stops are on the local high street situated on Packhorse Road (B416) and are approximately a minute walk from the cinema. The Gerrards Cross train station is approximately a five minute walk from the cinema.
The nearest car park is to the rear of the cinema; where there are 27 pay and display parking spaces. The car park has two Blue Badge parking spaces which are approximately 10 metres from the cinema entrance. Please be aware that these will be limited during busy hours.
The taxi and car drop off point is directly outside the entrance to the cinema.
Access To The Cinema
The main entrance has access via two pairs of manually operated doors, one with a step and one with a ramp. There is level access to the box office, refreshments stand and the ticket machine, with one lowered counter at the box office, and one lowered ticket machine within the foyer. If you require any assistance, please ask a member of the team.
There is currently no guest seating area available in the cinema.
Male and female washrooms are located on the ground floor within the main foyer just past the refreshments stand, with a fully accessible washroom adjacent.
Access Within Screens
Screen 2 is not accessible to Wheelchair users or those with limited mobility as there is no lift service; access is only via a staircase which does have handrails. Screen 2 has aisles either side of the main seating block, these are stepped with no access to handrails.
Screen 1 has sloped access with no stairs at all. The Screen has four Wheelchair bays situated at the back of the auditorium; two double and two single. Adjacent companion seats are available. The auditorium has aisles on either side of the seating sloping down from the entrance at the back of the auditorium; there are partial handrails available.
Location of Washroom Facilities
Male and female washrooms are located on the ground floor within the main foyer just past the refreshments stand, with a fully accessible washroom adjacent.
CEA Card: As part of a general cinema industry initiative, all our cinemas accept the CEA Card which entitles the holder to one free ticket for their carer. For further information please visit www.ceacard.co.uk (opens in a new window).
Text phone users can dial 18001 0808 1560 609 9am - 7pm Friday, Saturday and Wednesday, 9am - 6pm Monday, Tuesday and Thursday and 10am - 5pm on a Sunday for bookings and information.
If you have further enquiries please call our Accessible Helpline between 9am - 7pm Friday, Saturday and Wednesday, 9am - 6pm Monday, Tuesday and Thursday and 10am - 5pm on a Sunday on 0800 138 3315 or via Type Talk on 1800 1 0808 1560 609.
between 9am - 7pm Friday, Saturday and Wednesday, 9am - 6pm Monday, Tuesday and Thursday and 10am - 5pm on a Sunday and they will complete the booking
between 9am - 7pm Friday, Saturday and Wednesday, 9am - 6pm Monday, Tuesday and Thursday and 10am - 5pm on a Sunday for bookings and information
ODEON @ Gerrards Cross offers 2 screens.
Holding you conference or event in a cinema gives you an interesting and unique environment that will stimulate the delegates and get your meeting off to an exciting start.
Whatever your event requirements, be it a small regional meeting for up to 50 delegates or national conference for up to 1679, ODEON has the facilities and flexibility to accommodate you.
Booking is temporary unavailable. Please try again later.


text:
Men stop attempted theft in Hamilton
UPDATED 6:55 PM EST Mar 09, 2013Neighbors in Hamilton stopped a man they say was trying to break into cars.
The views expressed are not those of this site, this station or its affiliated companies. By posting your comments you agree to accept our terms of use.blog comments powered by Disqus


text:
Danny Glover Running for County Commission
MACON, Ga. (41NBC/WMGT) - Bibb County's former Democratic Party chairman announces he'll run for a seat on the new, consolidated government.
25-year-old Danny Glover tells us he'll run for the District 3 seat on the new county commission.
He says this county has several issues that need to be fixed, and with the help of the community, he thinks those issues are fixable.
"Macon, Georgia is that city upon a hill," says Glover. "East Macon can be that guiding light which leads way to more jobs, safer neighborhoods and more economic prosperity for all of us. Today, the odds are upon us as we build and sculpt a new government."
Glover says over the next few months, he'll put together a comprehensive plan that lays out which of the county's issues to attack first.
His announcement comes just a week after Macon City Council member Elaine Lucas announced she's running for the District 3 seat.


text:
Mr. Food's Pizzas with Pizzazz
by Art Ginsburg
There's nothing like homemade pizza right out of the oven, and now Mr. Food shares recipes and tips for making it at home. He's got more than 125 ... Show synopsis
You're signed up (and we ♥ you). Watch for our Welcome e-mail and your first coupon. Thanks!


text:
But prior to setting that bond, Copenhaver took note of a string of worthless check misdemeanor convictions against Starks, which dated back to the 1980s.
He gave her a stern warning to abide by the law until she is sentenced.
"If there is a single worthless check written by you while you are on bond, it will be revoked," Copenhaver said.
"This is a very thorough history of writing worthless checks, and let me be clear to you, it will not be tolerated," he said.
The case was handled West Virginia's Small Business Protection Initiative, a special project U.S. Attorney Booth Goodwin began in November 2010 to focus on the prosecuting individuals who defraud small West Virginia businesses.
Goodwin said he hoped Starks' plea will send a message to those who prey on business owners and nonprofits.
"Three hundred thousand dollars is significant to any business, large or small, but it's especially significant to a small business or charity, like the one that puts on MultiFest," he said.
"That's why my office focuses on incidents like this -- to protect small businesses and charities and send a clear message that it won't be tolerated."
While Starks could have been charged with embezzlement at the state level, Goodwin said the federal tax fraud charge was more appropriate in this case because of the $200,000 in extra income Starks had hidden.
"The tax charge fully encapsulated her crime," Goodwin said.
Federal probation officers will conduct a pre-sentence investigation in the case and report their findings to Copenhaver.
Copenhaver said he will use that report to determine the appropriate sentencing guidelines in the case.
Attorneys will also work to determine an appropriate restitution pay schedule, as well as how those payments would be divided between MultiFest and the IRS.
Contact writer Jared Hunt at jared.h...@dailymail.com or 304-348-5148.


text:
Develop-Mental Impact
Find out more
Connect with Denis AKA Ditch the Kitsch on Twitter
nature, ecology, industry, developmental, mental, green, vector, cool, graphic design, environment, earth friendly, top selling chemistry t shirts, top selling, chemistry t shirts, ipad cases, cool nature vector, cool graphic design, environment earth ecology, pollution, pollution vector, cool pollution
Hello and welcome!
I'm Denis, AKA Ditch the Kitsch (32 – Argentina)
Designing T-Shirts, the idea of you wearing what came out of my mind is indescribable and mind-blowing! That you will be happy with your new T-shirt, that motivates me the most. That's my fuel. I'll never thank you enough!
Hoping you look extremely cool wearing my art…
Denis ;-)
View Full ProfileNice drawing, nasty message. But true, nevertheless. Great work!
Thanks! Yes…unfortunately it is. Thank you so much for your kind comment and support Janna! ;-D
– Denis Marsili
This couldn't have been done any better… wow.
I've always loved WOW comments! :D Thanks for your awesome comment Graeme! Again, I really appreciate each and every comment you left here(and the favourites! Thanks for taking the time to browse my portfolio and speaking your mind! ;-)
– Denis Marsili
Great piece, almost like an industrial cloud raining down all the waste
EXACTLY! Love your reading of it! Thanks heaps for your comment and favorite! :) I appreciate your support!
– Denis Marsili
Your welcome denis.
Well think about it, industrial buildings pollute the air, and in return sometimes we get acid rain.
So true! And they don't just pollute the air…but the whole environment, water, etc…not fair! That's why I created this. Thank you again! Much appreciated!
– Denis Marsili
love this desing!
I'm so pleased you like it that much Laura! Many thanks for letting me know! Much appreciated! ;-)
– Denis Marsili
Well, maybe some day people will realize that we need to stop with the machines
but the other day me an my friend were talkng about earth, and seeing how she evolves alot. There is the possiblity that pollutants will evolve into a good thing.
(becuase before we were on earth, the earth had methane instead of oxygen)
Interesting point! I really hope you're right about it…and the future is different than what it seems it's gonna be… Thanks for your thoughtful comment! ;-)
– Denis Marsili
Welcome man. That would be actually really awsome to see happen. But then again, humans are stupid and will do soemthing worse
Let's have faith Brenden! Let's think positively! :D
– Denis Marsili
Of course. But lifes a bitch so theres always some bad times haha
Haha! What can I say…I agree, but I expect we never run out of hopes for a better world! :D
– Denis Marsili
very good, i like it in white. reminds me of oil and gas city aberdeen
So pleased you like it, thanks for your kind comments! ;-)
– Denis Marsili
Great t-shirt! Awesome!
Many thanks James! I appreciate your words! ;-)
– Denis Marsili


text:
Seattle II Shirt - Herringbone
Style # 10483
A breathable cotton herringbone shirt cut for easy movement
This long-sleeve work shirt for is cut for mobility so you don't have to worry about snagging extra fabric on brush or your table saw. Made of midweight cotton herringbone.
- Seattle Fit
- High back yoke and outer back pleats for ease of movement
- Double-needle construction for durability
- 7-button closure
- Two chest pockets with snap flap closure, Two patch pockets with buton flap closure
- Straight collar
Workwear, Casual, Everyday
Product Care
Machine wash
3.83-oz. 100% cotton Herringbone


text:
Ego is an impediment for a leader, wise man, merchant or a servant, but it is a necessity for a warrior, a competitor.
A warrior is one who takes on challenges and commitment and stands by it.
Ego makes one sacrifice oneself for a cause. Ego gives strength and courage, brings valour to meet the challenges with endurance and perseverance. A strong ego will counteract depression. Often ego is thought to be selfish but it is the greatest motivating factor for creativity and generosity.
Ego propels one to venture into the unknown.
There are 3 types of ego - Sattvic, Rajasic and Tamasic.
If you cannot surrender, at least have a Sattvic ego, as a Sattivic ego is always ready to sacrifice.
Bhanu: This is very good! It gives many people a relief. (laughter!)
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Published December 08, 2012, 01:37 PM
North Dakota, Mont. counties settle on inmate bill
GREAT FALLS, Mont. (AP) — A yearlong dispute between two counties in neighboring states has come to an end, with officials in North Dakota agreeing to pay part of the hospital bill of a fugitive who was arrested in Montana.


text:
Pauls Valley, Oklahoma —
Rosemary Ann Wadlow, 67, passed away December 29, 2012.
Services were held at 10 a.m. Wednesday, Jan. 2 at Midway Hill Baptist Church in Sulphur. Services were under the direction of Hale's Funeral Home of Sulphur.
Go to www.halesfuneralhomes.com to send online condolences.
Rosemary Ann Wadlow
- Obituaries
Archie Lee King
Longtime Cushing resident, Archie Lee King passed away on March 4, 2014 at his home in Cushing.
Vivian 'Marie' Crouch
Vivian 'Marie' Crouch, of Paoli, passed away March 1, 2014 in Pauls Valley, Oklahoma at the age of 91 years.
Jimmy Dale Fitch
Jimmy Dale Fitch, 66, passed away Feb. 27, 2014 at his home in Blanchard.
Danny Ross Taylor
Danny Ross Taylor, 66, was born June 3, 1947 and passed away Feb. 27, 2014 at his home in Lindsay.
Deanna Kay Creel
Deanna Kay Creel, 44, of Pauls Valley was born to Morris and Glenda (Moulton) Newcomb on Aug. 5, 1969 and passed away Feb. 26, 2014 in Pauls Valley.
Rosie Alice Mae Watts (Breath)
Rosie Alice Mae Watts, 79, of Tatums, Okla., entered this life on September 28, 1934 to George Breath and Rosie (Antwine) Breath and entered eternal life on February 22, 2014.
Dorothy Yoakum Byrd
Funeral services for Dorothy Yoakum Byrd, age 97, of Rosedale, Okla., will be at 10 a.m. Thursday, February 27, 2014 at Wooster Funeral Home Chapel in Pauls Valley, Okla., with Rev. Mike Ridgway officiating.
Lou Ella Prather Wade
Lou Ella Prather Wade of Ardmore passed away February 21, 2014 in Ardmore, Oklahoma at the age of 70 years.
Lenora Geneva McCaskill Cobb
Lenora Geneva McCaskill Cobb was born on October 4, 1922 in Davis, Okla., and entered eternal life on February 21, 2014 at the age of 91.
Arvil Wayne Blankenship
Services for Arvil Wayne Blankenship, 88, of Ada, were held Wednesday at the Criswell Funeral Home Chapel. Revs. Darrel Blankenship, Justin Blankenship and Robert Ware will officiate.
- More Obituaries Headlines
Archie Lee King


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Run with MeeGo
Any device that will run MeeGo needs two things: the MeeGo core software stack and the MeeGo User eXperience (UX) for that specific device, although you are not limited to using the MeeGo UX, and you can create and deploy your own branded UX. Currently, MeeGo is available for Netbooks, IVI and handsets.
The MeeGo Core 1.1 release provides a common base operating system for the user experiences of all supported device categories. It provides a complete set of enabling technologies for mobile computing. The MeeGo stack contains Linux kernel 2.6.35, X.org server 1.9.0, Web Runtime, Qt 4.7 and Qt Mobility 1.0.2, supporting the contacts, location, messaging, multimedia, and sensor and service frameworks. It also includes a number of leading-edge components, such as the oFono telephony stack, the ConnMan connection manager, the Tracker data indexer, the Telepathy real-time communications framework, the Buteo sync framework and many more.
These technologies are brought to application developers through the MeeGo API, which is based on Qt and other technologies, such as the MeeGo Touch Framework. With the latest Qt version 4.7, the MeeGo developer experience is now enhanced with the introduction of QML, the easy-to-use scripting technology for animated touch-enabled GUI apps.
Table 1. MeeGo v1.1 Core Software Platform Key Feature List
Key Feature | Description | Related Upstream Project |
Complete MeeGo-compliant packages | Ensures compatibility. | N/A |
GCC 4.5.0 toolchain | Includes support for the Intel Atom microarchitecture and runtime library functions optimized for the Intel SSSE3 instruction set. | gcc.gnu.org/gcc-4.5 |
Linux kernel 2.6.35 | Includes support for the Intel Atom processor Z6xx series family. | kernel.org |
X.org Server 1.9.0 and Mesa 7.9 | Improves 2-D and 3-D graphics. | www.x.org/wiki and www.mesa3d.org |
Qt 4.7 and Qt-mobility 1.0.2 | Provides a rich set of APIs for creating compelling applications that include location, sensors, contacts and messaging. | qt.nokia.com |
QtWebKit 2.1 | Qt port of WebKit. | developer.qt.nokia.com/wiki/QtWebKit |
BTRFS | Next-generation filesystem aimed at implementing advanced features while focusing on fault tolerance, repair and easy administration. | https://btrfs.wiki.kernel.org |
ConnMan connection manager | Provides support for static IPv6, dhcp-lib and VPN. | connman.net |
New oFono telephony stack | Provides support for the telephony functionality. | ofono.org |
PulseAudio | Provides support for the audio functionality. | www.pulseaudio.org |
GStreamer 0.10.30 with liborc support | General performance improvements. | www.gstreamer.net |
Zypper/libzypp package management. | Provides full package management functionalities, such as repository access, dependency solving, package installation and so on. | en.opensuse.org/Portal:Zypper |
Udisks and upower | Replaces the deprecated devicekit-disks and devicekit-power. | freedesktop.org/wiki/Software/udisks and upower.freedesktop.org |
Buteo synchronization framework and Personal Information Management | Based on Tracker. | projects.gnome.org/tracker |
DeviceKit and udev | Used for interacting with hardware devices. | fedoraproject/wiki/Features/DeviceKit and git.kernel.org/?p=linux/hotplug/udev.git |
Sensor Framework | Allows developers to take advantage of platform sensors, such as accelerometers, compasses and gyroscopes. | Part of Qt |
Universal Plug and Play (gUPnP) | Support for gUPnP providing an easy-to-use, efficient and flexible framework for creating devices and control points. | gupnp.org |
Linux has become a key foundation for supporting today's rapidly growing IT environments. Linux is being used to deploy business applications and databases, trading on its reputation as a low-cost operating environment. For many IT organizations, Linux is a mainstay for deploying Web servers and has evolved from handling basic file, print, and utility workloads to running mission-critical applications and databases, physically, virtually, and in the cloud. As Linux grows in importance in terms of value to the business, managing Linux environments to high standards of service quality — availability, security, and performance — becomes an essential requirement for business success.
Sponsored by Red Hat
If you already use virtualized infrastructure, you are well on your way to leveraging the power of the cloud. Virtualization offers the promise of limitless resources, but how do you manage that scalability when your DevOps team doesn't scale? In today's hypercompetitive markets, fast results can make a difference between leading the pack vs. obsolescence. Organizations need more benefits from cloud computing than just raw resources. They need agility, flexibility, convenience, ROI, and control.
Stackato private Platform-as-a-Service technology from ActiveState extends your private cloud infrastructure by creating a private PaaS to provide on-demand availability, flexibility, control, and ultimately, faster time-to-market for your enterprise.
Sponsored by ActiveState
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Good point. At the state level the Republican party is actually doing quite well.I guess all the blue states don´t want Democrats running their own state (except CA and a few others). And, in helps that most of Obama´s ´´low information voters´´ can´t manage to vote for any candidate beyond the top line on the ballot. Click Here if you Like this Comment 2 persons like this.
How long will it be before we begin reading about the violence and intimidation of employees who choose not to contribute dues??I give it about 1 month at the max--it will take individuals with a backbone to stand against the union thugs and fellow employees who still "believe" the benefit of unions. Click Here if you Like this Comment
Yep, you won´t have to pay union dues anymore but you´ll get beat up if you don´t. The nation is now a little over 50% losers. Click Here if you Like this Comment
The big picture is that unions are losing the war in America. Michigan was an important battle and the union´s reaction, foolishly illustrated to the public, only turns more people against it. Click Here if you Like this Comment
That´s what I´m waiting for #2. Hopefully the legislature put some teeth into the law regarding that. Click Here if you Like this Comment
Companies will go where they can be most successful. Since Indiana passed RTW over 90 companies have announced intent to move there (I imagine many from IL). Of course if all states had cumpulsory unions then business would look to China Click Here if you Like this Comment 1 person like this.
I doubt many new business will locate in Michigan until the state proves it will defend them against destruction of thier property and injury to thier workers. The latter issue could be solve itself if Michigan is also a right to carry state. Click Here if you Like this Comment


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Md. House, Senate pass health exchange bill
ANNAPOLIS, Md. (AP) - The Maryland General Assembly has passed a measure to create a framework for a health insurance marketplace to provide coverage to the uninsured.
The House of Delegates and state Senate voted 94-44 and 35-12, respectively, for the bill Monday.
The measure builds on legislation passed last year to create the health care exchange, a mandate of federal health care reform. It sets up standards and regulations to run the program. Maryland has about 700,000 uninsured residents.
Democratic supporters say the state needs to be prepared to implement the law by the January 2014 deadline under federal law.
Republican critics of the measure say Maryland is moving too fast, because the law is being challenged in the Supreme Court. The high court began hearing arguments Monday.
More in "Maryland"
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Author: thypitty4 Added: November 27, 2011 Views: 391 Rated: (1) |
i keep loosing to the guy with this army list i (he is 9 years of age)
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