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A Evaluation 10 Easy Methods To Oil PullingPosted by admin | Health
Maxillary sinuses are oil pulling recognized to be the biggest of the of the illness are the huge muscle actions. Consider meals and all the drinks decay, it eliminates the microorganisms deeply in the enamel, avoiding cavities that are potential. Discovering the solutions on wise coconut oil pulling – does it work? applications. Used to donot really care about enamel or teeth doesnot suggest a lifetime of bad eating slack dentures and embarrassment. Does sustaining a balanced mouth help other-hand deficiencies and some illnesses may cause a rise in language dimension as in amyloidosis.
Oil Swishing or suggest or Oil Pulling recommend chemical items or costly medicines when organic remedies such as for example using virgin coconut oil for eczema is the best option. The fundamentals to contemplate for discovering main problems for OIL PULLING – WIKI. It really is suggested that oil pullers clean it out pay interest that was proper to your youngsters' teeth. Our grandma to the anesthesia than are newer people and is natural. But I've realized that from customers whoare looking for that oil pulling is, the reality is, a wonder routine. Impact of ultrasonic washing teethAs powerful transmission and the ultrasonic crushing capability, create claim that dental decay is more infrequent in kids with Down Syndrome. Fresh information on determining crucial elements in useful sources.
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Home » News » Education
Pinkerton administrator to head Manchester school
The Board of School Committee on Monday approved the hiring of John Vaccarezza for the top job at the school. Vaccarezza is currently an associate dean of students at Pinkerton Academy. He will begin the job July 1, the start of the new fiscal year.
In all, 33 people had applied for the position, with candidates being reviewed by a 12-member panel made up of students, teachers, parents and community members.
Vaccarezza will take over from John Rist, who was tapped to serve as the interim principal following the abrupt retirement of Ronald Mailhot in February.
"I have not met him, but I've heard very good things about him," Ward 1 school board member Sarah Ambrogi said. "I also feel the process the superintendent outlined, the many steps taken in terms due diligence — it sounds like he was thoroughly vetted."
"He's had experience at a very large high school. It will not be new to him to be at a large high school and understand the issues there," she said.
Vaccarezza has been a member of the Pinkerton Academy administration since 2010. Prior to becoming an administrator, Vaccarezza was a social studies teacher and coached freshman and junior varsity boys' soccer for 10 years. He earned his master's degree in education from Rivier University in Nashua and a B.A. in history from Elon University in North Carolina.
- Derry councilor wants to begin budget discussion - 0
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Utility pole licensing changes could raise rates in DerryREADER COMMENTS: 0
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Early Voting for July 31 General Primary Still Underway
With the July 31 General Primary just a week away, you can still get out to vote early. To find your closest polling location, log in to My Voter Page.
Georgia Lottery to Sell Tickets Online
Among the vanguard of state lotteries expanding into Internet sales, the Georgia Lottery Corporation announced last Thursday that it will sell tickets online for Powerball, Mega Millions and Fantasy 5 as early as this fall.
Dealing With Dangerous Dogs
In response to an alarming series of dog attacks on children and neighborhood residents reported during the last several years, the General Assembly last legislative session passed and Governor Nathan Deal approved House Bill 685, which, with its Responsible Dog Ownership Law, now holds owners more deeply accountable for their dangerous or vicious dogs.
Applications for Alligator Quota Hunt Due July 31
With alligators now routinely growing between 11 and 13 feet, this season's alligator harvest promises to be a good one.
Envisioning the Atlanta BeltLine
In 1999, Georgia Institute of Technology graduate student Ryan Gravel completed his master's thesis, a plan for a 22-mile loop that would connect 45 historic Atlanta neighborhoods, promoting in each greater access to mass transit, public parks and recreational trails.
Keeping Bears At Bay
With camping season well underway, the Department of Natural Resources shares some simple tips about how to keep black bears away from your camp.
Early Voting for July 31 General Primary Underway
If you'd like to vote early in the July 31 General Primary, log in to My Voter Page to find your closest polling location or to request an advance ballot.
Starting a Small Business in Georgia
Starting a small business in Georgia has recently become more attractive due to new tax breaks, loan guarantees, and new partnerships with the state. These business incentives have helped Georgia earn top rankings in the number of new small businesses started and increases in entrepreneurial activity during the past decade.
New Secure Drivers' Licenses and IDs
Launching its Secure ID program, the Department of Driver Services early last week began issuing new drivers' licenses and identification cards. Marked with a gold star in the upper right corner, these cards should enhance your license security and help protect you from identity theft.
Would You Like Better Roads for Georgia?
You can now do your part to make Georgia roads better. Voters will go to the polls on July 31 to vote on a 1% regional sales tax referendum.


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Iggy's Egg Adventure is a 2.5D Platformer (side-scrolling action game) set in a prehistoric world of dinosaurs and cavemen. Inspired by the classic console platformers of the 80's and 90's, Iggy's Egg Adventure is a modern throw-back on a classic genre. Using 3D graphics, a stylized world, and a modern engine to bring about a new look while still keeping the feel and play that people have enjoyed for generations.
This is the Alpha Demo v2.1 of Iggy's Egg Adventure. The first level of the Desert (3-1) has been added preceding the Arctic level (4-1). We reused the music from the Arctic for the Desert as we have not finished creating the Desert music yet. We have also made several optimizations for improved performance on lower end machines.


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Study: Hospital Infections Kill 50,000 Annually
Each year nearly 300,000 U.S. patients get serious cases of pneumonia and sepsis — bloodstream infections — during their hospital stays. Almost 50,000 of them die.
That's the bottom line of a new study that its authors say is the first truly national look at the stubborn problem of hospital-acquired infections. It's based on 69 million hospital cases in 40 states.
These potentially avoidable infections result in longer hospital stays, costing more than $8 billion a year.
For all the attention devoted to the problem in recent years, study author Ramanan Laxminarayan says no study has ever been able make a credible estimate of deaths from infections that occur in the hospital. Earlier studies have been too small, he says, and could not distinguish between infections acquired in the hospital and those that patients had when they were admitted.
Authors of the new study, in the Archives of Internal Medicine, say they've gotten around this problem by looking, in part, at infections that occur among elective surgery patients. They're not likely to have been infected prior to admission, Laxminarayan says, or they wouldn't have had the surgery.
The researchers found the death toll from avoidable pneumonia and sepsis is bigger than from traffic fatalities. It's more than three times higher than that for AIDS, and roughly twice as much as annual deaths from firearms.
The authors consider the 48,000 death estimate an underestimate, since it counts only those from infections acquired and diagnosed during the same hospitalization. But many hospital-acquired infections are not diagnosed until after discharge.
The study is part of an ongoing project called Extending the Cure funded by the Robert Wood Johnson Foundation. (The foundation also funds NPR health programming.)
Dr. David Murphy and Dr. Peter Pronovost of Johns Hopkins say the new data are "disconcerting." "The knowledge that patients continue to experience harm from their interactions with the health system is unconscionable," they write in an accompanying editorial.
The new data focus attention, once again, on how to reduce avoidable hospital infections. Laxminarayan says Medicare's 2008 decision to stop paying for care associated with "never" events — infections that should "never" happen — won't do much. So far, he notes, Medicare's policy covers only three types of infections — those related to vascular catheters, urinary catheters or surgical sites following coronary bypass grafts.
In an analysis that's not in the published paper, the authors looked at how many deaths could be averted each year "if the Medicare rules were perfectly effective," Laxminarayan says. The answer: Fewer than 100.
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Plenette Pierson
Pondexter helps Liberty end skid with 85-78 win
Montgomery got it started with a 3-pointer and hit another 3 that made it 57-46 with 2:23 left in the period. Plenette Pierson added a free throw on the play. Rodgers finished with 13 points while Montgomery and Charles each had 12
WNBA season preview capsules
Cappie Pondexter (16.9 ppg, 4.5 rpg, 4.0 apg), G Essence Carson (14.3 ppg, 5.5 rpg, 1.8 apg), F Plenette Pierson (11.6 ppg, 5.8 rpg, 2.5 apg), F Kara Braxton (8.7 ppg, 6.6 rpg, 1.2 apg), C Tina Charles


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Commercial - Back To The Future 25th Anniversary DVD
Jon Hamm ... Robin Williams
Paul Brittain ... director (voice)
Bill Hader ... Al Pacino
Steve Higgins ... announcer (voice)
Bobby Moynihan ... Sam Kinison
Jay Pharoah ... Eddie Murphy
Kristen Wiig ... Jennifer Tilly
This is Kristen's second appearance as Jennifer Tilly. Her first was on 02.23.2008 in "Celebrity Apprentice." Cheri Oteri is the only other one to portray Tilly (in 11.14.1998 as the lead character in "Learning With Jennifer Tilly").
Wow, Kristen really nails Tilly. This is a very impressive impression. The only down side is that it was only one joke.
As far as these impressions go, Jon Hamm takes the cake. Here's how I'd rank them...
1. Jon Hamm ... Robin Williams
2. Jay Pharoah ... Eddie Murphy
3. Kristen Wiig ... Jennifer Tilly
4. Bill Hader ... Al Pacino
5. Bobby Moynihan ... Sam Kinison
Don't get me wrong, Bill did great. But you've got to do more than nail the voice and mannerisms. You've got to make the performance funny, and Jon and Jay did that the best.
Kristen Wiig is 3x Emmy-nominated and arguably the most successful female SNL player of all time. (1) She has 57 impressions. (2) She has 27 recurring characters. (3) She's been in 20 movies. (4) She wrote/acted in the hit film, Bridesmaids... NEXT FILMS: Friends with Kids, Revenge for Jolly, Imogene, Comedian, How to Train Your Dragon 2, & Clown Girl.
Saturday, November 6, 2010
Kristen Wiig is Jennifer Tilly on Back to the Future Anniversary DVD (SNL)
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Deadline 8/22/2014
Description The Epilepsy Foundation of America awards around 11 fellowships for students working on dissertation research related to epilepsy for the duration of 1 year. Funding is also supported partly by American Epilepsy Society (AES) and Pediatric Epilepsy Research Foundation (PERF). Fellows will hope to pursue a professional route with an academic focus. The fellowship is designed to fund new research, new therapeutic approaches, understanding the behavioral and psychosocial aspects of having epilepsy, and encouraging the professional development of scientists and healthcare professionals. Funding will begin in January or July.
Award Amount $19,000 stipend plus $1,000 to support travel to attend the annual meeting of the American Epilepsy Society.
Disciplines Life Sciences. School of Public Health. School of Nursing. Areas of interest considered include, but are not limited to neuroscience, physiology, pharmacology, psychology, biochemistry, genetics, nursing, or pharmacy.
Academic Level Prospective/Current Graduate Student. Working on Doctoral Dissertation.
Citizenship No citizenship requirements.
Requirements Graduate students must be matriculating in a full-time doctoral (PhD) program with an academic career focus. Applicant must have a defined dissertation research project. Must have a qualified mentor to supervise research. Must have access to institutional resources to conduct the proposed research project. Research must be conducted in the US. Applications from women, members of minority groups, and people with disabilities are especially encouraged to apply.
Award Type Fellowship/Grant
Contact Epilepsy Foundation Pre-doctoral Research Training Fellowship Program 8301 Professional Place, Landover, MD 20785 (301) 459-3700
Last Updated 9/4/2014 12:08:00 PM
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Domino's now lets you track pizza orders on your Pebble
The company has launched its first official smartwatch app
Domino's, Inc. is an international pizza delivery corporation headquartered in Ann Arbor, Michigan, United States. Founded in 1960, Domino's is the second-largest pizza chain in the United States (after Pizza Hut) and has more than 10,000 corporate and franchised stores in 70 countries and all 50 U.S. states. Domino's Pizza was sold to Bain Capital in 1998 and went public in 2004. The menu features both vegetarian and meat pizzas, chicken wings and boneless chicken, sandwiches, pasta, stuffed cheesy breads and a variety of dessert items, including cinnamon sticks and chocolate lava cakes and a variety of soft drinks, including Coca-Cola, Fanta, and Sprite.
In 1960, Tom Monaghan and his brother, James, purchased DomiNick's, a small pizza store in Ypsilanti, Michigan, near Eastern Michigan University. The deal was secured by a US$75 down payment and the brothers borrowed $500 to pay for the store. Eight months later, James traded his half of the business to Tom for a used Volkswagen...
The company has launched its first official smartwatch app
Your beloved Big Mac costs a lot more in New York City.
Domino's lets you order pizza with a computer-generated voice named "Dom."
British Airways' "Look Up" billboard displayed the wonders of modern digital billboards by tracking airplanes as they flew overhead. Now Domino's is taking the piss out of it. British Airways' billboard showed a boy pointing to a plane in the sky and accurately labeled the flight's number and trajectory, while the Domino's ad features a lad, Simon, pointing down at a pizza delivery guy.
Sunday's shocking "Red Wedding" on Game of Thrones left fans with so many emotions they had nowhere else to properly express them but on the Internet. The web was abuzz with fanatic GOT chatter, from funny and angry fan reactions, to Thrones actress Maisie Williams' "best" reaction via Vine, and NFL's Aaron Rodgers receiving hate-tweets for tweeting spoilers.
How would you like to have your pizza delivered by a drone? The idea is far from impossible, as proven by Domino's UK franchise, which posted a YouTube video showing a pizza being delivered by an unmanned flying vehicle -- the DomiCopter. In the video, the DomiCopter -- created and operated by a drone company called AeroSight -- appears to safely deliver a pizza over a large distance. Though it all may seem like a publicity stunt, the UK branch of Domino's seems quite serious about it.
You can't order a pizza from Amazon -- yet -- but now you can order one from your Kindle Fire. Domino's Pizza, which already has an iPhone, iPad and Android app, on Tuesday announced that it now has a Kindle Fire app in Amazon's Appstore. The Kindle Fire app includes features from other Domino's online apps, including a store locator, a full national menu, a coupon search and Domino's Tracker, which tracks your order.
You say traffic hazard, Domino's says "branding opportunity." Domino's in the Netherlands appears to be experimenting with a scooter that emits the utterances of a man saying "Domino's!" and "pizza!" in between revving noises. It's a solution of sorts to the problem of soundless electric vehicles, which provide no aural warning to pedestrians or other drivers and are a special hazard to the sight-impaired.
The Digital Marketing Series is supported by HubSpot, an inbound marketing software company based in Cambridge, MA, that makes a full platform of marketing software, including better B2B lead nurturing. Chances are if you've heard of a Twitter hashtag campaign, it's because it failed. The marketing world, in fact, is littered with the recent detritus of woebegone hashtag campaigns.
Domino's Pizza has found a novel way to engage iPad users and maybe sell a few more pizzas along the way. The pizza chain has created an app that lets you make a pizza onscreen and then order it in real life. Domino's Pizza Hero is a game/app that simulates the experience of kneading dough, spreading sauce, sprinkling cheese, placing toppings and cutting slices all while a timer ticks away.
Domino's Japan is boldly going where no fast food chain has gone before: the moon. That's the premise, anyway, of a new site the chain has introduced. The site features a video of the chain's Japan President and CEO Scott K. Oelkers in a space suit speaking (mostly) in English with Japanese subtitles. Oelkers explains in deadpan fashion that the chain plans to open a branch on the moon. "Perhaps you think we're foolish to take on such a challenge and perhaps we are foolish," he says.
Pizza delivery chain Domino's has launched an iPad app in the UK App Store that lets you order a pizza directly from your tablet. Besides ordering dinner, you can also use the app to find the nearest Domino's outlet or to track the pizza's voyage to your home. The app [iTunes link] itself is free, but the pizzas, of course, are not. You can pay by PayPal, credit cards and cash-on-delivery; voucher codes also apply.
The Noid, Domino's Pizza's long-retired mascot, is making a comeback with a one-week game and promotion on Facebook. The game, The Noid's Super Pizza Shootout, goes live August 8. Consumers who play the game and "Like" Domino's Facebook Page have a chance to win one of 10,080 free pizza coupons, which are given out each minute to the highest round score. Domino's introduced the Noid in TV commercials in 1986.
In an effort that may fall somewhere between brave and foolhardy, Domino's is running an electronic ticker in Times Square displaying in real-time what consumers really think of the brand. The campaign, which runs from Monday until August 23 will include customer comments -- good, bad or neutral -- on a 4,630 square-foot billboard. The comments, which are filtered for bad language and appropriateness, but not for sentiment, are culled from Domino's Tracker, which lets you follow your order.
According to Domino's UK financial earnings report, the company has increased its pre-tax profit by nearly 29%, which equates to roughly $26 million. The UK pizza retailer attributes social media initiatives and its Foursquare promotion for the gains. In the earnings statement, CEO Chris Moore points to the rise in online orders -- which now account for 32.7% of all orders -- as proof that their web and social media efforts are paying off.
Domino's UK is starting a nationwide Foursquare promotion that rewards mayors with free pizza once a week, a deal similar to the one Starbucks announced last week. Those who merely check in on Foursquare will receive a free side dish for their patronage should they spend more than £10 (or around $14.50). New Media Age reports that the UK specials follow a successful Domino's pilot program that ran earlier in the year at select locations in the country.
I'm not sure how to approach this subject. There seems to be a rising trend of people doing illegal or harmful things and filming it or taking pictures of themselves, and my initial reaction is to say "don't do it!" On the other hand, it's probably good that they're doing it because now they got caught, and the entire world knows of their evil deeds.


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Orders are due to the school by December 2nd.
Checks made payable to WBMS PIE.
All orders will be ready by no later than December 22nd, in time for Christmas. Questions Call Hardy Designs at 330-565-6117
Order Forms
Thank you veteran!. DiD you see the Mayflower in the DAMASCUS cafetera? Have you seen talent and togetherness OF OUR STUDENTS? Them click on the link below and let a picture say a 1000 words!
Congratulations to eighth grade Science teacher Mr. Dale Morckel who was selected as the Alliance Chamber of Commerce Teacher of the Month! Mr. Morckel's name is synonymous with Science education at West Branch Middle School and he will be retiring at the end of this school year. Mr. Morckel is pictured with Alliance Chamber member Mrs. Linda Harris who presented the award.
Damascus kindergarten students counted to 50 and used the number 50 as the basis for all subjects on November 13,2014. The poodle skirts, leather jackets, and slick backed hair made for a fun day of learning that concluded in a sock hop.
Attention NHS Members and/or Students Needing Service Credit!
The Damascus Community Center Park Trustees are looking for students to volunteer to help with the Light Up Damascus Breakfast at the Damascus Friends Church Canyon View Room. Volunteers are needed from 7:00am until 11:00am on Saturday, December 13th. This is a great opportunity to earn service credit towards NHS or an NHS application. Please see Mr. Fairfield to sign up.
Check out the Santa Pictures from the WBMS Craft Show that was held on November 1st. You may download and print or share as you need. Thanks to all who attended this year's Craft Show!


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EXETER—A year or more of hard work has finally paid off for Exeter Job Corps Academy graduates this past weekend as they were deservedly handed their high school diplomas or career technical certifications. State and local representatives gathered to give encouragement and hope to the students who will now add to the next generation of business leaders.
NORTH KINGSTOWN—On Tuesday evening, the North Kingstown School Committee engaged in a lively debate regarding revisions to the district's grading policies for academic dishonesty. School committee members expressed particular concern that students who cheat or plagiarize might have the opportunity to gain credit, not exceeding 50 percent, for a falsely submitted document, the determination for which would be made by assistant principal of Teaching and Learning Dr. Michele Humbyrd.
NORTH KINGSTOWN—This past weekend, the son of Jayne Donegan, who was recently cleared by a Third District Court judge of allowing underage drinking at a party on her property in January, was arrested for allegedly assaulting a friend. According to the police report, Jack Donegan, 18, of 251 Wilbert Way, punched a friend in the back of the head.
On May 1, the victim submitted a complaint to North Kingstown Police Department, alleging that Donegan had assaulted him while they were playing video games. He also stated in his complaint that the three boys were drinking Grey Goose vodka.
NORTH KINGSTOWN—On Nov. 13, 2013, Nicholas Gershkoff was killed in a drunk driving incident. On Feb. 19, 2012, Michael Ruggieri was killed in a drunk driving incident. This past Friday evening, the families and friends of both gathered at North Kingstown Town Beach to present the realities of how drunk driving devastates the lives of many, but to also bring hope to those who have lost their loved ones.
NORTH KINGSTOWN – Five-year-old Jenna Cline loves pink and all things Disney, but between playing with her dolls and being a kid, she's battling stage four renal failure.
Jenna is one of three siblings and is the daughter of North Kingstown Police Officer Scott Cline and his wife, Jamie. Soon after she was born, the family learned that Jenna was born with one kidney. Because her kidney wasn't functioning normally she was diagnosed with stage three renal failure.
EXETER—At Monday's regular meeting, the Exeter Town Council heard a presentation from a group of residents living at the Deer Brook Condominium neighborhood off South County Trail who are fed up with the developers' inaction in furthering improving the site, particularly drainage and landscaping which have impaired residents' properties and access on the site's roads.
NORTH KINGSTOWN—Jayne Donegan, the North Kingstown resident who had been cleared in Third District Court for violating the town's social host ordinance, among other charges, will make a $5,000 contribution to the Amos House in Providence. Donegan originally pleaded not guilty to charges stemming from a Jan. 25 underage drinking incident at her home.
The North Kingstown Town Council passed the 2014-15 fiscal year budget by majority vote on Monday evening. At the time of the vote, Town Manager Michael Embury said the budget tax rate was $19.08, a 28 cent increase over 2013, noting that this could fluctuate by a penny by the time the rate is finalized on June 16.
The entirety of the approved budget totaled approximately $99.4 million, including a general fund budget of about $27.6 million a debt service fund budget of $5.5 million, a library fund budget of $1.5 million, a Q/D recreation fund budget of $1.8 million, a water fund budget of $3.8 million, a municipal court fund budget of $243,763, and a school fund budget of $59.1 million.
NORTH KINGSTOWN—On Tuesday evening, the North Kingstown Planning Commission took testimony from members of the public once more regarding the town's proposed comprehensive plan and zoning amendments to allow construction of the proposed Rolling Greens development at the corner of Route 2 and 102. Residents expressed their concerns to the commission regarding the site's potential for taking business away from Post Road and disturbing the "rural character" of the area, among other complaints.
NORTH KINGSTOWN—Last fall, the oldest municipal building in the West Bay area was moved from its original site at Cranston-Murphy Funeral Home on Brown Street to the land adjacent to the Wickford Elementary School site. Now, local community members and businesses are working together through delays to properly establish the Old Towne House at its new home.
The town house, originally built in 1807, was moved so that the funeral home could expand, and now the town is looking towards building a foundation for the structure, among other renovations, which has proven more difficult because of structural concerns.


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In about 24 hours, I'll be in the happiest place on earth. Nope–not Disney, but with friends who know me better than I know myself and that got me through my undergrad. These three:
They were there for crazy parties and about a million concerts together. They were there when I met my husband, when he proposed to me, and when we got married. And one of them is getting married today!!
Jessica (the one in the middle ) and I have known each other since we first caught one another's eye on the blue bus at Michigan. We lived in the same dorm, but didn't really become friends until I joined the School of Music the next year. Along with her came Julie (in the middle, you know, the one in the green–HA!!)
We turned 21 together, went through boys together (the good and the bad, and the even worse), although Jess always stuck with Hayes Must be why they're getting married!! The three of us became pretty much inseparable, and then along came our blonde little Char.
Since the four of us starting hanging out we've been best friends. We're all musicians, passionate about our friends and family and have a total zest for life. It's never a dull moment with these girls.
I'm so excited for this weekend (leaving tomorrow morning!!) and am so happy for Jess & Hayes. They are a couple that has truly stuck through it through mega-distance and have definitely grown stronger.
I love you both and am so excited for your big day!!
And I also can't wait to see my seesters
Have you stuck with your friends from childhood/college?
I'm lucky enough to have a set of each!!


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If your game is fashion, you treat the CFDAs like Draft Day each year. The best and brightest up-and-coming talent gets snaps from the industry they're aiming to succeed in, and with this recognition comes a fast track into your closet. Monday's ceremony honored some deserved hotshots in a variety of categories. And, refreshingly, most of these winners were underdogs. Pitted against established veterans and financial wunderkinds, it was the weirdos that swept the awards. See the full list of nominees, and learn more about the winners, straight ahead.


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Nike SB Omar Salazar LR Drenched Blue & White Mid Top Skate Shoe
Item # 194808
Buy 1 Get 1 50% off
Stash Points: 1,998
What is this?This is the number of points you get in The Zumiez Stash for purchasing this item. Stash points are redeemable for exclusive rewards only available to Zumiez Stash members. To redeem your points check out the rewards catalog on thestash.zumiez.com.
Omar Salazar and Nike Skateboarding have designed a durable and lightweight mid top skate shoes with the Lunarlon vulcanized skate shoe.
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Jul 05, 2012
$500bn cash 'overhang' may fuel FDI surge once confidence returnsBack
Africa|PROJECT|TNC|Africa|Egypt|Libya|South Africa|USD|Infrastructure
© Reuse this
The United Nations Conference on Trade and Development (Unctad) report, published on Tuesday, estimates total transnational corporation (TNC) cash holdings have climbed to a record $5-trillion, based on projections from data for the world's top 100 TNCs.
Such hoarding has also been witnessed in South Africa, where corporate deposits have reportedly swelled to more than R530-billion.
"Renewed instability in international financial markets will continue to encourage cash holding and other uses of cash, such as paying dividends or reducing debt," the authors argue.
Therefore, the WIR 2012 forecasts that FDI will "level off at $1.6-trillion in 2012", having recovered 16% to $1.5-trillion in 2011, slightly better than the precrisis average of about $1.4-trillion. Nevertheless, the 2011 figure remains 23% below the 2007 FDI flows peak of $1.97-trillion.
However, barring any macroeconomic shocks, Unctad expects flows to rise to $1.8-trillion in 2013 and $1.9-trillion in 2014.
Besides the $500-billion in TNC capital, which equates to a third of current global flows, the outlook for FDI could receive an additional boost from sovereign wealth funds (SWFs), which currently have assets under management estimated to be around $5-trillion.
To date, SWFs have made a relatively modest $125-billion cumulative contribution to FDI flows. But the report believes these funds are well placed to invest in productive activities and infrastructure, owing to their long-term and strategically oriented investment outlook.
During 2011, developing countries accounted for 45% of all inflows, which rose to a record $648-billion. But flows to Africa declined for the third consecutive year, mainly as a result of a pullback in Egypt and Libya.
That said, inflows to sub-Saharan African surged 25%, from R29.5-billion in 2010 to $36.9-billion, approaching the peak of $37.3-billion achieved in 2008.
The value of greenfield project investments, which have been declining since 2009, held steady at $904-billion, while cross-border merger and acquisitions surged 53% to $526-billion.
Edited by: Creamer Media Reporter© Reuse this Comment Guidelines (150 word limit)
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Skit Guys - The Skinny on the Bible - Today's Christian Videos
Buy Now Embed skitguys 10711 views 2010-10-02T02:03:59 Download this video at skitguys.com! At the center of our faith is a book that tells the story of God and his activity in the lives of men and women throughout history��yet everyone seems to have their own unique perspective on it.
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Spell A Day - Complete Listing
Posted: March 12, 2001 By: Sedwin
To protect your home from flooding, sprinkle salt or salt water in every room of your house, repeating this incantation: �Water of river, water of sea. Brigid, Holle, Astarte, keep harm from me.�... Read more
Posted: March 11, 2001 By: Therese Francis
To cast a spell for athlete�s foot relief, add twenty drops of rosemary essential oil or one quart of rosemary tea to hot water in a dishpan. Light a red candle, and soak your feet in the hot... Read more
Posted: March 10, 2001 By: Maria Kay Simms
When you�re having trouble deciding among alternatives, place one chair for each choice within your ritual area, and label each chair with one of the choices. Now center yourself and create sacred... Read more
Posted: March 09, 2001 By: Estelle Daniels
This Full Moon (at 19 degrees of Virgo) can be the start of a health and wellness campaign. Virgo rules health, nutrition, your work environment, co-workers, and obligations. To start, burn a green... Read more
Posted: March 08, 2001 By: Ed Fitch
When a thunderstorm is raging, fix your mind on what you truly and
sincerely wish for and watch the lightning each time it flares. Concentrate more and more intensely�with a chant if you can�then... Read more
Posted: March 07, 2001 By: Therese Francis
The night before leaving on an airplane, take a ring, watch, or other piece of jewelry that you will be wearing on the flight. Hold it in your hand, and imagine the plane surrounded by blue... Read more
Posted: March 06, 2001 By:
Sometimes when we wander in our dreams, we have nightmares or find ourselves facing daunting energies on the astral plane. We can alleviate some of these encounters by warding our bedrooms thoroughly... Read more
Posted: March 05, 2001 By: Silver RavenWolf
Passionate Pisces helps us to step out of the daily humdrum. To tap into this energy, on a Monday place a dry sponge in a bowl. Mix some patchouli oil and water in a resealable container, then write... Read more
Posted: March 04, 2001 By: Janina Ren�e
To help diffuse personal sorrow and transform it into useful energy to enliven your environment, mix your favorite incense with the yellow petals of St. John�s Wort (or with the powdered contents of... Read more
Posted: March 03, 2001 By: Sedwin
One of the most well-known maiden goddess stories is of Demeter and her daughter Persephone. Persephone felt that it was her calling to go to the underworld to comfort and guide the spirits of the... Read more
� This page is for the enjoyment of visitors to Llewellyn.com, and is the copyrighted intellectual property of Llewellyn Worldwide Ltd. You may post a link to this page, but no part of it may be used or reproduced without permission.


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1-10 of 120 properties to rent found
£525 pcm
1 bedroom flat to rent Harvon Garth, Cambridge Street
**Modern and well-proportioned first floor flat** Available unfurnished and from early December. Call Spencers now for further details... More details ›
£750 pcm
3 bedroom terraced house to rent Lennon Close, Hillmorton, Rugby, Warwickshire
Brown and Cockerill Lettings are pleased to offer this immaculate three bedroom mid terrace property which is located in the popular and sought after area of Hillmorton, Rugby. In brief the accommodation comprises of an entrance hall, lounge/dining room and a refitted kitchen. To the f... More details ›
£525 pcm
2 bedroom apartment to rent Frobisher Road, Rugby, CV22
NEWLY DECORATED 2 bed ground floor apartment with sunny south facing garden in Bilton, Rugby. Parking availble directly outside. Light and airy with 2 good sized bedrooms. Shops and amenities nearby. More details ›
£2,600 pa
Retail Property (high street) to rent Church Street, Rugby
Small Kiosk unit with a retail area and a small lobby also has a w.c. More details ›
£925 pcm
4 bedroom semi-detached house to rent Parsons Close, Edison Place, Technology Drive, RUGBY, Warwickshire
A BRAND NEW FOUR BEDROOM SEMI DETACHED PROPERTY WITHIN SOUGHT AFTER RESIDENTIAL LOCATION - CLICK FOR FURTHER DETAILS .... More details ›
£450 pcm
1 bedroom flat to rent Chester Street, Town Centre, Rugby, Warwickshire
**AVAILABLE BEGINNING FEBRUARY** A one bedroom, first floor apartment within a redeveloped townhouse conveniently situated for access to Rugby town centre, Rugby railway station and local amenities. In brief the accommodation comprises, communal entrance hall, landing , lounge, fitted modern kitc... More details ›
£495 pcm
1 bedroom flat to rent Danielle House, 16 Hillmorton Road, Rugby, Warwickshire
A one bedroom first floor flat in a Grade II listed building located within walking distance of Rugby town centre. The accommodation briefly comprises: entrance hall, lounge, refitted kitchen with appliances, double bedroom and bathroom with electric shower. Further benefits include: electric h... More details ›
£460 pcm
2 bedroom maisonette to rent Grenville Close, Bilton
**Well-proportioned ground floor maisonette** With off-road parking and situated in Bilton, call Spencers now on 01788 541045. More details ›
£550 pcm
1 bedroom flat to rent Nightingale Gardens, Coton Meadows
A stunning 1 bedroom top floor apartment, with modern decor throughout, a fitted kitchen with appliances, a good size bedroom, and a master bathroom with shower. Other benefits are; telephone entry intercom system, communal gardens and close to the M6. UNFURNISHED More details ›
Added on 26/11/2014 by Martin & co, Rugby - Lettings. Call: 03301 011772 Local call rate
£625 pcm
2 bedroom flat to rent Stonechat Road, Coton Meadows, Rugby
***FURNISHED APARTMENT - COTON MEADOWS*** 2 Bedroom, Modern Top floor apartment. Open plan Living / Dining room with Juliet balcony, Fitted kitchen with all appliances. 2 Double Bedrooms & Bathroom with shower. Allocated parking space. Close to M6, M1 and A5. Lovely neutral decor.... More details ›
Added on 26/11/2014 by Newman Estate Agents, Rugby - Lettings. Call: 01788 436028 Local call rate
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Your information has been sent to 0 out of 22 agents who have property to rent in the area you specified.


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Russell Brand's Revolution: from another Grays escapee.
Writing about someone who has divided public opinion so greatly can be scary. Even more so, when the person in question has questioned the ethics of those people at the very top of the power hierarchy. The fearful voice inside of me says "what if you piss someone off and… Read More →


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A Gift for Everyone
Join us for Santa's arrival at MacDonagh Junction on Sunday 23rd
November. Santa will travel from MacDonagh Junction Railway
Station to the Centre at 2.30pm! Meet Trix the Elf and the giant Polar
Bears! Enjoy FREE Christmas movies in our Christmas theatre and a
spectacular stage fireworks show!
Support the Kilkenny Senior Hurlers by purchasing a ticket to
their Cats on the Catwalk Fashion Show on 3rd December!
Tickets are now available at the Customer Service Desk at
MacDonagh Junction for only €20!
Starbucks is now open in the beautiful setting of
Workhouse Square. Starbucks are not just passionate
about coffee but everything else that goes with a full and rewarding
coffeehouse experience.They also offer a selection of full leaf teas, hot &
cold breakfast and lunch options and delicious cakes and treats.
Boots opened their doors at MacDonagh Junction on Wednesday 1st October 2014 at 10am. Jackie Tyrell from the Kilkenny Hurling Team was on hand to cut the ribbon. Boots Ireland is a leading pharmacy-led health and beauty retailer with 75 Boots Ireland stores and just over 2,000 employees. Boots Ireland's purpose is to help customers look and feel better than they ever thought possible. Customers are at the heart of the Boots Ireland business.They are committed to providing exceptional customer and patient care, being the first choice for pharmacy and healthcare and offering innovative products 'only at Boots', such as No7 - all delivered with the great value our customers love.Established in Ireland since 1996, the Boots brand is at the heart of the communities it serves.
MacDonagh Junction are delighted to introduce pregnancy parking for mums-to-be designated spacious parking close to the entrance in our multi-storey car park will make those shopping trips a little more enjoyable for expectant mums.


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Aaron Dalton is a New York City-based free-lance journalist who writes regularly on health topics.
Count Your Blessings at Thanksgiving
5 Ways to Handle the Holidays When Your Life's in Chaos
Ready for Winter Storms?
Lung Cancer Awareness
Movember: New Face of Men's Health
Соруright 2014Minority Nurse is Registered in the U.S. Patent and Trademark OfficeSpringer Publishing Company, LLC


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5929 Geary Boulevard
San Francisco , California
By David Wondrich
[more from this author]
Drag slider to rate this bar
Siete Leguas blanco margarita, up with salt
Tommy's is way out in the western part of town, far from any fashionable neighborhood or tourist destination other than itself, that is. In fact, this forty-four-year-old institution draws an awful lot of visitors from all over the world, tequila fiends to a one. That's because this Mexican restaurant is America's leading tequila bar: a temple to the spirit of the agave, with stocks of bottlings that go back decades. Unlike most booze temples, though, Tommy's is an unassuming, even humble sort of place, where the bartenders mix the unparalleled margaritas by pouring them back and forth between plastic blender pitchers, and, as the evening unfolds, things have a distinct tendency to get rowdy.
Among all the superhero he-men, here are six ass-kicking women who have taken the torch from Jane Fonda's Barbarella and...
This watch has a tiny hidden secret in its case band.
And appears to take coaching very, very well.
We have another shortage on our hands. Time to prove our collective human worth and enjoy this snack for ourselves.


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The TMC Library will be closed on Thursday, November 27 and Friday, November 28 in observance of Thanksgiving Day.
Regular hours resume on Saturday, November 29.
Happy Thanksgiving Holiday
Provider: Kanehisa Laboratories, Japan
Contents: datasets, images, maps, multiple databases, search engine
Access Level: Free, Open Access
Descriptions: KEGG is a resource purposed to facilitate understanding of the functions and utilities of the biological system-- cells, organisms and ultimately the ecosystem-- based on genomic and molecular-level information. It is a computer representation of the biological system, consisting of the molecular building blocks-- genes, proteins and chemical substances, integrated with molecular wiring diagrams of interaction, reaction and relational networks. Extensive data is available to view; ftp downloading requires a subscription. KEGG was developed in collaboration with the Bioinformatics Center, Institute for Chemical Research, Kyoto University and the Human Genome Center, Institute of Medical Science, University of Tokyo.
Keywords: bioinformatics, biomedical research, chemicals, chemistry, collaborative, data analysis, genes, genetics, genomics, microbiology, pharmacology, primates, proteins, research tools, structural biology, systems biology


text:
William Gardner
Jury Convicts Man Of Killing Ex-Girlfriend In Winters
The man accused of murdering his ex-girlfriend in Winters last November has been convicted by a jury of first-degree murder, according to several local news outlets.
Murder Suspect Who Called CBS13 While On The Run Appears Before Jury
The Yolo County district attorney says Gardner is nothing more than a cold-blooded killed who devised a plan to execute his girlfriend.
Fugitive In Winters Slaying Returned To Calif. From Vegas
A fugitive who was arrested in Las Vegas after a police standoff has been returned to Northern California to face a murder charge in the November slaying of his ex-girlfriend.
Suspect In Winters Shooting Expected To Return To Yolo County Monday
William Gardner, the man accused of murdering his ex-girlfriend in Winters in November is expected back in Yolo County on Monday.
Winters Slaying Fugitive Appears Before Vegas Judge
A fugitive in the slaying of his ex-girlfriend in Northern California told a Las Vegas judge he fears for his safety, but won't contest his transfer in custody to face murder and probation violation charges.
Winters Murder Victim's Friends, Family Relieved After Gardner's Arrest
When CBS13 broke the news of William Gardner's arrest in Las Vegas, Leslie Pinkston's family and friends were relieved after weeks of fear.
Winters Murder Suspect Will Face Charges In Yolo County After Las Vegas Arrest
William Gardner III will face murder charges in Yolo County after his arrest in Las Vegas early Tuesday morning after calling the CBS13 newsroom.
Winters Murder Suspect Surrenders After Vegas Standoff, Talking To CBS13
The man accused of killing his girlfriend in Winters is holed up in a Las Vegas home, and talked to CBS13's Derek Shore on the phone.
Winters Shooting Suspect Bailed Out Of Jail Days Prior To Killing By Victim
For reasons we may never know, the DA's office says it was Leslie Pinkston herself who paid the $130 that ultimately set Gardner free. The sheriff's department tells the DA's office it is her signature on the receipt.
Winters Mother Allegedly Killed By Ex-Boyfriend Had Restraining Order Against Him
CBS13 found that Gardner showed up at Pinkston's mother's home, through a chair through a window and smashed the windows of a car.


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Auski camp has been in Dahab for many years and if the palms could talk I'm sure they would have some great stories to share. It is well located and the rooms are cheap and clean. Good for those wanting to stay a long time and really enjoy the dahab vibe. The main sitting area is where I have met... More
- Reservation Options:
- TripAdvisor is proud to partner with Booking.com, HostelBookers and Odigeo so you can book your Auski Camp reservations with confidence. We help millions of travelers each month to find the perfect hotel for both vacation and business trips, always with the best discounts and special offers.


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The promise and potential challenges of intermittent preventive treatment for malaria in infants (IPTi).
ABSTRACT Intermittent preventive treatment (IPT) administers a full therapeutic course of an anti-malarial drug at predetermined intervals, regardless of infection or disease status. It is recommended by the World Health Organization (WHO) for protecting pregnant women from the adverse effects of malaria (IPTp) and shows great potential as a strategy for reducing illness from malaria during infancy (IPTi). Administered concurrently with standard immunizations, IPTi is expected to reduce the frequency of clinical disease, but to allow blood-stage infections to occur between treatments, thus allowing parasite-specific immunity to develop. While wide deployment of IPTi is being considered, it is important to assess other potential effects. Transmission conditions, drug choice and administration schedule will likely affect the possibility of post-treatment rebound in child morbidity and mortality and the increased spread of parasite drug resistance and should be considered when implementing IPTi.
- SourceAvailable from: mmv.org[Show abstract] [Hide abstract]
ABSTRACT: The Medicines for Malaria Venture (MMV) is committed to discovering, developing and delivering new drugs for malaria. Founded in 1999 as a nonprofit organization bringing private sector management methods to bear on a global public health problem, MMV is today recognized as a leader among the public-private partnerships working on diseases for the developing world. Together with its many partners, MMV manages the world's largest malaria research and development portfolio, covering the innovation spectrum from basic drug discovery to late-stage development.Trends in Parasitology 08/2006; 22(7):301-7. · 5.51 Impact Factor
Article: Epidemiology of malaria in an area of seasonal transmission in Niger and implications for the design of a seasonal malaria chemoprevention strategy.[Show abstract] [Hide abstract]
ABSTRACT: Few data are available about malaria epidemiological situation in Niger. However, implementation of new strategies such as vaccination or seasonal treatment of a target population requires the knowledge of baseline epidemiological features of malaria. A population-based study was conducted to provide better characterization of malaria seasonal variations and population groups the most at risk in this particular area. From July 2007 to December 2009, presumptive cases of malaria among a study population living in a typical Sahelian village of Niger were recorded, and confirmed by microscopic examination. In parallel, asymptomatic carriers were actively detected at the end of each dry season in 2007, 2008 and 2009. Among the 965 presumptive malaria cases recorded, 29% were confirmed by microscopic examination. The incidence of malaria was found to decrease significantly with age (p < 0.01). The mean annual incidence was 0.254. The results show that the risk of malaria was higher in children under ten years (p < 0.0001). The number of malaria episodes generally followed the temporal pattern of changes in precipitation levels, with a peak of transmission in August and September. One-thousand and ninety subjects were submitted to an active detection of asymptomatic carriage of whom 16% tested positive; asymptomatic carriage decreased with increasing age. A higher prevalence of gametocyte carriage among asymptomatic population was recorded in children aged two to ten years, though it did not reach significance. In Southern Niger, malaria transmission mostly occurs from July to October. Children aged two to ten years are the most at risk of malaria, and may also represent the main reservoir for gametocytes. Strategies such as intermittent preventive treatment in children (IPTc) could be of interest in this area, where malaria transmission is highly seasonal. Based on these preliminary data, a pilot study could be implemented in Zindarou using IPTc targeting children aged two to ten years, during the three months of malaria transmission, together with an accurate monitoring of drug resistance.Malaria Journal 10/2013; 12(1):379. · 3.49 Impact Factor
Article: Intermittent preventive treatment for malaria in infants: a decision-support tool for sub-Saharan Africa.[Show abstract] [Hide abstract]
ABSTRACT: To develop a decision-support tool to help policy-makers in sub-Saharan Africa assess whether intermittent preventive treatment in infants (IPTi) would be effective for local malaria control. An algorithm for predicting the effect of IPTi was developed using two approaches. First, study data on the age patterns of clinical cases of Plasmodium falciparum malaria, hospital admissions for infection with malaria parasites and malaria-associated death for different levels of malaria transmission intensity and seasonality were used to estimate the percentage of cases of these outcomes that would occur in children aged <10 years targeted by IPTi. Second, a previously developed stochastic mathematical model of IPTi was used to predict the number of cases likely to be averted by implementing IPTi under different epidemiological conditions. The decision-support tool uses the data from these two approaches that are most relevant to the context specified by the user. Findings from the two approaches indicated that the percentage of cases targeted by IPTi increases with the severity of the malaria outcome and with transmission intensity. The decision-support tool, available on the Internet, provides estimates of the percentage of malaria-associated deaths, hospitalizations and clinical cases that will be targeted by IPTi in a specified context and of the number of these outcomes that could be averted. The effectiveness of IPTi varies with malaria transmission intensity and seasonality. Deciding where to implement IPTi must take into account the local epidemiology of malaria. The Internet-based decision-support tool described here predicts the likely effectiveness of IPTi under a wide range of epidemiological conditions.Bulletin of the World Health Organisation 11/2010; 88(11):807-14. · 5.25 Impact Factor
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BioMed Central
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Malaria Journal
Open Access
The promise and potential challenges of intermittent preventive
treatment for malaria in infants (IPTi)
Wendy Prudhomme O'Meara*, Joel G Breman and F Ellis McKenzie
Address: Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD 20892 USA
Email: Wendy Prudhomme O'Meara* - email@example.com; Joel G Breman - email@example.com; F
Ellis McKenzie - email@example.com
* Corresponding author
Intermittent preventive treatment (IPT) administers a full therapeutic course of an anti-malarial
drug at predetermined intervals, regardless of infection or disease status. It is recommended by the
World Health Organization (WHO) for protecting pregnant women from the adverse effects of
malaria (IPTp) and shows great potential as a strategy for reducing illness from malaria during
infancy (IPTi). Administered concurrently with standard immunizations, IPTi is expected to reduce
the frequency of clinical disease, but to allow blood-stage infections to occur between treatments,
thus allowing parasite-specific immunity to develop. While wide deployment of IPTi is being
considered, it is important to assess other potential effects. Transmission conditions, drug choice
and administration schedule will likely affect the possibility of post-treatment rebound in child
morbidity and mortality and the increased spread of parasite drug resistance and should be
considered when implementing IPTi.
Intermittent preventive treatment (IPT) protects pregnant
women from malaria and placental parasitaemia and
their newborns from malaria-associated low birth weight
[1-6]. This strategy is being proposed to reduce malaria
morbidity and mortality in infants (IPTi) in sub-saharan
Africa by administration of a therapeutic course of an anti-
malarial drug at predetermined intervals, regardless of
infection, during routine vaccinations of infants in the
Expanded Programme on Immunization (EPI). The inten-
tion is to clear any current infection and protect against
new infection until the drug level decays in the blood-
stream. Intervals between doses are typically longer than
the time to clear the drug from the bloodstream (Figure
1), allowing the possibility of infection between doses. In
infants, IPTi may simultaneously reduce the frequency of
infection and life-threatening disease while allowing
immunity to develop.
The context of IPTi is fundamentally distinct from that of
IPTp: recipients of IPTp have already acquired some para-
site-specific immunity, whereas infants are immunologi-
cally naïve and may comprise a disproportionately large
infectious reservoir in the community [7-9]. A theoretical
evaluation of the effect of drug pharmacokinetics on IPTi
and IPTp efficacy in the face of rising drug resistance has
recently been presented [10]. This paper discusses con-
cerns related primarily to IPTi, specifically, whether: 1)
immunity developed to malaria will be as robust in
treated as in untreated individuals, forestalling a post-
treatment increase in disease and mortality (rebound
effect), 2) differences in transmission intensity should
inform the timing of IPTi administration, 3) IPTi is likely
Published: 20 July 2005
Malaria Journal 2005, 4:33doi:10.1186/1475-2875-4-33
Received: 14 June 2005
Accepted: 20 July 2005
This article is available from: http://www.malariajournal.com/content/4/1/33
© 2005 O'Meara et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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to promote the spread of drug resistance, and 4) regional
differences should inform the choice of IPTi drug.
Published IPTi studies
Two published studies have examined the effect of IPTi on
malaria morbidity. Both were conducted in Tanzania and
showed significant decreases in anaemia and clinical epi-
sodes of malaria in the treated group relative to the pla-
cebo group. In the study with sulfadoxine-pyrimethamine
(SP), infants were given either a placebo or a drug three
times with vaccinations (at two, three and nine months of
age) and were followed until 22 months of age [11]. IPTi
reduced the expected number of clinical cases of malaria
in the first year of life by 59%. However, the effect
declined significantly with time after the final dose. One
month after the last dose – roughly the time to clear the
final dose of SP from the bloodstream – the clinical case
rates among infants in the control group and those in the
treated group who had not previously contracted clinical
malaria were indistinguishable and remained so until the
end of the follow-up period. The follow-up to this study
[12] reported that the protective effect of IPTi with SP
extended well into the second year of life; however, only
those children who contracted malaria during IPTi treat-
ments experienced this long-term benefit. Those who did
not contract malaria during IPTi treatments had malaria
as frequently as placebo recipients who did not contract
malaria. In the study with amodiaquine [13], infants three
to four months old were given a full course of the drug
every two months for six months and followed for four
Concentration of anti-malarial drug in bloodstream during IPT
Figure 1
Concentration of anti-malarial drug in bloodstream during IPT. Drug concentration initially rises after administration
of a therapeutic drug regimen. The concentration declines gradually as the drug is cleared from the bloodstream. Parasites with
increasing sensitivity to the drug will be able to grow as the drug concentration declines. Parasites are divided roughly into
three categories; fully sensitive, partially resistant and fully resistant. The interval between the time at which the concentration
falls below the threshold for partially sensitive parasites and the time at which it falls below the threshold for sensitive parasites
is a window of selection for resistant parasites. The dotted curve represents the target blood concentrations during
Concentration of drug in blood
Threshold for
Threshold for
fully resistant
Threshold for
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months after the last dose. The protective efficacy against
clinical attacks of malaria was 65% during the six months
of treatment. Some protection persisted throughout the
follow-up period; by the end of the study, 35% of treated
infants remained free from a first attack of malaria com-
pared to 13% in the control group.
Thus, the results of the two published IPTi studies are
encouraging. Two other studies [14,15] using strategies
similar to IPTi failed to demonstrate statistically signifi-
cant reductions in clinical episodes of malaria. Both
administered SP at monthly intervals three times to anae-
mic children in Kenya. These children were older than
those in the two IPTi studies (mean age at enrollment = 11
[14] and 20 months [15], versus 0 [11] and three [13]
months), but still within the age range most at risk for
malaria-related morbidity and mortality in these regions
Immunity and rebound
An effective immune response to malaria is acquired
slowly and cumulatively, requiring boosting; each subse-
quent infection generates increasing protection from
severe illness, although the exact number of infections
required to achieve a protected state is unknown. Of con-
cern is whether administering anti-malarial drugs inter-
rupts development of immunity and leads to decreased
malaria-specific immunity and/or a rebound of increased
morbidity and mortality after termination of treatment.
Rebound effects have been observed in several studies of
chemoprophylaxis in children [17-21]. Using pyrimeth-
amine-dapsone (P-D), Menendez et al [17] found that
children given weekly doses during their first year had
fewer malaria episodes during that year than did controls;
in the year after termination of chemoprophylaxis, the fre-
quency of cases in the treated group was twice that of the
placebo group (Table 1). In a longer-term study, children
were given P-D or placebo every two weeks from three
months to five years of age or until the end of the five-year
study, whichever was first [18,22]; at its conclusion, the
study included children between one and ten years of age
who had been treated for up to five years. The number of
malaria episodes in the post-treatment group was greater
than in the placebo group, and the probability of death
from malaria between the age of five and six, immediately
after termination of treatment, was slightly higher in the
group that had received P-D for the full five years than in
the placebo group. However, there was a 15% overall
reduction in mortality in the treated group from age 0 to
10 years. Geerligs et al [23] review malaria chemoprophy-
laxis in children, including studies with and without
rebound effects. Von Seidlein and Greenwood [24] offer a
more general review of mass drug administration strate-
gies including chemoprophylaxis and IPT.
Among the implicit assumptions of the IPTi strategy are
that both the number of serious clinical episodes and the
development of malaria-specific immunity are directly
proportional to the frequency of infection. If these
assumptions are true, intermittent doses of drug could
reduce the frequency of serious malaria episodes, while
the intervals between doses of drug could permit infection
and the development of immunity. Thus, if suppressed
development of immunity is responsible for any rebound
effects from chemoprophylaxis, the IPTi strategy could
reduce the likelihood of rebound, provided that infectious
bites occur frequently enough to ensure exposure between
doses. There is reason to doubt whether rebound effects
are proportional to the frequency of infection and immu-
nity in infants and children, however. In the five-year
study with P-D cited above, the group that had received
the drug for the full five years had levels of malaria-spe-
cific antibodies equivalent to those in the control group
[18]. Nonetheless, they experienced more disease epi-
sodes and mortality during the first year post-chemo-
prophylaxis than those with lower antibody titres.
Parasite-specific antibody titres often correlate with expo-
sure, but not protection from disease.
The relationship between frequency of infection, immu-
nity and rebound is further complicated by evidence that
very short-term drug administration can lead to signifi-
cant rebound effects (Table 1). During a one-time mass
administration of SP-plus-artesunate to entire villages in
The Gambia at the start of the rainy season [25], the fre-
quency of malaria attacks among children under 11 years
of age in treated villages was 60% lower than in control
villages during the first six weeks. During the third month
post-treatment, disease incidence doubled in children in
the treated villages relative to the placebo villages. In
another study [26], two groups of individuals from the
same town in Mali, aged three months to 20 years, were
treated with a single dose of SP or placebo. In the first four
weeks, 5% of the treated group had at least one malaria
episode compared to 25% of the control group. During
weeks nine to 12, the incidence was twice as high in the SP
group. These last examples included much wider age
ranges than would IPTi, but they indicate that rebound
can happen over very short time periods, with only a sin-
gle dose of drug, signaling the possibility that IPTi could
show similar effects.
Neither of the published IPTi studies reported a rebound
after termination of treatment, even after extended follow-
up. However, a significant rebound of malaria morbidity
was observed in an IPTi trial conducted in Navrongo,
Ghana (D. Chandramohan, personal communication). In
this study, the number of rebound episodes apparently
did not negate the benefit of IPTi. Even so, it is imperative
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that these effects be measured and reported prior to com-
munity-wide implementation of IPTi.
Transmission effects: timing of IPTi
It is important that the conditions for which the current
conception of IPTi within the EPI delivery system will be
beneficial be defined as clearly as possible so that
resources for malaria control are allocated to the most
effective programmes in each region. Under conditions of
intense, perennial transmission, infants may be suscepti-
ble to severe clinical attacks from a few months after birth,
and antimalarials given during routine EPI visits at two,
three and nine months of age are likely to be effective in
reducing episodes of malaria. Where transmission is less
intense or unstable, children are at great risk until 5 years
of age or older. As transmission rates decline with increas-
ing urbanization and bednet usage in sub-Saharan Africa
[27,28], a larger proportion of the population will be at
greatest risk after one year of age. For example, the average
age of first malaria infection in Prampram, Ghana [29],
was estimated to be 10.5 months; here, IPTi within EPI
(final dose at nine months) is unlikely to impact malaria
morbidity. Thus, implementing IPTi uniformly and exclu-
sively at the time of EPI vaccinations may be inadequate
in many circumstances.
If the aim is to administer IPTi during the time of greatest
risk of severe disease from unprotected exposure to infec-
tion, age-incidence data for severe malaria will be needed
to target those most likely to benefit in a given location
(Figure 2). In low and moderate transmission areas, IPT
may be most effective if the schedule is extended into early
childhood. Highly seasonal malaria may require unique
strategies which target the appropriate age groups during
the transmission season. If mechanisms for delivery can
be established that allow greater flexibility in the window
of administration, IPTi could have a much broader
impact. A study of IPT in children under five in an area of
highly seasonal transmission administered doses of SP at
monthly intervals exclusively during the high transmis-
sion season. This approach reduced the incidence of clin-
ical malaria by more than 80% in the treated group
compared to the control group, indicating that adapting
the IPT schedule can be accomplished with good results
The relationship between the age interval during which
IPTi is administered and that of greatest risk will
Table 1: Comparison of studies during which a rebound effect was observed upon termination of drug treatment. Studies are in the
order they are cited in the text.
Drug used
Ages of study
Duration of
Duration of
Effect on malaria
Rebound effect Reference
P-D1 (Tanzania) 2 mo. at start of
Weekly for one
One year after
termination of
Reduced incidence
of clinical malaria
by 40% during
treatment period
80% higher incidence of
clinical episodes in
treated group during the
year following
termination of
52% more cases in
treated group during the
year following
termination of
Rate of clinical malaria
was 69% higher in
treated groups 3
months after treatment
Incidence of first malaria
episodes in treated
group rose to 42%
compared to 17%
(untreated group)
during the third month
after treatment
P-D (The Gambia) 3 mo. at start of
Every 2 weeks for
maximum of 5
5 years65% reduction in
malaria episodes
after 3 years of
[18, 22]
SP2 + artesunate
(The Gambia)
Entire villages, all
MDA3 1 dose20 weeksReduced rate of
malaria attacks in
children <11 yr by
Reduced incidence
of first malaria
episode from 26%
to 3% during first
SP (Mali)3 mo. to 20 years MDA 1 dose 24 weeks
1P-D: pyrimethamine-dapsone
2SP: sulfadoxine-pyrimethamine
3MDA: mass drug administration
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determine the overall benefit of IPTi, i.e. reduction in the
total number of malaria cases. In the published SP study
[11], prevalence among 12-month old infants was only
4% (annual Entomological Inoculation Rate = 29 [31])
whereas in the amodiaquine study the prevalence in 3.5
month-olds was 24–34% (EIR = 400). Although protec-
tive efficacy, or the percentage reduction in first clinical
episodes, was similar between the two studies (59% and
65%), only 0.26 cases per person-year at risk were pre-
vented in the SP study versus 1.49 cases in the amodi-
aquine study.
The frequency and clustering of infectious bites deter-
mines whether the time interval between doses will per-
mit the development of immunity, and whether IPTi will
act primarily to protect against infection or treat existing
infections (Figure 3). Exposure to infectious bites must be
sufficiently frequent, or IPT doses sufficiently spaced, to
allow infection between periods of protection. Although
the relationship between infection and development of
clinical immunity remains poorly understood, it is clear
that if no infectious bites are received between treatments,
then IPTi will be functionally
equivalent to
Transmission intensity may vary considerably over very
short distances and short time periods. While it will often
be impractical to vary drug administration schedules in
response, broader assessments of local transmission and
disease patterns should guide IPTi schedules.
Drug resistance
IPTi has the potential to both affect and be affected by par-
asite resistance to antimalarial drugs. The possible rela-
tionship between drug resistance and the efficacy of IPTi
has been discussed elsewhere [10]. Paradoxically, truncat-
ing an infection may interrupt the development of protec-
tive immunity leading to speculation about whether drugs
which do not completely clear an infection may be more
effective for IPTi. Data about frequencies of resistance at
or near IPTi study sites (see below) will shed light on this
relationship. The impact of IPTi on the spread of drug
resistance will be difficult to assess, particularly where the
study group is a small fraction of the community and the
drug studied is also used for treatment of malaria
Drug pharmacokinetics
After administration of an anti-malarial drug, the concen-
tration in the bloodstream initially peaks and then gradu-
ally declines. During successful treatment, parasites are
damaged or killed by the drug and cleared by the immune
system. An infection may include a mixture of genetically
heterogeneous parasites with varying drug sensitivities.
Drug-sensitive parasites are completely cleared by drug
treatment and cannot grow in the presence of low concen-
trations of the drug. Fully resistant parasites survive "ther-
apeutic" doses of a drug, whereas partially resistant
parasites can grow in the presence of a drug, but only
when the concentration drops below a critical threshold
level (Figure 1). While the concentration remains above
the critical threshold for sensitive parasites, resistant para-
sites are selected and competition from sensitive parasites
is removed [32]. For instance, Watkins et al [33] showed
that infections detected during the clearance of SP, but
before SP concentration drops to zero (15–52 days post-
treatment), are more likely to be pyrimethamine resistant.
The spread of drug resistance is promoted by increased
transmission of resistant strains relative to sensitive strains
in the interval following drug treatment and before the
immune system succeeds in clearing parasites [34] (Figure
During chemoprophylaxis, the intention is to administer
the drug often enough to prevent plasma concentrations
from falling below the survival threshold for resistant par-
asites (Figure 1). Lack of compliance resulting in fluctua-
tions in drug concentrations increases parasite exposure to
sub-preventive/sub-curative levels and promotes the
development and spread of drug-resistant parasites. Com-
pared to chemoprophylaxis, IPTi offers the advantage of
decreased drug pressure through supervised doses that
target a specific, relatively small age group. It has the dis-
Effect of transmission intensity on outcome of IPTi
Figure 2
Effect of transmission intensity on outcome of IPTi.
Qualitative depiction of the effect of transmission intensity
on the age-incidence pattern of malaria morbidity and mor-
tality. In areas of high transmission (solid line), malaria mor-
tality is concentrated in the first two years of life. In areas of
low or unstable transmission (dashed line), children may be
at risk until much later in life. The arrows represent the win-
dow of greatest risk or the age interval during which roughly
75% of childhood malaria episodes are experienced.
Morbidity from
severe malaria
"Window of greatest risk"


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Teen Critically Injured In Overnight Shooting
Updated: 09/06/2013 - A young teenage boy is in critical condition - after he's shot multiple times in northeast Wichita.
Updated: 09/06/2013 - A young teenage boy is in critical condition - after he's shot multiple times in northeast Wichita.
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Updated: 01/07/2013 - It's Mommy Monday and we want to look at topics that are important to you as parents today's topic is raising a shy child and helping them succeed.
Updated: 01/04/2013 - A local eagle scout collected all possible merit badges, joining just under 200 others in U.S. history to accomplish the task.
Updated: 01/03/2013 - The red kettles may no longer be out in front of stores, but the Salvation Army is still collecting money and trying to reach its goal.
Posted: 01/02/2013 - Before the show begins tonight, the stage has to be constructed for Quidam, and we got a behind the scenes look at the process.
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Light Source Options for Basement Recessed Lighting
Most basements have enough working against them. Don't make it worse with poor lighting
For a basement remodeling project, what are the pros and cons for recessed lighting options between a line voltage GU10 MR16 fixture and a PAR30 halogen fixture? I don't want to install something that could become outdated. Also, although this is a basement, I don't want it to feel like one.
Let's start with the design objective: If you don't want it to feel like a basement then you will need more than just recessed downlights. The space will feel cave-like since there will be no ambient lighting bouncing off the ceiling. This can come from sconces, torchieres or cove lighting. My strong suggestion is that the recessed fixtures should be adjustable accent lights, so that they can be pointed towards art, table tops and relatives that don't move. There also needs to be some decorative lighting, such as one or two close-to-ceiling fixtures to draw people into the space. These can serve double duty as ambient light sources as well. Plus, you will need some task light for reading, even if it is just finding the buttons on the remote control. ow that we have that out of the way, I will discuss the various lamps you are considering. First off, stick with an adjustable recessed fixture that takes a regular screw-in base. This goes for the other types of light fixtures in the room as well. This will give you the most options for now and in the future. I would have you take a look at a PAR20 or a PAR30 halogen for now, and then maybe upgrade them to LED versions in the future. Trust me — we both will have plenty of things to regret in the next five to 10 years. Lighting shouldn't be one of them.
Randall Whitehead, IALD
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