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Publications (23)76.11 Total impact
Article: Cognitive Behavioral Treatment for Recurrent Binge Eating in Adolescent Girls: A Pilot Trial.[Show abstract] [Hide abstract]
ABSTRACT: There is a need for treatment interventions to address the high prevalence of disordered eating throughout adolescence and early adulthood. We developed an adolescent-specific manualized CBT protocol to treat female adolescents with recurrent binge eating and tested its efficacy in a small, pilot randomized controlled trial. We present lessons learned in recruiting adolescents, a description of our treatment approach, acceptability of the treatment for teens and parents, as well as results from the pilot trial. Participants in the CBT group had significantly fewer posttreatment eating binges than those in a treatment as usual/delayed treatment (TAU-DT) control group; 100% of CBT participants were abstinent at follow-up. Our results provide preliminary support for the efficacy of this adolescent adaptation of evidence-based CBT for recurrent binge eating. The large, robust effect size estimate observed for the main outcome (NNT=2) places this among the larger effects observed for any mental health intervention.Cognitive and Behavioral Practice 05/2013; 20(2):147-161. · 1.33 Impact Factor
Article: Incremental Net Benefit of Early Intervention for Preschool-Aged Children with Emotional and Behavioral Problems in Foster Care[Show abstract] [Hide abstract]
ABSTRACT: Of 1 million cases of child maltreatment identified every year in the United States, one-fifth result in foster care. Many of these children suffer from significant emotional and behavioral conditions. Decision-makers must allocate highly constrained budgets to serve these children. Recent evidence suggests that Multidimensional Treatment Foster Care for Preschoolers can reduce negative outcomes for these children, but the relative benefits and costs of the program have not been evaluated. The objective of this study was to assess net benefit, over 24 months, of Multidimensional Treatment Foster Care for Preschoolers compared to regular foster care. Data were from a randomized controlled trial of 117 young children entering a new foster placement. A subsample exhibited placement instability (n = 52). Intervention services including parent training, lasted 9–12 months. Multidimensional Treatment Foster Care for Preschoolers significantly increased permanent placements for the placement instability sample. Average total cost for the new intervention sample was significantly less than for regular foster care (full sample: $27,204 vs. $30,090; P = .004; placement instability sample: $29,595 vs. $36,061; P = .045). Incremental average net benefit was positive at all levels of willingness to pay of zero or greater, indicating that the value of benefits exceeded costs. Multidimensional Treatment Foster Care for Preschoolers has significant benefit for preschool children in foster care with emotional and behavioral disorders compared to regular foster care services. At even modest levels of willingness to pay, benefits exceed costs indicating a strong likeliness that this program is an efficient choice for improving outcomes for young children with emotional and behavioral disorders in foster care.Children and Youth Services Review 01/2013; · 1.27 Impact Factor
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ABSTRACT: Background/Aims Adolescent depression is common and leads to many negative personal, social, and economic consequences for youth and their families; unfortunately, most youth who experience major depression do not receive any treatment. Depression prevention programs can reduce these negative consequences, but they must be affordable to be widely disseminated and useful for health care systems. Decision-makers need to weigh relative costs and benefits of providing efficacious prevention programs to depressed adolescents, but little cost-effectiveness analysis exists. The Prevention of Depression trial (POD) was a brief prevention program that compared a group cognitive- behavioral preventive (CBP) intervention to usual care (UC) to reduce depression risk in at-risk youth; the intervention decreased the number of days with depression. We present an incremental cost- effectiveness analysis of the group CBP program relative to UC, from the societal perspective, for 9 months following the intervention. Methods POD was conducted in four U.S. academic and community clinics. Participants were 316 youth aged 13-17 with a past history of depression and/or current elevated, but sub-diagnostic, depressive symptoms. They were randomly assigned to the CBP group consisting of 8 weekly, 90- minute group sessions followed by 6 monthly continuation sessions or to UC alone. The main clinical outcome measures were depression-free days (DFD) and quality-adjusted life-years based on DFD (DFD-QALYs). Costs of intervention, non-protocol services, and families were included. Results CBP achieved 13 additional DFD (p=.008), 0.022 more DFD-QALYs (p=.008). CBP cost $591 (SD=286) on average. Cost per DFD was $59 (ICER = $59; 95% CI: 11-263), $35,434 per DFD-QALY (ICER=$35,434; 95% CI: 6,350 - 157,594). Cost-effectiveness acceptability curve analyses suggest a 69% probability that CBP is more cost-effective at a willingness to pay of $50,000 per QALY. CBP had a higher net benefit for youth whose parent's depression was in remission at baseline. Discussion The societal cost-effectiveness of POD is comparable to or better than that of many health care services currently covered under most insurance programs. The program is particularly cost effective for the sub-group of youth whose parent's depression was in remission at baseline.Clinical Medicine & Research 08/2012; 10(3):183.
Article: PS2-21: Validity and Reliability of the Family Economic Impact Interview: A New Instrument to Measure Costs Related to Child Mental Health Conditions.[Show abstract] [Hide abstract]
ABSTRACT: Background/Aims Care of children with mental health and developmental conditions (MHC) is often demanding and expensive, imposing both financial and time costs on families. Because costs to families are relatively difficult to quantify, most studies have focused on studying family costs using health system data which are more readily available. Few studies have collected cost data directly from families. Methods This study presents results of psychometric analyses of a new instrument that directly measures family costs, the Family Economic Impact Interview (FEII). Reliability and validity of the FEII was evaluated as part of a developmental study which recruited a random sample of 70 parents of children with MHC between the ages of 3 and 12 years old from a large integrated health system. Parents were invited to participate in two interviews within a two week time period. Kappa statistics were calculated to evaluate the agreement between categorical variables. Results We used standard cut off values (values over .75 - excellent agreement, values between .40 and .75 - good agreement, and values less than .40 - poor agreement). Reliability of parents' reports of time spent in activities related to MHC were also good. In 20 of 24 time use categories, kappas ranged from .60 to 1.00. Validity of the FEII was assessed by examining the relationship between the degree of emotional burden a parent perceived from MHC and the amount of family costs measured by the FEII. We used regression analyses to examine whether there was a significant relationship between the main FEII outcomes and family emotional burden. Discussion As hypothesized, we found significant positive association between emotional burden of care and family costs (p<.001). Preliminary analyses of the FEII indicate that a wide range of parents' can complete the FEII, that parents' can reliably report a variety of family costs including out-of-pocket financial costs and time costs, and that many families with children with MHC experience a wide range of costs - many of which have not been measured in previous studies.Clinical Medicine & Research 08/2012; 10(3):181.
Article: P04.09. Acupuncture and chiropractic utilization among chronic musculoskeletal pain patients at a health maintenance organizationBMC Complementary and Alternative Medicine 06/2012; 12(1). · 2.08 Impact Factor
Article: Anhedonia predicts poorer recovery among youth with selective serotonin reuptake inhibitor treatment-resistant depression.[Show abstract] [Hide abstract]
ABSTRACT: To identify symptom dimensions of depression that predict recovery among selective serotonin reuptake inhibitor (SSRI) treatment-resistant adolescents undergoing second-step treatment. The Treatment of Resistant Depression in Adolescents (TORDIA) trial included 334 SSRI treatment-resistant youth randomized to a medication switch, or a medication switch plus CBT. This study examined five established symptom dimensions (Child Depression Rating Scale-Revised) at baseline as they predicted recovery over 24 weeks of acute and continuation treatment. The two indices of recovery that were evaluated were time to remission and number of depression-free days. Multivariate analyses examining all five depression symptom dimensions simultaneously indicated that anhedonia was the only dimension to predict a longer time to remission, and also the only dimension to predict fewer depression-free days. In addition, when anhedonia and CDRS-total score were evaluated simultaneously, anhedonia continued to uniquely predict longer time to remission and fewer depression-free days. Anhedonia may represent an important negative prognostic indicator among treatment-resistant depressed adolescents. Further research is needed to elucidate neurobehavioral underpinnings of anhedonia, and to test treatments that target anhedonia in the context of overall treatment of depression.Journal of the American Academy of Child and Adolescent Psychiatry 04/2012; 51(4):404-11. · 6.97 Impact Factor
Article: A primary care-based, multicomponent lifestyle intervention for overweight adolescent females.[Show abstract] [Hide abstract]
ABSTRACT: Most clinic-based weight control treatments for youth have been designed for preadolescent children by using family-based care. However, as adolescents become more autonomous and less motivated by parental influence, this strategy may be less appropriate. This study evaluated a primary care-based, multicomponent lifestyle intervention specifically tailored for overweight adolescent females. Adolescent girls (N = 208) 12 to 17 years of age (mean ± SD: 14.1 ± 1.4 years), with a mean ± SD BMI percentile of 97.09 ± 2.27, were assigned randomly to the intervention or usual care control group. The gender and developmentally tailored intervention included a focus on adoptable healthy lifestyle behaviors and was reinforced by ongoing feedback from the teen's primary care physician. Of those randomized, 195 (94%) completed the 6-month posttreatment assessment, and 173 (83%) completed the 12-month follow-up. The primary outcome was reduction in BMI z score. The decrease in BMI z score over time was significantly greater for intervention participants compared with usual care participants (-0.15 in BMI z score among intervention participants compared with -0.08 among usual care participants; P = .012). The 2 groups did not differ in secondary metabolic or psychosocial outcomes. Compared with usual care, intervention participants reported less reduction in frequency of family meals and less fast-food intake. A 5-month, medium-intensity, primary care-based, multicomponent behavioral intervention was associated with significant and sustained decreases in BMI z scores among obese adolescent girls compared with those receiving usual care.PEDIATRICS 03/2012; 129(3):e611-20. · 4.47 Impact Factor
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ABSTRACT: Antidepressant (AD) dispensing for depression in youth declined in the years following the 2003-04 Food and Drug Administration actions regarding increased risk of suicidal behavior. To extend observation of youth AD dispensing and associated characteristics through 2009 to determine if AD dispensing continues to decline, has stabilized, or has rebounded. Design: Retrospective time series design. Sample: Youth (n=57,782) ages 10 to 17 inclusive. Both new (incident) and refill AD dispensing continued to decline through 2009, with no sign of leveling off. However, among youth who started AD treatment the cumulative supply of AD medication remained consistent across the pre- and postperiods, suggesting that cumulative treatment episode duration has not been degraded--possibly as a function of greater days supply with each new refill in the postperiod. Prescribers dramatically curtailed preauthorized refills in the postwarning period. Declines in AD dispensing to depressed youth may not reflect less intensive treatment for those youth who persist beyond the initial dispense. Lower rates of preauthorized refills may have been an attempt by prescribers to encourage return visits to evaluate response and adverse consequences.Journal of child and adolescent psychopharmacology 02/2012; 22(1):11-20. · 2.59 Impact Factor
Article: Acupuncture and chiropractic care for chronic pain in an integrated health plan: a mixed methods study.[Show abstract] [Hide abstract]
ABSTRACT: Substantial recent research examines the efficacy of many types of complementary and alternative (CAM) therapies. However, outcomes associated with the "real-world" use of CAM has been largely overlooked, despite calls for CAM therapies to be studied in the manner in which they are practiced. Americans seek CAM treatments far more often for chronic musculoskeletal pain (CMP) than for any other condition. Among CAM treatments for CMP, acupuncture and chiropractic (A/C) care are among those with the highest acceptance by physician groups and the best evidence to support their use. Further, recent alarming increases in delivery of opioid treatment and surgical interventions for chronic pain--despite their high costs, potential adverse effects, and modest efficacy--suggests the need to evaluate real world outcomes associated with promising non-pharmacological/non-surgical CAM treatments for CMP, which are often well accepted by patients and increasingly used in the community. This multi-phase, mixed methods study will: (1) conduct a retrospective study using information from electronic medical records (EMRs) of a large HMO to identify unique clusters of patients with CMP (e.g., those with differing demographics, histories of pain condition, use of allopathic and CAM health services, and comorbidity profiles) that may be associated with different propensities for A/C utilization and/or differential outcomes associated with such care; (2) use qualitative interviews to explore allopathic providers' recommendations for A/C and patients' decisions to pursue and retain CAM care; and (3) prospectively evaluate health services/costs and broader clinical and functional outcomes associated with the receipt of A/C relative to carefully matched comparison participants receiving traditional CMP services. Sensitivity analyses will compare methods relying solely on EMR-derived data versus analyses supplementing EMR data with conventionally collected patient and clinician data. Successful completion of these aggregate aims will provide an evaluation of outcomes associated with the real-world use of A/C services. The trio of retrospective, qualitative, and prospective study will also provide a clearer understanding of the decision-making processes behind the use of A/C for CMP and a transportable methodology that can be applied to other health care settings, CAM treatments, and clinical populations. ClinicalTrials.gov: NCT01345409.BMC Complementary and Alternative Medicine 11/2011; 11:118. · 2.08 Impact Factor
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ABSTRACT: To compare health-care utilization between participants who met DSM-IV criteria for binge eating disorder (BED) and those engaged in recurrent binge eating (RBE) and to evaluate whether objective binge eating (OBE) days, a key measurement for diagnosing BED, predicted health-care costs. We obtained utilization and cost data from electronic medical records to augment patient reported data for 100 adult female members of a large health maintenance organization who were enrolled in a randomized clinical trial to treat binge eating. Total costs did not differ between the BED and RBE groups (β = -0.117, z = -0.48, p = .629), nor did the number of OBE days predict total costs (β = -0.017, z = -1.01, p = .313). Findings suggest that the medical impairment, as assessed through health care costs, caused by BED may not be greater than impairment caused by RBE. The current threshold number of two OBE days/week as a criterion for BED may need to be reconsidered.International Journal of Eating Disorders 09/2011; 44(6):524-30. · 3.03 Impact Factor
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ABSTRACT: The aim of this study was to replicate and extend results of a previous blended efficacy and effectiveness trial of a low-intensity, manual-based guided self-help form of cognitive-behavioral therapy (CBT-GSH) for the treatment of binge eating disorders in a large health maintenance organization (HMO) and to compare them with usual care. To extend previous findings, the investigators modified earlier recruitment and assessment approaches and conducted a randomized clinical trial to better reflect procedures that may be reasonably carried out in real-world practices. The intervention was delivered by master's-level interventionists to 160 female members of a health maintenance organization who met diagnostic criteria for recurrent binge eating. Data collected at baseline, immediately posttreatment, and at six- and 12-month follow-ups were used in intent-to-treat analyses. At the 12-month follow-up, CBT-GSH resulted in greater remission from binge eating (35%, N=26) than usual care (14%, N=10) (number needed to treat=5). The CBT-GSH group also demonstrated greater improvements in dietary restraint (d=.71) and eating, shape, and weight concerns (d=1.10, 1.24, and .98, respectively) but not weight change. Replication of the pattern of previous findings suggests that CBT-GSH is a robust treatment for patients with recurrent binge eating. The magnitude of changes was significantly smaller than in the original study, however, suggesting that patients recruited and assessed with less intensive procedures may respond differently from their counterparts enrolled in trials requiring more comprehensive procedures.Psychiatric services (Washington, D.C.) 04/2011; 62(4):367-73. · 2.81 Impact Factor
Article: Incremental cost-effectiveness of combined therapy vs medication only for youth with selective serotonin reuptake inhibitor-resistant depression: treatment of SSRI-resistant depression in adolescents trial findings.[Show abstract] [Hide abstract]
ABSTRACT: Many youth with depression do not respond to initial treatment with selective serotonin reuptake inhibitors (SSRIs), and this is associated with higher costs. More effective treatment for these youth may be cost-effective. To evaluate the incremental cost-effectiveness over 24 weeks of combined cognitive behavior therapy plus switch to a different antidepressant medication vs medication switch only in adolescents who continued to have depression despite adequate initial treatment with an SSRI. Randomized controlled trial. Six US academic and community clinics. Three hundred thirty-four patients aged 12 to 18 years with SSRI-resistant depression. Participants were randomly assigned to (1) switch to a different medication only or (2) switch to a different medication plus cognitive behavior therapy. Clinical outcomes were depression-free days (DFDs), depression-improvement days (DIDs), and quality-adjusted life-years based on DFDs (DFD-QALYs). Costs of intervention, nonprotocol services, and families were included. Combined treatment achieved 8.3 additional DFDs (P = .03), 0.020 more DFD-QALYs (P = .03), and 11.0 more DIDs (P = .04). Combined therapy cost $1633 more (P = .01). Cost per DFD was $188 (incremental cost-effectiveness ratio [ICER] = $188; 95% confidence interval [CI], -$22 to $1613), $142 per DID (ICER = $142; 95% CI, -$14 to $2529), and $78,948 per DFD-QALY (ICER = $78,948; 95% CI, -$9261 to $677,448). Cost-effectiveness acceptability curve analyses suggest a 61% probability that combined treatment is more cost-effective at a willingness to pay $100,000 per QALY. Combined treatment had a higher net benefit for subgroups of youth without a history of abuse, with lower levels of hopelessness, and with comorbid conditions. For youth with SSRI-resistant depression, combined treatment decreases the number of days with depression and is more costly. Depending on a decision maker's willingness to pay, combined therapy may be cost-effective, particularly for some subgroups. clinicaltrials.gov Identifier: NCT00018902.Archives of general psychiatry 03/2011; 68(3):253-62. · 12.26 Impact Factor
Article: Long-term outcome of adolescent depression initially resistant to selective serotonin reuptake inhibitor treatment: a follow-up study of the TORDIA sample.[Show abstract] [Hide abstract]
ABSTRACT: We examined the long-term outcome of participants in the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) study, a randomized trial of 334 adolescents (aged 12-18 years) with DSM-IV-defined major depressive disorder initially resistant to selective serotonin reuptake inhibitor (SSRI) treatment who were subsequently treated for 12 weeks with another SSRI, venlafaxine, another SSRI + cognitive-behavioral therapy (CBT), or venlafaxine + CBT. Responders then continued with the same treatment through week 24, while nonresponders were given open treatment. For the current study, patients were reassessed 48 (n = 116) and 72 (n = 130) weeks from intake. Data were gathered from February 2001 to February 2007. Standardized diagnostic interviews and measures of depression, suicidal ideation, related psychopathology, and level of functioning were periodically administered. Remission was defined as ≥ 3 weeks with ≤ 1 clinically significant symptom and no associated functional impairment (score of 1 on the adolescent version of the Longitudinal Interval Follow-Up Evaluation [A-LIFE]), and relapse, as ≥ 2 weeks with probable or definite depressive disorder (score of 3 or 4 on the A-LIFE). Mixed-effects regression models were applied to estimate remission, relapse, and functional recovery. By 72 weeks, an estimated 61.1% of the randomized youths had reached remission. Randomly assigned treatment (first 12 weeks) did not influence remission rate or time to remission, but the group assigned to SSRIs had a more rapid decline in self-reported depressive symptoms and suicidal ideation than those assigned to venlafaxine (P < .03). Participants with more severe depression, greater dysfunction, and alcohol or drug use at baseline were less likely to remit. The depressive symptom trajectory of the remitters diverged from that of nonremitters by the first 6 weeks of treatment (P < .001). Of the 130 participants in remission at week 24, 25.4% relapsed in the subsequent year. While most adolescents achieved remission, more than one-third did not, and one-fourth of remitted patients experienced a relapse. More effective interventions are needed for patients who do not show robust improvement early in treatment. clinicaltrials.gov Identifier: NCT00018902.The Journal of Clinical Psychiatry 11/2010; 72(3):388-96. · 5.81 Impact Factor
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ABSTRACT: Adoption of effective treatments for recurrent binge-eating disorders depends on the balance of costs and benefits. Using data from a recent randomized controlled trial, we conducted an incremental cost-effectiveness analysis (CEA) of a cognitive-behavioral therapy guided self-help intervention (CBT-GSH) to treat recurrent binge eating compared to treatment as usual (TAU). Participants were 123 adult members of an HMO (mean age = 37.2 years, 91.9% female, 96.7% non-Hispanic White) who met criteria for eating disorders involving binge eating as measured by the Eating Disorder Examination (C. G. Fairburn & Z. Cooper, 1993). Participants were randomized either to treatment as usual (TAU) or to TAU plus CBT-GSH. The clinical outcomes were binge-free days and quality-adjusted life years (QALYs); total societal cost was estimated using costs to patients and the health plan and related costs. Compared to those receiving TAU only, those who received TAU plus CBT-GSH experienced 25.2 more binge-free days and had lower total societal costs of $427 over 12 months following the intervention (incremental CEA ratio of -$20.23 per binge-free day or -$26,847 per QALY). Lower costs in the TAU plus CBT-GSH group were due to reduced use of TAU services in that group, resulting in lower net costs for the TAU plus CBT group despite the additional cost of CBT-GSH. Findings support CBT-GSH dissemination for recurrent binge-eating treatment.Journal of Consulting and Clinical Psychology 06/2010; 78(3):322-33. · 4.85 Impact Factor
Article: Randomized effectiveness trial of an Internet, pure self-help, cognitive behavioral intervention for depressive symptoms in young adults.[Show abstract] [Hide abstract]
ABSTRACT: This study evaluated an Internet-delivered, cognitive behavioral skills training program versus a treatment-as-usual (TAU) control condition targeting depression symptoms in young adults aged 18 to 24 years. Potential participants were mailed a recruitment brochure; if interested, they accessed the study website to complete an online consent and baseline assessment. Intervention participants could access the website at their own pace and at any time. Reminder postcards were mailed periodically to encourage return use of the intervention. The pure self-help intervention was delivered without contact with a live therapist. The primary depression outcome measure was the Patient Health Questionnaire, administered at 0, 5, 10, 16, and 32 weeks after enrollment. A small but significant between-group effect was found from Week 0 to Week 32 for the entire sample (N = 160, d = .20, 95% confidence interval [CI] 0.00-0.50), with a moderate effect among women (n = 128, d .42, 95%C1 = 0.09-0.77). Greater depression reduction was associated with two measures of lower website usage, total minutes, and total number of page hits. Although intervention effects were modest, they were observed against a background of substantial TAU depression pharmacotherapy and psychosocial services. Highly disseminable, low-cost, and self-help interventions such as this have the potential to deliver a significant public health benefit.Cognitive behaviour therapy 06/2009; 38(4):222-34.
Article: Using a website to build community and enhance outcomes in a group, multi-component intervention promoting healthy diet and exercise in adolescents.[Show abstract] [Hide abstract]
ABSTRACT: This article describes website use and behavioral outcomes in a multi-component lifestyle intervention promoting healthy diet and exercise. A 2-year randomized clinical trial to improve bone density in 228 adolescent girls, the intervention included a website designed to enhance intervention adherence, retention of participants, and behavioral outcomes. Measures included diet and exercise recalls, surveys, and web-usage data. Website use was associated with increases in calcium intake (ss = 69.72, p =.01, ES = 0.15) and high-impact activity (ss = 10.93, p =.04, ES =.13). Use of web pages related to behavioral feedback and communications was not significantly associated with behavioral outcomes. The most visited website pages had content related to incentive points, caption contests, and fun facts. Web elements of a multi-component intervention may promote retention and engagement in target behaviors. Such websites may be most acceptable to adolescent participants if they blend fun and behavioral elements, rather than exclusively focusing on behavioral changes.Journal of Pediatric Psychology 01/2009; 34(5):539-50. · 2.91 Impact Factor
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ABSTRACT: This study examined healthcare services used by adults diagnosed with an eating disorder (ED) in a large health maintenance organization in the Pacific Northwest. Electronic medical records were used to collect information on all out-patient and in-patient visits and medication dispenses, from 2002 to 2004, for adults aged 18-55 years who received an ED diagnosis during 2003. Healthcare services received the year prior to, and following, the receipt of an ED diagnosis were examined. Cases were matched to five comparison health plan members who had a health plan visit close to the date of the matched case's ED diagnosis. Incidence of EDs (0.32% of the 104,130 females, and 0.02% of the 93,628 males) was consistent with prior research employing treatment-based databases, though less than community-based samples. Most cases (50%) were first identified during a primary-care visit and psychiatric co-morbidity was high. Health services use was significantly elevated in all service sectors among those with an ED when compared with matched controls both in the year preceding and that following the receipt of the incident ED diagnosis. Contrary to expectations, healthcare utilization was found to be similarly high across the spectrum of EDs (anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified). The elevation in health service use among women both before and after diagnosis suggests that EDs merit identification and treatment efforts commensurate with other mental health disorders (e.g. depression) which have similar healthcare impact.Psychological Medicine 12/2007; 38(10):1465-74. · 5.59 Impact Factor
Article: Youth: a health plan-based lifestyle intervention increases bone mineral density in adolescent girls.[Show abstract] [Hide abstract]
ABSTRACT: To test the efficacy of a health plan-based lifestyle intervention to increase bone mineral density in adolescent girls. Two-year randomized, controlled trial. Large health maintenance organization. Girls 14 to 16 years old with body mass index below the national median. Intervention Behavioral intervention (bimonthly group meetings, quarterly coaching telephone calls, and weekly self-monitoring) designed to improve diet and increase physical activity. Total bone mineral density was measured by dual-energy x-ray absorptiometry. Behavioral outcomes included intake of calcium, vitamin D, soda, and fruits and vegetables; high-impact and strength-training physical activity; measures of strength and fitness; and biomarkers (osteocalcin and naltrexone). Compared with control subjects, girls in the intervention group had significantly higher bone mineral density in the spine and trochanter regions during the first study year, which was maintained during the second study year. The naltrexone biomarker demonstrated a greater relative decrease in the intervention group compared with the control group, with nonsignificant changes in osteocalcin consistent with more bone building in the intervention group. Participants in the intervention group reported significantly greater consumption of calcium in both study years, vitamin D in the first year, and fruits and vegetables in both years. We found no effect on soda consumption or target exercise rates. A comprehensive health care-based lifestyle intervention can effectively improve dietary intake and increase bone mineral gains in adolescent girls. To our knowledge, this study is the first to significantly improve bone mass in adolescent girls in a non-school-based intervention. Trial Registration ClinicalTrials.gov Identifier: NCT00067600.Archives of Pediatrics and Adolescent Medicine 01/2007; 160(12):1269-76. · 4.28 Impact Factor
Article: Cost-effectiveness of an Intervention to Prevent Depression in At-Risk TeensLynch FL, Hornbrook M, Clarke GN, et al (Kaiser Permanente Northwest, Portland, Ore; Oregon Health and Science Univ, Portland) Arch Gen Psychiatry 62:1241–1248, 2005§Yearbook of Psychiatry and Applied Mental Health 01/2007; 2007:57-58.
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ABSTRACT: Depression is common in adolescent offspring of depressed parents and can be prevented, but adoption of prevention programs is dependent on the balance of their incremental costs and benefits. To examine the incremental cost-effectiveness of a group cognitive behavioral intervention to prevent depression in adolescent offspring of depressed parents. Cost-effectiveness analysis of a recent randomized controlled trial. Kaiser Permanente Northwest, a large health maintenance organization. Teens 13 to 18 years old at risk for depression. Usual care (n = 49) or usual care plus a 15-session group cognitive therapy prevention program (n = 45). Clinical outcomes were converted to depression-free days and quality-adjusted life-years. Total health maintenance organization costs, costs of services received in other sectors, and family costs were combined with clinical outcomes in a cost-effectiveness analysis comparing the intervention with usual care for 1 year after the intervention. Average cost of the intervention was $1632, and total direct and indirect costs increased by $610 in the intervention group. However, the result was not statistically significant, suggesting a possible cost offset. Estimated incremental cost per depression-free day in the base-case analysis was $10 (95% confidence interval, -$13 to $52) or $9275 per quality-adjusted life-year (95% confidence interval, -$12 148 to $45 641). Societal cost-effectiveness of a brief prevention program to reduce the risk of depression in offspring of depressed parents is comparable to that of accepted depression treatments, and the program is cost-effective compared with other health interventions commonly covered in insurance contracts.Archives of General Psychiatry 12/2005; 62(11):1241-8. · 13.77 Impact Factor
Top Journals
Kaiser Permanente
Oakland, California, United States
- Center for Health Research (Oregon, Hawaii, and Georgia)


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Jewellery and rubber have emerged as the two industries
in which Thailand has the highest potential in Asean, while the
country lags behind in food processing, electronics and textiles,
a study by the Commerece Ministry shows.
In terms of competitiveness based on factors such
as outlook, operators' competitiveness, productiion factors, support
industries, local demand and government support , Thailand leads
in two industries, jewellery and rubber. It comes second in automobiles,
appliances, chemicals and furniture, and third in food, electronics
and textiles.
Mrs Apiradi said Thai operators should keep abreast
of new global trends such as climate change, environment, urbanisation
and links to regional and global production chains. and IT and
telecommunication developments, in addition to changes within
specific industries. To do so, the competitiveness of Thai operators
could be enhanced through upgrades in facilities, infrastructure,
designs, production technology research and development. Thai
operators should also take advantage of the upcoming Asean Economic
Community and regional suply chains, she said.
Political gridlock and street protests
that culminated in a military takeover of the government in Thailand
in May reduced business and consumer confidence in the first half
of 2014, such that gross domestic product (GDP) contracted by
0.1%. Fixed investment dropped, and privated consumption fell
slightly. Tourist arrivals fell by 10.4 % in the first half. Net
external demand rose as imports of goods and services fell more
than exports, which statistically moderated the decline in GDP
caused by weak domestic demand.
The restoration of public spending programmes
that were blocked by political and legal challenges will stimulate
the economy. A backlog of applications for investment privileges
is being cleared, and a revised medium -term infrastructiure programme
has been approved. Economic growth is expected term infrastructure
programme has been approved. Economic grownth is expected to improve
by the end of 2014, though it will undershoot the Asian Development
Outlook (ADO) 2014 forecast in April. A Recovery in investment
and better export performance is seen generating GDP grownth next
year at 4.5%
Grownth should get support from a reduction
last March in the policy interest rate, decided in response to
the econimic contraction and modest inflation. Over the first
8 months, inflation averaged 2.2%, and it is expected to stay
around this rate for the rest of 2014, slightly below the previous
forecast. Next year, inflation is still seen rising to 2.6% as
domestic demand strenghens.
The steep decline in imports contributed
to a turnaround in the trade balance and generated a large current
account surplus in the first half. A current account surplus is
now projected for the year as a whole, instead of a small deficit
previously anticipated. Exports will pick up in 2015 in line with
better grownth in the major industrial economics, and tourism
will recover from a contraction this year, but imports will also
rebound, narrowing the current account surplus in 2015.


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Roadwork Next Week
Contributed by Lillian Tavelli on 06/20/2006
As a part of the electrical work for the new Business School Building, digging will be done under the Main Campus Road.
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Luminarias and T-shirts and Baskets...Oh My!
Contributed by Anne Woodard on 06/20/2006
IC Hope, our campus Relay for Life team, has just learned some very exciting news. We will be part of a national marketing campaign for the American Cancer Society. The Tompkins County Relay has been chosen as the only Relay in the country to be filmed for a part of the American Cancer Society's new marketing campaign. Our Relay will be filmed on location in Lansing July 14-15. In addition to the Relay, 5-7 survivors will be interviewed by phone and in person as part of the campaign, and three of those selected are part of the IC Hope team. What a tremendous opportunity to show the nation how Ithaca College cares! You can show how you care, too, by supporting the team's fundraising efforts and by showing up to lend support at the Relay. Don't wait for the winged monkeys to bring you to the Campus Center. Check out this schedule to see how and when you can help us:
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Fall Technology Renewal Information
Contributed by Irene Scott on 06/19/2006
Are there computers or network laser printers in your area scheduled for replacement this Fall under the Technology Renewal Program?
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Thank You!
Contributed by Tanisha Graves on 06/16/2006
Another annual Day of Learning! has come and gone and what a magnificent day THANK YOU! From the behind the scenes folks in Conference & Events, Physical Plant and Recreational Sports, to those who took time and enthusiastically taught and attended the workshops offered throughout the day; you are why Ithaca College is what it is A Great Place to Work! Again, I would like to thank each and every Ithaca College employee that has made this event a resounding success, and I look forward to next years Day of Learning!
Free TCAT Bus to Community Fireworks Show on July 3
Contributed by Maureen Forrest on 06/16/2006
TCAT will provide free bus service between downtown and Ithaca College for the community fireworks show on Monday night, July 3. This is the tenth year that TCAT (Tompkins Consolidated Area Transit) has offered the service, according to Fran Benedict, chair of the volunteer committee that organizes the annual fireworks shows.
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New ITS Workshop Series
Contributed by Dan Barrow on 06/15/2006
ITS is proud to announce the introduction of the latest series of workshops Institutional Information Systems! This new set of workshops will teach you about ARGUS and other reporting-related systems on campus.
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Dr. Janice Elich Monroe
Contributed by Lana Morse on 06/15/2006
Dr. Janice Elich Monroe, CTRS Associate Professor in the Department of Therapeutic Recreation and Leisure Services and a Gerontology Institute Faculty Fellow has been selected to be a member of the editorial board for the Gerontology Geriatrics Education Journal.
Still Need a Job this Summer?
Contributed by Beth Blinn on 06/15/2006
The Campus Center Dining Hall is in need of summer workers.
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College Mourns the Loss of Long Time Friend and Employee Ken DeGraff
Contributed by April Johanns on 06/14/2006
It is with great sadness that I inform the Ithaca College community of the death of Ken (Foxhole) DeGraff. Ken passed away Saturday, June 10, 2006, at his home in Slaterville Springs, NY.
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TCAT Bus Stop on Lower Campus to Relocate from Textor to Park Hall
Contributed by Marian Brown on 06/14/2006
A notice provided to TCAT bus riders details a change to Route 11, 12, and 65, effective Monday, June 12. The TCAT bus stop at Textor Hall has moved to the Roy H. Park building.
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E Lot Handicap Spaces Will Move Temporarily
Contributed by Lillian Tavelli on 06/14/2006
The handicap spaces in E lot will be moved while they are running the utilities for the New Business Building from Monday, June 19 to Friday, June 23.
Athletics and Events Center and Gateway Building Projects
Contributed by Karen McGavin on 06/14/2006
Come and learn more about the plans for the Athletics and Events Center and Gateway Building Projects.
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Finger Lakes Environmental Film Festival and 7th Art Corporation Launch The City Series
Contributed by Patricia Zimmermann on 06/14/2006
The Finger Lakes Environmental Film Festival (FLEFF) at Ithaca College and the 7th Art Corporation, the non profit organization which operates Cinemapolis and Fall Creek Cinemas downtown, announce the launch of new collaborative partnership, The City Series.
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Construction Update
Contributed by Jackie Hopkins on 06/13/2006
A section E lot, North West of the flagpole will be closed starting June 19 thru June 23. Four handicapped and one temporary parking spaces will be closed during the week for construction purposes.
Were You Once an RA or Residential Life Professional?
Contributed by Fred Chandra on 06/13/2006
The RA Training committee is exploring the possibility of hosting a panel discussion of former RAs and Residential Life professionals.
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New Department
Contributed by Diane Kinne on 06/13/2006
Its official! As of June 1, 2006, the H&S Teacher Education Program and the Center for Teacher Education have merged to form the newest department in H&S and at the College the Education Department.
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McAfee VirusScan Upgrade for PC Computers
Contributed by Wendy Pearle on 06/12/2006
To ensure that College-owned computers are kept as clean and safe as possible from viruses and spyware, ITS is deploying the latest version of McAfee VirusScan with an anti-spyware module.
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Flurry of Free Flute Festivities Upcoming
Contributed by Erik Kibelsbeck on 06/12/2006
There will be four free public concerts associated with the Ithaca College Flute Institute. All will take place in the Hockett Family Recital Hall.
Speech-Pathology Graduate Students Participate in Research Project
Contributed by Julie Chambers on 06/12/2006
Speech-Language Pathology graduate students Nicole Sgobbo (MS '01) and Anne Coleman (MS '01) participated in a collaborative research project with the occupational therapy program at the Medical School of Ohio.
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New Parnassus Financials Newsletter
Contributed by Jo Anne Rosato on 06/09/2006
Take a look at our newsletter created for users of the financial system in Parnassus! We hope you find it informative and helpful as you work in Parnassus.
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The Ashe County Chamber of Commerce, located in West Jefferson, is a dynamic force, ensuring the economic health of our community by nurturing…
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West Jefferson (7.27 mile)
December 6 , December 6
Celebrate the Christmas season in historic downtown West Jefferson with a visit from Santa, holiday story time & crafts, Tree Fest & the art gallery open house!
Boone (18.54 mile)
November 28 -
December 24
Start a new family tradition! Visit one of our area Christmas tree farms, choose a tree, and the farmer will cut it, bale it and tie it to your car.
November 24 -
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Tree Fest and Christmas Miniatures Art Exhibit. Beautifully decorated trees with handcrafted ornaments, holiday crafts, gift items and miniatures!
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Jefferson (4.31 mile)
We want to satisfy every appetite. That's why there's a variety of different pizzas on our menu. With so many toppings and crust options, everyone ...
Home of the Angus Burger. Delicious.
Jefferson (4.84 mile)
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Ashe County, Blue Ridge Parkway, Seclusion and beauty. ~ 2 bedrooms w/ queen beds, a queen pullout sofa bed, 2 full baths and a fully equipped kitchen
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I'm thinking about getting a 20gb Archos 605 wifi.
These are only £150 delivered and the 20gb would store everything I need in terms of music and video.
Just wondering if anyone has one allready.
The new TV+ dvr box for home looks good as well then you just plug in your archos player and transfer content.


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ASP.Net Developers, it is time to change your attitude towards JavaScript. I know you hate it. I used to hate it too. But I've come to terms with JavaScript and now actually quite like it! It isn't my favorite language but I've been working hard to understand this important client side technology.
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Americas Best Value Inn & Suites
No availability found through our partners. Please contact the business directly or check some of our recommended alternatives.
TravelPod Member ReviewsAmericas Best Value Inn & Suites Kissimmee
I have stayed here before because of how cheap it is and it has decreased in quality. The bar has closed, the store is rarely open, the pool is dirty, and the mini-golf course is run down. All the numbers in the room that were provided were no longer in service and it was hard to get some late night food.
I would stay there because of the free shuttle to Disney World & back. But I would not take younger family or anyone who hasn't been to the Orlando area before. It's not a good impression of the area.
This review is the subjective opinion of a TravelPod member and not of TravelPod.com.
TripAdvisor Reviews Americas Best Value Inn & Suites Kissimmee
Travel Blogs from Kissimmee
Hither, Thither and Yon
... lab with a very serious handler patrolling him or her. That was a first for me. In fact, I observed "police" patrolling throughout the park which, again, I have never seen before. Is it the era? Have things changed that much? It saddens me that even "the happiest place on earth" is at def-con 9 worrying about terror. If you haven't been for some time (I first experienced this on our trip in 2012 to Anaheim), everyone must go through a bag search before entering the park as ...
Day 2: Magic Kingdom
We are staying at the Key West resort- a collection of time share villas operated by Disney and let out to holidaymakers when empty. It is really nice - lots of space with all the cleanliness and artificiality of Disney (which might grate on my nerves in a few days but for now is strangely soothing). Despite the exhausting day yesterday we are ready to go. Magic Kingdom is our first stop. The weather is awful ...
I'm Aboard!
... back to the room, had another bath (I'm already missing baths), packed up and went to sleep. Embarkation day is exhausting, and staying up late wasn't the best idea since we had a 3.30am alarm. I'll write up more about that another day cos typing this all on an iPad isn't easy. I have the afternoon off tomorrow so me and Paige are going to get off at St Maarten, which is super exciting! Hopefully we'll find somewhere with free wifi so I can actually post this! ...
Catching our breath!
... see the 60,000 names carved into the wall, and to hear the chatter of the visitors and Vets explaining the memorial. One such person described how the memorial had been designed by a university student who got a B+ for her efforts! The design cut a large slice into the earth depicting a scar in the side of the hill. It was the day before Veterans Day as there were flowers, photos and poems etc placed beside their loved ones names....very ...
Magic Kingdom/Universal
... and then we head back to the hotel to get a cab to the Loews Royal Pacific Hotel. Sean falls asleep in the stroller for the first time all week, and probably the only time that is completely inconvenient. We get all the bags and kids in the car and head out. All of the kids fell asleep in the van, leaving me to practice my very rusty French with our Haitian cab driver. Thirty minutes and $50 later we are at the entrance to our new hotel and I am loving it. The walkway into ...
Other places to stay in Kissimmee
Seralago Hotel and Suites5678 W. Irlo Bronson Memorial Hwy (US192), Kissimmee | 3 star hotelfrom $44
- Caveat Emptor
- Good value for the money
Holiday Inn Orlando SW - Celebration Area5711 West Irlo Bronson Memorial Highway (US 192), Kissimmee | 3 star hotelfrom $75
- Bon h�tel pour les parcs Disney
- Good hotel for off WDW stay
- A very nice Hotel for Disney vistors
Ramada Kissimmee Gateway7470 W. Irlo Bronson Memorial, Kissimmee | 3 star hotelfrom $44
- Disney Sports Travel Rip Off
- Proximity good, needs some updates
- Not the Worst But Certainly Not the Best
Ramada Orlando Celebration Resort & Convention Center6375 West Irlo Bronson Memorial Highway, Kissimmee | 4 star hotelfrom $71
Flamingo Waterpark Resort2261 E Irlo Bronson Memorial Hwy, Kissimmee | 3 star hotelfrom $66
- Super !
- Wonderfil
- Wundervolle Unterkunft in Kissimmee
Maingate Lakeside ResortWalt Disney World Resort, Kissimmee | 3 star hotelfrom $43
- Great Value
- Superb Hotel
- Not what I expected
Ramada Inn Resort Eastgate5150 West Highway 192, Kissimmee | 2 star hotelfrom $55
- Old hotel
- What a dump!!!!
- We wished we were somplace else!
Champions World ResortCitrus Ridge, Kissimmee | 2 star hotelfrom $38
Quality Suites Royale Parc Suites5876 W. Irlo Bronson Memorial Hwy, Kissimmee | 3 star hotelfrom $82
- What's the problem?
- Been there...
Comfort Suites Maingate EastOld Town, Kissimmee | 3 star hotelfrom $86
- Place To Stay At Disney!
- Good Deal For the Price
- Great Family Place
Celebration Suites5820 W. Irlo Bronson Memorial Hwy, Kissimmee | 2 star hotelfrom $47
- Yikes, stay away if you can afford it!
- Oh poopie!!!
- Its not Disney, BUT...
Roomba Inn & Suites Orlando5840 West Irlo Bronson Memorial Highway, Kissimmee | 2 star hotelfrom $47
- Good Quality Motel
- Would not recommend this hotel!
- Don't stay at this hotel!!!
Rodeway Inn Maingate5995 W Hwy 192, Kissimmee | 1 star hotelfrom $32
- A sense of loathing...
- Very Comfortable and Affordable
- Never ever ever again
Comfort Inn MaingateCitrus Ridge, Kissimmee | 3 star hotelfrom $69
- Really Great Hotel!
- Very nice but...
- Outstanding
Masters Inn Orlando Kissimmee5367 W. Irlo Bronson Highway, Kissimmee | 2 star hotelfrom $52
- Couldn't Wait To Get Out!
- Good for the price
- Horrible!
Holiday Inn Express Hotel And Suites Orlando-Lake Buena Vista East3484 Polynesian Isle Boulevard, Kissimmee | 2 star hotelfrom $81
- La Quinta Maingate -- Excellent!
- Wonderful accomodations
- Bravo, La Quinta!
Continental Plaza HotelWalt Disney World Resort, Kissimmee | 1 star hotelfrom $27
- Pass on this one
- Great if you like roaches
- Clean, safe, great value to go with the location
Howard Johnson Hotel Kissimmee2323 East Irlo Bronson Memorial Highway, Highway 192, Kissimmee | Hotelfrom $35
Travelodge Suites East Gate Orange5399 West Irlo Bronson Memorial Highway, Kissimmee | 2 star hotelfrom $49
Ramada Heritage ParkOsceola County Complex, Kissimmee | 2 star hotelfrom $49
HomeSuiteHome Nikki Bird Main Gate7300 W. Irlo Bronson Memorial Hwy., Kissimmee | 3 star hotelfrom $64
- Not Good
- Wonderful Time!
- Needs Renovation
Heritage Park Inn2050 East Irlo Bronson Mem Hwy, Kissimmee | 2 star hotelfrom $52
Palms Hotel by Lexington3104 Parkway Boulevard, Kissimmee | 2 star hotelfrom $59
- OK property
- Loved the Hampton
- First Class Stay at the Hampton.
Howard Johnson Express Inn & Suites Lake Front ParkCitrus Ridge, Kissimmee | 2 star hotelfrom $46
Galleria Palms HotelWalt Disney World Resort, Kissimmee | 3 star hotelfrom $63
- Give me a Break!!!
- Great Stay!
- Sleep Inn ~No way
Knights Inn MaingateWalt Disney World Resort, Kissimmee | 2 star hotelfrom $34
- Don't do it to yourself
- Horrible Motel! Do Not Stay Here.
- Been to worse down the road from here


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PIAA GT-X replacement bulbs are designed with an exclusive purple low beam and an Xtreme White high beam. A purple topcoat gives the headlamp a bluish-purple look even when the lamp is turned off. GT-X bulbs feature PIAA's Xtra high efficiency technology that produces greater light output than the bulb's rated power consumption (for example, a bulb that consumes 45/65W of electricity has a light output that is similar to most 95/120W bulbs). GT-X bulbs are street-legal in Canada and all 50 U.S. states.
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Example 55 watts = 85 watts of light output
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Histoplasmosis is an infection that occurs from breathing in the spores of the fungus Histoplasma capsulatum.
Alternative Names
Ohio River Valley fever; Fibrosing mediastinitis
Causes, incidence, and risk factors
Histoplasmosis is a fungal infection. It occurs throughout the world. In the United States, it is most common in the southeastern, mid-Atlantic, and central states.
Histoplasma fungus grows as a mold in the soil. You may get sick when you breathe in spores produced by the fungus. Soil that contains bird or bat droppings may have larger amounts of this fungus. The threat is greatest after an old building is torn down or in caves.
Having a weakened immune system increases your risk for getting or reactivating this disease. Very young or very old people, or those with AIDS, cancer, or an organ transplant have more severe symptoms.
People with chronic lung disease (such as emphysema and bronchiectasis) are at higher risk of a more severe infection.
Most people have no symptoms, or only have a mild flu-like illness.
If symptoms do occur, they may include:
The infection may be active for a short period of time, and then the symptoms go away. Sometimes, the lung infection may become long-term (chronic). Symptoms include:
In a small number of patients, histoplasmosis may spread throughout the body, causing irritation and swelling (inflammation) in response to the infection. Symptoms may include:
Signs and tests
Histoplasmosis is diagnosed by:
To help diagnose this condition, your doctor may perform:
Most of the time, this infection goes away without treatment.
If you are sick for more than 1 month or are having trouble breathing, your doctor may prescribe medication. The main treatment for histoplasmosis is antifungal drugs. Amphotericin B, itraconazole, and ketoconazole are the usual treatments.
Sometimes, long-term treatment with antifungal drugs may be needed. You may need to take these medications for up to 1 to 2 years.
Expectations (prognosis)
The outlook depends on how severe the infection is, and the patient's health. Some people get better without treatment. An active infection will usually go away with antifungal medicine, but there may be scarring left inside the lung.
The death rate is higher for people with untreated widespread (disseminated) histoplasmosis whose immune system is not working well.
Scarring in the chest cavity may trap:
Enlarged lymph nodes in the chest (called mediastinal granulomas) may press on body parts such as the esophagus and blood vessels of the lungs.
Calling your health care provider
Call your health care provider if you live in an area where histoplasmosis is common, and you develop flu-like symptoms, chest pain, cough, and shortness of breath. While there are many other illnesses that have similar symptoms, you may need to be tested for histoplasmosis.
Histoplasmosis may be prevented by reducing exposure to dust in chicken coops, bat caves, and other high-risk locations. Wear masks and other protective equipment if you work in these environments.
Deepe GS Jr. Histoplasma capsulatum. In: Mandell GL, BennettJE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 264.
Kauffman CA. Histoplasmosis. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 340.
Review Date:10/6/2012
Reviewed by:David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorousstandards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information andservices. Learn more about A.D.A.M.'s editorialpolicy, editorialprocess, and privacypolicy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch.)
The information provided herein should not be used during any medical emergency or for the diagnosis or treatmentof any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions.Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 2014 A.D.A.M., Inc. Any duplication ordistribution of the information contained herein is strictly prohibited.


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Mote honors volunteers at ceremony
Date: April 12, 2010
by: Robin Hartill | Community Editor
In 2009, Mote Marine Laboratory's 1,300 volunteers donated about 200,000 hours of their time. Of those volunteers, 293 were honored at Mote's Volunteer Awards Ceremony Thursday, April 8.
Ruth DeLynn, Frederick Derr, Don Garlock and Virginia Sanders, who all have posted at least 2,500 hours, received the 25-Year Award.
The 20-Year Award, for volunteers with 20 years and at least 2,000 hours of service, was given to William Feldman, Anita Kincade, Dru Liebler, Michael Martin and Thekla Kahn.
The President's Call to Service Award, a national honor for volunteers who have served at least 4,000 hours throughout their lives, was given to Mary Abraham-Kinney, Chuck Armitage, Pauline Becker, Ron Ciaravella, Ronnie Enander, Melanie Kauk, Sally Knachel, Cathy Marine, Ray Mason, Howard Meltzer, Freda Perrotta, Cyndi Seamon, Mary Smigielsi, William Thibodeau and Lin Vertefeuille.
Contact Robin Hartill at firstname.lastname@example.com.
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- Nov
29 Santa Jaws at Mote Aquarium
12:00 pm - 2:00 pm
- Dec
6 Longboat Key Gourmet Lawn Party
12:00 pm - 2:00 pm
- Dec
6 Santa Jaws at Mote Aquarium
12:00 pm
- Dec
13 Santa Jaws at Mote Aquarium
12:00 pm - 2:00 pm
PHOTO GALLERY: Interfaith Thanksgiving Worship Service
On Nov. 25, the 34th annual Interfaith Thanksgiving Service was held at St. Armands Lutheran Church.
Cumming heads back to school
Where in the world is Longboat Key Police Chief Pete Cumming?
Toys for Tots seeks holiday cheer
Toys for Tots needs help to make Christmas wishes come true for local children in need.


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Robert Pattinson Allegedly Left Kristen Stewart Behind At Christmas After Fighting With Her
Robert Pattinson allegedly left Kristen Stewart behind at Christmas after fighting with her. According to Hollywood Life and their sources, it turns out that Twilight Saga mega couple Robert Pattinson and Kristen Stewart ,probably didn't spend Christmas 2012 together because they had a big blowout fight just before they were going to head to London. Kristen wanted her mom, Jules, to tag along and Rob wasn't having it as he had a different idea in mind. This prompted him to leave K-Stew behind in Los Angeles.
Sources for Life & Style magazine ,told them, "Kristen was all set to go to London with Rob for Christmas, but they got into a huge fight and he told her that she should stay in L.A." The source went on to elaborate that, "At the last minute, Kristen wanted her mom to go, too, but this trip was meant to be about Kristen spending more time with the Pattinsons. Bringing her mom was not the plan, and Rob was annoyed."
If they did actually have this big fight,they definitely made up,quick, as K-Stew was spotted kicking it with Rob in London on the December 29th. Stay tuned. Follow us on Twitter by Clicking Here.Follow us on Facebook by Clicking Here.Did You Enjoy this Post? Subscribe to Hollywood Hills on Facebook, Twitter, & Email
Recent Posts from On The Flix:
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Louisiana Office Of Tourism Named Top Tourism Office Among 14 Southeastern States
"We're really trending very much in the right direction with people wanting to see Louisiana, visit Louisiana." - Louisiana Lt. Gov. Jay Dardenne
"We're really trending very much in the right direction with people wanting to see Louisiana, visit Louisiana." - Louisiana Lt. Gov. Jay Dardenne
Letting people talk on their cellphones while traveling on an airplane makes as much sense as letting people eat onions at a funeral. There are going to be a lot of tears shed and not for the right reasons
While the weather might be cold and wet in Acadiana at least it isn't raining rocks. Tha'ts what people in Sicily are experience these days.
Rain is likely for the beginning of the holiday week in Acadiana. For those jetting out or jetting in there could be weather related issues for at least one major hub that serves Lafayette. We have the information that can help you get over the river and through the woods and not stuck in some airport bar.
Every country music fan we talked to was excited about the inaugural Boots in the Sand event: A five day/four night vacation with Dierks Bentley, Brantley Gilbert, Billy Currington and Jana Kramer next February at the all-inclusive and brand-spanking new Hard Rock Hotel in the Riviera Maya in Mexico, but some of you said room packages were a little out of your price range. Well, we heard you and are lowering our room prices in time for the holidays so you can party in Mexico with us!
When some people think about delicious restaurants, they think big city, elegant, and pricey. However, some of America's best spots to stuff your face are in small towns. Ever watch Food Network's Diners, Drive-Ins and Dives? It's those culinary-creative places that are the most popular.
Travelers in the Iowa area near Exit 44 on I-10 can expect delays in traveling on Interstate 10 beginning this weekend. We can tell you alternate routes and when the slow downs will be over.
Tropical Nights' "Boots in the Sand" is an all-inclusive, four-night getaway in Riviera Maya, Mexico, featuring some of country music's biggest stars, an all-inclusive resort and more fun than you can imagine.
I love this travel video for New York City. I am sure those who have made many trips to the Big Apple can agree that this guy is spot on when it comes to being a good tourist and having a safe trip.
An outsiders look inside our Cajun Culture has opened my eyes. What does the New York Times say about living in South Louisiana? It might surprise you. What else would you want visitors to know about where we live? Where would you tell them to eat, drink and let the good times roll?


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Persona Q shows off its launch trailer in time for reviews
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What has four legs, a mouth full of kunai, and packs his own Persona? Koromaru of course! SEES second non-human member... Read More
Darling misunderstood Kanji Tatsumi makes his presence known in Persona Q. Sure he's not the quacking on the uptake,... Read More
Put your trust in the loving hands of everyone's favorite idol Rise Kujikawa. Risette brings her star power to the... Read More
Leave it to Fuuka Yamagishi to guide the gang through the treacherous halls of the cultural festival labyrinths. Good ole... Read More
One thing Persona Q definitely has is a massive selection of party members. Between the cast of Persona 4, Persona 3, and... Read More
Look, I don't care if you hate or love Marie – she's here to stay. In Persona Q she's sarcastic,... Read More
The aloof Elizabeth will be playing nurse in Persona Q. After all, who else would you trust more than Elizabeth with your... Read More
You can think of good guy Theodore as a shop keeper for you in Persona Q. He'll be running the workshop where you can... Read More
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As expected of ranged characters, keep Yukari in the back lines in Persona Q. She has the healing and magic attribute to... Read More
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Instructor in Human Services and Sociology
Office Location: Fournier Hall, Morton Wing, SJ15
Office Phone: 215.753.3699
E-Mail: firstname.lastname@example.com
Educational Background
Courses Taught
Scholarly Interest
Selected Publications
One of Chestnut Hill College's favorite traditions in Carol Night, returns for its 38th year on December 5th at 7:30 PM. Carol Night features performances by many of CHC's instrumental ensembles as well as the Hill Singers. The event is free and open to public. There will be a reception following in the East Parlor.
Information: 215.248.7164
Sunday, Dec. 14, at 10:30 a.m. at the Redmond Room, East Parlor and Rotunda, St. Joseph Hall. It will have a breakfast buffet, children's activities and Christmas carols.


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11/20/2014Abbeville Community FCU warns League, CUs of fraudulent checks
11/20/2014Registration now open for Trainers Roundtables Jan. 27 & 28
11/20/2014FinCEN issues statement on providing banking services to money services businesses
12/3/20142014 Co-op Dynamics Workshop
12/10/2014BSA Workshop (Columbia, SC)
12/10/2014Southeast Chapter of CUs - December 10 Meeting
12/17/2014NCUA Webinar: Internal Controls
12/18/2014BSA Workshop (Raleigh, NC)
The Carolinas Credit Union League offers participants in its 2014 Annual Meeting May 29-31 in Myrtle Beach, SC an advanced experience and connection to details through its new 2014 Annual Meeting mobile site. Browsing to www.carolinasleague.org/annualmeeting via smartphone or tablet will redirect users to the mobile site, which can be bookmarked for quick retrieval.
Key features of the mobile site, built by Georgia Credit Union Affiliates' web development team, include the agenda, speakers/sessions, an exhibit hall guide, and a participants list.
"We are very excited to be able to offer this new application to our participants, guests, and exhibitors," said Eric Gelly, CCUL EVP/COO. "This is a first-time venture for both former state leagues, and our hope is that it will enhance the meeting experience for all."
Additional features include information on Kingston Plantation shuttle service, an interactive map of the Myrtle Beach area, a live Twitter feed of the conference (#CCUL2014), and a link to the post-meeting evaluation.
To view or bookmark the 2014 Annual Meeting mobile site, go to www.carolinasleague.org/annualmeeting on your smartphone or tablet device.


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WOONSOCKET — It took multiple meetings and a line-item-by-line-item spending review but on Wednesday the School Committee finally came to terms on how much money it needs to spend during the 2012-2013 school year.
Four members of the panel gave a unanimous first passage to a budget of $69.8 million after School Committeeman Christopher Roberts made a final round of adjustments based on his meetings with the School Administration and City Finance Director Thomas M. Bruce III.
WOONSOCKET – Landmark Medical Center is one giant step closer to becoming a for-profit hospital owned by Steward Health Care this week after the health department approved the sale, with numerous conditions.
Health Director Michael Fine announced Tuesday that the state Department of Health had approved Steward's application to buy the struggling hospital under the complex Hospital Conversions Act.
Despite the persistent rain, work crews set up the big top for the Piccadilly Circus at Barry Field in Woonsocket Tuesday. Two shows begin Wednesday at 4:30 and 7:30 p.m.
WOONSOCKET – A Chicago-based insurance carrier has covered more than half of the $389,000 the city had claimed as a financial loss due to embezzlement.
Axis Insurance Co. recently paid the city $200,000, the maximum its policy allows for claims of employee theft, said Finance Director Thomas M. Bruce III.
PROVIDENCE – The House Finance Committee passed the Woonsocket supplemental tax bill on a 12-2 voted Tuesday allowing it to go to the House floor for a final vote on Thursday.
Two Woonsocket representatives, Lisa Baldelli-Hunt and Jon Brien told the panel they would lend their support to the bill "as a professional courtesy" to city officials, but both spoke about what they see as better alternatives for the city.
WOONSOCKET — The City Council voted 6-1 last night to table a measure asking the state to appoint a budget commission to take over the city's finances, saying it would resurrect the measure quickly if the House of Representatives fails to push forward the city's request for a 13 percent supplemental tax bill today.
CUMBERLAND — The Cumberland school community will come together May 29 to honor the 35 students who finished in the the top 10 percent of their graduating class .
Those students include Cumberland High School Class of 2012 Valedictorian Katilyn S. Krajanowski and Salutatorian Gabriella K. Cottiero.
The top 10 graduates will be honored at the annual Cumberland High School Distinguished Scholars Ceremony to be held Tuesday, May 29 at 9:15 a.m. in the front foyer of the high Shhool.
WOONSOCKET — It takes a lot of hard work to earn top scholastic honors in high school and Justyna Pietrus certainly did that on her way to become the high school's valedictorian for the Class of 2012.
And like Hailey Kadisevskis, a Woonsocket Area Career and Technical Center student claiming the title of class salutatorian, Pietrus also graduates from high school with much more than just the top marks from her classes.
Mary Elaina Elmasian, left, of Cumberland, a senior at Mount Saint Charles Academy in Woonsocket, browses through stuffed animals for sale with her mom, Christine Elmasian, during the annual Mount St. Charles Academy's Service Opportunity Depot yard sale in Chapel Hall Saturday morning.
SOUTH KINGSTOWN — When Andy Rithiphong, a senior at the University of Rhode Island and a Woonsocket native, walks across the stage Sunday to receive his diploma, he will represent the product of the dedication his professors have given to their teaching in a more unique way than most. Rithiphong is one of three URI students to obtain a bachelor's degree in Chinese, an achievement he holds as an especially personal accomplishment.


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We have so much to offer at The Wandle. We were previously known as the Puzzle and have transformed ourselves into a truly independent pub in Earlsfield. We lead with great food, eclectic and exciting drinks, not to mention our dazzling personality, fantastic service and beautiful beer garden.
Here at the Wandle, named after our famous newly cleaned, fish breeding river, we endeavour to help you escape the hustle and bustle of everyday life, surrounding you in comfort where you can truly kick back and relax!
Venue Details & Map
- Address
332 Garratt LaneSouthfieldsLondonSW18 4EJ
- Public transport:
- Earlsfield, National Railway
Book a taxi on +44 (0)844 556 0706 or with London's biggest car service app


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Accounting & Bookkeeping Program offered; March-May June-August September-November This Internship program consists of a business designed to take you step-by-step through the techniques and skills yo…
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The position you are applying for will work with one of my web startup companies. One of my first companies I posted here on Internships.com was my Valuepon Corporation which had an overwhelming numbe…
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Divine Purpose Enterprises is in the process of building 3 consulting agencies in areas of Insurance, Coaching, and Furniture Services. We are in need of strong team players to implement plans into ac…
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Established in 2009, Tastefully Done Events is an event production company serving the New Jersey/New York area. Since inception, we have hosted a variety of events including bridal and vendor showcas…
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8 Signs Your Trainer May Not Be Qualified for the Job
You're finally going to dish out cash for some extra motivation and guidance in the gym? Here's how to make sure you're really getting your money's worth.
5. His Clients Drop Him
If a trainer goes through his clients in a number of months or even weeks, it's a clue into how much he struggles to motivate them and bring in the results they're after. So Duffy recommends that you simply ask a potential trainer about his longest-lasting clients. "An experienced trainer will say they have clients for 5, 10, 15 or 20 years," he says. This is a great way to find out how long the guy's been around—and it also shows how effective his training style is.
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VACORP vote expected in November for merger to be finalized next March.
First Community Credit Union, Beloit, Wis., announced that the members of Rock County Employees Credit Union, Janesville, Wis., have voted to merge their credit union into First Community Credit Union.
Battle Creek, Mich., CU picks up 1,500 members to add to its 29,000.
The $385 million First South Financial Credit Union of Bartlett, Tenn., is adding to its Memphis-area footprint by merging the $12 million Dyersburg CU.
CEOs in 10-minute sitdown explain reasons for consolidation.
The $540 million Great Lakes Credit Union in Illinois has had a big year in mergers–four of them–and its latest of the long-troubled Federated Family CU provides Great Lakes first entry into Wisconsin.
Sudden retirement of Northwest Community CEO led to end of merger move between healthy CUs as new CEO settles in.
Combination would create a single nationwide shared branching network for U.S. credit unions.
Northwest Community, Mid Oregon had announced plans last fall but backed off as economy faltered, CEO changed at Northwest Community.
"We see this merger as a model for the future of strong, viable corporate credit unions," said Brad Miller, CEO of Tallahassee, Fla.-based Southeast Corporate, in announcing the decision of his corporate to pursue a merger with Columbus, Ohio, based Corporate One.


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I use this product because my derm told me to. I have skin that can be dry and itchy, and extremely sensitive compounded by minor psoriasis. I have experienced no ill effects with this moisturizer, and it has a nice light feel and absorbs quickly. I have not experienced chronically dry skin since using this product. It does not stop my pores from being clogged by environmental conditions, however. It is not glamourous. It does not have any fragrance, but that's the point. I find it to be expensive for the amount in the tube. I prefer the tube as a quick, messless way of dispensing the product. For those interested, my derm was specific in telling me to use the cream, not the lotion.
This moisturizer is the best. It doesn't have any lovely smells but it does moisturize wonderfully, and isn't that the point? Put your smelly stuff on top of this and you're good to go. Would be a definite repurchase for me, but I am looking for an alternative since they test on animals. A must for people on accutane, by the way.
This cream is great. It is gentle, fragrance free, non-greasy, and very effective. I use it on my hands in the winter and it works just as well if not better than creams that cost three times as much. I am a huge fan of Cetaphil products because of their gentleness, quality, and price.
i got the one in the 16oz tub.... works great a bit grease tho....
More reviews by TheWhiteRabbit
I have very acne prone skin and I am on tons of drying prescriptions for it. My derm recomended the lotion version of this and it was good but not enough in the winter. I tried it out and with one layer it completely quenched my flaking parched face. I have never had any breakout problems with this and I get a zit if I think the word "oil." I definitley recomend this, but only as a night cream, it's way too shiny for the day.
1 out of 1 people found this review helpful. Did you? Yes No
GREAT!!!! Very nice moisturizer. As good as the best.
Why oh why did I not find this gem earlier? I have dry, itchy skin (except on my face) and it is bad at night, trying to sleep while my skin itches like crazy. I kept wasting my money on lotions that weren't working, smelled strong, and didn't seem to actually take care of my itchy skin beyond the first half hour or so after lotion application. Sooner or later, the dry itchiness came back. I saw this on sale, and was intrigued by the packaging claiming "dry, sensitive skin treatment" and "free of lanolins, parabens and fragrances that can irritate sensitive skin..non-comedogenic". This sounded right up my alley. Sure enough, this thick cream came through! Yes, it is thick--it reminds me of L'Occitane Shea Butter almost, and initially, it feels kind of sticky/tacky on the skin. But it soaks in nicely, and what is neat is that a little goes a long way. This 16 oz jar will last a long time. I do not use it on my face (no need right now) but I have also used it on chapped lips (better than most lip balms) and also used it on dry cracked heels. Great for both. I bet too, that if someone wanted to make a fragranced cream, this would be an interesting base. The only oil this contains is sweet almond oil, and it is about midway down the ingredient list.
Fantastic product! It leaves my skin feeling very soft, smooth, and supple. I use it not only for my face, but for my entire body. Excellent for my arms, legs, and feet, which are super-dry! I'm throwing out all my other body lotions because I don't need them anymore. Oh yeah, when you use it on your face, be careful to avoid your eye area. I accidentally dabbed some of this cream over my eyelids and I woke up to puffy eyelids because of all the retained moisture and whatnot. Other than that, I really love this cream and I will continue to buy it!
Amazing! I bought this for my son's dry skin, and just for grins tried it on my face. It has only been a week, but I am truly awe struck by this 'simple' moisturizer.
So far no breakouts and I am the queen of breakouts. If this continues, it will replace my very expensive Arbonne night creme as a HG moisturizer.
It stings. It sinks into my pores, clogs them, and makes my allready dry skin flake. It does work well for razorburn though...lol


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- North America »
- United States »
- Louisiana »
- Hammond »
Oops… no streams currently available for WFPR.
Click here to visit the Station's website:
WFPR is a broadcast radio station from Hammond, Louisiana, United States, providing Country, Classic Country and Hits music.
Hammond - Louisiana, United States - English
200 E Thomas St
Songs playing in WFPR


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Library: (603) 887-3404
For more information about the Library, visit our website www.chesterlibrary.org
Breakfast with Santa – Saturday, December 13, 8 to 11 am
To be held at the Multipurpose Room at 84 Chester Street, Chester, NH
Sponsored by the Friends of the Chester Public Library.
Santa will visit, and each family will receive a free family photo along with a full breakfast for $6 a person with a maximum charge of $25 per family Additional photos will be available for $2 each. There will also be crafts, stories, and raffles. Fun for the whole family. All proceeds benefit the Friends of the Chester Public Library. Please contact Diane Arrato Gavrish for more info at 603-887-3404.
Polar Express – Friday, December 19th, 6:30 to 7:30 pm
To be held at Stevens Hall next door to the Chester Public Library, 1 Chester Street, Chester, NH
Families are encouraged to hop upon the Polar Express and enjoy a reading of the now familiar children's book, as well as a visit from Santa himself. There will be crafts and goodies for one and all. This program is free and no registration is required. Please contact Diane Arrato Gavrish for more info at 603-887-3404.
3 Chester Street, PO Box 277
Friends of the Library
The Friends of the Library are a volunteer support organization of the Library.
The group's mission is to support the Library in a way that benefits not only the Library but the community as well. The group fundraises and hosts programs in conjunction with the staff and the Board of Trustees. The Friends are the Library's primary source of nontax dollars and exist to help the Library as needed either through story time help or fundraising for a new set of encyclopedias. Contact the Library for more information.


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Windows Help
It's free to register, to post a question or to start / join a discussion
AVG uninstall
Likes # 0
Posted September 15, 2012 at 10:51AM
I am trying to uninstall AVG 2012 Free Edition. I go through the Uninstall steps but every time I do the following message appears "AVG LinkScanner(r) Free Edition 2012, remind in X minutes" Please restart and it all begins again How can I get rid or AVG?
Likes # 0
Posted September 15, 2012 at 4:43PM
Try removing it with Revo Uninstaller Free.
Likes # 0
Posted September 15, 2012 at 11:32PM
The best way would be to download AVG Remover 2012 from the AVG website. Follow the instructions here enter link description here
Likes # 0
Posted September 16, 2012 at 10:54PM
Thanks for the advice. Problem solved. Regards
Likes # 0
Posted September 17, 2012 at 2:32PM
No problem - how did you resolve it?
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417 Third Avenue Albany, Georgia 31701(229) 312-1000
2000 Palmyra Rd. Albany, Georgia 31701(229) 434-2000
126 Hwy. 280 West Americus, Georgia 31719(229) 924-6011
807 S. Isabella St. Sylvester, Georgia 31791(229) 776-6961
361 Randolph St. Cuthbert, Georgia 39840(229) 732-2181
Chemotherapy affects normal cells as well as cancer cells. The possible side effects depend on what kind of drug you take and the dose.
These are common side effects of chemotherapy:
Nausea and vomiting. This can be well-controlled with medication most of the time
Temporary hair loss
Mouth sores. A feeding tube can help you maintain nutrition during the time when it may be difficult to eat.
Other common side effects are a decrease in 1 of these blood counts:
A decrease in the white cell count is called leukopenia. This is an important risk factor for infection. If you run a fever during chemotherapy, tell your doctor or nurse right away.
A decrease in platelets is called thrombocytopenia. It is a risk factor for bleeding. Tell your doctor or nurse about any bleeding or easy bruising during chemotherapy.
A decrease in red blood cells is called anemia. It causes fatigue, weakness, and lack of energy. These symptoms should be reported to your doctor or nurse.
The third-party content provided in the Health Library of phoebeputney.com is for informational purposes only and is not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. If you or your child has or suspect you may have a health problem, please consult your primary care physician. If you or your child may have a medical emergency, call your doctor or 911 or other emergency health care provider immediately in the United States or the appropriate health agency of your country. For more information regarding site usage, please visit: Privacy Information, Terms of Use or Disclaimer.
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The Tub Posters
The Tub Posters is immoderately well-known and makes a famous wall decoration, the product dimension is 24 x 18 inch and the price is $59.99. If you're trying to search top recommended The Tub Posters with penny price, the poster is the famous deals for you.
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text: Gregoire Maret at WBGO. Josh Jackson/WBGO hide caption itoggle caption Josh Jackson/WBGO Favorite Sessions Gregoire Maret: Harmonica With Legs WBGO-FM June 12, 2012 He's a restless creative spirit who can't keep still on stage, but now the jazz harmonica player has the recorded document to back up his reputation. Maret brings his quartet to WBGO to perform tunes from his self-titled debut album. Listen Loading… 36:30 Playlist


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Narrow your search
Black & Decker's newest stick vacs promise lots of suction and long lasting power.
Stanford researchers may have discovered a path to pure lithium batteries, which would mean lighter, smaller, and more powerful charges for our devices. The science of it is pretty dense; but if we don't need to find plugs for our phones anymore while we're out and about? We're in.
Today's show features some enterprising hackers who modded an ATM to play Doom, Stanford researchers discovering a potential path to a viable, pure lithium battery, and some mind-bending 360-degree video art.
Researchers at Virginia Tech have developed a working sugar-powered fuel cell with energy density greater than that of current lithium-ion batteries.
Much cheaper, longer-range electric cars are on the way if Japan's Sekisui Chemical claims are realized in 2015.
Green Car Journal chose the BMW i3 for its Green Car of the Year award, announced at the 2014 Los Angeles auto show, beating out such cars as the Volkswagen Golf, Honda Fit, and Audi A3 TDI.
Audi showed off a new development vehicle at the Los Angeles Auto Show, a fuel cell-battery hybrid car called the A7 h-tron.
With a body taken from an American racing car legend and a dose of Silicon Valley start-up tech under the hood, the Renovo Coupe looks set to turn up our perception of what an electric car can do.
The electric-car maker also says problems upgrading the assembly line reduced production of the Model S and forecasts 2,000 fewer units will be delivered this year.
Using neodymium magnets and a unique process that embeds LEDs in silicone, the Orfos lights bring the power of flares to your bike.


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Listen to free music by The Pimps Of Joytime
Blip.fm is internet radio made social. It's easy to search for, play, and discover free music recommended by real people. Join today to create your own free station.
monsters_inc my girl
KaapseKind ਨੂੰ *•.¸♬¸.٭*•. ਨੂੰ
monsters_inc our kid thanks you for what you did Chow322
monsters_inc and a few sex pests like @lukesharp (radio:)
monsters_inc sleep for days given the chance
monsters_inc oh joii
SGMan Hahah *cough*haa.. @monsters_inc: "strangely we lost interest in you @SGMan. where do find these eh :D" (reblip)
monsters_inc strangely we lost interest in you @SGMan. where do find these eh :D
monsters_inc something like that @DarkLady
monsters_inc aha
Osibisaba The Pimps Of Joytime – "Bonita"................"Osibisaba is Fante for High Life! Keep the spirit high! Vibes from Africa and the diaspora!"
Sep 14, 2013 at 5:44 am via YouTube | AMAZON | ITUNES
monsters_inc tell the kid what just happened there Ryan duck
monsters_inc she's costing you and us revenue. make the badge reflect her few friends.
Groovasm The Pimps of Joytime – 'Janxta Funk!'
Jul 22, 2013 at 4:14 pm via YouTube | AMAZON | ITUNES
KaapseKind ❀•*¨*•.♥.•*¨*•♫
Groovasm The Pimps of Joytime – 'Janxta Funk!'
Feb 18, 2013 at 7:00 am via YouTube | AMAZON | ITUNES
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"I have done my part. May Christ teach you to do yours."
~ St. Francis of Assisi; widely considered the most approachable and "saintliest" of all saints, whose sympathy for all has made him beloved by Christian and non-Christian alike


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Ever want to fuck a sexy coworker? What about My MILF Boss! Hot new hardcore episode is out with Addie Juniper and Kevin Wang. Watch this hot scene now!
Paul: hi I just like u and would like to suck u and u fuck me
Posted Aug 15, 2011
All models were over the age of 18 at time of photography.18 U.S.C. 2257 Record-Keeping Requirements Compliance Statement