text:
Attitudes and beliefs of pediatricians and genetic counselors regarding testing and screening for CF and G6PD: implications for policy.
ABSTRACT There is wide variability in conditions included in state newborn screening (NBS) panels. The American College of Medical Genetics (ACMG) was commissioned by Health Resources and Services Administration to develop a uniform NBS panel. Based on survey data, the ACMG committee proposed a panel that included cystic fibrosis (CF) and glucose-6-phosphate dehydrogenase deficiency (G6PD), although G6PD was excluded from their final recommendations. We examine the attitudes of pediatricians and genetic counselors concerning screening for these two conditions. Data were collected as part of two different studies. Koopmans and Ross surveyed a random sample of 600 pediatricians from four states based on their NBS panels. Hiraki et al. surveyed genetic counselors who were members of the National Society of Genetic Counselors (NSGC) listserv. For this analysis, we compare the health care professionals' (HCPs') attitudes toward a universal NBS program for CF and G6PD, and how their support is influenced by state policy and personal interest in testing their own children. Two hundred twenty-three pediatricians and 267 genetic counselors provided partial or complete responses. Pediatricians are more likely to support NBS for both CF (84%) and G6PD (58%) than genetic counselors (56%, P < 0.001 and 39%, P < 0.001, respectively). Both pediatricians and genetic counselors' attitudes toward screening correlate with interest in screening their own children (P < 0.001). Interest in CF screening also correlates with state policy (pediatricians, P < 0.001; genetic counselors, P < 0.025). The correlation of professional recommendations with state policies and personal preferences reinforces the need for systematic evidence-based reviews rather than reliance on stakeholder opinions for developing national guidelines.
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ABSTRACT: Since the availability of testing for hereditary diseases, genetic testing of minors has stirred controversy as regards the ethical implications of the tests. The fear that genetic testing of children could have adverse social, emotional. psychosocial and educational consequences in childhood or later life has motivated a cautious approach. In summary, guidelines agree that genetic testing of children is appropriate in two situations. The first is the testing of a symptomatic child if the tests are likely to help establish a diagnosis and/or a prognosis and to avoid further invasive diagnostic tests. The second is predictive genetic testing in healthy children where onset of the condition regularly occurs in childhood and useful medical interventions can be offered.
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ABSTRACT: Expanded newborn screening (NBS) identifies some disorders for which clinical benefit is uncertain, as well as "incidental" findings (eg, carrier status), thus enhancing the need to inform parents about NBS before sample collection. A self-complete survey was sent to a cross-sectional, stratified, random sample of 5 provider groups in Ontario (obstetricians, midwives, family physicians, pediatricians, and nurses). Univariate and multivariate analyses were used to investigate the effects of core beliefs, perceived barriers, and demographic characteristics on the reported frequency of informing parents about NBS before sample collection. Virtually all of the midwives and almost half of the nurses reported discussing NBS with parents, whereas less than one sixth of the physicians did so. Providers who perceived a responsibility to inform parents were 3 times more likely to report doing so than those who did not perceive this responsibility (odds ratio: 2.9 [95% confidence interval: 2.1-4.1]). Those who lacked confidence to inform parents were 70% less likely to discuss NBS with parents compared with those who did not experience this cognitive barrier (odds ratio: 0.3 [95% confidence interval: 0.2-0.4]). Controlling for these covariates, family physicians and obstetricians were more likely than pediatricians to inform parents. These results provide guidance for capacity building among providers who are positioned to inform parents about NBS before sample collection. Our findings call for targeted educational interventions that consider patterns of provider practice related to prenatal and NBS care, seek to redress confidence limitations, and engage key provider groups in the importance of this professional responsibility.PEDIATRICS 09/2009; 124(3):950-8. · 4.47 Impact Factor
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ABSTRACT: Genetic susceptibility research and testing is leading to an era of personalized medicine. Genetic counselors act as liaisons between the medical genetics community and the public. Understanding the opinions of genetic counselors will be important in developing testing guidelines. Attitudes towards genetic susceptibility testing in children were assessed for 216 NSGC members. Genetic counselors were likely to support testing if the results would determine: disease progression or prognosis, likelihood of survival after a specific treatment, or risk for an adverse drug reaction. Genetic counselors were unlikely to support testing to determine susceptibility to later disease development or in the absence of available intervention. There was a strong positive correlation between attitudes associated with desire to test their own child, if at risk and their support for genetic testing in any child at risk. Respondents strongly favored parent/guardian and child's rights over doctor or insurance rights. They indicated assent should be obtained prior to testing, when appropriate, and that a copy of results should be kept in a permanent medical record. Respondents expressed concerns about insurance discrimination, testing in the absence of medical necessity, and taking away a child's autonomy.Journal of Genetic Counseling 04/2010; 19(4):402-16. · 1.45 Impact Factor
Page 1
? 2006 Wiley-Liss, Inc.American Journal of Medical Genetics Part A 140A:2305–2311 (2006)
Attitudes and Beliefs of Pediatricians and Genetic
Counselors Regarding Testing and Screening for
CF and G6PD: Implications for Policy
Joy Koopmans,1Susan Hiraki,2and Lainie Friedman Ross3*
1Carver College of Medicine, University of Iowa, Iowa City, Iowa
2Alzheimer's Disease Center, Boston University School of Medicine, Boston, Massachusetts
3Department of Pediatrics, University of Chicago, Chicago, Illinois
Received 17 January 2006; Accepted 19 July 2006
There is wide variability in conditions included in state
newborn screening (NBS) panels. The American College of
Medical Genetics (ACMG) was commissioned by Health
Resources and Services Administration to develop a uniform
NBS panel. Based on survey data, the ACMG committee
proposed a panel that included cystic fibrosis (CF) and
glucose-6-phosphate dehydrogenase deficiency (G6PD),
although G6PD was excluded from their final recommenda-
tions. We examine the attitudes of pediatricians and genetic
counselors concerning screening for these two conditions.
Data were collected as part of two different studies.
Koopmans and Ross surveyed a random sample of 600
pediatricians from four states based on their NBS panels.
Hiraki et al. surveyed genetic counselors who were members
of the National Society of Genetic Counselors (NSGC)
listserv. For this analysis, we compare the health care
professionals' (HCPs') attitudes toward a universal NBS
program for CF and G6PD, and how their support is
influenced by state policy and personal interest in testing
their own children. Two hundred twenty-three pediatricians
and 267 genetic counselors provided partial or complete
responses. Pediatricians are more likely to support NBS for
both CF (84%) and G6PD (58%) than genetic counselors
(56%, P<0.001 and 39%, P<0.001, respectively). Both
pediatricians and genetic counselors' attitudes toward
screening correlate with interest in screening their own
children (P<0.001). Interest in CF screening also correlates
with state policy (pediatricians, P<0.001; genetic counse-
lors, P<0.025). The correlation of professional recommen-
dations with state policies and personal preferences
reinforces the need for systematic evidence-based reviews
rather than reliance on stakeholder opinions for developing
national guidelines. ? 2006 Wiley-Liss, Inc.
Key words: newborn screening; cystic fibrosis; glucose-6-
phosphate dehydrogenase deficiency; attitudes; genetic
testing; public policy; health disparities
How to cite this article: Koopmans J, Hiraki S, Ross LF. 2006. Attitudes and beliefs of pediatricians and
genetic counselors regarding testing and screening for CF and G6PD: Implications for policy.
Am J Med Genet Part A 140A:2305–2311.
There is wide variability within the United States
(US) and around the world regarding what disorders
and conditions are screened for in the newborn
period [Stephen et al., 1997; Stoddard and Farrell,
American College of Medical Genetics (ACMG) was
given a contract by the Health Resources and
Services Administration (HRSA) to recommend a
committee recruited survey respondents from list-
servs of genetic and metabolic professionals and
interested laypersons. When certain conditions did
not receive adequate responses, the committee
recruited respondents through personal contacts.
In August2004, a draft report proposed a panel of 30
on an ACMG survey score of 1,200 or higher. The
ACMG/HRSA committee also commissioned condi-
but they were not available at the time of the draft
report so it is not clear if they had any impact on the
original report.
29 primary and 25 secondary targets [ACMG, 2005].
*Correspondence to: Lainie Friedman Ross, M.D., Ph.D., Department
of Pediatrics, University of Chicago, 5841 S. Maryland Avenue, MC 6082,
Chicago, IL 60637. E-mail: firstname.lastname@example.com
DOI 10.1002/ajmg.a.31463
Page 2
(G6PD) was omitted from the final panel despite
the fact that it scored 1,286 on the ACMG survey
whereas cystic fibrosis (CF) scored 1,200 and was
retained [ACMG, 2005]. The exclusion of G6PD was
recommended to the ACMG committee at various
professional meetings. Its exclusion was justified in
the condition summary on the grounds that the
association with kernicterus and severe hemolytic
crises are not clearly understood [ACMG, 2005]. The
condition summaries, however, were neither sys-
tematic nor comprehensive and no criteria were
given in the report to explain how the experts
which negates its validity [Botkin et al., 2006]. CF,
on the other hand, was included, despite a weak
endorsement by a large consensus panel convened
during the committee's deliberations [Grosse et al.,
Currently in the US, 14 states test for CF, with at
least three of these states having added CF since the
release of the ACMG report [National Newborn
Screening, 2005]. In contrast, only Washington DC
screens for G6PD [National Newborn Screening,
lab (Pediatrix). Internationally, CF is screened for in
many European countries and Australia (as it is most
prevalent in the Caucasian population) whereas
G6PD is screened for mainly in Asian, African, and
Mediterranean countries (as it is more prevalent and
more severe in these communities).
In this manuscript, we chose to study the attitudes
and beliefs of genetic counselors and pediatricians
because they are two stakeholders in the debate
on the ACMG/HRSA committee that designed the
survey. They were also not targeted to fill out the
ACMG/HRSA survey which was the main tool for
developing the list of conditions. There is existing
literature on the educational and attitudinal differ-
ences between these two groups of healthcare
professionals, which provides the context for our
exploration specifically into their views on NBS.
[Geller et al., 1993; Carnevale et al., 1997; Harman,
correlate with personal interest in testing one's own
children and with existing state policies. We explore
how and why these correlations can further discus-
sions about the process of developing a uniform
panel that is based mainly on stakeholder opinion
dehydrogenase deficiency
Koopmans and Ross surveyed a random sample of
600 US pediatricians listed in the 2005 edition of the
American Academy of Pediatrics (AAP) web-based
directory. One hundred and fifty physicians were
chosen from each of four states based on their NBS
panels: Illinois, Wisconsin, Florida, and Colorado.
Physicians were excluded if they did not have an
email address listed in the AAP directory or were
listed as members of one or more of the following
sections: anesthesiology and pain medicine, cardiol-
ogy and cardiac surgery, neurological surgery,
tric dentistry, plastic surgery, radiology, residents,
were contacted up to three times by email and fax in
May and June 2005 and were able to respond by
email, fax, or post. A full methodology is given
elsewhere [Koopmans and Ross, 2006]. This is
referred to as Survey A. Recipients of Survey A were
part of a larger study to determine how state NBS
policy influences physicians'
screening for CF, G6PD, and type 1 diabetes (T1D).
Hiraki et al. surveyed genetic counselors who were
members of NSGCLIST, an electronic discussion
[Hiraki, unpublisheddata].
received three invitations between September and
November 2005 to participate in a voluntary internet
and seventy-five genetic counselors consented to
participate and 267 partial or complete surveys were
collected. This is referred to as Survey B. Recipients
of Survey B were part of a larger study to determine
Dystrophy, and Fragile X. A full methodology is
given elsewhere [Hiraki et al., 2006]. The case
descriptions and questions were identical between
the two surveys although Survey B included addi-
tional cases. These cases and questions are based on
previous work by Acharya et al. [2005]. Some of the
demographic questions were modified in Survey B
because of the different training and experiences of
genetic counselors.
In both surveys, the health care providers (HCPs)
were provided with a description of the conditions
(e.g., etiology, incidence (when known), impact of
early diagnosis) as well as treatments available to
children who are identified through screening
supplementation after early diagnosis has been
proven to improve height and weight, while the
pulmonary benefits of early diagnosis are more
diagnosis on long-term survival is still unknown. For
G6PD, the HCPs were told that most affected
individuals remain asymptomatic until specific trig-
neonatal screening and health education have been
shown to be effective in some countries but that
attitudes toward
ListServ members
American Journal of Medical Genetics Part A: DOI 10.1002/ajmg.a
Page 3
screening is rare in the US because most affected
descriptions and copies of the survey are available
through the corresponding author.)
For this study, we are comparing responses from
Surveys A and B about: (1) HCPs' support for
including CF and G6PD in a uniform NBS program;
and (2) whether they would want to test their own
childrenforthese twoconditions.Wealsoexamined
policy. For this second comparison, we excluded
Canadian responses from questions regarding state
policy as we did not ask the Canadians to specify
their province and CF is included in only certain
Canadian provinces. For consistency, we also
no Canadian provinces screen for G6PD.
For Survey A, approval from the University of
Chicago Institutional Review Board for the project
and for waived written consent were obtained prior
to contacting any of the clinicians. For Survey B,
an on-line consent form was included and respon-
dents could not access the survey unless they
consented. Both Northwestern University Institu-
tional Review Board and the University of Chicago
some statistical analyses, we excluded those who
did not answer or responded ''not sure.'' Tables
(2?3 and 2?2) were analyzed for statistical
significance by chi-square using P<0.05.
Survey A was administered to 600 pediatricians.
Thirty physicians were excluded because they could
not be located and 22 excluded themselves because
they were either no longer practicing or specialized
Of the remaining 548 respondents, 225 (41%)
had usable data), and 33 (6%) refused.
Survey B was sent to an online listserv with 1,381
seventy-five genetic counselors consented to parti-
cipate and 267 usable surveys were returned.
Table I gives the demographic data of our
respondents. The pediatricians were more likely to
be male, have completed training before 1989, and
live in a state that screened for CF.
In Table II, we show the genetic counselor and
pediatricians' attitudes toward universal NBS for CF
respectively). Pediatricians were more likely to
prefer NBS for both CF and G6PD (P<0.001) and
genetic counselors were more likely to respond ''not
sure'' or to skip the question (P<0.001).
TABLE I. Demographics
Survey A [number of
pediatrician respondents] % (n)
Survey B [Number of genetic
counselor respondents] % (n)
Year Completed Training*
1989 and before
1990 to present
State CF Policy*
Screens for CF
Does not screen for CF
State G6PD Policy
Screens for G6PD
Does not screen for G6PD
49 (110)
51 (113)
40 (85)
60 (125)
57 (127)
43 (96)
0 (0)
100 (223)
3 (7)
97 (232)
13 (31)
87 (199)
32 (73)
68 (156)
7 (16)
93 (213)
TABLE II. Genetic Counselors' [GC] and Pediatricians' [P] Attitudes Regarding Newborn Screening
Condition Training
Do you support newborn screening % (n)
Yes NoNo answer/not sure
56 (150)
84 (188)
39 (105)
58 (130)
18 (49)
9 (20)
31 (82)
25 (55)
25 (68)
7 (15)
30 (80)
17 (38)
Percentages do not equal 100% because of rounding.
American Journal of Medical Genetics Part A: DOI 10.1002/ajmg.a
Page 4
Table II can be explained by whether respondents
live in a state which screens for these conditions.
Given the few respondents who live in a state that
screens for G6PD (0 pediatricians and 16 genetic
counselors), this analysis was only done for CF. The
data show that both pediatricians and genetic
counselors are more likely to support CF screening
if they live in a state in which CF NBS occurs
(pediatricians: 92% vs. 75%, P<0.001; genetic
counselors: 85% vs. 70%, P<0.025). When we
account for the existence of state policy, the
difference in support for CF NBS between pediatri-
cians and genetic counselors is not significant.
In Table IV, we show pediatrician and genetic
counselors' attitudes toward testing their own
children for CF (rows 1 and 2) and G6PD (rows 3
and 4). Pediatricians were more likely to be inter-
ested in testing their own children for CF than were
genetic counselors (P<0.001) but there was no
difference between the two groups for support for
testing their own children for G6PD.
In Table V, we consider whether the data from
Table IV correlates with the HCPs' attitude about
NBS. The data show that pediatricians and genetic
counselors are more likely to support universal CF
and G6PD screening if they would test their own
children (for CF: 99% vs. 54% of pediatricians,
P<0.001 and 90% vs. 48% of genetic counselors,
P<0.001; and for G6PD, 100% vs. 57% of pediatri-
cians, P<0.001 and 95% vs.41% of genetic counse-
lors, P<0.001). The data also show that when the
attitudes of pediatricians and genetic counselors
toward screening are correlated with their interest in
testing their own children, then the differences
they do not entirely disappear). When HCPs support
testing their own children for CF, pediatricians are
more likely to support CF NBS than genetic
counselors (99% vs. 90%, P<0.01). When HCPs do
difference in support for CF NBS (54% vs. 48%,
for G6PD NBS (100% vs. 95%, P¼NS). When HCPs
do not support testing their own child for G6PD,
pediatricians are more likely to support G6PD NBS
than genetic counselors (57% vs. 41%, P<0.01).
Gender, year completed training, experience with
patients, and family members with the condition
were entered in a logistic regression. None signifi-
cantly affected the attitudes of either group of HCPs
explain the differences between the attitudes of the
two groups.
Although the ACMG survey was geared to all
stakeholders, general pediatricians and genetic
counselors were not targeted despite the fact that
they will be the front-line providers of genetic
services to children who screen positive. We chose
to study their attitudes about NBS for CF and G6PD
because their inclusion and exclusion, respectively,
in the proposed uniform panel represent a political
issue that has not been adequately addressed.
TABLE III. Comparison of the Influence of State Policy on Support for Newborn Screening for CF
between Genetic Counselors and Pediatricians
Do you support universal newborn screening for CF?
Yes % (n) No % (n)
Does your state
screen for CF?
Genetic counselor (N¼61)
Pediatrician (N¼127)
Genetic counselor (N¼115)
Pediatrician (N¼95)
85 (52)
92 (117)
70 (80)
75 (71)
15 (9)
8 (10)
30 (35)
25 (24)
TABLE IV. Genetic Counselors' [GC] and Pediatricians' [P] Attitudes Regarding Testing Their Own
Condition Training
Do you support testing for your own child? % (n)
Yes No No answer/not sure
46 (124)
66 (147)
19 (52)
27 (60)
36 (95)
27 (61)
64 (171)
59 (132)
18 (48)
7 (15)
16 (44)
14 (31)
Percentages do not equal 100% because of rounding.
American Journal of Medical Genetics Part A: DOI 10.1002/ajmg.a
Page 5
We found pediatricians are supportive of NBS for
supported these NBS programs, they showed less
support and more ambivalence (no answer/''not
sure''). Part of the difference may be due to
recruited from two states that have screened new-
borns for CF for more than a decade and half were
recruited from two states that do not screen new-
that screen for CF whereas the number of genetic
counselor respondents who live in states that screen
only 14 of 50 states currently screen for CF and some
last year). When we corrected for whether the HCPs
lived in a state that screened for CF (Table III), we
found that the difference in level of support for NBS
for CF between pediatricians and genetic counselors
disappeared. This suggests that state policy has a
significant impact on one's attitude toward NBS.
Other studies have also shown that state policies
influence the attitudes of HCPs about screening
programs [Bradley and Parsons, 1998; O'Connor
et al., 2002; Acharya et al., 2005]. Although our data
do not prove causality, additional data from Koop-
mans and Ross [2006] show that perceived state
policy correlates with support for screening which
suggests that the policy influences the HCPs'
attitudes rather than the HCPs' attitudes influencing
state policy.
The increased support of HCPs for screening in
states where screening already occurs may be based
on HCPs' beliefs that existing programs are benefit-
ing individuals and families. More pessimistically,
this support for screening may be due to misunder-
standing or even fears of legal liability if they do not
provide it [Wilfond and Thomson, 2000]. Consider,
for example, that Koopmans and Ross [2006] found
for T1D for research when they lived in states that
of clinical predictability or utility.
Both genetic counselors and pediatricians were
more likely to test their own children for CF than
G6PD. Whether this is because they believe that CF
knowledge is more useful or whether this is due to
the demographics of our sample is unknown, as we
both conditions, however, pediatricians were more
genetic counselors. Both genetic counselors and
pediatricians were also more likely to support
universal NBS if they were interested in testing their
own children.
population screening, even for conditions that they
do not want testing for their own children, may be
due to their appreciation of the heterogeneous
society in which we live. While laudatory, this belief
should be tempered by the potential risks and harms
of screening which are frequently overlooked
[Holtzman, 1989; Feldman, 1990; Botkin, 2005;
that the support is due to less laudatory reasoning
such as fear of legal liability [Wilfond and Thomson,
Our data show that there is some ambivalence
tion to include CF in the uniform panel, and some
interest in screening for G6PD despite the ACMG's
exclusion of G6PD from the uniform panel. The
fact that existent state policy correlates with
HCPs' attitudes towards NBS for CF suggests that
basing future policy on surveys may not correlate
with scientific evidence but rather with familiarity
[Koopmans and Ross, 2006]. Botkin et al. [2006] have
argued that the ACMG methodology, based mainly
on stakeholder surveys, is flawed and a more
evidence-based approach that focuses on scientific
evidence, such as recommended by the US Pre-
ventative Services Task Force (USPSTF) [Harris et al.,
2001], should be undertaken.
A more evidence-based approach, however, may
result in the recommendation to exclude CF from a
uniform panel. In 2002, a British Health Technology
Assessment report found insufficient evidence for
implementing NBS for CF [Murray et al., 1999]. In
TABLE V. Influence of Interest in Testing Their Own Children on Attitude About Universal Newborn Screening
Do you support universal newborn screening for...?
Yes % (n)No % (n) Yes % (n) No % (n)
Would you test your
own newborn?
CF: Yes* Genetic counselor
Genetic counselor
90 (100)
99 (144)
48 (30)
54 (37)
10 (11)
1 (2)
52 (32)
46 (31)
G6PD Yes 95 (41)
100 (56)
41 (50)
57 (71)
5 (2)
0 (0)
59 (73)
43 (53)
CF: No G6PD No*
American Journal of Medical Genetics Part A: DOI 10.1002/ajmg.a
Page 6
2003, Botkin summarized a conference co-spon-
sored by the Cystic Fibrosis Foundation and the
Centers for Disease Control and Prevention by
stating that ''current data suggest that carefully
designed NBS programs are justified'' [Botkin,
2003]. He clarified that this does not imply that states
not screening for CF are below the standard of care
ing'' to warrant such a conclusion [Botkin, 2003]. To
what extent the conference influenced the decision
panel is unknown. Although the final conference
report was not published until October 2004, the
proceedings were posted on the web in 2003, and
in the conference.
An evidenced-based systematic review of G6PD
would help determine whether sufficient scientific
evidence exists to include this condition or to justify
its exclusion from an NBS program. To date no such
reviewhas taken place in the US or internationally in
contrast with numerous reviews of CF [Centers for
Disease Control and Prevention, 1997; Murray et al.,
1999; Grosse et al., 2004]. Given the different ethnic
backgrounds of individuals affected by these condi-
tions, one must wonder whether the lack of review
reflects differences in the utility of screening or
The failure to perform a comprehensive review is
consistent with other health disparities research
regarding diseases and conditions more prominent
of Medicine, 2003].
There are a number of limitations to this study.
First, the two surveys were conducted in different
manners. Although both were based on email
recruitment, some pediatricians were also sent a
fax. Pediatricians were also directly recruited having
been randomly pre-selected whereas genetic coun-
selors were recruited by a generic invitation on a
listserv. Second, both surveys had low response
rates. The physician survey had a 41% response
which is consistent with other surveys of HCPs [Asch
et al., 1997]. The response rate of genetic counselors
was less than 20%. This may be due to the fact that
they were recruited via a mass invitation to a listserv.
It is unknown how many of the members of the
listserv are truly active.
Third, the demographics between the two surveys
are quite different which limits the value of compar-
to pediatricians from four states whereas Survey B
was distributed to an international pool of genetic
counselors. Survey A had an equal number of male
and female respondents whereas Survey B had
almost exclusively female respondents. Despite this,
in a logistic regression, gender, year completed
training, experience with patients, and family mem-
bers with the condition did not significantly affect
either group's attitudes toward NBS for either
condition. Nevertheless, particularly with respect to
genetic counselors, the difference in numbers
between male and female respondents may mask
gender differences.
Fourth, we did not collect race/ethnicity data on
our respondents nor their patient population. The
race and ethnicity of our survey participants could
have a significant impact on interest in testing one's
own child for both CF and G6PD. The race and
ethnicity of their patient population could have a
significant impact on their interest in screening,
although neither Acharya et al. [2005], Koopmans
and Ross [2006] nor Hiraki et al. [2006] found that
experience correlated with professional attitudes.
CF and G6PD are two conditions for which NBS is
possible. In the US, CF is currently being recom-
mended for inclusion in a uniform panel whereas
G6PD is not. Excluding those who were unsure or
did not respond, the majority of genetic counselors
and pediatricians support NBS for both conditions
(CF>G6PD). Their beliefs and attitudes are influ-
enced by their state policies (CF) and their personal
This reinforces the need for systematic evidence-
based reviews (rather than reliance on stakeholder
opinions) for developing national policy guidelines.
Both the high score for G6PD on the ACMG survey
and the support expressed for screening in this
project suggest that an evidence-based review is
necessary to inform policy decisions about whether
to include or exclude G6PD from a uniform panel.
Ms. Hiraki's work was done as part of her Master's
project in Genetic Counseling at Northwestern
University, Chicago, IL. The authors would like to
thank Carol Stocking, Ph.D., for her advice.
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fibrosis: Evaluation of benefits and risks and recommenda-
tions for state newborn screening programs. MMWR
Gurain EA, Kinnamon DD, Henry JJ, Waisbren SE. 2006.
Expanded newborn screening for biochemical disorders:
The effect of a false-positive result. Pediatrics 117:1915–1922.
Harman LB. 2003. Attitudes toward genetic testing: gender, role,
and discipline. Top Health Inf Manage 24:50–58.
Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch
SM, Atkins D, for the Methods Word Group, third U.S.
Preventive Services Task Force. 2001. Current methods of the
U.S. Preventive Services Task Force: a review of the process.
Am J Prev Med 20(3S):21-35.
counselors towards expanding newborn screening and
offering predictive genetic testing to children. Am J Med
Genet Part A (in press).
Holtzman NA. 1989. Proceed with caution: Predicting genetic
risks in the recombinant DNA era. Baltimore MD: The Johns
Hopkins University Press.
and ethnic disparities in health care. Washington DC: The
National Academy Press.
Koopmans J, Ross LF. 2006. Does familiarity breed acceptance?
The influence of policy on physicians' attitudes toward
newborn screening programs. Pediatrics 117:1475–1483.
Murray J, Cuckle H, Taylor G, Littlewood J, Hewison J. 1999.
Screening for cystic fibrosis. Health Technol Assess 3:i–104.
National Newborn Screening Status Report. 2005. Last updated
12/22/2005. On the web at: http://genes-r-us.uthscsa.edu/
Natowicz M. 2005. Newborn screening—Setting evidence-based
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O'Connor KS,MacDonald SE,Hartling L, SeguinRM, Hollands H,
Mowat DL, Hoey JR, Masse ´ R, Rekart ML. 2002. The influence
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American Journal of Medical Genetics Part A: DOI 10.1002/ajmg.a


text:
The Waitresses- Christmas Wrapping if I am feeling gleeful (it happens in very short spurts)
Anaheim Steamroller- They managed to take annoying songs and make them inoffensive... kind of an application of musical deodorant.
On the other end of the spectrum is the by far, absolute, without a doubt worst Christmas song ever written or produced... "Red Shoes." I will say no more, as discussion of this monstrosity sends me into a rant every year.
I tend to like the classics. White Christmas etc.
That being said the newer stuff is mostly garbage and some of the older stuff is as well.
Take this gem for example:
Something in this song speaks to a dark part of my soul that wants to come out and do violence upon anything in my general vicinity....
Oh yeah, I like the crooners honestly.
With one exception. "Baby its cold outside". Seriously, Dean-o... the lady said no.
My mother used to put Christmas music on right after Thanksgiving and she left it on until the day before Thanksgiving. Actually I think she still does but I avoid her house this time of the year!

subset: commoncrawl


text:
You are always welcome here at ringtone download service Audiko.net, where you can easily use the most popular ringtones for your iPhone. Today we have a ringtone of "Never Mess With Sunday" by Yppah as well as 38 other ringtones by Yppah. "Never Mess With Sunday" is a hit from the "Eighty One" album that was produced by Yppah at their label together with other 5 tracks. You can listen to all 7 Yppah – "Never Mess With Sunday" ringtone variations available here and download it for free to your PC. You can also examine other 3 albums produced by Yppah for all time. "Never Mess With Sunday" is referred to , and you may listen to a huge amount of collaborations absolutely for free. And finally, we have collected lyrics for this track and you can view it here as well. So feel free to browse, listen, download ringtones at Audiko.net. Make your phone sound cool!
Yppah - Never Mess With Sunday
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2 Apr 2012
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Watch as we take this second 2015 Ford F-150 and transform it from ordinary
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sadly its in the rules for rides that they can only take us up to 120
Desert Proofing the Ford Raptor! - Dirt Every Day Episode 2
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2014 Ford F450 Black Ops Fully Loaded
EBAY Item # 281343256200
email firstname.lastname@example.com
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text:
Why First Solar (FSLR) Stock Is Higher Today
NEW YORK (TheStreet) -- Shares of First Solar (FSLR) are up 2.32% to $64.60 after it was reported that the manufacturer and seller of photovoltaic solar modules will build 45 megawatts of photovoltaic projects in India's Telangana state, Bloomberg reports.
The company signed a 20-year contract with state-run utility Southern Power Distribution Co. to sell power at an average of 6.49 rupees (10.7 cents) a kilowatt-hour, according to an e-mailed statement today.
Must Read: Warren Buffett's 25 Favorite Stocks
STOCKS TO BUY: TheStreet Quant Ratings has identified a handful of stocks that can potentially TRIPLE in the next 12 months. Learn more.TheStreet Ratings team rates FIRST SOLAR INC as a Hold with a ratings score of C+. TheStreet Ratings Team has this to say about their recommendation: "We rate FIRST SOLAR INC (FSLR) a HOLD. The primary factors that have impacted our rating are mixed some indicating strength, some showing weaknesses, with little evidence to justify the expectation of either a positive or negative performance for this stock relative to most other stocks. The company's strengths can be seen in multiple areas, such as its revenue growth, largely solid financial position with reasonable debt levels by most measures and reasonable valuation levels. However, as a counter to these strengths, we also find weaknesses including disappointing return on equity, weak operating cash flow and poor profit margins." Highlights from the analysis by TheStreet Ratings Team goes as follows:
- The revenue growth came in higher than the industry average of 8.4%. Since the same quarter one year prior, revenues rose by 25.8%. Growth in the company's revenue appears to have helped boost the earnings per share.
- FSLR's debt-to-equity ratio is very low at 0.04 and is currently below that of the industry average, implying that there has been very successful management of debt levels. To add to this, FSLR has a quick ratio of 2.15, which demonstrates the ability of the company to cover short-term liquidity needs.
- FIRST SOLAR INC reported significant earnings per share improvement in the most recent quarter compared to the same quarter a year ago. The company has demonstrated a pattern of positive earnings per share growth over the past two years. However, we anticipate underperformance relative to this pattern in the coming year. During the past fiscal year, FIRST SOLAR INC turned its bottom line around by earning $3.61 versus -$1.19 in the prior year. For the next year, the market is expecting a contraction of 25.6% in earnings ($2.69 versus $3.61).
- Net operating cash flow has significantly decreased to -$318.18 million or 578.78% when compared to the same quarter last year. In addition, when comparing to the industry average, the firm's growth rate is much lower.
- The company's current return on equity has slightly decreased from the same quarter one year prior. This implies a minor weakness in the organization. When compared to other companies in the Semiconductors & Semiconductor Equipment industry and the overall market, FIRST SOLAR INC's return on equity is below that of both the industry average and the S&P 500.
- You can view the full analysis from the report here: FSLR Ratings Report
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text:
Column: Pitino breaks his own mold, just this once
But Pitino wouldn't be deterred. And he was rewarded not just with 3-pointers from Hancock - who finished with 20 points, 14 in the second half - but with a couple of slashing drives to the basket that rocked the Shockers defense back onto their heels.
"If you said to me, `Is Luke a top three player on the team?' I would say, `Without question.' Then you may say, `Why doesn't he start?'" Pitino said, without waiting for an answer. "We don't want to get him in foul trouble."
And once the Cardinals got their noses in front, 56-55 at the 6:30 mark on a 3-pointer from Hancock, all that preparation Pitino excels at turned out to be enough to keep Louisville there at the final buzzer.
For the Louisville press to succeed it has to start on the in-bounds play, and once the Cardinals started making baskets, it took its toll. The Shockers went more than 26 minutes - from late in the first half until the 6:21 mark of the second - without turning the ball over once. But over the next minute and a half, the Cardinals forced three, two from Shockers freshman guard Fred VanVleet, and suddenly Louisville looked more like the No. 1 overall seed again coming into the tournament.
"I felt really, really good until we had that flurry of turnovers," Shockers coach Greg Marshall said. "I didn't realize it was five in seven possessions, which is certainly big.
"You know, they do that to everyone," he added glumly. "We were looking really good there for 32 minutes or whatever it was."
It was almost long enough.
"We're one of the better pressing teams in the country. They had four turnovers. We were giving them everything but the kitchen sink, and they wouldn't turn it over," Pitino recalled.
"What happens in the press, if you play an extremely well-coached team, you may have one run per game. If you're going against guys that are freshman, not great ball-handlers," he added, "then you may have three or four runs."
What Louisville had, to be fair, were more like surges. A 3-pointer from Hancock nudged the Cardinals ahead to 65-60 with 2:06 left and they made just enough free throws to hold off Wichita State.
"You're elated when you win, so excited to be in a championship game," Pitino said finally. "But there's always a part of you that looks at the other team and says, `They played their hearts out.' There's always a part of you that really wants to win, but you appreciate your opponent."
Enough in this case to force Pitino way out of his comfort zone, anyway.
Jim Litke is a national sports columnist for The Associated Press. Write to him at jlitke(at)ap.org and follow him at Twitter.com/JimLitke.
The Associated Press


text:
From Kokoro no Oasis: Tomas is a proud and fearless assassin who has never failed a commission. So what happens when he's commissioned to kill Myra, an immortal vampire?
Top Members
- tayrashashank · 3 months ago
i like the plot but short
- Volume 1
- 4 years agoVampire to Shinigami 1
- 2 years agoVampire to Shinigami 0
By editing this manga you will earn the editor title for this manga!
Characters (2)more
- Tomas Berard Main
- Myra Lala Main


text:
I have an older night rider light set. Can I leave the batteries on the carger? Does this hurt them?
Also are these pretty decent lights? I acquired them in a trade 3 years ago when they were new. I'm not sure what model they are, all they say is 10.5w on the bottom.
Edit: I found the model Niterider HID rage. I guess they're pretty decent.
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Hey guys... long time lurker, first post. Still a beginner, using kit tins, but with malt instead of dextrose, and dry hopping. Spent many a night shift reading through these boards and learnt a lot. Pretty sure i've got my first infection, so thought it'd be a good excuse to finally register and start posting
IPA-Hopped LME
Amber LME
Kit Yeast
3weeks into primary... was about to transfer to secondary and dry hop. And i see this:
Smell isn't bad, but not as beery as i was expecting.
Taste is really bitter - citrus-rind-acid kinda bitter. Not pleasant.
One thing that I've changed from my other batches is this is a new fermenter with more headspace.
Cheers for any input guys.
Sorry... yet another "am i infected" thread
Looks like a pellicle is forming to me, could be lacto? I'm certainly not the authority on these kinds of things around here though.
hmmmmmm........the only thing that makes me think it might be infected is the citrus rind taste. I've only ever tasted one infected batch and that is what it tasted like.
edit: I wouldn't think that the additional head space would be a concern for primary unless its just a silly amount of headspace.
In the 15 or so batches i've done, i've never had a pellicle. Hence the worry!
Screw it... I've dry hopped. Fingers crossed. It's got it's name already if it turns out ok: Infectious Pale Ale!
Definitely infected. Either Lacto and/or Brett. Not sure what to tell you, other than to double check your sanitizing process. Sometimes though something gets in despite what seems to be good process. If it's in a plastic bucket, you should probably get a new one. Along with any other plastic that came in contact with the beer. Otherwise you risk infecting future batches.
You never know how this will turn out, though unintentionally infected beers tend not to be that good.
Agree with JLem. I don't have the experience he does, but I've read enough "is this an infection" threads - that while filmy look seems like it's always diagnosed as lacto or brett. Good luck, but I'm thinking this will not end well.
Barrel age it for 18 months and call it a sour?
And if that is a plastic cube you are fermenting in, I would make sure it was really clean before using it again. If you get another infection in that cube, toss it.
How do you BBQ an elephant....first you get your elephant....


text:
Find commute times to your work, school, gym and more.
Hillside Apartments
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Prices, specials, features and availability subject to change.
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Close to Highways & Shopping...Washer & Dryer in Every Home!
Hillside offers you great value and a great location! You will enjoy the seclusion of a country setting that yet places you close to all your shopping needs. We offer several spacious floor plans, all with washer and dryer, ceiling fans, cable and high speed Internet ready, and fully applianced kitchen.
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katie d.
Manager stole money and ultimately was caught and spent a short time in jail. The landlord brushed off the lat Read Moree notices and told me it was a mistake and "don't worry about it". The late notices are now on my credit report and I'm having the hardest time having them removed. The maintenance crew was NEVER on time (ex...weeks later). There were several nights I woke up to police and also fire engines to residents homes. Very scary!!!
January 23, 2014


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The general body of the Vijayawada Municipal Corporation (VMC) on Friday passed a resolution seeking immediate release of grant from the State government for revival of flood-hit areas in the city and to take permanent steps to protect the city from floods in the future.
All the three MLAs of the city - Malladi Vishnu of the Congress, Vellampalli Srinivas and Yelamanchili Ravi of the Praja Rajyam Party - participated in serious discussion that lasted for about two hours.
Corporators of all the political parties lauded the role of the employees of the VMC in providing relief and rehabilitation to the flood victims by responding in time. They also thanked the service organisations for providing a helping hand to the victims.
Donepudi Sankar and Koteswara Rao of the CPI, Donepudi Kasinath and Korada Ramu of the CPI (M), Yerubotu Ramana Rao of the TDP and independent corporator U. Bahadur spoke in detail about the floods. They said there was an immediate need to strengthen the floodbank to prevent inundation of the city in the event of a similar massive flood in the future.
Mr. Vellampalli Srinivas urged the VMC officials to ensure that there were no breaches to the floodbank. He alleged that some people were resorting to breaching of the bund near Bhavanipuram for their business interests. Mr. Yelamanchili Ravi observed that there was a need to strengthen the bund between Geetha Nagar and Ramalingeswara Nagar.
Permanent steps
Mr. Vishnu said there was no dearth of funds to take up permanent measures to strengthen the bund. "Let the general body pass a resolution seeking funds from the government. It is better if an all-party delegation represents the issue to the State government. I am ready to join the delegation," he said.
A wordy duel between TDP and Congress corporators took place over the issue of helping the flood victims. Mayor M.V. Ratna Bindu and the Congress corporators took strong objection to dragging the name of Lagadapati Rajagopal, MP, into the discussion.
As the members continued to discuss the issue despite several appeals, Ms. Ratna Bindu announced that she was moving the resolution seeking grant from the State government and to take an all-party delegation to Hyderabad to urge the government for the grant.
Earlier in the day, the general body witnessed a prolonged wordy duel, as the corporators of the TDP and the Left parties demanded that the issue of Public Private Partnership (PPP) in Brindavan Colony and the flood issue be discussed first.
The Mayor adjourned the meeting for 10 minutes and announced a change in the order of priority of subjects. Based on the change, the issue of flood was discussed first, which was followed by the underground drainage and PPP.
Keywords: Vijayawada Municipal Corporation, grant, flood victims, TDP, Congress, Public Private Partnership


text:
I see a ton of people swapping in LA and SD but I don't like to drive that far. Traffic really pisses me off more than anything.
Who wants to swap HB in the OC? I'm in the Newport,HB, FV, Westminster, Irvine and Costa Mesa areas.
I'm in Riverside, but I'm 2-3 days a week on OC so may work for me from time to time
im down to do a swap like this? im in Orange
Count me in I'm Costa Mesa area
theres a homebrew club meeting next week Thursday at OUT OF THE PARK PIZZA.
its in anaheim. 91 off of imperial highway. last week they poured Remy RIS aged in Pappy Van Winkle barrels and it wasnt even bottled yet. hoparazzi served a couple of their beers as well
I'm in Orange/ Santa Ana. I'd love to trade/ get some more brewing friends.
Lets play a game. It's called drink a beer.
what style do you brew? i currently have farmhouse, sours, RIS and APA


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Get the Best Priced Mercedes 380SEL AC Expansion Valve
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Search our online ac expansion valve catalog and find the lowest priced discount auto parts on the web. We sell wholesale to the public. We offer high quality new, OEM, aftermarket and remanufactured Mercedes 380SEL AC Expansion Valve parts. We specialize in a wide-variety of high-quality car parts and accessories for your car, truck or SUV. Call toll free to order or place your order online via our secure checkout system. Our online parts catalog uses real-time inventory, so you can be assured the parts you buy are in stock at the time of ordering. Most orders are shipped the same day. They are available for the following Mercedes 380SEL years: 1983, 1982, 1981, 83, 82, 81. This part is also sometimes called Mercedes 380SEL Air Conditioner. We stock ac expansion valve parts for most Mercedes models including ML320, E320, C230, 300D, 300SD, 300TD, 190E, E300, C280, 300E, S500, ML430, S430, C240, 240D, CLK320, 380SL, 560SL, S320, 280SE, 190D, 300CD, ML350, 300SE, E350, 250C, 420SEL, C220, 450SEL, SLK230, C320, 300SDL, 300TE, E430, E420, GL450, S420, Sprinter 2500, CLK430 and ML500.
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Great price fast turn around the exact part i needed..
Order process was straghtforward. There was a problem with my credit card and I had to use a different card, which they updated with no delay. The only issue I had was getting through on the phone....


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Vienna, Austria
Margaretenstraße 92, 05. Margareten, 1050 Vienna, Austria – Show map
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pentahotel Vienna's staff speaks: Polish, Hungarian, French, English, German
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Pool Table, Sauna, Fitness Center
Food & Drink
Restaurant, Bar, Breakfast in the Room, Restaurant with Dining Menu
WiFi is available in all areas and is free of charge.
Public parking is available on site (reservation is not possible) and charges apply.
Room Service, Vending Machine (drinks), Vending Machine (snacks), Shuttle Service (surcharge), Airport Shuttle (surcharge), 24-Hour Front Desk, Express Check-in/Check-out, Baggage Storage, Laundry, Shoeshine, Meeting/Banquet Facilities, Fax/Photocopying
Newspapers, Safe, Non-smoking Rooms, Elevator, Heating
Polish, Hungarian, French, English, German
From 3:00 PM
Until 12:00 PM
Cancellation and prepayment policies vary according to room type. Please enter the dates of your stay and check what conditions apply to your preferred room.
Children and Extra Beds
All children are welcome.
All children under 12 years stay free of charge when using existing beds.
All children under 2 years stay free of charge in a crib.
One older child or adult is charged EUR 25 per person per night in an extra bed.
The maximum number of extra beds/cribs in a room is 1.
Any type of extra bed or crib is upon request and needs to be confirmed by management.
Additional fees are not calculated automatically in the total cost and will have to be paid for separately during your stay.
Pets are allowed. Charges may apply.
When booking more than 9 rooms, different policies and additional supplements may apply.
Cards accepted at this property
Hover over the cards for more info.
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Opened in November 2014, Motel One Wien-Staatsoper is just 165 ft from the Ringstraße boulevard and 325 ft from the State Opera.
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In Austria's highest skyscraper, the DC Tower, the Melia Vienna features luxurious and modern rooms as well as a rooftop terrace with a cocktail bar offering stunning views of the Danube River and the...
Score from 1040 reviews Very good
The staff is very helpful and friendly! The heat didn't work in our room and they upgraded us to a better room at no charge!
Is a bit overpriced for what you get!
It was perfect for our needs and I was particularly taken with the design features in the bar/lounge. The staff were exceptional and very helpful.
Honestly, I am finding it very difficult to identify anything I did not like.
The staff at the Pentahotel are wonderful with a nothing too much trouble attitude The bar staff can make a wonderful mojito The restaurant is well worth a visit in fact we ate there every night
- bed and pillows were very comfortable - very clean and updated room - nice bar and breakfast was outstanding - A few blocks walk to the metro - The staff was very friendly and helpful
- I wish there were more restaurants and bars closer to the hotel, but it is still a nice area.
Very nice trendy hotel, good sized rooms and lovely food in the restaurant.
I personally would have preferred two pillows to sleep on and tea and coffe in the rooms would have been good.
Good location, proximity to sights, shopping, etc. Nice, young staff. We liked the 24h bar and the eclectic design of the lobby, it was nice to rest there when returning to the hotel. Comfortable beds.
Our room was somewhat tiny and the wi-fi slow, indeed, but that was not bothering us during a one-night stay.
The bar
Very cold in the rooms
location quirky design comfortable room
slow wifi (higher speed is optional, for an extra fee) breakfast expensive (19€/person)
Wifi was terrible.
beautiful rooms. Hotel bar is fabulous with biliard table. Grate location, 5 minutes far from the famost city market. 20 minutes walk to the center, or 8 eur taxi drive.
Unfortunately, there are no smoking place in hotel. When you want to drink glass of wine, you realy need cigarete. In Austria, most of restaurants has separate space for smokers and non-smokers. Why not here?
staff,hotel facilities
Very trendy bar area as the main lobby and reception, the breakfast was really good
The hotel is so trendy with dark and moody décor which we liked but then the room was inconsistent, it was bright, colourful and too obviously budget in comparison..actually a bit orange like easyjet...
Hotel was very fancy. Prices are friendly at the bar & restaurant for good quality. Tip: reserve breakfast the day before for 10€ discount.
Very bad pillows too soft.
great staff lovely location great breakfast wonderful bar
The decoration is brilliant, as well as the concept. The beds are really big and good.
The service, the guys in the reception were playing Playstation (FIFA) and had to scream to them for getting a drink. The shower was broken. The location is not so good.
Free TV :)
Stylish design. Clean and quiet(if close the window). Near to the Naschmarkt and the U bahn,but little far away from Stephansplatz.
The speed of wifi is totally a disaster. Only one free bottle of water even you booked for three days, they only provided it on the first day. Only a few number of staffs so you will spend a lot of time waiting for check in/out. Some staffs were rude and unprofessional . No bath. Very expensive food.
Great location close to public transportation. Excellent breakfast buffet.
Beds and linen are merely perfect. One of the best I've ever tried.
Free WiFi is too slow. Even if you just want to surf or handle applications the performance is bad.
The lobby and toiletries
Extremely slow wifi The rooms are a bit small
Very cool design. Bed is excellent, location and food at breakfast too.
"Free" internet is 256Kb/s? It is like 10 years ago.... Breakfast seating is pretty chaotic, no one tells you that you can sit wherever in lobby, and since at breakfast area there are limited tables, people are wandering through tables asking for free chair.
This place was great, and fairly cheap for being so close to the center of Vienna. I will definitely come back again!
The free wifi is extremely slow, to the point where it's practically unusable
Some of the staff were very unprofessional and has a very rude attitude .
Huge comfy bed, reasonable location, nice bar, aircon was good. For the price paid (Euro47) good value. Did not try the breakfast.
Wifi worked but sometimes very slow, room only 2.5m or so wide, so felt a bit tight moving around,
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This Spring Assisted knife combines the Italian style stilettos with a lever opening system except ours is Spring Assisted, not lever opening, making this knife legal in most states (please check your state and local laws). It features a traditional stiletto style dagger point blade with a false upper edge. The blade is black anodize 440 stainless steel finish. Just assist the blade about 45 and watch the spring flicks into action. The blade opens smooth while it locks up solid and has an easy release liner lock mechanism. The Handle features a traditional style Leverlock design with a black and red design and a strip of black insert making this knife the ultimate classic Leverlock look-a-like. The insertion can also be used to inscribe a name to give to someone as a gift. The handle also sports a double wall reinforcement making the knife sturdy and unbreakable. Teflon spacers allow the blade and handle to open and close with ease. The back of our Leverlock Italian Spring Assisted knife offers a pocket clip for easy to access when ready to use. Specifications:
Overall Length: 8.50 inch
Blade Length: 3.75 inch
Blade Material: 440 Stainless Steel, Black Anodize
Blade Style: Spear Point
Blade Thickness: 3.00 mm
Handle Length: 4.75 inch
Handle Material: Double Wall Reinforcement, Red & Black Aluminum Finish.
Includes: Black Pocket Clip


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Mississippi State at Mississippi in the 109th Egg Bowl. Coach Dan Mullen and MSU aim for a fourth-straight win over the Rebels, who need a win to gain bowl eligibility. QB Bo Wallace runs the Ole Miss attack, while LB Cameron Lawrence stokes MSU.
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Adding [a] new type[s] in gen 3?
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August 8th, 2013 (11:55 AM).
Ksiazek Bartlomiej
Rejishan awake...
Join Date: Jun 2008
Location: Takoabe Town (Region Thonsu)
Age: 21
Gender: Male
Nature: Hardy
But when I asked about every Pokemon Emerald routine adresses noone gave me them. I need routines of Pokemon Cries, Dex Entries and Types. Meybe you can help me.
- Thonsu Region will never die when Rejishan take care about them. Even the evilnesse of Team Mystic do not destroy land of Thonsu.
POKEMON DIRTY SUN - Comming Soon.
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text: Youku Tudou Inc (ADR) Company Profile (NASDAQ:YOKU) Tweet Analyst RatingsEarningsDividendsInsider TradesCompany ProfileSocial ActivityToday's Chart Consensus Ratings for Youku Tudou Inc (ADR) (NASDAQ:YOKU) (?) The ratings breakdown includes the most recent rating from each analyst that has rated the stock within the last twelve months. The ratings score is a calculation of the average number of sell, hold, buy and strong buy ratings (0-1.5 = Sell, 1.5-2.5 = Hold, 2.5-3.5 = Buy, >3.5 = Strong Buy). The consensus price target is a mean average of the most recent price target set by each analyst that has set a price target for the stock in the last twelve months.Ratings Breakdown: 3 Sell Rating(s), 4 Hold Rating(s), 7 Buy Rating(s)Consensus Rating:Hold (Score: 2.29)Consensus Price Target: $25.43 (47.16% upside) Analysts' Ratings History for Youku Tudou Inc (ADR) (NASDAQ:YOKU) Show: All Ratings For This Stock Only the Most Recent Rating From Each Brokerage DateFirmActionRatingPrice TargetDetailsShare12/10/2014Credit SuisseUpgradeNeutral -> OutperformView 11/17/2014JPMorgan Chase & Co.Reiterated RatingHold$26.00 -> $22.00View 11/14/2014HSBCDowngradeNeutral -> UnderweightView 9/16/2014OTR GlobalDowngradePositiveView 8/21/2014MacquarieReiterated RatingOutperform$30.00 -> $28.00View 8/21/2014BarclaysReiterated RatingOverweight$30.00 -> $28.00View 8/20/2014Morgan StanleyDowngradeOverweight -> Equal WeightView 8/20/2014Goldman SachsLower Price Target$21.00View 8/20/2014Brean CapitalLower Price TargetBuy$27.00 -> $24.00View 8/18/2014T.H. CapitalInitiated CoverageBuy -> HoldView 8/18/2014TH CapitalDowngradeBuy -> HoldView 6/12/2014TheStreetDowngradeHold -> SellView 6/4/2014Goldman SachsInitiated CoverageNeutralView 5/27/2014MacquarieReiterated RatingOutperform$36.00 -> $30.00View 5/27/2014HSBCUpgradeUnderweight -> Neutral$22.00View 5/23/2014Maxim GroupReiterated RatingSellView 5/23/2014ING GroupReiterated RatingBuy$36.00 -> $27.00View 5/23/2014Brean CapitalLower Price TargetBuy$36.00 -> $27.00View 5/1/2014Maxim GroupReiterated RatingSell$24.00 -> $18.00View 4/25/2014NomuraUpgradeNeutral -> BuyView 4/16/2014Goldman SachsUpgradeSell -> Neutral$27.00View 3/3/2014Deutsche BankLower Price Target$29.00 -> $28.00View 2/24/2014Goldman SachsDowngradeNeutral -> SellView 2/19/2014Deutsche BankDowngradeHold -> Sell$24.00View 2/19/2014Maxim GroupDowngradeHold -> Sell$24.00View 11/18/2013HSBCDowngradeOverweight -> UnderweightView 11/18/2013T.H. CapitalBoost Price TargetBuy$28.00 -> $33.00View 11/15/2013Deutsche BankReiterated RatingIn-LineView 11/15/2013Maxim GroupReiterated RatingHoldView 11/15/2013Bank of AmericaDowngradeBuy -> NeutralView 11/11/2013JPMorgan Chase & Co.UpgradePositiveView 11/11/2013Brean CapitalUpgradeHold -> Buy$1.15 -> $36.00View 9/26/2013Credit SuisseInitiated CoverageNeutralView 9/4/2013HSBCLower Price TargetOverweight$29.00 -> $28.00View 8/30/2013JPMorgan Chase & Co.DowngradeOverweight -> Neutral$25.00 -> $23.00View 8/12/2013Deutsche BankDowngradeBuy -> Hold$22.84 -> $23.00View 8/9/2013HSBCLower Price TargetOverweight$30.00 -> $29.00View 8/9/2013Goldman SachsReiterated RatingBuy -> NeutralView 8/9/2013Brean CapitalReiterated RatingHoldView 5/21/2013T.H. CapitalBoost Price Target$28.00View 5/16/2013Bank of AmericaInitiated CoverageBuyView 5/16/2013HSBCUpgradeNeutral -> Overweight$21.00 -> $30.00View 5/16/2013Maxim GroupUpgradeSell -> HoldView 4/24/2013Maxim GroupLower Price TargetSell$16.00 -> $14.00View 3/20/2013Goldman SachsReiterated RatingBuy$20.00View 3/14/2013TheStreetUpgradeSell -> HoldView 3/11/2013NomuraLower Price TargetBuy$40.00 -> $38.00View 3/4/2013Deutsche BankLower Price TargetBuy$29.56 -> $26.20View 3/1/2013NomuraLower Price TargetBuy$40.00 -> $38.00View 3/1/2013Goldman SachsReiterated RatingBuyView 3/1/2013Piper JaffrayInitiated CoverageNeutral$17.00 -> $16.00View 2/4/2013Maxim GroupDowngradeHold -> Sell$16.00View 1/28/2013Deutsche BankInitiated CoverageBuy$29.56View (Data available from 12/19/2012 forward) Earnings History for Youku Tudou Inc (ADR) (NASDAQ:YOKU)DateQuarterConsensus EstimateActual EPSRevenue EstimateActual RevenueRelease LinkConference CallDetailsShare11/13/2014Q314($0.07)($0.08)$1.10 billion$180.00 billionViewListenView 8/19/2014Q214($0.34)($0.07)$154.54 millionViewListenView 5/22/2014Q1($0.20)($0.14)$112.70 millionViewListenView 2/27/2014Q413($0.33)($0.02)$148.90 millionViewN/AView 11/14/2013Q313($0.39)($0.21)$850.75 million$140.20 millionViewListenView 8/8/2013Q2 2013($0.75)($0.10)$122.30 million$122.80 millionViewListenView 5/15/2013Q1 2013($0.20)($0.23)$82.00 million$83.10 millionViewListenView 2/28/2013Q4 2012($0.14)($0.11)$102.00 millionViewListenView 11/29/2012-0.11($0.11)$79.90 millionViewListenView 8/6/2012($0.10)($0.09)ViewN/AView 5/17/2012($0.19)($0.22)ViewN/AView 3/12/2012($0.05)($0.07)ViewN/AView 11/16/2011($0.05)($0.07)ViewN/AView 8/8/2011($0.05)($0.04)ViewN/AView 5/5/2011($0.08)($0.07)ViewN/AView 2/28/2011($0.03)($0.13)ViewN/AView (Data available from 1/1/2011 forward) Dividend History for Youku Tudou Inc (ADR) (NASDAQ:YOKU)No dividend announcements for this company have been tracked by Analyst Ratings Network Insider Trading History for Youku Tudou Inc (ADR) (NASDAQ:YOKU)No insider trades for this company have been tracked by Analyst Ratings Network About Youku Tudou Inc (ADR) Youku Tudou Inc. (Youku), formerly Youku Inc., is an Internet television company in the People's Republic of China. The Company's Internet television platform enables consumers to search, view and share video content across multiple devices. During the year ended December 31, 2011, the Company had approximately 263 million monthly visitors from homes and offices. As of December 31, 2011, the Company's video content library contained more than 2,700 movie titles, 2,111 television serial drama titles and over 400,000 hours of other professionally produced content, including 613 variety shows. The Company and Tudou Holdings Limited announced the completion of the merger (the Merger) between Tudou and Two Merger Sub Inc., a wholly owned subsidiary of Youku, pursuant to the agreement and plan of merger, dated March 11, 2012, by and among Youku, Tudou and Merger Sub. As a result of the Merger, Tudou became a wholly owned subsidiary of Youku. Headlines: (12/11) Youku Tudou (YOKU) Targets Growth Through Diversification - Bidness ETC (12/18) Youku Tudou Inc Receives Consensus Rating of "Hold" from Analysts (NASDAQ ... - The Legacy (11/19) What Latest Financials Indicate for Youku Tudou Inc (ADR) (NYSE:YOKU)? - Inside Trade (12/17) What's affecting Chinese ADRs? - Weibo Corp (ADR) (NASDAQ:WB), Youku ... - Markets Emerging (12/11) Notable Names: Lands' End, Inc. (NASDAQ:LE), Youku Tudou Inc (ADR) (NYSE ... - Stafford Daily (11/21) Youku (YOKU) Gets MNVO License In China - Bidness ETC (12/12) Asian stocks rose: SK Telecom (SKM), Youku Tudou (YOKU), Siliconware ... - Investor Wired (press release) (12/12) Credit Suisse Upgrades Youku Tudou Inc to "Outperform" (YOKU) - Watch List News (press release) (12/16) Youku Tudou Inc Receives Average Rating of "Hold" from Analysts (NASDAQ ... - sleekmoney (12/10) Technology Stocks in Review: Youku Tudou Inc (ADR)(YOKU), Teradyne, Inc ... - Techsonian (press release) Industry, Sector and Symbol: Sector: N/A Industry: N/A Sub-Industry: N/A Exchange: NASDAQ Symbol: YOKU CUSIP: Key Metrics: Previous Close: $17.2250 Day Moving Average: $19.1734200 Day Moving Average: $19.6549P/E Ratio: N/AP/E Growth: N/AMarket Cap: $3.421BCurrent Quarter EPS Consensus Estimate: $-3.90 EPS Additional Links: View YOKU on Google FinanceView YOKU on Yahoo FinanceView YOKU's Company Profile on ReutersSearch for Youku Tudou Inc (ADR) on Google Youku Tudou Inc (ADR) (NASDAQ:YOKU) Chart for Friday, December, 19, 2014 (Chart Provided by Yahoo Finance)


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BNY Mellon
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I applied online. The process took 5 weeks – interviewed at BNY Mellon in November 2012.
Contacted by recruiter and set up for initial interview with hiring manager. Interview was quick, maybe 20 minutes. Second interview set up and met with another manager in the division. Recruiter followed up less than a week later with offer.
- More conversational than questions. Answer Question
Other Interview Reviews for BNY Mellon
Financial Analyst InterviewApplication Details
I applied through a staffing agency. The process took 2 days – interviewed at BNY Mellon in November 2009.Interview Details
Interview arranged by my head hunter. First met with hiring manager who asked questions to see if I was a good personality fit. Then met with supervisor to asked more technical questions to see if I had the right skill set. Invited for a second round to meet with managing directors. The purpose was for them to see if I was the kind of person who would be able to contribute to the overall success of the firm. They weren't interested in my entire resume/background just certain parts. My suggestion is that when you meet with BONY for an interview, only elaborate on relevant parts of your resume.Interview Questions
Negotiation DetailsThere was no negotiation, they knew what they wanted to pay. (No more-no less)Accepted OfferPositive ExperienceAverage Interview
- How did you acquire your skill set? View Answer
Financial Analyst InterviewApplication Details
I applied online. The process took a day – interviewed at BNY Mellon in June 2012.Interview Details
its quit good and have good communication with all interviewInterview Questions
No OfferNegative ExperienceDifficult Interview
- last interview fill that my communication is not good where all other convince View Answer
Financial Analyst InterviewApplication Details
interviewed at BNY Mellon in November 2010.Interview Details
Written Aptitude Test, HR and Ops ManagerInterview Questions
Accepted OfferPositive ExperienceDifficult Interview
- Depend upon you View Answer


text:
Pronunciation: Fontäne
Added on: 2010-04-16 Listened: 91 timesin: water
Pronunciation in German [de]
- Pronunciation by sunny77 (Female from Germany)
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- Could you do it better? different accent? Pronounce Fontäne in German
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- Random word: Insektenkamera
by Wiktionary Phonetic spelling:
by Google Translate English translation:
Fontäne = Fountain
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text:
I am new to doing manually installing.
I reinstalled sdl manually, now everytime I run pygame or a game that uses SDL (eg. solarwolf or supertux) I get the message: Unsupported console hardware. I know my computer can run SDL, because it worked prior to the reinstallation.
I want to now how I can reinstall SDL properly, so that pygame will work again.
ubuntu: Ubuntu 10.04 LTS Lucid Lynx
sdl: 1.2.14
Stuff I have tried:
I have tried this commandoes I found on the net:
wget http://www.libsdl.org/release/SDL-1.2.14.tar.gz
tar -xzvf SDL-1.2.14.tar.gz
cd SDL-1.2.14
./configure --prefix=$HOME
make install
I tried again with sudo and no prefix. Maybe that wrecked some prior configurationsfile or something?
wget http://www.libsdl.org/release/SDL-1.2.14.tar.gz
tar -xzvf SDL-1.2.14.tar.gz
cd SDL-1.2.14
sudo make install
3)I used the Synaptic Package Manager to completely remove and reinstall all files starting with libsdl.
4)I have tried reinstalling supertux and solarwolf (with ubuntu software senter) hoping it could resolve the problem if there were some missing dependencies.
Conclusion. I geuss a have installed sdl, but wrecked a confirgurationfile or something preventing communication between sdl and the graphic driver. But that is a wild guess.


text:
sweet. definitely buying that baby!!
Mine came in yesterday! Works great.
It's a bit tricky to reseal hopsdirect bag though. Gotta hold it in place for a little while after it's done its cycle.
My Beer Review Blog: Beer Review Dude
My Craft Beer Social Network: Craft Beer Network
I purchased this sealer. What type of bags are cheapest and still work?
Not sure if these work, but they're dirt cheap, $42 for 1000 bags.http://www.uline.com/BL_5563/Vacuum-...=Vacuum%20Bags
I use these and they work great.http://www.amazon.com/Weston-30-0106...1237451&sr=8-1


text:
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J M Heating & Cooling
(708) 310-2621 (Disconnected)448 Englewood Ave, Hillside, IL 60162-1811 Send email to J M Heating & Cooling
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Contact InformationPrincipal: Mr. Oscar Meja (Owner)Mr. Ubaldo Rodriguez (Owner)
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text:
Inspector Gadget the cyborg detective starred in his own tv-show that ran from '83 to '86.
Design made in vector for perfect quality.
These silhouette tshirts are a great idea, this is my favourite I think! I used to love Inspector Gadget, was it really that long ago?!
thnx! Hard to believe it's been so long isn't… thank god for re-runs ;-)
– Luc Kersten