text:
From Wikipedia, the free encyclopedia - View original article
|Systematic (IUPAC) name
|Clinical data
|Legal status
|CAS number
|ATC code
|Artemisinine, Qinghaosu
|Chemical data
|Mol. mass
|282.332 g/mol
|Physical data
|1.24 ± 0.1 g/cm³
|Melt. point
|(what is this?) (verify)
|Systematic (IUPAC) name
|Clinical data
|Legal status
|CAS number
|ATC code
|Artemisinine, Qinghaosu
|Chemical data
|Mol. mass
|282.332 g/mol
|Physical data
|1.24 ± 0.1 g/cm³
|Melt. point
|(what is this?) (verify)
Artemisinin /ɑrtɨˈmɪsɨnɨn/, also known as Qinghaosu (Chinese: 青蒿素), and its derivatives are a group of drugs that possess the most rapid action of all current drugs against Plasmodium falciparum malaria.[1] Treatments containing an artemisinin derivative (artemisinin-combination therapies, ACTs) are now standard treatment worldwide for P. falciparum malaria. Artemisinin is isolated from the plant Artemisia annua, sweet wormwood, a herb employed in Chinese traditional medicine. It can now also be produced using genetically engineered yeast.
Chemically, artemisinin is a sesquiterpene lactone containing an unusual peroxide bridge. This peroxide is believed to be responsible for the drug's mechanism of action. Few other natural compounds with such a peroxide bridge are known.[2]
Use of the drug by itself as a monotherapy is explicitly discouraged by the World Health Organization, as there have been signs that malarial parasites are developing resistance to the drug. Therapies that combine artemisinin with some other antimalarial drug are the preferred treatment for malaria and are both effective and well tolerated in patients. The drug is also increasingly being used in Plasmodium vivax malaria,[3] as well as being a topic of research in cancer treatment.
Artemisinin is an antimalarial lactone derived from qing hao (Artemisia annua or sweet wormwood). The medicinal value of this plant has been known to the Chinese for at least 2,000 years. In 1596, Li Shizhen recommended tea made from qing hao specifically to treat malaria symptoms. The genus name is derived from the Greek goddess Artemis and, more specifically, may have been named after Queen Artemisia II of Caria, a botanist and medical researcher in the fourth century bce. [4]
|This section needs additional citations for verification. (June 2014)
Artemisia annua (A. annua) is a common herb found in many parts of the world, and has been used by Chinese herbalists for more than two thousand years in the treatment of many illnesses, such as skin diseases and malaria.[citation needed] The earliest record dates back to 200 BC, in the "Fifty-two Prescriptions" unearthed from the Mawangdui Han Dynasty tombs.[citation needed] Its antimalarial application was first described, in Zhouhou Beiji Fang ("The Handbook of Prescriptions for Emergencies", Chinese: 肘后备急方), edited in the middle of the fourth century by Ge Hong; in that book, 43 malaria treatment methods were recorded.[citation needed] Images of the original scientific papers that record the history of the discovery, have been available online since 2006.[citation needed]
In the 1960s, a plant screening research program, under the name Project 523, was set up by the Chinese army to find an adequate treatment for malaria; the program and early clinical work were ordered of Chairman Mao Zedong at the request of North Vietnamese leaders to provide assistance for their malaria-ridden army.[citation needed] In the course of this research, Tu Youyou discovered artemisinin in the leaves of Artemisia annua (annual wormwood; 1972).[5] The drug is named Qinghaosu (Chinese: 青蒿素) in Chinese.[citation needed] It was one of many candidates tested as possible treatments for malaria by Chinese scientists, from a list of nearly 5000 traditional Chinese medicines.[citation needed] Tu Youyou also discovered that a low-temperature extraction process could be used to isolate an effective antimalarial substance from the plant; Tu says she was influenced by a traditional Chinese herbal medicine source saying that this herb should be steeped in cold water.[6] The extracted substance, once subject to purification, proved to be a usable antimalarial drug.[7] A 2012 review reported that artemisinin-based therapies were the most effective drugs for treatment of malaria at that time;[8] it was also reported to clear malaria parasites from patients' bodies faster than other drugs. 'In addition to artemisinin, 'Project 523 developed a number of products that can be used in combination with artemisinin, including lumefantrine, piperaquine, and pyronaridine.[5]
For many years after the discovery, access to the purified drug and the plant from which it was extracted were restricted by the Chinese government.[citation needed] It was not until the Chinese economic reform in the late 1970s and early 1980s that news of the discovery reached scientists outside China via results published in the Chinese Medical Journal (in 1979).[9][non-primary source needed] Ying Lee, one of the scientists involved in the research into artemisinin, said the Chinese had distrusted the West at the time.[this quote needs a citation] The research was met with skepticism at first, partly because the chemical structure of artemisinin, particularly the peroxide portion, appeared to be too unstable to be a viable drug.[2]
In the late 1990s, Novartis bought a new Chinese patent for a combination treatment with artemether and lumefantrine, providing the first artemisinin-based combination therapies (ACTs) (Coartem) at reduced prices to the World Health Organisation.[10] In 2006, after artemisinin had become the treatment of choice for malaria, the WHO called for an immediate halt to single-drug artemisinin preparations in favor of combinations of artemisinin with another malaria drug, to reduce the risk of parasites developing resistance.[11]
In 2011, Tu Youyou was awarded the prestigious Lasker-DeBakey Clinical Medical Research Award for her role in the discovery and development of artemisinin.[5][12] The New York Times notes that the discovery of artemisinin is under consideration for a future Nobel Prize in Physiology or Medicine.[13]
Because artemisinin itself has physical properties such as poor bioavailability that limit its effectiveness, semisynthetic derivatives of artemisinin have been developed. These include:
There are also simplified analogs in preclinical research.[14]
A synthetic compound with a similar trioxolane structure (ring containing three oxygen atoms) named arterolane[15] showed promise in in vitro testing. Phase II testing in patients with malaria was not as successful as hoped, but the manufacturer decided to start Phase III testing anyway.[16] A combination with piperaquine is also in development.[citation needed]
Artemisinins can be used alone, but this leads to a high rate of recrudescence (return of parasites) and other drugs are required to clear the body of all parasites and prevent recurrence. The World Health Organization (WHO) is pressuring manufacturers to stop making the uncompounded drug available to the medical community at large, aware of the catastrophe that would result if the malaria parasite developed resistance to artemisinins.[17]
The WHO has recommended artemisinin combination therapies (ACT) be the first-line therapy for P. falciparum malaria worldwide.[18] Combinations are effective because the artemisinin component kills the majority of parasites at the start of the treatment, while the more slowly eliminated partner drug clears the remaining parasites.[19]
Several fixed-dose ACTs are now available containing an artemisinin component and a partner drug which has a long half-life, such as mefloquine (ASMQ[20]), lumefantrine (Coartem), amodiaquine (ASAQ), piperaquine (Duo-Cotecxin), and pyronaridine (Pyramax). Increasingly, these combinations are being made to GMP standard. A separate issue concerns the quality of some artemisinin-containing products being sold in Africa and Southeast Asia.[21][22]
Artemisinins are not used for malaria prophylaxis (prevention) because of the extremely short activity (half-life) of the drug. To be effective, it would have to be administered multiple times each day.
Artesunate administered by intravenous or intramuscular injection has proven superior to quinine in large, randomised controlled trials in both adults [23] and children.[24] Combining all trials comparing these two drugs, artesunate is associated with a mortality rate that is approximately 30% lower than that of quinine.[24] Reasons for this difference include reduced incidence of hypoglycaemia, easier administration and more rapid action against circulating and sequestered parasites. Artesunate is now recommended by the WHO for treatment of all cases of severe malaria.
Artemisinin is undergoing early research and testing for the treatment of cancer.[25][26] Chinese scientists have shown artemisinin has significant anticancer effects against human hepatoma cells.[27] Artemisinin has a peroxide lactone group in its structure, and it is thought that when the peroxide comes into contact with high iron concentrations (common in cancerous cells), the molecule becomes unstable and releases reactive oxygen species. It has been shown to reduce angiogenesis and the expression of vascular endothelial growth factor in some tissue cultures. Recent pharmacological evidence demonstrates the artemisinin-derivative dihydroartemisinin targets human metastatic melanoma cells with induction of NOXA (phorbol-12-myristate-13-acetate-induced protein 1)-dependent mitochondrial apoptosis that occurs downstream of iron-dependent generation of cytotoxic oxidative stress.[28]
Serendipitous discovery was made in China while searching for novel anthelmintics for schistosomiasis. Artemisinin was effective against schistosomes, the human blood flukes, which are the second-most prevalent parasitic infections, after malaria. Artemisinin and its derivatives are all potent anthelmintics.[29] Artemisinins were later found to possess a broad spectrum of activity against a wide range of trematodes, including Schistosoma japonicum, S. mansoni, S. haematobium, Clonorchis sinensis, Fasciola hepatica, and Opisthorchis viverrini. Clinical trials were also successfully conducted in Africa among patients with schistosomiasis.[30] A randomized, double-blind, placebo-controlled trial also revealed the efficacy against schistosome infection in Côte d'Ivoire[31] and China.[32]
Clinical evidence for artemisinin resistance in southeast Asia was first reported in 2008,[33] and was subsequently confirmed by a detailed study from western Cambodia.[34] Resistance in neighbouring Thailand was reported in 2012.[35] The parasite's kelch gene on chromosome 13 appears to be a reliable molecular marker for clinical resistance in Cambodia.[36]
In April 2011, the WHO stated that resistance to the most effective antimalarial drug, artemisinin, could unravel national (India) malaria control programs, which have achieved significant progress in the last decade. WHO advocates the rational use of antimalarial drugs and acknowledges the crucial role of community health workers in reducing malaria in the region.[37]
Artemisinins are generally well tolerated at the doses used to treat malaria.[38] The side effects from the artemisinin class of medications are similar to the symptoms of malaria: nausea, vomiting, anorexia, and dizziness. Mild blood abnormalities have also been noted. A rare but serious adverse effect is allergic reaction.[38][39] One case of significant liver inflammation has been reported in association with prolonged use of a relatively high-dose of artemisinin for an unclear reason (the patient did not have malaria).[40] The drugs used in combination therapies can contribute to the adverse effects experienced by those undergoing treatment. Adverse effects in patients with acute P. falciparum malaria treated with artemisinin derivatives tend to be higher.[41]
All artemisinins used today are prodrugs of the biologically active metabolite dihydroartemisinin, which is active during the stage when the parasite is located inside red blood cells. Although there is no consensus regarding the mechanism through which artemisinin derivatives kill the parasites,[42] several lines of evidence indicate that artemisinins exert their antimalarial action by perturbing redox homeostasis in malaria parasites. When the parasite that causes malaria infects a red blood cell, it consumes hemoglobin within its digestive vacuole, a process that generates oxidative stress.[43] In one theory the iron of the heme directly reduces the peroxide bond in artemisinin, generating high-valent iron-oxo species and resulting in a cascade of reactions that produce reactive oxygen radicals which damages the parasite and lead to its death.[44] A more recently described alternative is that artemisinins disrupt cellular redox cycling.[45]
Numerous studies have investigated the type of damage oxygen radicals may induce. For example, Pandey et al. have observed inhibition of digestive vacuole cysteine protease activity of malarial parasites by artemisinin.[46] These observations were supported by ex vivo experiments showing accumulation of hemoglobin in the parasites treated with artemisinin and inhibition of hemozoin formation by malaria parasites. Electron microscopic evidence linking artemisinin action to the parasite's digestive vacuole has been obtained showing that the digestive vacuole membrane suffers damage soon after parasites are exposed to artemisinin.[47] This would also be consistent with data showing that the digestive vacuole is already established by the mid-ring stage of the parasite's blood cycle,[48] a stage that is sensitive to artemisinins but not other antimalarials.
Another theory suggests that the electron transport chain activates artemisinin, generates local reactive oxygen species, and causes depolarization of the mitochondrial membrane.[49] The possible role of the parasite's SERCA pump (PfATP6 / PfSERCA) in the action of artemisinins[50] has been questioned by several authors[51][52] and study findings[53][54][55] and it has emerged that the original studies reporting specific interactions between SERCAs and artemisinins [50][56] were undertaken in a Xenopus oocyte system with a variable signal:noise ratio.[57]
Artemisinin derivatives have half-lives of the order of an hour, and therefore require at least daily dosing over several days. For example, the WHO-approved adult dose of co-artemether (artemether-lumefantrine) is 4 tablets at 0, 8, 24, 36, 48 and 60 hours (six doses).[58][59]
Artemisinin is not soluble in water, therefore Artemisia annua tea was postulated not to contain pharmacologically significant amounts of artemesinin.[60] However, this conclusion was rebuked by several experts who stated that hot water (85 °C), and not boiling water, should be used to prepare the tea. Although Artemisia tea is not recommended as a substitute for the ACT (artemisinin combination therapies), more clinical studies on its tea preparation have been suggested.[61]
China and Vietnam provide 70% and East Africa 20% of the raw plant material. Seedlings are grown in nurseries and then transplanted into fields. It takes about 8 months for them to reach full size. The plants are harvested, the leaves are dried and sent to facilities where the artemisinin is extracted using solvent, typically hexane. Alternative extraction methods have been proposed.[62] The market price for artemisinin has fluctuated widely, between $120 and $1200 per kilogram from 2005 to 2008.[63]
After negotiation with the WHO, Novartis and Sanofi-Aventis provide ACT drugs at cost on a nonprofit basis; however, these drugs are still more expensive than other malaria treatments.[64] Artesunate injection for severe malaria treatment is made by the Guilin Factory in China where production has received WHO prequalification,[65] an indicator of drug quality.
High-yield varieties of Artemisia are being produced by the Centre for Novel Agricultural Products at the University of York using molecular breeding techniques.[63]
Using seed supplied by Action for Natural Medicine (ANAMED), the World Agroforestry Centre (ICRAF) has developed a hybrid, dubbed A3, which can grow to a height of 3 m and produce 20 times more artemisinin than wild varieties. In northwestern Mozambique, ICRAF is working together with a medical organisation, Médecins sans frontières, ANAMED and the Ministry of Agriculture and Rural Development to train farmers on how to grow the shrub from cuttings, and to harvest and dry the leaves to make artemisia tea.
In April 2013, Sanofi announced the launch[66] of a production facility in Garessio, Italy, to manufacture the anti-plasmodial drug on a large scale. The partnership to create a new pharmaceutical manufacturing process was led by PATH's Drug Development program (through an affiliation with OneWorld Health), with funding from the Bill & Melinda Gates Foundation and based on a modified biosynthetic process for artemisinic acid, initially designed by Jay Keasling at the University of California, Berkeley and optimized by Amyris. The reaction is followed by a photochemical process creating singlet oxygen to obtain the end product. Sanofi expects to produce 25 tons of artemisinin in 2013, ramping up the production to 55-60 tons in 2014. The price per kg will be $350–400, roughly the same as the botanical source.[67] Despite concerns that this equivalent source would lead to the demise of companies, which produce this substance conventionally through extraction of A. annua biomass, an increased supply of this drug will likely produce lower prices and therefore increase the availability for ACTs treatment.
The biosynthesis of artemisinin is believed to involve the mevalonate pathway (MVA) and the cyclization of farnesyl diphosphate (FDP). It is not clear whether the non-mevalonate pathway pathway can also contribute 5-carbon precursors (IPP or/and DMAPP), as occurs in other sesquiterpene biosynthetic systems. The routes from artemisinic alcohol to artemisinin remain controversial, and they differ mainly in when the reduction step takes place. Both routes suggested dihydroartemisinic acid as the final precursor to artemisinin. Dihydroartemisinic acid then undergoes photo-oxidation to produce dihydroartemisinic acid hydroperoxide. Ring expansion by the cleavage of hydroperoxide and a second oxygen-mediated hydroperoxidation finish the biosynthesis of artemisinin.
Figure 1. Biosynthesis of artemisinin
The total synthesis of the sesquiterpene lactone, artemisinin (quinghaosu) has been performed from available organic starting materials, using basic organic reagents, many times. The first two total syntheses were a "remarkable... stereoselective synthesis" by Schmid and Hofheinz at Hoffmann-La Roche in Basel starting from (−)-isopulegol (13 steps, ≈5% overall yield) and a concurrent synthesis by Zhou and coworkers at the Shanghai Institute of Organic Chemistry from R-(+)-citronellal (20 steps, ≈0.3% overall yield).[68] Key steps of the Schmid-Hofheinz approach included an initial Ohrloff stereoselective hydroboration/oxidation to establish the "off-ring" methyl stereocenter on the propene side chain; two sequential lithium-reagent mediated alkylations that introduced all needed carbon atoms and that were, together highly diasteroselective; and further reduction, oxidation, and desilylation steps performed on this mono-carbocyclic intermediate, including a final singlet oxygen-utilizing photooxygenation and ene reaction, which, after acidic workup closed the three remaining oxacyclic rings of the desired product, artemisinin, in a single step.[68][69] (In essence, the final oxidative ring closing operation in these syntheses accomplishes the closing three biosynthetic steps shown above.)
A wide variety of further routes continue to be explored, from early days until today, including total synthesis routes from R-(+)-pulegone, isomenthene,[68] and even 2-cyclohexen-1-one,[70] as well as routes better described as partial or semisyntheses from a more plentiful biosynthetic precursor, artemisinic acid—in the latter case, including some very short and very high yielding biomimetic synthesis examples (of Roth and Acton, and Haynes et al., e.g., 3 steps, 30% yield), which again feature the singlet oxygen ene chemsitry.[68][71][72]
The partnership to develop semisynthetic artemisinin was led by PATH's Drug Development program (through an affiliation with OneWorld Health), with funding from the Bill & Melinda Gates Foundation. The project began in 2004, and initial project partners included the University of CA, Berkeley (which provided the technology on which the project was based – a process that genetically altered yeast to produce artemisinic acid); and Amyris, Inc. (a biotechnology firm in California, which refined the process to enable large-scale production and developed scalable processes for transfer to an industrial partner).
In 2006, a team from UC Berkeley reported they had engineered Saccharomyces cerevisiae yeast to produce small amount of the precursor artemisinic acid. The synthesized artemisinic acid can then be transported out, purified and chemically converted into artemisinin that they claim will cost roughly $0.25 per dose. In this effort of synthetic biology, a modified mevalonate pathway was used, and the yeast cells were engineered to express the enzyme amorphadiene synthase and a cytochrome P450 monooxygenase (CYP71AV1), both from A. annua. A three-step oxidation of amorpha-4,11-diene gives the resulting artemisinic acid.[73]
The Berkeley method proved impractical and too inefficient for commercial scale production, and the process was revamped using technology from various other organizations. The final successful technology is based on inventions licensed from UC Berkeley and the National Research Council (NRC) Plant Biotechnology Institute of Canada.
Commercial production of semisynthetic artemisinin is now underway at Sanofi's site in Garessio, Italy. This second source of artemisinin is poised to enable a more stable flow of key antimalarial treatments to those who need them most.[66] The production goal is set at 35 tons for 2013. It is expected to increase to 50-60 tons per year in 2014, supplying approximately 1/3 of the global annual need for artemisinin.
On May 8, 2013, WHO's Prequalification of Medicines Programme announced the acceptability of semisynthetic artemisinin for use in the manufacture of active pharmaceutical ingredients submitted to WHO for prequalification, or that have already been qualified by WHO.[74] Sanofi's API produced from semisynthetic artemisinin (artesunate) was also prequalified by WHO on May 8, 2013, making it the first semisynthetic artemisinin derivative prequalified.
In 2010, a team from Wageningen University reported they had engineered a close relative of tobacco, Nicotiana benthamiana, that can also produce the precursor artemisinic acid.[75]
This article contains public domain text from the CDC as cited
|Look up artemisinin in Wiktionary, the free dictionary.


text:
When you install Windows XP in a workgroup, the first time you restart the computer after setup completes, the OOBE program runs, to perform:
mouse tutorial
user creation</b>.
If you start the install with Winnt.exe or from the CD-ROM, running Winnt.sif from disk, OOBE runs the first time you start your computer after setup is complete.
To prevent OOBE from running during an unattended install, edit the unattend.txt file:

subset: commoncrawl


text:
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text:
|Name: _________________________
|Period: ___________________
This test consists of 5 multiple choice questions, 5 short answer questions, and 10 short essay questions.
Multiple Choice Questions
1. According to McConnell, both humans and dogs are ______and_______.
(a) Highly oral and shy.
(b) Highly visual and social.
(c) Highly sensitive and shy.
(d) Highly oral and social.
2. According to McConnell, what do decades of research indicate about what almost all dogs respond to?
(a) That almost all dogs respond to aural stimuli.
(b) That almost all dogs respond to physical stimuli.
(c) That almost all dogs respond to visual stimuli.
(d) That almost all dogs respond to gustation stimuli.
3. What will primates do with the objects around them?
(a) Manipulate them to get food.
(b) Ignore them.
(c) Use them as weapons.
(d) Barter them for comfort.
4. When an owner yells at a dog to stop barking, what is she or he encouraging the dog to do?
(a) Continue to bark.
(b) Sit down.
(c) Run away.
(d) Stop barking.
5. What is "doggie play bow"?
(a) Spreading feet apart.
(b) Kneeling on the ground.
(c) Slightly crouched stance.
(d) Touching hands on the ground.
Short Answer Questions
1. What are the corners of a dog's mouth called?
2. What three behaviors do dogs consider highly rude?
3. What is a dog pushing the corners of her or his mouth back a sign of?
4. What ingrained behavior is considered affectionate for humans but rude for dogs and should be avoided?
5. How conscious are humans of their pheromones?
Short Essay Questions
1. What are the differences between the way humans and dogs show affection, and why is it significant?
2. What is the "guy-with-the-gold-chain" hypothesis and what does it signify?
3. What myth do humans perpetuate about how dogs respond to them, and what does it signify?
4. In what ways are dogs' personalities similar to humans, and why is it significant?
5. What do the steps in teaching a dog how to come illustrate about training dogs?
6. What is the command McConnell teaches that mimics pack behavior, and how is it executed?
7. In what circumstances is a dog wrong for a home and what are the consequences?
8. According to McConnell, what are the repercussions of a dog who has had a sensitive period?
9. What biological and anatomical differences are their between humans and dogs in terms of smell, and why is it significant for owners and trainers?
10. How does a person spot submissiveness in a dog, and why is it important?
This section contains 835 words
(approx. 3 pages at 300 words per page)


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Chevron Corp (NYSE:CVX)
Provides administrative, financial, management and technology support to U.S. and foreign subsidiaries that engage in integrated petroleum operations, chemicals operations, mining operations, power generation and energy services.
I believe the whole sector is attractive because there is a lot of upside potential in oil prices as the economy recovers and this is not reflected on valuations, mostly around 10 times P/E. Chevron in particular has the advantage of possesing one of the cleanest balance sheets among petrol companies.


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BASEBALL: Oldham Aces vs. Next Level
Score: 9-6 Aces
When: Sunday.
Where: Beechmont Baseball complex, Louisville.
Key players: The Aces' Brad Reinbold, Alex Sharrard, Jason Sterrett and Preston Theiss.
A Kentucky State Police trooper suffered minor injuries during a traffic stop Monday on Interstate 71 as a commercial truck side-swiped his cruiser.
According to police, KSP Trooper Rick Ellis stopped a motorist about 10:55 a.m. Monday near the 32 mile-marker on I-71 in Henry County.
In addition to the daily duties performed by a group of instructional assistants self-named as SWAT (Super Women All the Time), these enthusiastic ladies have a unique talent for bolstering staff morale at La Grange Elementary.
This spring in Oldham County, Kentucky is no exception.
Thursday, July 3
American Legion Post No. 39. 7 p.m. Oldham County post, La Grange. 241-9701.
South Oldham High School Booster Club. 7 p.m. SOHS library. Call Jim Murphy, 552-5024. Aerobics class. 6 to 7 p.m. Tuesday and Thursday. La Grange Community Center, 307 W. Jefferson St. 225-6474.
At least we're not in California. Home sales have slowed, housing prices have leveled off, but it seems Oldham County has escaped the worst of the housing market crash that has adversely affected much of the country in the last year.
As the United States experiences home depreciation for the first time in 13 years, home values in Oldham County have only leveled off.
School's out, construction's on.
Without having to contend with school operations, construction crews are in full swing this summer in order to have North Oldham High, Oldham County High and Locust Grove Elementary schools ready for the start of school Aug. 13.
Officials at La Grange City Hall decided to "go green" but rising fuel prices are not the reason.
City officials recently launched a new four-day work week for employees based at city hall. Saving gas money, they say, is just a bonus.
La Grange Mayor Elsie Carter said that at a recent staff meeting, the conversation turned to Fridays and how slow the office was that day.
Celebrating Independence Day often involves fun in the great outdoors. Here's an option for the whole, nature-loving family: participate in the annual butterfly count.
University of Louisville biology professor emeritus Charles Covell will lead the butterfly census expedition Saturday at UofL's Horner Wildlife Sanctuary in Oldham County.
Magistrates tabled the first reading of an ordinance Tuesady allowing the City of Crestwood to withdraw from the Oldham County Sewer District.
Judge-Executive Duane Murner said there is a dispute whether the Oldham County Sewer District is organized under Section 76 or Section 220, as well as if the fiscal court approved the merger at all.
GOSHEN – The balance in the local boys high school basketball scene will be on display later this summer in the annual Fifth/Sixth Region vs. Seventh/Eighth Region All-Star game at Bellarmine University.
The game brings together some of the metro area's best talent including North Oldham's Dale Tingle, Oldham County's Eric Dunlap and South Oldham's Drew Kraemer.
Copyright © 2014
The Oldham Era is your source for local news, sports, events, and information in Oldham County and LaGrange, Kentucky, and the surrounding area.


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Good News in Housing: Home Sales Up
(Updated for mid-day change in shares prices).
WASHINGTON, D.C. ( TheStreet) -- Existing home sales showed a strong gain in October, the seventh consecutive month of an upward trend, surging 10.1% for the month to 6.10 million units.
The rate was 23.5% above the October 2008 level and the highest since February 2007, when 6.55 million units were sold. The level topped market estimates of 5.7 million units, which was itself an optimistic outlook for a beaten-down sector.
The looming expiration of the first-time buyer tax credit, since extended, could have played a large part in driving up home sales across the country. Still, it was a bright piece of news for a Monday morning that followed a really tough previous week for the U.S. home market.
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Colleen Curtis joined the White House as Director of Digital Content in July 2011. Prior to this role, she was most recently Editorial Director of Womens & Lifestyle Programming at AOL, where she launched 15 websites that reached more than 20 million Americans each month. In addition, Curtis has held numerous leadership roles in media in the United States and overseas, including senior editorial positions at ABC's Good Morning America, the New York Daily News, and the National Post.
A native of Sparta, New Jersey, Curtis studied journalism at Boston University's College of Communications and Columbia University's Graduate School of Journalism.
Colleen Curtis's Posts
Be Healthy, Be Active, Be You: The 2013 White House Easter Egg RollApril 1, 2013 at 5:44 PM EST
The First Family hosted more than 30,000 visitors for the 135th annual Egg Roll, the largest public event held at the White House each year.
Weekly Address: President Obama Offers Easter and Passover GreetingsMarch 30, 2013 at 5:00 AM EST
President Obama uses his weekly address to mark a sacred time for the millions of Americans celebrating Easter and Passover, and he calls on everyone to use this time to reflect on the common values we share as a nation.
In Miami, President Obama Talks About his Plan to Put People to Work Rebuilding AmericaMarch 29, 2013 at 3:11 PM EST
Despite strong efforts to fix our broken national infrastructure over the past four years, much work needs to be done if we are to prove to the world that there is no better place to do business than in the United States.
What You Need to Know About President Obama's Plan to Improve American InfrastructureMarch 29, 2013 at 12:58 PM EST
The President's plan to improve America's infrastructure will create good jobs doing the work America needs done, and encourage more businesses to start here, grow here, and hire workers here.
Julia Pierson Is Sworn In As First-Ever Female Director of the US Secret ServiceMarch 27, 2013 at 4:11 PM EST
During a ceremony in the Oval Office, President Obama praised the veteran agent for her dedication, professionalism and commitment to her work.
L.A. Kings and L.A. Galaxy Celebrate Championship Seasons at the White HouseMarch 26, 2013 at 4:15 PM EST
It was the second trip in two years for the Galaxy, while the Kings made their first visit after winning their first Stanley Cup in 2012.
Weekly Address: Helping Protect Our Kids by Reducing Gun ViolenceMarch 23, 2013 at 4:45 AM EST
The American people made their voices heard, and the Senate acted to make it harder for criminals and people with serious mental illnesses to get guns, to crack down on anyone trying to funnel guns to criminals, and to reinstate and strengthen a ban on the sale of military-style assault weapons. Each of these ideas deserves a vote.
On Third Day of Middle East Trip, President Obama Visits Jewish and Christian LandmarksMarch 22, 2013 at 6:12 PM EST
President Obama began the third day of his historic visit to the Middle East with a visit to Mount Herzl, Israel's national cemetery, where he honored the significant contributions of two Jewish heroes, Theodor Herzl, the founder of Zionism and former Israeli Prime Minister Yitzhak Rabin.
President Obama Tells Israeli People: The U.S Is Proud to Be "Your Strongest Ally and Your Greatest Friend"March 20, 2013 at 2:19 PM EST
The first stop on President Obama's trip to the Middle East marks the first time the President has visited Israel since taking office, and comes as its citizens celebrate the 65th anniversary of a free and independent State of Israel.
Watch Live: President Obama's Middle East TripMarch 20, 2013 at 9:29 AM EST
We will be posting regular updates from the road and livestreaming several of the President's events on whitehouse.gov/live
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73 results for "world cup qualifier"
Beckenbauer wants Kuranyi recallSoccernet staff
Franz Beckenbauer has urged Joachim Low to reconsider his stance on Kevin Kuranyi after seeing the ostracised striker lead the Bundesliga goalscoring charts this season.Story | Conversation | March 29, 2010
FIFA to investigate EgyptSoccernet staff
FIFA today opened disciplinary proceedings against the Egyptian Football Association after the Algerian team bus was pelted with stones in the lead-up to the World Cup qualifier between the two teams last Saturday.Story | Conversation | November 19, 2009
Keane: Let's have no regretsSoccernet staff
Robbie Keane has challenged his Republic of Ireland team-mates to come off the pitch at the Stade de France with no regrets while insisting there will yet be a "twist" in the tale of the highly anticipated World Cup qualifying decider on Wednesday.Story | Conversation | November 18, 2009
Ivory Coast FA explain Kalou absenceSoccernet staff
Ivory Coast striker Salomon Kalou was left out of the World Cup qualifier against Guinea at the weekend after an altercation with a team mate, the Ivorian Football Federation said on Tuesday.Story | Conversation | November 17, 2009
New Zealand primed for date with destinySoccernet staff
New Zealand are at full strength and their stadium at full capacity for Saturday's decisive World Cup qualifier against Bahrain. Other than long-term suspended goalkeeper Glen Moss, All Whites coach Ricki Herbert should have a full squad to choose from for the Asia/Oceania play-off second leg, with the score poised at 0-0 from the first meeting in October in Manama.Story | Conversation | November 10, 2009
Injured John Obi Mikel Mikel included in Nigeria squadSoccernet staff
Chelsea's injured midfielder John Obi Mikel has been included in his Nigeria's 23-man squad for their final World Cup qualifier away to Kenya on November 14.Story | Conversation | November 02, 2009
Egypt coach re-calls Nations Cup-winning strikeforceSoccernet staff
Egypt have re-called their African Nations Cup-winning strike partnership of Mohamed Zidan and Emad Moteab for their must-win World Cup qualifier against Algeria in Cairo on November 14.Story | Conversation | October 29, 2009
Real star Ronaldo targets Milan returnSoccernet staff
Real Madrid have pencilled in Cristiano Ronaldo for a return to action against AC Milan in their crucial Champions League clash at the San Siro in November.Story | Conversation | October 23, 2009
Capello opts for Agbonlahor and CrouchSoccernet staff
England boss Fabio Capello will turn to Gabriel Agbonlahor and Peter Crouch against Belarus as he experiments with his strikers in the absence of Wayne Rooney.Story | Conversation | October 14, 2009
Czech tabloid offers reward for San Marino winSoccernet staff
Czech newspaper Blesk has offered European minnows San Marino one million crowns (GBP;36,100) to beat Slovenia in Wednesday's World Cup qualifier and help the Czech Republic go through to next year's tournament.Story | Conversation | October 13, 2009
Oscar Washington Tabarez calls on support of "all of Uruguay"Soccernet staff
Coach Oscar Washington Tabarez has called on "all of Uruguay" to play the World Cup qualifier against Argentina, with both teams fighting for the last South American automatic qualification berth.Story | Conversation | October 13, 2009
Gerrard out of Belarus clash after missing trainingSoccernet staff
Steven Gerrard will miss England's World Cup qualifier against Belarus because of a groin injury. The Liverpool captain picked up the injury during Saturday's 1-0 defeat in Ukraine and limped out of Tuesday morning's training session.Story | Conversation | October 13, 2009
Real Madrid bemoan month-long Ronaldo injurySoccernet staff
Real Madrid director general Jorge Valdano insists Cristiano Ronaldo should not have played in Portugal's World Cup qualifier against Hungary at the weekend, as he was not in the right condition to return after injuring his ankle playing for his club.Story | Conversation | October 13, 2009
Spain won't take Fernando Torres riskSoccernet staff
Vicente del Bosque has told Rafael Benitez he will not take an unnecessary risk over the fitness of Fernando Torres in Wednesday's World Cup qualifier between Spain and Bosnia-Herzegovina.Story | Conversation | October 12, 2009
Foster gets England callSoccernet staff
England manager Fabio Capello has called up Manchester United goalkeeper Ben Foster to replace the suspended Robert Green for Wednesday's World Cup qualifier against Belarus.Story | Conversation | October 11, 2009
Rooney withdraws from England squadSoccernet staff
Wayne Rooney has pulled out of England's squad for Wednesday night's World Cup qualifier with Belarus because of a calf injury. Steven Gerrard will remain with the squad after having his groin injury assessed.Story | Conversation | October 11, 2009


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Once Upon a Time Creators on Season Finale: Airing Sunday!by Christine Orlando at . Comments
Will Henry survive? Will Rumplestiltskin's agenda help break the curse? Have we seen the last of his lost love, Belle?
Heading into this Sunday's Once Upon a Time season finale, and secure in the knowledge that season two is a go, I spoke this week to creators/executive producers Edward Kitsis and Adam Horowitz.
Read on for excerpts from the interview, as the pair offers up inside scoop on how this unique show came to be and where it's all going.
How did you come up with this incredible concept?
Edward: The idea kind of hatched nine years ago. We were sitting around in my apartment and we had just come off of a year on Felicity and our agent said have you ever started to think about what you wanted to do and Adam and I started talking about the type of pilot we'd like to write. What are the things that excite us?
Adam: We realized that these fairy tales were so formative in growing up and in making us want to be writers that it kind of led to a discussion of what would be a fun way to explore these things in a new way.
Edward: We started to ask ourselves questions like, imagine being the Evil Queen and you're trapped in a place that only has happy endings and everything you do fails. You get a working oven in a gingerbread house and that stupid witch can't burn the two kids. Where is the one place she can win? That's in our world and that started a nine year writer's block because we were way to young to kind understand our idea or figure it out. I think that through our experience with Lost and through the years we kind of understand a different way to tell the show.
Adam: We had to figure out the way to express it as a series.
What can you tell us about the finale?
Edward: To expect the unexpected.
Adam: That it's on Sunday at 8 p.m.
Edward: We don't want to give away anything that's too spoilery. The kind of story that we started to tell in the pilot this year, it kind of reaches a boil and a lot of things kind of come together in a way that we think are surprising and cool.
Fans have been asking lots of Rumplestiltskin questions, such as will Belle will be back?
Adam: I would be disappointed if we went this entire season and didn't see them again.
Edward: I'll say it more simply, yes.
And does Mr. Gold want the curse to continue or is he rooting for it to be broken?
Edward: He has an agenda. He is clearly a man looking for his son but just when you think you know him, he throws you a curve ball. Although we may find out some more about him we'll still wonder what he's really up to.
Do you already have any plans for going into season 2?
Edward: With any show you want to make it grow and evolve and change, while still being true to itself, but...
Adam: ... it won't make sense to you until after you see the finale.
And see it we will! Return to TV Fanatic soon after "A Land Without Magic" airs for a complete review.
C. Orlando is a TV Fanatic Staff Writer. Follow her on Twitter.Tags: Exclusives, Interviews, Once Upon a Time
Just when I thought tv was a waste of time, Once Upon A Time happened. I am a huge fan and can't wait for each episode. Which storybook character is Henry?
Saw the season finale!!! It was amazing. It seems like something sinister is about to happen to the town of Storybrooke. I was wondering, does Emma have powers of her own? Will she get powers? And where is the back story of how Henry knew the truth about the people and town of Storybrooke all along? Maybe that could be explored.
OMG! this gets my heart racing, this is one TV series i will watch till the bitter end. i have never been this anxious to see the next season of a TV series before, i normally don't watch TV at all but i have never missed an episode of this. its just too good
What happened to Reginas Mother? Surely Regina didn't just let her get away.
This is a great show. When is season 2?
this show is better than any soap opera i have changed my schedule to make sure im home every sunday to see the next episode would love to know when season 2 is coming out it kept me on the edge of my seat tell the finale ....
I Love Once Upon a Time, it leave me curious for the next episode every Sunday, and i can't wait until Season 2, i know it going to be a BANG!
When is the next episode coming out??
I like ALL characters....even Regina, I want to know who Henry's Father is....is it an important character?? or no?? But at the same time I don't want his Henry's father back because I do like Emma and August
Just watched the finale. Well done. Next season should be even more interesting.


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Vote now in the Western Australian Premier's Book Awards People's Choice Award!
The judges have selected these six titles as the short list for the Fiction Category. Now you can have a say. Voting closes on 1 August 2014.
Cast a vote for your favourite title listed below, the title with the most votes will be named the 2014 People's Choice Award at the Western Australian Premier's Book Awards presentations in September 2014.
Click on your favourite book to vote Please see the terms and conditions below
THE LIFE AND LOVES OF LENA GAUNTTRACY FARRFREMANTLE PRESSClick here to vote for
Coal CreekAlex MillerAllen & UnwinClick here to vote for
Coal Creek
EyrieTim WintonPenguin Group (Australia)Click here to vote for
The Narrow Road to the Deep NorthRichard FlanaganRandom House AustraliaClick here to vote for
The Narrow Road to the Deep North
All the Birds, SingingEvie WyldRandom House AustraliaClick here to vote for
All the Birds, Singing
ElementalAmanda CurtinUWA PublishingClick here to vote for
Voting terms and conditions:
- Only residents of Australia are permitted to vote.
- Only one vote per person is permitted.
- We respect your privacy and will not disclose your personal information to any third party.


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Book your room at Hotel Zaghini
Please enter your travel dates.
Hotel with a nearby private beach, in Rimini (Rivazzurra)
This hotel is located in Rimini (Rivazzurra), close to the beach, Fiabilandia, Centro Congressi SGR, and Multiplex le Befane. Also nearby are Beach Village Water Park and 105 Stadium.
Hotel Features
In addition to a bar/lounge, Hotel Zaghini provides complimentary wireless Internet access, a rooftop terrace, and a computer station.
Room Amenities
In addition to complimentary wireless Internet access and day beds, guestrooms feature desks along with hair dryers and private bathrooms.Information missing or incorrect? Tell us!
At your hotel
At your hotel
This Rimini hotel has its very own private beach. A bar/lounge is on site where guests can unwind with a drink. Guests can enjoy a complimentary breakfast. A computer station is located on site and high-speed wireless Internet access is complimentary.
This Rimini hotel also offers a rooftop terrace, tour/ticket assistance, and complimentary newspapers in the lobby.
- 24-hour front desk
- Total number of rooms - 24
- Number of floors - 2
- Bar/lounge
- Complimentary newspapers in lobby
- Free breakfast
- Computer station
- Tours/ticket assistance
- Free Wi-Fi
- Rooftop terrace
- Luggage storage
- Beach umbrellas
- Beach cabanas (complimentary)
- Beach sun loungers
- Free parking nearby
- Private beach nearby
- Year Built 1954
- Number of buildings/towers - 1
- Television in lobby
Stay connected
Available in all rooms: Free Wi-Fi
Available in some public areas: Free Wi-Fi
Park your car
Free parking nearby
In your room
- Daily housekeeping
- Private bathroom
- Complimentary toiletries
- Hair dryer
- Shower only
- Rainfall showerhead
- Desk
- Flat-panel TV
- Free Wi-Fi
- Cribs/infant beds (complimentary)
- Day bed
Eat and drink
A complimentary breakfast is offered.
The recreational activities listed below are available either on site or nearby; fees may apply.
- Kayaking nearby
- Sailing nearby
- Windsurfing nearby
- Scooter/moped rentals nearby
- Hiking/biking trails nearby
- Bicycle rentals nearby
- Boat tours nearby
To make requests for specific accessibility needs, complete the "Special or Accessibility Requests" section of "Trip Preferences" when you book your hotel.
- Roll-in shower
The fine print for Hotel Zaghini
When you arrive
Check-in time starts at 12:30 PM
Check-in time ends at 11 PM
When you leave
Check-out time is 10:30 AM
How you can pay
You need to know
Extra-person charges may apply and vary depending on hotel policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
- No onsite parking is available.
Debit cards not accepted
No elevators
No pets or service animals allowed
Noise-free rooms not guaranteed
- A tax is imposed by the city: EUR 0.50 per person, per night. This tax does not apply to children under 14 years of age.
We should mention
Cash transactions at this property cannot exceed EUR 999.99, due to national regulations. For further details, please contact the property using information in the booking confirmation. No pets and no service animals are allowed at this property.


text: 2012 MTV Video Music Awards: Most Shocking Moments Previous Next « Back to Story Replay 1/7 Lady Gaga had heads turning -- and animal rights activists stewing -- when she arrived to the 2010 VMAs in a dress made out of meat. Yes, meat. Source: WENN « Back to Story Share Tweet By Loraine Pavich


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Standard canada precancel catalogue (6th edition)
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The Standard Canada Precancel Catalogue 6th edition
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Prized by philatelists
Growind rapidly in popularity, one of the pleasures of collecting precancels is that addtions ans expansion of your prencancel collection can be made by spending time rather than money. Regardless of the length of time involved in collecting stamps, anyone has an equal chance of discovering the scarcer precancels.
The mos comprehensive catalogue of canadian precancels ever published
This is the sixth edition, fully edited in Canada. The listings have been extensively revised and updated to reflect current research. Up-to-date pricing, new entries and many new features make this the most comprehensive catalogue on the subject ever published.
- numbering system based on the established Scott Numbering System used throughout North America
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- alphabetical listing of Town and City Precancels
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Feedback from our customers:
C'était parfait! Beau chandail et délai de livraison vraiment court! Merci pour le bon service!
bonjour imaginaire,j'ai bien reçu mon colis aujourd'hui,merci encore pour tout,je suis sur que nous referons affaire dans l'avenir,et encore merci pour toute l'attention que vous avez porté a mes réclamations et votre sérieux ;)


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Latest Articles
Temples & Fixies (Rian)
Dec 15, 2014
The day had finally arrived, our departure for another incredible adventure overseas. I have found that over the years and numerous long-distance rides, my preparation process has become more streamlined. I know my equipment and what works and doesn't. I check the weather forecast to pack appropriate clothing and see which sleeping bag is necessary. Having not ridden with Dylan for almost 2 years, this new adventure to Taiwan would be a great opportunity to get back into a riding pattern with a good mate.
Taiwan here we come!
Aug 14, 2014
Taiwan here we come! Our next destination for the Eat.Sleep.Surf series has been confirmed, Taiwan! With the backing of the Nautical Channel we will be surfing, cycling and filming on the beautiful tropical island of Taiwan. Located 180km off the southeastern coast of mainland China, we will produce 2x 45min episodes that will highlight the beauty of seeing a country by bicycle.
Week 5 - Chased by monkeys on Sumbawa and the october mega swell.
Oct 25, 2013
The bay at scar reef is one of the most beautiful I have seen, you can easily compare it to some places in the Mentawai, clean water, huge reef pass and breath taking headlands on each side. I book into the Jelenga bungalows for 3 nights, $15 per night, I have just missed the massive swell the day before as I was at yoyos.
Week 4 - The return of the "HELLO MISTER, WHERE YOU GOING!"
Oct 4, 2013
After 3 nights at desert point I reluctantly hit the road at 6:30am, needing to leave early to beat the midday heat. I packed the bike while a few of the professional surfers slept on the deck of the bungalows. Out the small village of Bangko Bangko and up the hill, its fairly quiet and about 26 degrees, the perfect temperature for riding.
Week 3 - Dusty barrels from a classic wave
Sep 24, 2013
I jump on the public ferry from Gili T to Bangsal the closest port on the main land, it's a 1hr boat ride in some turbulent waters from strong currents and high wind, even at 7.30am in the morning. It a mission to get the bike and gear on to a very full ferry, but some kind passangers helped me in the narrow boat and but the bike between there knees.
Week 2 - Keramas and Nusa Lembogan, starting to get itchy riding feet.
Sep 18, 2013
Arriving at Kermas beach I found the homestay I had searched on Tripadvisor.com the Nirwala Homestay. The homestay is set amongst beautiful rice paddies and has a few bungalows with small fish ponds. They are still building a few more rooms while I was there.
Week 1 - Bingin and only 1 day of cycling.
Sep 11, 2013
Landing late at night at the Denpasar airport which is actually closer to Kuta, sees me greeted by Arie, a local transport driver who friended us last time traveling to Bali. He is all smiles as he askes what's in the large oversize box. I told him what I plan to do which surprises him.
Fiji - Part 1
Apr 27, 2013
Dylan and friends venture to fiji for 1 week. This video was filmed with the gopro at 100fps and as a mouth camera. Song is by Amos.
Winter Touring Cycling Gear
Feb 3, 2013
A list of Dylan's equipment he took to New Zealand's South Island.They ventured there in the middle of winter and experienced temperatures from -3 to +14.
New Zealand - Episode 2. Fox Glacier to Queenstown
Jan 24, 2013
This episode sees Rian and Dylan cycle from Fox Glacier to Queenstown. They do a helitour of Fox glacier, vist the mirror lake, (Lake Matherson) and climb over the Haast Pass, 550m Elevation and then cycle the...
Join the community


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ESPN's John Walsh Holds First Of Regular Chats With Network's Editorial Decision Makers
It's already in progress, but ESPN.com is hosting a chat with John Walsh, executive vice president and executive editor of ESPN.
According to the chat description,this is the first of regular ESPN.com chats with the editorial decision-makers at the network, and coincides with the introduction of formalized Editorial Guidelines for Standards and Practices at ESPN.
The chatters, who have have likely been chomping at the bit to communicate directly with ESPN management, aren't shying away from Walsh.
Timothy Jones (Chicago, IL)
While I appreciate the unique knowledge that a former professional athlete can bring to a discussion, I feel ESPN has gone a little overboard in this respect. Is there an equal desire/commitment to nurturing true journalists? Read more


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5 Reasons Nurses Want to Leave Your Hospital
4. Bullying and toxic behavior
Bored of hearing about this topic? So am I. So are nurses. Nothing makes nurses want to walk out the door more than toxic colleagues—whether physicians, nurses, or anyone else—who are allowed to behave badly.
It's not enough to have a zero-tolerance policy. Enforce it. Preach it. Talk about the importance of respectful behavior. Explain expectations, not just at orientation but at multiple times through the year. Send information via emails, hold continuing education classes, and have the topic as a standing item on meeting agendas.
Give managers the tools to confront problem employees and back them up when they do. Have a plan in place to educate offenders. If the behavior continues after that, fire them. Support managers through this work. Nurses would rather work a nurse short than keep a disruptive employee who sabotages the morale and cohesiveness of the others.
You've heard it before: People don't leave companies, they leave managers. Yet hospitals still don't pay enough attention to leadership skills for nurse managers. Bad nurse managers who don't know how to lead are retention nightmares. Skilled managers are retention magnets.
Comments are moderated. Please be patient.
door1967 (10/25/2013 at 2:42 PM)
17 years nursing and met some fantastic nurses and patients. For me the job just is not what I came into, however I believe that is the case for many. I can accept long hours and late of shift, but not the toxic culture. I feel I am top of my game at time management and still have no time to actually spend time with a patient. I see all these ward statements which are no more than paper. If you cannot sit with a dying patient or just chat then what is nursing really worth. A few nurses, doctors have commented commented I am very good at my job. Their definition of good did not include comfort, caring, having a little fun, sharing your day. I have decided to become a HCA and give up my pin. Maybe I want to be carer and not a nurse as the role has changed from what I loved. It was never a perfect job and there has always been bullies and stress, but somehow being allowed to give something of yourself made it ok. Truth is I don't get anything from nursing and find so toxic which I am sad to say. I think when I heard one nurse call another for chatting to a patient who was upset stating they should be working. I don't blame anyone, as it is what it is. I do believe in my opinion something so fundamental has been lost.
Elaine Kinsey (11/18/2011 at 3:01 PM)
My comment is to those who do not make the grade. All RNs have had minimum scores for exams and those that do not pass are out of the program, period. A 73 score or even a 80% informs me that only 73%- 80% of the time you knew what to do for a patient. This is unacceptable in school and is unacceptable to me as a Director of an ICU. My advice, is to go through the program again and not give up so easily.
Deb Watson (9/5/2011 at 2:15 PM)
When will they ever learn enough is enough! I can remember when volunteers left the hospitals b/c nurses were loosing jobs back in the mid 70's. Then the medical assistants (who are trained both in clinical and administrative) got shifted b/c the nurses were hired at doctors' offices for less pay and higher education. Over the years, medical assistants haven't been recognized for doing all of what nurses do in the doctors' offices nor utilized in the hospitals as part of the on going education of our medical field. In fact, to higher my education and ultimately be of greater service, I attended a 2 yr. nursing school w/i the hospital. With 2 semesters to graduation and $22,000 in debt, I was CUT from the accredited RN Associate program. How could this happen? I was given 2 weeks notice to retake the final from the previous year that I had passed with the manditory 80% and above. Not only was this in addition to each semester's manditory practicals and nursing calculations but put in a noisy hallway to take it. Out of the 80%, I scored 73, was immediately CUT and lost my only income of 16 hours from a student nurse job. Although totally numb from having been put out of being at the hospital 7 days a week for school, clinicals and work, I called and wrote to the deans that only acknowledged missing the cut off by 7 points. I did, however, receive a congradulations for the bill paid in full!! It saddens and angers me to see the continued numbers of opening for nurses when there's such a lack of mentorship to begin with right under their noses.
- 'Mega Boards' Could be Rural Healthcare Disruptor
- 1 in 5 Eligible Hospitals Penalized for HACs
- Meaningful Use Payment Adjustments Begin
- HL20: Rebecca Katz—Cooking Up Sustainable Nourishment
- HL20: Peter Semczuk, DDS, MPH—Taking on the Big Challenges
- PA hospital to pay $662,000 to settle Medicare fraud case
- Supreme Court to hear Obamacare subsidy challenge in March
- How the high cost of medical care is affecting Americans
- Dr. Oz gets fact-checked and the results aren't pretty
- HL20: Lee Aase—Who's Behind @MayoClinic


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Be careful, don't tell her unless you're really sure that she likes you back. Otherwise, you're gonna be moping over being "put in the friendzone"
Maybe she already knows... and is just too shy to say it to *your* face. ;)
be honest, and suck it up ! she's probably waiting on you .
Sounds to me that you're friend zoned pal. One thing I learned in my life through experience is that you will never know the answer to something if you don't ask. I know it's hard because I'm shy too. I suggest you kind of hint her a little toward the idea that you want to be more than friends and see her reactions.
Well like I said earlier, don't tell her straightforward unless you're sure that she wants to be more than friends too or you might end up losing her as both. My advice to you is that in life, you're not just going one girl but rather a couple. I mean just tell her you love her and that you've for a while. Life is all about risking it. What's the worse that can happen? She says no and laughs at you? You get sad and a few months later most likely you'll find a new girl that you'll like/love. That's just how life is.
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Why do men like me better even though I'm shy vs. my scantily-clad friend? I'm naturally shy & they eat it up...why?If a guy sees me and smiles at me, I will usually flash him a smile back and feel my cheeks turn pink and I turn away... they LOVE it. My friend, I love her, but she dresses like...valkor5 22-25, F 11 Answers 3 Sep 23, 2010
I Can't get a girlfriend I'm shy so that's one thing and for some reason I just get depressed over it. Plz not hatersxXFALKENJ4MXx 16-17, M 9 Answers 1 Sep 29, 2013 in Dating & Relationships


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'Today' Mishandles Ann Curry's Departure
Savannah Guthrie was officially named the new Today show co-host, just a day after Ann Curry gave her tearful on-air good-bye. Now the challenge for Today is making the transition to a new host without alienating the fans of the old one. To do that, according to the NY Times, the show is trying to keep the change low-key.
The problem is this change was anything but. There were leaks and speculation for about a week. And on the day of her departure, there was this big story in USA Today.


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Welcome to the Hills of Worcester.
JB and I went for a bike ride yesterday… February 18th and we were riding outside- I still can't believe it. The roads were dry and the sun was shining! Although it was an "off day" for me (training wise, for the Hyannis Half marathon) I was itching to get outside. I recently bought a new saddle for my ride too, so I wanted to give that a try
"Life is too short for a man to hold bitterness in his heart."-Marshall Taylor
Ever heard of George Street in Worcester? or Major Taylor? No?…
JB and I headed over there during our ride to give it a go. He nailed it of course flying up in 26 seconds… I've got some work to do. I was psyching myself out the whole ride thinking I couldn't even do it, because my bike fitness was down the drains. I haven't been riding as running has been my focus the past 4 months! Once we got to the climb I just went for it, and it wasn't THAT bad… check out the stats on {STRAVA}
Once the summer months come I'll shave some serious time off my 47 seconds. 47 seconds though- that's not soo shabby for my 1st time, and not giving 100%. Last year the fastest woman's time was 31.97 -pretty sure I won't be beating that. (looked her up and she's a racer.. DAMNIT)
Hey- I can try can't I? Pffftttt.. Who wants to do the challenge with me?
*Today is officially the last day of vacation for us* Instead of the regular sunday blues.. we have a case of the MONSTER SUNDAY BLUES!!! I'm trying to look on the bright side..
- next weekend is the race!
- we're going down the Cape to see all the renovations my parents made which will be exciting,
- we're have some pretty awesome company staying with us


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Community, Environmental DesignAnd Pretty Soon You Have Some Real… What? I planned to spend the month of January clearing out files and getting old interests off of my computer to make room for new ones rather than doing any writing but a telephone call from a person well informed about banking, bank regulations, the American legal system, and many other things (including USA, Inc.), and it changed my plans. He called and asked a simple question: "What's your opinion of Bitcoin?" I've had many other friends ask… and have avoided an answer – until now. Banking, not currency, is my area of expertise… but the two concepts overlap. Without money, what good is a bank? What is money? Before I address the topic of Bit coin, this question must be answered. What is money? What is wealth? What is profit? The three are intertwined, but they are not the same thing. Money is a reward for labor and risk management. People who run their own independent businesses are rewarded with profit for their good decisions (or take losses for bad ones) involving risk management. People who work for them – or for multi-national companies – take no risk but provide the sweat of their brow to gain access to money. Stock market investors are rewarded for their good decisions with profit – or are penalized for bad ones. For most people, however, money is the reward for labor and risk management. After earning it, it becomes the means to survive, giving us access to everything from housing and comfort – to the opposite. Anyone who...
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|18 Sep 2012
Graphics screen corruption - random noise, flickers,etc
Hi All
I have a problem with my year old desktop pc and random screen corruption when I startup the pc. Sometimes it does it once a month, but in the last week its happened it every day.
This is a video of what happens but its not always the same, but its always at startup. Usually anytime upto and including the windows login screen, but never before or during the bios screen. Once it corrupts I then need to hard reset, soft reset does nothing. Also, after a successful reboot windows complains of a previous bluescreen. All drivers are up to date.
nvidia_gtx465_corruption.3gp - YouTube
I`ve tried replacing the graphics card and I still had problems and i`ve reinstalled windows 7. I`m thinking the next thing is to replace the psu? Whats strange is that it never goes wrong once windows is up and running, its only at startup. It also cause the external monitor (TV) to blank out and it freezes the pc ie caps lock,etc dont function. i`ve also tried it in someone else`s house with different monitor and the same occurred.
My equipment is as follows:
CPU: Intel Core i7-2600K (Sandy Bridge-DT XE, D2)
3400 MHz (34.00x100.0) @ 3511 MHz (35.00x100.3)
Motherboard: ASUS P8P67 PRO
Chipset: Intel P67 (Cougar Point) [B3]
Memory: 16384 MBytes @ 668 MHz, 9.0-9-9-24
- 4096 MB PC10600 DDR3 SDRAM - Kingston 9905403-439.A00LF
- 4096 MB PC10600 DDR3 SDRAM - Kingston 9905403-400.A00LF
- 4096 MB PC10600 DDR3 SDRAM - Kingston 9905403-439.A00LF
- 4096 MB PC10600 DDR3 SDRAM - Kingston 9905403-400.A00LF
Graphics: Zotac GeForce GTX 465
nVIDIA GeForce GTX 465 (GF100/D12U), 1048256 KB GDDR5 SDRAM
Drive: C300-CTFDDAC128MAG, 125.0 GB, Serial ATA 6Gb/s
Drive: WDC WD1002FAEX-00Z3A0, 976.8 GB, Serial ATA 6Gb/s
Drive: WDC WD1002FAEX-00Z3A0, 976.8 GB, Serial ATA 6Gb/s
Drive: HL-DT-ST DVDRAM GH22NS70, DVD+R DL
Sound: Intel Cougar Point PCH - High Definition Audio Controller [B3]
Sound: nVIDIA GF100 - High Definition Audio Controller
Network: Intel 82579V (Lewisville) Gigabit Network Connection
Network: D-Link DWA-525 Wireless N 150 Desktop Adapter
OS: Microsoft Windows 7 Home Premium (x64) Build 7601
PSU: Coolermaster 750W
Any Ideas??
Thanks alot
|My System Specs
|18 Sep 2012
Windows 7 Ultimate SP1 X64 (Windows 10, 8.1, Linux Mint, Windows XP and others in VM)
What drivers are you using. It should be 306.23. Also, when you updated drivers, did you uninstall the old drivers in safe mode first? You can download the current drivers from Nvidia's web site if that is not what you are running. I reinstall drivers by using Driver Sweeper in safe mode. Select only the Nvidia Display drivers, click analyze and then delete. Then reboot and install the new driver selecting custom install and make sure the clean install box is checked.
When you say you tried it in someone else's house, do you mean the computer or the card? If you can try just the card in someone else's computer, it may show whether it is the card or something else. Also, if you can borrow or if you have an extra PSU, you can try that. I would rather see you find out for sure what the problem is before you spend money to replace something that may or may not be defective. Just based on what I understand about your problem, it sounds like drivers. If it were the PSU, it would do the same on the bios screen. The drivers don't load until windows starts. That is where you are having the issues.
|My System Specs
|19 Sep 2012
Thanks, I have always kept upto date with the display drivers although hadnt seen these latest ones. Will give them a go. I have in the past uninstalled the old ones in safe mode yes. I usually use revo uninstaller to clean up files and registry but will give driver sweeper a go.
I took the whole PC to someone elses house, but I also tried a different graphics card that was cheaper and less powerful (only 1 power input) and that exhibited similar problems.
The PSU is a coolermaster GX-750 which is supposed to be a descent model, unless theres a fault somewhere with it. Somebody did say to me it could be a capacitor problem being it only happens at startup. But I think its odd it doesnt happen whilst in bios/dos mode only when it begins loading windows somewhere between the animated windows loading screen and the login screen. The mainboard could also be the culprit.
Strangely today has been the first day for a week it booted up first time without any problems. Two things have change, I updated the bios yesterday and also the weather is about 18c degrees cooler. So perhaps it was a heat or bios problem or maybe i was just lucky today. I`ve spoken to the shop I bought the PC from and they are willing to check it out, i`m just upto my eyeballs with work currently so it`ll have to wait until next month.
|My System Specs
|19 Sep 2012
Windows 7 Ultimate SP1 X64 (Windows 10, 8.1, Linux Mint, Windows XP and others in VM)
Try booting into safe mode and see if the problem exists. It's true that startup put a great deal of strain on the PSU, but it is the same starin when you boot into bios.And you have no problems there. But, you are going in before you load drivers. Drivers are loaded on windows startup. That's where you have the problem. I'm just guessing, but if it was a problem with the card or the PSU, you would have the same problems when booting into bios.
|My System Specs
|19 Sep 2012
ok thanks i will try safe mode first thing in the morning. Its usually ok once i`ve booted the machine more than once.
I`ve booted a few times today from powering down and installed the new nvidia drivers and havent had any problems so far.
Wouldnt windows give extra strain when loading device drivers, usb devices,switching to gfx higher resolution ,etc. Just a thought, i`m not very technical on these things.
|My System Specs
|19 Sep 2012
Windows 7 Ultimate SP1 X64 (Windows 10, 8.1, Linux Mint, Windows XP and others in VM)
To answer your question, I don't know either. But, during POST, your bios is initializing all of your hardware before you can get into bios. Whether that is more or less strain than windows loading drivers, I don't know.
I would still try to borrow a known working PSU and try it before you buy one. That would answer your question with some certainty. If you do get a new PSU, I always recommend Corsair, Seasonic or Antec. They are more expensive, but are among the best quality PSU's around. My rule is you never skimp on the PSU. It is the heart of the machine.
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|Property type
|Minimum Stay
|4 nights
Our Beach House is an easy 1/2 block walk to the sand and crystal blue ocean of Seal Beach. Come swim, wade, sun, surf and relax at the ocean. Garage Parking for 1 car and a full sized private driveway for a 2nd car provide 2 parking spots and allow you to avoid street parking hassles. Also, to provide convenience, we have an on-site laundry facility.
Marble counter tops in the kitchen and 2 bathrooms give a feel of elegance and warmth to this charming home. The kitchen is equipped with a stove, oven, coffee maker, toaster and blender, as well as all pots, pans, dishes and glasses.
A TV in both the master bedroom and living room allow everyone to watch their favorite DirecTV show or movie with Starz and Encore Movie channels. We also have a DVD player and an assortment of DVDs. Each bathroom has a sink and toilet and shower, and the Master Bath also has a bathtub.
The master bedroom has 1 Queen sized bed. The 2nd bedroom has 1 Full sized bed and 1 Twin Bed with plenty of closet space in each bedroom.
Our Beach House is a short, flat. 3 block walk to the downtown Seal Beach restaurant, shopping and arts district as well as to the Seal Beach Pier. In addition, Seal Beach is 5 minutes from 3 major Los Angeles and Orange County Freeways - the 405, 22 and 605 freeways.
Major attractions such as Disneyland, the Queen Mary, Knott's Berry Farm, Commerce Casino and Huntington Beach are an easy 1/2 hour drive or less and with Hollywood, Universal Studios, the Staples Center, Griffith Park Observatory and Downtown LA just about 45 minutes away.
Charming Beach Community: Our Beach House affords most of the benefits of renting a home at the beach, without having to pay the pricey cost of a beachfront villa. Being only 1/2 block from the sand, it's a short, flat, easy walk down 13th Street (just 6 houses down the street) to the beach. From the front yard looking down the street, you can see the palm trees swaying in the breeze on top of the golden sand. The soft sound of the fog horn can be heard in the distance, and has been known to lull travellers to sleep.
The quiet, refreshing ocean breezes surround you in our Beach House via either the large sliding glass door or front door - both of which have screen doors to allow the sounds and scents of the ocean to surround you. The Seal Beach Pier and shopping district of Main Street beckons just 3 blocks away, another flat, easy walk to multiple restaurants, cafes and shops. Fishing off the pier is a fun adventure, and Seal Beach hosts a National Wildlife Refuge, as well.
Walking Distance to Restaurants and Shops: A car really is optional once you are in Seal Beach itself. Our Beach House sits just 3 short, flat, easy blocks to numerous restaurants, shops, and galleries. Some of these include Ruby's Diner (at the end of the pier), Cold Stone Creamery, Kinda Lahaina (with oceanfront views), New York Pizza, the Coffee Bean,a local coffeehouse (also with oceanfront views), Sweet Jill's Bakery, Hennessey's Grill, O'Malley's Pub, a music store, many clothing stores, and 3 art galleries.
We have compiled a list of grocery stores, drug stores, banks, coffee houses, and some restaurants with a local map into a soft-bound folder in our Beach House for further reference, detailed information and the convenience of our guests. That said, we do everything we can to make your stay relaxing and enjoyable. Also nearby and within walking distance are churches, a movie theatre, a library and a small grocery store.
Easy Freeway Access from airports. We are located 14 miles from the John Wayne Orange County Airport (SNA) straight south on the 405 freeway (no other freeway changes required), and Los Angeles International Airport (LAX) is similarly easy to reach just 27 miles straight north on the 405 freeway. Full maps and detailed driving directions are provided once you book a reservation, and are included in a soft-bound booklet for use at our Beach House.
The beach and playground are essentially your front yard. Our actual front yard is only big enough to hose the sand off after a day at the beach or for a small picnic.
Our Beach House is located within Southern California in the city of Seal Beach, which lies at the intersection of the Orange and Los Angeles County Lines. We are 1/2 block away from the Blue Pacific Ocean. The peaceful, beautiful town of Seal Beach is a wonderful vacation destination. Our Beach House is walking distance to the beach, the Pier, shopping, art, restaurants, coffee and groceries. We are about 5 minutes from 3 major freeways (the 405, 22 and 605 freeways), so Seal Beach functions as a natural hub for multiple tourist destinations.being an easy, 1/2 hour drive to major attractions such as Disneyland, the Queen Mary and Long Beach Pier, Knott's Berry Farm, Huntington or Newport Beach, In addition, an easy 45 minute drive from our Beach House will take you to Hollywood, the Staples Center, the Home Depot Arena and Downtown Los Angeles. Seal Beach revels in its serenity as a relaxation paradise with plenty of fun things to do nearby.
Other Activities: National Wildlife Refuge in Seal Beach. There is boogie boarding, surfing, sunning and all kinds of beach activities just 1/2 block away. See above.
Golf: There is public access to the Navy Golf Course in Cypress, CA. It is approximately 4 miles away. We provide maps, adress, directions and contact and reservation of tee time information.
|Rate Period
|Weekend Night
|Monthly *
Sep 20 2014 - Dec 31 2014
4 night minimum stay
Jan 1 2015 - Mar 15 2015
4 night minimum stay
Mar 16 2015 - Jun 6 2015
4 night minimum stay
|Tax Rate
See Rate Chart
A credit card deposit of 50% of the rental rate for the entire stay (including all fees and taxes) is required at the time of signing the rental contract.. The remaining 50% is due by credit card also 14 days prior to the arrival date. .
A non-refundable cleaning fee is also required. This cleaning fee is $75 if the stay is less than 5 days; $100 is the stay is between 6-14 day
* Approximate monthly rate. Actual rate will depend on the days of the month you stay.
Payment is usually accepted in the quoted currency (USD) unless the currency and the amount is specifically agreed in advance with the owner / advertiser.


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Get Golden With Paul & Joe Beauté!
Having shimmering skin and nails is sexy for summer, especially when they've got a hint of gold: Paul & Joe Beauté just launched their limited-edition collection and it's gold in more ways than one. The new nail enamels, eye shadows, and lip glosses come in three different golden categoriesBronze Gold, Yellow Gold, and Pink Gold (my favorite is the pink!). Bonus: There are a couple of gold-flecked bronzers to choose from too. Like all of Paul & Joe's beauty products, every item in the new lineincluding the nail polishis packed with moisturizing ingredients like jojoba oil and white lily extract. To get your gold on, visit beautyhabit.com or Bergdorf Goodman.
Emily Hebert
Photo: Courtesy of Paul & Joe Beauté


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WHAM13 - Search Results
Local man pleads guilty to Medicaid fraud
Rochester, N.Y. - A Rochester man pleaded guilty Wednesday to defrauding Medicaid of more than $115,000 for optometry and ophthalmic dispensing services.
New York State Attorney General Eric Schneiderman announced Wednesday Shamil Tadros had pleaded guilty after an investigation found he lied about having a valid New York State license for dispensing optometric or ophthalmic materials.
Over a 13-year period, from 2000 to 2013, Tadros admitted to defrauding several people using a fake license.
In doing so, Tadros obtained more than $15,000 from the State of New York/Excellus Medicaid Managed Care, more than $65,000 from Excellus Health Plan-Private paid insurance plans, more than $15,000 from MVP Health Care, more than $1,000 from Aetna, more than $3,000 from EyeMed Vision Care, and more than $10,000 from UnitedHealthcare.
"Providing medical services in New York State is a privilege," Attorney General Schneiderman said. "No patient should ever have to fear being treated by someone who doesn't have the proper credentials. It's important that we hold individuals like Mr. Tadros accountable to help restore trust and send the message that this sort of behavior will not be tolerated."
Tadros will be sentenced in June in Monroe County Court.


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Tasty Tidbits
Find a Conversation
|Sun, 10-23-2011 - 12:09am
Yesterday I came across a cookbook (in a "Free - Take One" box) that had lots of tasty recipes that involve fruits and vegetables.
|Sun, 10-23-2011 - 5:13am
That sounds good. Frozen peas are so useful. You can also boil them with a little chicken stock a clove of garlic and a small onion, then pure and add some fresh mint (or don't), throw some croutons on top and you have a yummy soup in about 5 minutes flat.
One of my favorite salads is chopped avocado, tomato and red peppers with lime and cilantro. You can add cooked kidney beans for more bulk.
|Mon, 10-24-2011 - 8:02am
I made some steamed veggies and fish for lunch, but it is, of course, not exactly wildly tasty. So, as a "sauce," I put some unsalted pumpkin seeds (about 2 tablespoons), juice of half a lemon, clove of garlic, a little salt, a huge handful of mint and parsley and some olive oil in the blender. Then I used that as a pesto-type thing for the steamed food. It was way easy and very tasty.


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This weekend we went to London and had a fabulous time.
It does rain here quite a lot.
Here's me on the tube catching up with important celebrity news!
Butterscotch has written 5 entries about this goal
This weekend we went to London and had a fabulous time.
Here we are at Stonehenge today. Imagine standing in the middle of a typhoon, torrents of rain, enormous gusts of wind, all at a balmy 35 degrees F!
Oh my!
I made it to England! My friend Kim has a lovely home. It's a 500 year old, cute Tudor. My little bedroom is very Victorian. I feel like I'm staying in a bed and breakfast. It's so quaint!
We're getting ready to do some serious touring. Today we went to Cambridge, tomorrow to Bath, and Thursday to Stonehenge. I'm so excited!! I can't wait to see everything. Yippee!
(1) meet a hot guy named Ian and pinch his ass.
(2) find, and marry, Hugh Grant. (I think I could excuse his prior escapades)
I am so excited, I'm going to London after Thanksgiving to visit my friend, for two weeks!! YAY!!