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I Hear a Rumor PrincessBetsy is in Walt Disney WorldA DCP Dining Review *9/24
I Hear a Rumor PrincessBetsy is in Walt Disney World A DCP Dining Review
Ahoy there mates! Perhaps you have joined me for my previous dining reviews or just happened to stumble upon this one by chance. Regardless of your way of arrival, Im glad youre here.
I am Betsy, a 21 year old recent college graduate. I have been to Walt Disney World 25 times, beginning when I was just a wee little lass at the age of 3. Disney has always been a huge part of my life, so I decided to apply for the Disney College Program. I checked in on June 11th and will be working in Attractions in Frontierland until January 2nd. Needless to say, I am ecstatic and cant wait to begin this magical journey!
Here is a picture from my last trip to WDW:
A few things I should probably warn you about:
1. I love pirates
2. I love Captain Jack Sparrow
3. I love to eat
Savvy? Here I am on June 2nd at the Blackbeard Pirate Festival in Hampton, VA:
This is going to be different from most dining reviews, since I will be updating this sporadically throughout my time in WDW. Hopefully Ill get to try a variety of new and exciting dining experiences, which I look forward to sharing with all of you! If anyone has any suggestions or has a hankering for something in particular, just let me know and Ill try to review it. Ill gladly take one for the team. :laughing:
If any of you are planning to visit WDW while Im there, feel free to stop by my attraction! Ill let you all know my exact work location as soon as I find out. Im also always up for a DIS meet - it would be great to meet you all in person! :goodvibes
Oh yes I should probably invoke some sort of rating system. Well since you all seem to love pirates as much as I do, you will probably find this to be satisfactory:
Captain Jack Sparrow
Captain Jack is intelligent, cunning, and witty, making him a clever pirate indeed. Handsome devil isnt he? :lovestruc
This is one of the best meals you have ever had in your entire life. You often spend time dreaming of this food and try to recreate it at home. This is definitely a must do on your next trip!
Hector Barbossa
An excellent pirate and swordsman, Barbossa is definitely someone to watch out for.
This is a good, solid meal. It is pretty gosh darn tasty, and something you would have again.
Angelica is incredibly sly and a good swordfighter, but not among the best pirates of all time.
This meal is just okay and not too memorable. You probably wouldnt go out of your way to eat this again.
The one pirate that all pirates fear. Blackbeard is downright evil, greedy, and ruthless.
This is a dreadful meal and one you would never want to eat again. Run away quickly and dont look back.
Alrighty! Now that you know a little bit about me and we have a rating system in place, you all should probably hop aboard and weigh anchor. We be setting our course for Walt Disney World. :sail:
To learn more about my Disney College Program experience, please read my blog:
*The opinions and comments in this thread are my own and do not necessarily reflect the views, opinions, policies or procedures of the Walt Disney Company or any of its subsidiaries or affiliates, including but not limited to the Walt Disney World Resort. (Figured I should put some sort of disclaimer in here :thumbsup2)
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Riverside Mill Food Court - Dinner
Earl of Sandwich - Lunch
Everything Pop - Dinner
Riverside Mill - Breakfast, Dinner, and Dessert
Hollywood Hills Theater
Columbia Harbour House
Plaza Ice Cream Parlour
Kouzzina - Breakfast
Karmel Kuche
Downtown Disney
Plaza Ice Cream Parlour
Seashore Sweets
Main Street Bakery - Desserts
Sleepy Hollow
Storybook Treats, Cosmic Rays, Gasparilla Grill and Games
Yak and Yeti
Plaza Ice Cream Parlour
Restaurant Marrakesh
Pecos Bill, Main Street Bakery
Roaring Forks
Sunshine Seasons
Beaches and Cream
Crystal Palace
Whispering Canyon
Snacks and Wawa
Nine Dragons
YAY, you are there! I hope you get to work at POTC!!!
We are organizing a mini DIS meet at the Tambu Lounge on August 5th around 6-6:30ish if you're available. We' love to meet you. If that time/place doesn't work for you, we will absolutely come find you at your attraction (which I hope is POTC)! ETA: Ooops, just saw on your other thread that you will be in Frontierland! Well, that's not gonna stink! Have fun!
How exciting Betsy!!! I wish I was in your shoes...but I doubt they would take old ladies like me into their College Program. :lmao: But, although it seems that neither of my college-age daughters will be able to fit this into their schedule, I'm still holding out hope for my highschool-age son. ;)
Anyway, I'm really looking forward to hearing about all your Disney adventures...both Dining and otherwise! :thumbsup2
Oh, and I forgot to say...Congrats on your recent college graduation!
Followed you from your dining review. Hope you have a great time while in the college program...how can't you, you're living at the best place in the world!
another report so soon - can't wait :goodvibes:
Can't wait to read your ongoing reviews!
How fun! I'm definitely in for this!
I'm excited about another Princess Betsy review!!!! You know I'll look you up in August!!
Can't wait to hear about your College Program experience (and the food) - have fun!
Sounds like you're going to have a great time! I really look forward to hearing all about your experience, and the food of course. :goodvibes
That sounds like so much fun! I will definitely try to make it over there, just have to make sure I get the day off. Can't wait to meet you! :thumbsup2
I found out my main work location today! I'll be working at...
How awesome is that? This is one of my favorite attractions, so I'm so excited to begin training! :woohoo:
What a fun attraction to work!!! Congrats! :banana: We'll definitely go on that a few times in August! Can you let us know your days off so I wouldn't be looking for you then?? :banana: (if you feel like sharing that much info in a public forum. :))
Subing! You and I sound A LOT alike! Have so much fun! What a great attraction. I wish I would have done the DCP. I have always wanted to be server at Crystal Palace or work in the Emporium! Can't wait to read more!
Watch out for Brer Alligator!
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"This recipe was disappointing and barely edible. The tortillas ended up completely mushy and the whole thing was just a bit too sweet. Now we're trying to figure out how to salvage all this food."

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Catholicism Appearances
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Testing a 2year old? Keeping him busy.
Find a Conversation
|Sat, 03-31-2012 - 2:56am
My son is 2 (27mo)
|Sat, 03-31-2012 - 12:11pm
Hi there and welcome to the gifted board.
Testing at this age is unreliabe. Most won't consider testing a child under 4 and even then, it's reccomended to wait until around 7. You say there are programs he'd qualify for with scores but I suspect these are programs for children a little older. Go and find out what these programs are, when they start and what your child would need to qualify. There are several IQ tests available and schools can be picky about which ones they accept. You don't want to be stuck re-testing because a favored program doesn't accept the scores you can provide.
I know the qualifications for early enrollment sound ridiculous but the reasoning behind it is actually pretty sound. By wanting your child to be 2.5 years advanced
|Sat, 03-31-2012 - 12:57pm
My eldest was similar at this age (except that she had lots of stranger anxiety). I agree with Turtletime. Take it a year at a time, or at this age even just a few months at a time. Don't worry about testing at this point. Don't borrow trouble.


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Unity by the Sea sponsors cookbook project
Unity By the Sea is sponsoring a cookbook project and is seeking participants to submit up to three recipes for inclusion. Recipes will be printed at no charge.
The three-ring binder cookbooks will contain more than 150 recipes and will be available the end of May or beginning of June. Pre-orders are being accepted. Cost: $20/per book. Information: email@example.com or 949-4790.


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Purdue University's Online Writing Lab
One stop shopping for writing instruction on the web. Handouts, tutorials galore.
Writing Tools From
Harvard's Writing Center
It is what it says.
Research On the Web
Your first choice should be the many online databases in our library. Access them via your oceancruiser account.
New York Review of Books
At this site, click on the New York Review of Books icon to access thoughtful,
considered, and in-depth articles on politics, social issues, and the arts: in other
words, articles on life itself. As the name suggests, this is a book review, but each
article amounts to a survey of the field under study. Ive read some fascinating
articles on Star Wars, prozac, Pi, Artificial intelligence, and Bosnia, in addition
to essays on Shakespeare and Virginia Woolf (and even references to Shakespeares
To use, click on the New York Review of Books icon, and go to "Search the
If any of the articles look good, but you do not want to pay for them, our
library has paper copies of back issues.
Asbury Park Press
The place for local news though it lacks a thorough archive.
Salon Magazine
One of the first fully online magazines; still manages to offer the thoughts of some of
the best writers of today.
New York Times
"All the news that fit to print"
A great reference site with links to everything from weather to financial
statistics in the Middle East.
Tom Paine Common
A progressive liberal
site offering an alternative view to the news
A bit more rigorous than TIME, which has degenerated into a celebrity mag.
The National Review
From a conservative point of view
The Washington Times
A conservative newspaper
The Source Home |
Citing Sources | MLA
| APA | Plagiarism
| How to Format Essays |
OCC Sources | Writing
OCC Home
| English Department | Faculty/Staff
Directory | Library
Direct comments or suggestions to David Bordelon at


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Legal Wills
A legal Will sets out who will receive a person's estate after they die. A legal Will should also include the appointment of executors (the people who administer the estate), and guardians if there are children under the age of eighteen.
Without a legal Will, any of the following may apply:
- A spouse/civil partner may only receive a small part of the estate
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- Children from a previous relationship may miss out on a share of the estate
- Children or grandchildren may receive a share of the estate contrary to the wishes of the deceased
- Family heirlooms may pass outside of the family
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It may be that an existing Will is in place already, but clients
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- Divorce - Getting divorced does not revoke a Will in its entirety but the former spouse/partner would not be allowed to act in the administration of the estate and any benefit they had under a Will would be revoked
- Separation - The effect is not the same as divorce, but a Will should be updated to reflect the change in circumstances
- Financial changes - It is important to keep an eye on the value of an estate to stay one step ahead of any inheritance tax liability and to also ensure that the estate is sufficient to provide for any legacies that may have been left
- Property abroad - It is essential that a Will is made in the relevant country to ease the administration of the estate. Different countries have different laws and any existing Will that may be in place may only take into account UK assets
Making a Will is quick and simple with the Flint Bishop Will writing service


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- Hotel Details
- Member Reviews
- Photos
The Comfort Hotel Royal Kettering2 Stars
Market Place Northamptonshire Kettering NN16 OAJ
Set in the heart of Kettering Town Centre Conservation Area, the Comfort Hotel Royal Kettering is an excellent starting point to discover Wicksteed Park, Stanwick Lakes, Billing Aquadrome, Gulliver's Land and many other amusements that are available in the surrounding area.
Spend a night in one of the 41 stylish, comfortable accommodation units that are adorned with beautiful furnishings, comfortable amenities and all the entertainment extras that are needed for the perfect business or leisure trip.
Maintaining the feel of Victorian times with its style, decor and Victorian glass dome, the fashionable on-site restaurant dishes out excellent meals for its guests to relish. Conclude your busy day with an exotic drink served at the lovely bar.
With its flexible as well as modern event space, this prestigious hotel creates the perfect setting for a business meeting or social gatherings. For your relaxation, this property also comprises a relaxing lounge.
Hotel Facilities
- Banquet Facilities
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Other Recommended Hotels
|Holiday Inn Express Kettering
|3 Stars
Find similar hotels as The Comfort Hotel Royal Kettering in Kettering
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Port et manutention :
6,99 $
(106 évaluations)
(Fondée sur 106 évaluations)
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Compte rendu par 106 clients
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Shoe came apart at the seam
Par Kteen
de Mississauga, Ontario
I was so excited to wear my new canoe shoes only to have them fall apart at the top seams after a handful of wears.. I contacted TSC but was told that I had to contact the company directly as it was past 30 days. I contacted the company only to find out that they can only do something within 90 days after they prove it wasn't improperly used. It takes them forever to contact you back and sad to say I am without my canoe shoes and out of pocket...so disappointed.
En résumé
Non, je ne recommanderais pas ceci à un ami
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( 4 of 4 clients ont trouvé ce commentaire utile)
Par SEdbr
de Comox Valley
I love Manitobah Mukluks... but was very disappointed with this pair. Have been wearing for about 2 hours and the seam around the toes came apart. Also, disappointed that these are not actually Canadian made only Canadian designed.
( 3 of 3 clients ont trouvé ce commentaire utile)
Came apart at seam
Par Mrs. Ponytail
de Montreal, QC
I really liked these moccasins and I think I originally gave a good review (but I don't see my review here). They are super comfy but after three months the seam fell apart. I noticed when I first received them that the right seam was crooked. but I kept them anyway. I should have returned them when I saw that because that is exactly where they fell apart. Beware if you get a pair with crooked seams. The left one is still in good shape.
En résumé
Oui, je recommanderais ceci à un ami
( 2 of 2 clients ont trouvé ce commentaire utile)
My favourite shoe
Par Zuzu
de Flamborough, On
I received a pair a couple of years ago as a gift. I wear them outdoors from spring to fall. They are so comfortable, like wearing slippers. I'm sure I will end up with every style on many colours.
( 1 of 1 clients ont trouvé ce commentaire utile)
very comfortable
Par jeanne
de N.B.
comfort and quality
( 12 of 12 clients ont trouvé ce commentaire utile)
Not really Canadian
Par Suzanne
de Surrey, British Columbia
I recently received a pair of these mocassins in the grey. I have been wanting a pair for a long while and was very excited to finally have some. However, I was quickly disappointed. Within 2 days of light wear in the house, I had to tie the laes at least 50 times and on the second day, the lace on the right foot sanpped while tying it. I also noticed on the box that the mocasins were in fact not hand made in Canada, but factory made in China which surprised me. I have sincce recceived a replacement pair, which are made in Vietnam. I had been under the impression that Manitobah Mukluks was a Canadian company, employing native craftsmen/artisans, but it seems that only the designs are of Metis origin. All in all, although the mocassins are indeed comfortbale and stylish, I am very dissappointed that they are not Aboriginal made. I could have bought something similar for a lesser price in the local mall and been just as pleased. I chose to pay the extra price for Manitoba Mukluks based upon the assumption that I was buying a genuine Metis product.
Fit is not the same
Par Colleen
de Edmonton
I bought two pairs the same size but different colours. The fit smaller on the black but I think it will stretch. I had to undo the tie at the top to stretch and now it will not stay tied. They are nice
( 0 of 3 clients ont trouvé ce commentaire utile)
Comfortable and excellent quality
Par PAT
de WATERLOO
This is my second pair of these moccasins. The quality and fit are excellent and the design is unique. These moccasins are good for people with narrow feet. I tried one of the other styles but the fit was so loose I couldn't walk in them. Good for the Chinese - they make excellent moccasins!
fit like a glove, very comfortable
Par ttmustang
de Greater Edmonton Area.
I have two pairs of these mukluks, I absolutely love the non-slip souls. The sizing is not reliable. I had to return an order as they were advertised as to order 1 size down, couldn't get those on with a shoe horn and no socks. The replacements however are a much better fit although quite SNUG - I'm hoping they will stretch a bit for more comfort. I do recommend these Canadian made mukluks, now if they would only be available in reliable sizing.
These moccasins are GREAT
Par mj
de NT
You can never go wrong with Manitobak Mukluks. I have several pair now and have bought both for myself and as gifts. They are comfortable and smart. It is wise to get as size down as they do stretch.


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My friend Vivek pointed me to this website Pro:Fx that helps one create a website using flash, online. I registered myself for a free account and was experimenting with the site. The power of flash is the richness and the ease of use under one single window. More than building a site I enjoyed using this site because the whole site is built using flash.
Happy Weekend!


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The fondness for relics—a piece of the True Cross, a tooth of the Prophet, the rod of Moses—is a well-known hallmark of real religion, and there was once a lucrative trade in hallowed body parts, often of dubious provenance. The trade in secular relics may be more lucrative still. The rhinestone-encrusted sheath worn by Marilyn Monroe when she sang "Happy Birthday, Mr. President" to John F. Kennedy, in 1962, was sold at auction a few years ago for $1,267,500. A pair of white cotton boxer shorts worn by Kennedy when he was in the Navy sold recently for $5,000. Almost every day the newspapers bring word of some new sale of celebrity memorabilia—Elvis Presley's sixth-grade report card; Marilyn Monroe's copy of The Little Engine That Could; a soiled towel used to wipe the face of Isaac Hayes (but not, alas, miraculously bearing his image). Despite concerns over its authenticity, a piece of Bazooka bubble gum chewed by Luis Gonzalez, of the Arizona Diamondbacks, was bought at a charity auction last year for $10,000.
In the god-drenched eras of the past there was a tendency to attribute a variety of everyday phenomena to divine intervention, and each deity in a vast pantheon was charged with responsibility for a specific activity—war, drunkenness, lust, and so on. "How silly and primitive that all was," the writer Louis Menand has observed. In our own period what Menand discerns as a secular "new polytheism" is based on genes—the alcoholism gene, the laziness gene, the schizophrenia gene.
Now we explain things by reference to an abbreviated SLC6A4 gene on chromosome 17q12, and feel much superior for it. But there is not, if you think about it, that much difference between saying "The gods are angry" and saying "He has the gene for anger." Both are ways of attributing a matter of personal agency to some fateful and mysterious impersonal power.
As noted, it is only a matter of time before brightness takes on some of the trappings of a religion. Already there is an element of evangelical witness: "By their visible example," the brights' Web site (www.the-brights.net) explains, adherents "can help other brights to step forward and take on the challenge of more firmly expressing their world view." There is also an apparent desire for a cadre of prominent apostles—"persons of acknowledged eminence and ethical standing," as the Web site describes them—to lend their names to the movement. And there is the telltale denominational urge to count the saved: in a New York Times op-ed article the bright philosopher Daniel Dennett put the number of brights in America at 27 million or more (which would place them below Catholics and Baptists in membership but well above Methodists and Lutherans).
Any religion worthy of the name needs a bitter schism, preferably over something that in retrospect seems trivial—and brightness is proving to be no exception. Some atheists have already sought to distance themselves from the brightness movement. "It's a cop-out," the president of the American Atheist Association told The Sacramento Bee. "It seems like a way to hide who you are to please other people. I'm not ashamed of my beliefs. Plus it's a silly name." No one should be surprised if a further schism develops, between the modest, mainline Nominalist camp (which holds that bright should be used only as a noun, as in "I'm a bright") and the in-your-face Descriptivist camp (which holds that bright should be wielded aggressively as an adjective, as in "I'm bright" and "You're not bright").
In time a bright liturgy will surely develop, perhaps starting with the adoption of an official hymn. Far be it from me to meddle in sectarian affairs, but thoughts turn naturally to one of the great spiritual epics of our time. Yes, I'm thinking of Monty Python's Life of Brian, about a man who is not the Messiah but gets put to death anyway. In the final scene, as Brian and his many followers hang on crosses, the crucified men start to whistle and then break into robustly good-natured song. It begins, "Always look on the bright side of life."
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Photo Credit: Andrew Burton/Getty Images
Weingergate, the story that started off with a quiet buzz last week, seemed to trounce all conversations the past few days. At iVillage the debate is not "should he resign" but rather, "should she forgive him?" Like so many other things, the rules around extra-marital affairs aren't being written quickly enough to keep up with our new digital habits. Is exchanging messages on Twitter the same as a real-life fling -- or worse? Take our poll on infidelity and share your thoughts.
Sarah Palin took some heat on our message boards for her revisionist P.O.V. of Paul Revere's historic ride. Though the facts quite clearly point out her misunderstandings, Palin supporters manage to see light through the fog.
And, since the most successful politicians seem to be the most polarizing, this question was bound to come up: Should Alec Baldwin run for mayor? The outspoken New Yorker has long flirted with politics, and in this day and age, weathering an ugly public divorce and tabloid scandals could be just the experience he needs to take on the job. Would you vote for him? According to our poll, the majority of you would!
Speaking of decisions, here's one the government needs to stay out of entirely: whether or not to circumcise. California's proposed ban on the infant procedure caused an uproar among our community. Most agree it's a personal decision for the parents, though one community member suggested that boys should decide for themselves once they hit age 18.
On to more important news: How the heck do you keep your hair looking good during this crazy heat? Luckily, things on the East Coast have cooled down as the weekend kicks in, but we know it won't be long before the frizz rises once again. Got any suggestions for us?


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Mon-Fri 4am-10pm PST Sat-Sun 5am-8pm PSTLive Chat
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Regal Seating R2065-Table Rectangular Dining Table with Double Cast Iron Base
Product Description
Rectangular Dining Table with Double Cast Iron Base
- Table Height Base
- Two base pieces
- 22"L x 5.5"W x 28.5"H each
- Column diameter: 3"
- Spider diameter: 10"
- Cast iron base & spider
- 18 gauge steel tube column
- Adjustable glides
- Table Top
- 1.63"Thick
- Laminate top
- Black T-mold edge
- Table top is double-sided, customer chooses which finish (black or mahogany) to permanently install as top side
|Frame Finish Option:
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Items Available In This Set
Regal Seating TT2430 Rectangular Table Top with T-Mold Edge
Regal Seating R2065 Table Height Cast Iron Base (2-pack)
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I'm from Tampa, FL but my background is varied and I'm looking for someone who gets my drift.
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33 • Jackson Heights, NY • Man
I'm looking for
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- Other, but not too serious about it
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- Gemini, and it's fun to think about
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Sushi restaurant Saito chef Takashi Saito (C) receives a trophy as he was selected as the new three-star chef by the new Michelin Guide Tokyo 2015 guidebook during the publication announcement ceremony in Tokyo on December 02, 2014, while Michelin Japan president Bernard Delmas (L) and Michelin guide International Director Michael Ellis (R) smile. Michelin guide announced the 12 three-star restaurants, 53 two-sar restaurants and 161 one-star resurarants being selected in the 2015 Tokyo guidebook. Michelin guide and Japan's restaurants guide website Gurunavi will launch the new restaurants guide website and service "Club Michelin" next Spring. AFP PHOTO / Yoshikazu TSUNOYOSHIKAZU TSUNO/AFP/Getty Images
Content engaging our readers now, with additional prominence accorded if the story is rapidly gaining attention. Our WSJ algorithm comprises 30% page views, 20% Facebook, 20% Twitter, 20% email shares and 10% comments.


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With labor costs increasing in China, the country is now shifting its manufacturing focus to high-tech exports such as computers and sophisticated power devices. Shaun Rein of China Markets Research tells the WSJ s Jake Lee how western countries are reacting.
Download the TV Guide app for iPhone, iPad and Android!


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What does OUO mean in Military?
This page is about the meanings of the acronym/abbreviation/shorthand OUO in the Governmental field in general and in the Military terminology in particular.
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"OUO." Abbreviations.com. STANDS4 LLC, 2014. Web. 22 Dec. 2014. <http://www.abbreviations.com/term/163632>.
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December 22, 2014
MEMPHIS, Tenn. (AP) -- International Paper and a forest conservation group are announcing a plan to protect endangered forests in key paper producing areas of the South.
The Memphis-based paper company and Dogwood Alliance said Wednesday that they will map forests around International Paper's southeastern operations to identify endangered forests or areas where conservation of natural resources is critical to environmental health.
The agreement between International Paper and Dogwood, a longtime critic of the paper company, also includes a plan to discourage the conversion of natural hardwood forests to pine plantations.
The first step will be a pilot project to map forests around the company's mill in Riegelwood, N.C. The partners will then try to apply the mapping practices to other paper-producing regions in the South.
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Soil-water reserves in France, the European Union's largest wheat producer, climbed across the country in April as more rain fell than usual, the Agriculture Ministry reported.
Rainfall was 65 percent above the long-term average last month, while temperatures of 11 degrees Celsius (51.8 degrees Fahrenheit) on average were close to normal levels for the month, the ministry wrote in a report on its website today.
France received 7 percent more rain than usual since March 1 on average, according to the ministry, after a deficit from the start of September through March. Soil-water reserves stayed below normal across much of the country, the report showed.
"After a start of the year marked by weak rains, all the territory benefited from precipitation that was particularly welcome in the west and southwest regions," the ministry wrote.
Average April rainfall was 101 millimeters (4 inches) for France, according to the report. Rainfall in the center-east region was 50 percent above normal, the north got 69 percent more than usual and the northeast received 16 percent more than in an average year, the ministry reported.
To contact the reporter on this story: Rudy Ruitenberg in Paris at email@example.com
To contact the editor responsible for this story: Claudia Carpenter at email@example.com


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soma/spasticity for ms pain only took it for a short while with codeine and then was switched to plain soma .
This was used for upper spasms in my back, and after they got better I was taken off them altogether, so I can say that yes they were a great medicine to take for spasm for as the also helped my legs and arms at the same time. however, my Dr didn't want me have too many meds in my arsenol of drugs, ;~)


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"Cheese-eating surrender monkey" is two out of four.
Monkey and Cheese ???? ;^p
A FEW days ago we pointed to a clever way of colour-coding the words in an English sentence to show their various origins. This particular method was automated, but a manual version of the approach is a lot older—and has been used at least once to make a very particular point.
In "Thinking the Twentieth Century", his valedictory work before his death from Lou Gehrig's disease in 2010, the historian Tony Judt describes visiting an exhibition at the Historical Museum of the City of Vienna, which included a reproduction of a rant from a right-wing newspaper:
The article, in German of course, was about the horrors of cosmopolitanism: the Jews and the Hungarians and Czechs and Slovaks and others who were polluting Vienna and creating crime. The curators had highlighted this text in different colors according to the words and their roots, to show how very little of it was in literary German: much of this characteristically nativist rant was, unbeknown to its author, written in words of Yiddish, Hungarian or Slavic origin.
It would have been fun, during the brief fit of American francophobia during the Iraq war (remember "freedom fries"?), to apply this technique to all the outraged politicians' speeches, showing how many words were of French origin. Or, indeed, for any country in the midst of a fit of nationalist pique.
Reader comments are listed below. Comments are currently closed and new comments are no longer being accepted.
"Cheese-eating surrender monkey" is two out of four.
Monkey and Cheese ???? ;^p
"Savoir-Faire is everywhere!"
You said that there was a automated version, is it available to the public?
Not as far as I can tell, alas: the author seems to have written the algorithm for his own use but not put it on the web. The original post is at http://ideasillustrated.com/blog/2012/04/01/visualizing-english-word-ori... (the link in my post was to a previous Johnson post, but was broken - I've now fixed it, with apologies.)
As the hours unrolled after 9/11 the Americans were scandalized by the disloyalty of their former French allies. "We are all Americans now" declared "Le Monde" the day after the tragedy but inevitably the majority of the French people retreated en masse from this position. What horror! What outrage! That these poltroons should succeed in causing irreparable damage to an honourable reputation for amity first forged in the sanguinary flames of revolution!
No, what caused the french people to remove their support was, that Bush, Cheney and the Neocons were making a BS case to attack Iraq, which had nothing to do with 9/11.
Yeah, somehow they weren't deceived, unlike TE.
American francophobia? I guess G.L. didn't see JAS's cartoon this week.
Dear The Economist(or Johnson), How can I find an earlier blog from a blogger called "Konker"? Sincerely, Watson
I am not TE or Johnson but if you type his name in the search bar at the top of the page and then sort it by people you should find it.
Our correspondents consider the use and abuse of languages around the world, in a blog named after the dictionary-maker Samuel Johnson
Images of Christmas: Mary Mary quite contrary
Daily chart: The 2014 Economist Advent calendar - Christmas day
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text:
Author: Dhawal Shah.
Dhawal Shah, CFE is an entrepreneur and a franchising professional based out of Mumbai, India, he publishes articles at Way2Franchise and is a sought out industry veteran. Way2Franchise.com is a high quality franchise lead generation platform. He can be reached at firstname.lastname@example.com To receive regular updates follow us at @Way2Franchise
"We believed that strategic alliances and partnerships we... Read more.


text:
Medical Books > Medicine > Internal Medicine > Pediatrics
Medical Books > Pharmacology > Pharmacy
Medicine & Health Sciences > Allied Health Services > Pharmacy
Medicine & Health Sciences > Medicine > Clinical > Pediatrics
Overview: The pediatric population is a dynamic group, with major changes in pharmacokinetics and pharmacodynamics taking place throughout infancy and childhood. Because of these changes, the need for the evaluation and establishment of medication dosing regimens in children of different ages is great. The "Pediatric & Neonatal Dosage Handbook" continues to be the trusted resource for all medical professionals managing pediatric patients. Benefits: 944 Drug Monographs; Up to 40 fields of information per monograph; more than 100 extemporaneous preparation recipes; and, more than 290 pages of appendix information.
TIme to replace
ByBrian Elmore on Jun 17, 2013
It was time to replace some of our reference books. My staff like this reference for quick questions. Nice for confirming doses on Pediatric patients.
Five Stars
ByKaren on Oct 20, 2014
Great Info!
ByT. Katz on Mar 28, 2013
This book has all information you want on any drug! While there's lots of information, I found this book somewhat hard to read. Print is small.
Five Stars
ByJames Soukup on Aug 10, 2014
Good book at a great price.
Great Book!
ByLt 123 on Jan 19, 2013
I liked everything! The book was true to description and came on time. I was happy with the whole process. Book is brand new with no tears, bends, or anything.
Excellent reference book
ByBobby M on Jan 13, 2013
As a pharmacist, this is a great go-to-book to reference whenever I need an immediate answer on dosing for an infant/child/adolescent. Especially in babies where the information is not always the easiest to locate as a pharmacist, this book has cleared up some important questions and problems that I have encountered in the past.
Pediatric classic
ByAlberto Maestre on May 10, 2013
It's very usefull for my job. It's the last version of a classic for pediatrics. Everyone involved have to purchase this book.
Excellent reference
ByCamilla Miller on Jan 31, 2013
The reference is very complete and appropriate for professions in our very busy, surgical NICU including all the multidisciplines. Some of the patients stay for an extended period of time qualifying them for dosing beyond the Newborn period. This reference is great in that it includes both specialties. It is a very complete book that we often are able to use as a single reference, if desired, and information very often confirmed by our own knowledgable Pharmacy staff.
Great reference
BySepepper on May 10, 2013
I was looking to upgrade my clinic's reference library, and this was the perfect one to accomplish that. Lexicomp is the best.
Perfect resource
ByAntonette on Feb 19, 2013
It's comprehensive, and provides the answers I need to pediatric dosing. A must have resource for anyone working in the pediatric health world.


text:
Remarkable People. Remarkable Medicine.
Dr. Atwood earned her undergraduate and graduate degrees at UNC-Greensboro and earned her Au.D. from Salus University. She is a fellow of the American Academy of Audiology, holds her certificate of clinical competency from the American Speech Language-Hearing Association and is licensed by the North Carolina Board of Examiners for Speech Pathology and Audiology.
At Forsyth Rehabilitation Center we provide comprehensive audiology services for patients of all ages. Our licensed audiologists use state-of-the-art technology to provide accurate results in the evaluation and treatment of hearing deficits and processing disorders. We offer a comprehensive selection of the most-current digital hearing aids and accessories. Your hearing ability is appropriately assessed and hearing devices are suited to meet each patient's individual needs and lifestyle.
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Read 1 verified patient review for Forsyth Medical Center! Their review score was 5 ().
"She was very knowledgeable and she had the answers to all of my questions. She was also very courteous and ..." more »


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Is Marco Rubio the Worst Climate Denier in Congress?
By Chris Joseph
Broward Judge Rules for Same Sex Marriage in FL
By Chris Joseph
New Times Writers to Host Reddit AMA
By Allie Conti
Potential Hurricane Forming in Atlantic
By Chuck Strouse
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Both issues are misunderstandings, Allard says. She contends her staff does everything possible before using physical force. "I think what was happening was that the staff wasn't putting down [in their paperwork] everything that happened before a child was restrained," Allard says. As a result, Allard says, Growing Together started using a form that provides additional space for the narrative. "There are times when a kid needs to be restrained if they are a threat to themselves or others," Allard explains. "If a child picked up a heavy chair and was going to throw it at another client, I can tell you that they would be restrained... Restraining is the last resort. No one wants to restrain anyone. You don't want that for the child, and you don't want that for the adult."
Allard refuses to alter her policy on bed frames, claiming that children could use the metal to cut themselves. "We can't do that in good conscience," she says.
On July 27, Piotr Blass, a computer-science professor at Key College in Dania Beach, sued Growing Together after his 16-year-old son, David, was court-ordered into the program. In his lawsuit, Blass alleges that Growing Together "often kidnaps children from their parents and then employs draconian, sadistic, destructive, and highly damaging psychological techniques to destroy the relationship between parent and child, all for their own benefit and financial gain."
These types of allegations can also be found on an Internet bulletin board (www.fornits.com/wwf) used by former patients of Growing Together and other Straight-based clinics. Most of the messages detail physical, psychological, or sexual abuse. Allard claims the allegations are "made up" and written by "people who are still involved in the druggie scene."
It's noon on Friday, November 19, and Jessica Norris sits quietly on a bench near the fountains at the end of Clematis Street in West Palm Beach. An anxious, pretty 18-year-old with long brown hair and a disarming smile, Jessica (not her real name) considers herself a survivor. At 14, she experimented with cocaine. Her parents placed her in Growing Together, where she says she endured 18 months of physical and psychological trauma. "When I first got there, the other girls were telling me about Naked Crusader," she says. "Everyone in Growing Together knew there was abuse. But no one said anything. We were all too scared."
Inside the facility, Jessica says she witnessed beatings and child neglect. In the "white room," where children were sent to calm down, clumps of hair lay on the floor and blood was smeared on the walls, she claims. Every day, staff interrogated the kids, making them give more and more outlandish confessions about their past. "I made up that my uncle molested me," Jessica says. "It was the only way to move up."
Now a student at Palm Beach Community College, Jessica is still adjusting to life on the outside. During her time at Growing Together, she claims she couldn't take a shower in private. She believed she was worthless. She became accustomed to the sight of staff members throwing children to the ground. To this day, she hears the screams that rolled through the halls like thunder between buildings.
"I've tried not to look back," Jessica says, brushing a string of hair behind her right ear. "What we went through was a terrible thing."
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Our name comes from our origins as a Florida pineapple plantation. Legend has it that when Key West's sea captains returned home from their voyages, they would leave pineapples out on their gateposts as an invitation to the community to stop by and join them in celebrating their return by sharing in the warmth and hospitality of their homes. Pineapple Cove is aptly named to convey both the hospitality you can expect as a resident and the warmth and tranquility that beckon you home. The pineapple is also a fruit that has always been a challenge to cultivate, and this difficulty made it a rare commodity, a mark of affluence. Rarity is an ideal metaphor for the level of attention we offer our residents and affluence echoes the resort lifestyle you will experience from the day you move in. In keeping with that rich and natural history, what thrives here today is the most fun-filled and free-spirited way of life in Jensen Beach.
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1 Bedroom $1150 - $1365 1 Bath 719 - 969
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2 Bedroom $1305 - $1775 2 Baths 1085 - 1304
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3 Bedroom $1755 - $1825 2 Baths 1304
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- High Speed Internet Available
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- Clubhouse
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- Package Receiving
- Free Weights
- Tennis Court(s)
- Fitness Center: Free
- On-Site Management
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- Preferred Employer Available
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- Private Detached Garages
- Climate-Controlled Storage Units
- Meticulously Maintained Grounds
- Free Wireless High-Speed Internet
- Professional On-Site Management Team
- Parking Garage
Additional Information:
- Private detached garages are available for an additional $110 per month.
Pet Policies
- Cats Allowed
- Small Dogs Allowed
Additional Information:
$10 per pet, pet rent. Two pets are permitted per apartment. Dogs under 25lbs $400 non-refundable pet fee. Dogs over 26lbs $500 non-refundable pet fee. $10 per pet, pet rent. Two pets are permitted per apartment.
Lease Length
- Pineapple Cove offers a minimum lease term of 7 months and up to 12 months.
Property Information
- BuildingType: Apartment
- Number of Floors: 3
- Number of Units: 260
Office Hours:
Weekdays: Mon: 08:30 AM-05:30 PM, Tue: 08:30 AM-05:30 PM, Wed: 08:30 AM-05:30 PM, Thu: 08:30 AM-05:30 PM, Fri: 08:30 AM-05:30 PM, Saturday: 10:00 AM-05:00 PM, Sunday: 01:00 PM-05:00 PM
Management Company:
Ram Realty Services
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Ratings & Reviews
Rated 1 out of 5?by 1 reviewer.
Rated 1 out of 5?by Mary Don't Move Here! this complex is not for families. some of the older folks treat the children like they are crminals. the appliances are old, and will out your energy costs! the washer and dryer are at least 10 years old, the stove older, and the dishwashers are non efficient or actually clean dishes. we just moved in last month, and wish we could leave. not to mention the way i see some neighbors who have no place to park when they come home because of the way pakring is. several people moved in next door all young people and they have relations on the balcony, and my child room is right downstairs from them. the office doesn't care, they just want your money. $1300 a month is way to much to pay for this place, and it's not child or pet friendly like they say they are. the children have no where to play and notices are posted that they cannot play in front of the buildings but in a grassy area full of snakes and wild life? how is that safe for our children? each person pays a different price for rent for the same apartment, how is this possible? we pay $1300, and the lady downstairs pays $1100? This complex needs to get its act together.our neighbors are sad as well because they lost their job and are being threatened to be evicted and are only late with rent 2 days today. not nice, and the new girl in the office has no heart when this family went to her and let her know they had no job the company shut down a few weeks ago and she said tough luck. don't move here, it's not a nice place unless you are an old December 6, 2012
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Enhance Technology UltraStor ES3160 FS
With Microsoft Multi-path I/O and Windows server clustering validation, the UltraStor ES3160 FS offers 4x 4G fibre channel connectivity and makes high capacity storage available for share in a SAN environment with multiple servers and workstations. It is equipped with dual-active RAID controllers and dual 500W redundant power supplies. It utilizes 16x hot-swappable disk trays with up to 32TB and is expandable up to 60TB total storage capacity via 3x ES3160 JS enterprise JBOD storage systems with SAS hard drives. IT administrators can add more storage capacity as their business grows.
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Book your room at Hotel Casino Morelia
Morelia hotel with a restaurant
Situated in the city center, this hotel is close to Plaza de Armas, Mariano Matamoros Theater, and Regional Museum of Michoacan. Also nearby are Palace of Justice and Rose Garden.
Hotel Features
In addition to a restaurant, Hotel Casino Morelia features a health club. Other amenities include a bar/lounge and complimentary wireless Internet access.
Room Amenities
Televisions come with premium cable channels. Guestrooms also feature complimentary wireless Internet access, safes, and coffee/tea makers.Information missing or incorrect? Tell us!
At your hotel
At your hotel
The hotel offers a restaurant. A bar/lounge is on site where guests can unwind with a drink. Business-related amenities at this 3-star property consist of a business center and meeting rooms.
Public areas are equipped with complimentary high-speed wireless Internet access. This Morelia hotel also offers a health club, multilingual staff, and gift shops/newsstands.
- 24-hour front desk
- Total number of rooms - 42
- Safe-deposit box at front desk
- Elevator/lift
- Number of floors - 3
- Restaurant
- Complimentary newspapers in lobby
- Concierge services
- Health club
- Free Wi-Fi
- Business center
- Gift shops or newsstand
- Bar/lounge
- Laundry facilities
- Meeting rooms
- Multilingual staff
- Porter/bellhop
- Year Built 1850
- Complimentary reception
- Number of buildings/towers - 1
Stay connected
Available in all rooms: Free Wi-Fi
Available in some public areas: Free Wi-Fi
In your room
- Premium TV channels
- Free local calls
- Turndown service
- Private bathroom
- Complimentary toiletries
- Hair dryer
- Shower only
- Iron/ironing board
- Coffee/tea maker
- Desk
- Room service (limited hours)
- Cable TV service
- Free Wi-Fi
- Blackout drapes/curtains
- Complimentary newspaper
- In-room safe
Eat and drink
Hotel Casino Morelia has a restaurant on site.
Room service (during limited hours) is available.
The fine print for Hotel Casino Morelia
When you arrive
Minimum check-in age is 18
When you leave
Check-out time is 1 PM
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.
- Minimum Spring Break check-in age is 18 years old.
No pets or service animals allowed
We should mention
This property's policy is to refuse certain bookings for the purpose of group events or parties, including pre-wedding stag/bachelor and hen/bachelorette parties. Children 12 years old and younger stay free when occupying the parent or guardian's room, using existing bedding. Only registered guests are allowed in the guestrooms. No pets and no service animals are allowed at this property.


text:
Are you M Elena Garralda?Claim your profile
Publications (61)250.56 Total impact
Article: Combined infant regulatory problems and early maternal psychiatric illness predict risk of functional somatic symptoms in later childhood.Evidence-based nursing 05/2013;
Article: Testing the Feasibility of Therapeutic Identification of Depression in Young People in British General Practice[Show abstract] [Hide abstract]
ABSTRACT: PurposeDepression in young people attending primary care is common and is associated with impairment and recurrence into adulthood. However, it remains under-recognized. This study evaluated the feasibility of training primary care practitioners (PCPs) in screening and therapeutic identification of adolescent depression, and assessed its effects on practitioner knowledge, attitudes, screening, and management.Methods We trained PCPs in therapeutic identification of adolescent depression during general practice consultations. To assess changes in knowledge and attitudes, PCPs completed questionnaires before and after training. We ascertained changes in depression screening and identification rates in the 16 weeks before and after training from electronic medical records of young people aged 13–17 years. Post-training management of depression was recorded on a checklist.ResultsAspects of practitioner knowledge (of depression prevalence and treatment guidelines) and confidence (regarding depression identification and management) increased significantly (all p < .04). Overall screening rates were enhanced from .7% to 20% after the intervention and depression identification rates from .5% before training to 2% thereafter (29-fold and fourfold increases, respectively). Identification was significantly associated with PCP knowledge of prior mental health problems (Fisher's exact test, p = .026; odds ratio, 4.884 [95% confidence interval, 1.171–20.52]) and of psychosocial stressors (Fisher's exact test, p = .001; odds ratio, 17.45 [95% confidence interval, 2.055–148.2]).Conclusions The Therapeutic Identification of Depression in Young People program is a feasible approach to improving primary care screening for adolescent depression, with promising evidence of effectiveness. Further evaluation in a randomized trial is required to test practitioner accuracy, clinical impact, and cost benefit.Journal of Adolescent Health 05/2013; 52(5):539–545. · 2.97 Impact Factor
Article: Neuropsychological Function Three to Six Months Following Admission to PICU With Meningo-Encephalitis, Sepsis, and Other Disorders: A Prospective Study of School-Aged Children.[Show abstract] [Hide abstract]
ABSTRACT: OBJECTIVE:: To assess short-term neuropsychological function and academic performance in school children following admission to intensive care and to explore the role of critical neurological and systemic infection. DESIGN:: A prospective observational case-control study. SETTING:: Two PICUs. SUBJECTS:: A consecutive sample of 88 children aged 5-16 yrs (median age = 10.00, interquartile range = 6.00-13.00) who were admitted to intensive care between 2007 and 2010 with meningo-encephalitis, septic illness, or other critical illnesses. They were assessed three to six months following discharge, and their performance was compared with 100 healthy controls. Patients were without prior neurological or neurodevelopmental disorder. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Data encompassing demographic and critical illness details were obtained, and children were assessed using tests of intellectual function, memory, and attention. Questionnaires addressing academic performance were returned by teachers. After adjusting for covariates, the children admitted to PICUs significantly underperformed on neuropsychological measures in comparison to healthy controls (p < 0.02). Teachers deemed more children admitted to PICUs than controls as performing educationally worse and having problems with school work (ps = 0.001), as well as performing below average on aspects of executive function and attention (ps < 0.04). Analysis of the effect of illness type on outcome revealed that aspects of neuropsychological function, such as memory function, and teacher-rated academic performance were most reduced in children with meningo-encephalitis and septic illness. In the pediatric intensive care unit group, multivariable linear regression revealed that worse performance on a composite score of neuropsychological impairment was more prevalent when children were younger, from a lower social class, and had experienced seizures during their admission (ps < 0.02). CONCLUSIONS:: Admission to intensive care is followed by deficits in neuropsychological performance and educational difficulties, with more severe difficulties noted following meningo-encephalitis and septic illness. These results highlight the importance of future studies on cognition and educational outcome incorporating type of illness as a moderating factor.Critical care medicine 02/2013; · 6.37 Impact Factor
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ABSTRACT: OBJECTIVE: To assess the frequency and associations of abdominal pain in a sample of British secondary school young people and to examine predictors of impairment and health care use. METHODS: Cross-sectional study of young people aged 11-16years that completed questionnaires documenting abdominal pain, related impairment and health care consultations. They also provided information detailing other physical symptoms, health problems and mental health status. RESULTS: 1173 students completed questionnaires; 598 (53%) reported abdominal pains in the previous 3months (15% >once a week). Pains were significantly linked to reporting medical illness, to high levels of a broad range of physical symptoms and with students deeming these symptoms to be stress/mood sensitive. They were also linked to depressive and other emotional and behavioural problems and with medical help seeking (seeing a health professional in the previous year and contact ever with mental health practitioners). Considerable impairment was reported by 36%; this was independently predicted by abdominal pain frequency, higher levels of concurrent physical symptoms and symptom stress/mood sensitivity. In 18% of students the abdominal pains had led to medical consultations; this was independently predicted by pain related impairment. CONCLUSIONS: Frequent abdominal pains are common in British secondary school adolescents; they are linked to emotional symptoms and are often impairing and lead to medical consultations. Impairment was associated not only to pain frequency but also to reporting other physical symptoms and symptom stress/mood sensitivity, and impairment was a strong predictor of medical help seeking.Journal of psychosomatic research 12/2012; 73(6):437-442. · 2.91 Impact Factor
Article: Sub-syndromal depression in adolescents attending primary care: frequency, clinical features and 6 months outcome.[Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND: The nature of adolescent sub-syndromal depression has not been investigated in primary care. AIMS: To document frequency, characteristics and 6 month outcome of sub-syndromal depression amongst adolescent primary care attenders. METHOD: Primary care attenders (13-18 years) completed depression screening questionnaires (Mood and Feelings Questionnaires) at consultation and at 6 month follow-up. Those screening positive were interviewed with the K-SADS. Sub-syndromal depression was defined as high levels of depressive symptoms in the absence of depressive disorder. RESULTS: Two hundred and seventy four questionnaires were completed at consultation: the estimated rate of sub-syndromal depression was 25 %. These young people were clinically intermediary between those without depressive symptoms and those with depressive disorder; at 6-months follow-up 57 % had persistent depressive symptoms and 12 % had developed a depressive disorder. Negative life events during the follow-up period and a positive family history of depression were the strongest predictors of symptom persistence and the development of depressive disorder, respectively. CONCLUSION: Sub-syndromal depression is common and persistent, in adolescent primary care attenders and it deserves attention.Social Psychiatry 09/2012; · 2.05 Impact Factor
Article: Emotional impact of genetic trials in progressive paediatric disorders: a dose-ranging exon-skipping trial in Duchenne muscular dystrophy.[Show abstract] [Hide abstract]
ABSTRACT: Background Gene-modifying trials offer hope for improvement in chronic paediatric disorders, but they may also lead to disappointment and have an adverse emotional effect on families. This study aimed to examine emotional impact on participants in a paediatric exon-skipping trial. Methods Nineteen male children with Duchenne muscular dystrophy (DMD), and their parents, taking part in a dose-ranging study of an i.v. administered morpholino splice-switching oligomer (which can restore the reading frame in DMD and induce dystrophin expression) underwent a psychosocial/psychiatric examination at trial entry. Emotional impact was assessed at trial completion using questionnaires. Results The mean child age was 8.9 years (SD 2.1); 13(68%) were attending mainstream school. Most families were well adjusted psychosocially at trial entry. Post-trial median child emotional impact scores were 5/10 (n= 18), but impact was rated as positive by 6/14 (42%), neutral/mixed by 5 (35%) and negative by 3 (21%). Median post-trial psychosocial/psychiatric change scores in children and parents were minimal. Actual post-trial negative impact was statistically significantly associated with higher expected impact at trial entry, at which time the families of the three children displaying actual negative impact reported higher family stress levels in combination with a variety of other psychosocial risks factors. Conclusions In carefully selected families with low levels of psychosocial stress/distress at trial entry, and with good support from paediatric research units (including psychiatric input when required), genetic trials in progressive disorders such as DMD can have a predominantly positive or neutral emotional impact. Nevertheless, negative impact is reported by a minority of families and possible psychosocial predictors deserving further scrutiny have been identified.Child Care Health and Development 06/2012; · 1.70 Impact Factor
Article: Recognising and responding to adolescent depression in general practice: Developing and implementing the Therapeutic Identification of Depression in Young people (TIDY) programme.[Show abstract] [Hide abstract]
ABSTRACT: Rates of depressive disorder in adolescents attending primary care are increasing. Most presentations are for physical complaints and concurrent depressive symptoms go unrecognised and untreated. Primary care practitioners describe reluctance to intervene due to lack of confidence and skills. This paper describes the development and implementation of TIDY (Therapeutic Identification of Depression in Young people), a programme designed by child psychiatrists and general practitioners to improve detection and intervention for depression within ordinary consultations. The paper describes the integration of educational principles and current evidence into the development of the training programme and the intervention package. The content of the intervention is described. For cases of mild to moderate depressive disorder, where patients do not require referral for specialist treatment, practitioners are trained to deliver self-help and coping strategies within a single consultation.Clinical Child Psychology and Psychiatry 04/2012; 17(4):482-94.
Article: Therapeutic identification of depression in young people: lessons from the introduction of a new technique in general practice.[Show abstract] [Hide abstract]
ABSTRACT: Mild-to-moderate depression in young people is associated with impaired social functioning and high rates of affective disorder in adult life. Earlier recognition of depression in young people has the potential to reduce the burden of depression in adulthood. However, depression in teenagers is underdiagnosed and undertreated. To assess the usability and usefulness of a cognitive-behavioural-therapy-based technique for Therapeutic Identification of Depression in Young people (TIDY). A qualitative study of four group practices in northwest London. Face-to-face semi-structured interviews were conducted with practitioners who had been trained in the use of the TIDY technique. Twenty-five GPs and six nurses were interviewed. The key themes that emerged from the interviews were: practitioners were 'making sense of teenage depression' when interpreting signs and symptoms; the training in the technique was variable in its impact on practitioners' attitudes and practice; and time factors constrained practitioners in the application of the technique. The TIDY technique is usable in routine practice, but only if practitioners are allowed to use it selectively. This need for selectivity arises partly from concerns about time management, and partly to avoid medicalisation of psychological distress in young people. The perceived usefulness of the TIDY technique depends on the practitioner's prior knowledge, experience, and awareness.British Journal of General Practice 03/2012; 62(596):e174-82. · 2.03 Impact Factor
Article: Adolescents who are frequent attenders to primary care: contribution of psychosocial factors.[Show abstract] [Hide abstract]
ABSTRACT: Frequent attendance to primary care services has shown an association with psychosocial factors in adult and child populations. Little is known about the psychosocial correlates of attendance in adolescents. To study the contribution of psychosocial factors to frequent primary care attendance in a community sample of young British people. The method used was a cross-sectional survey of 1,251 secondary school pupils, using self-report questionnaires for socio-demographic, physical and psychological health data. A total of 1,116 pupils [mean age 13.51 years (SD 1.5), 52% female] completed questionnaires and provided information about contact with their general practitioner (GP) in the previous year; 30% were frequent attenders (≥4 appointments). Frequent attenders were significantly younger; they were more likely to come from lower socioeconomic backgrounds, report significantly more past and current physical problems, have more hospital visits in the previous year, have more recent intense somatic symptoms made worse by stress and causing impairment, and have more days off school. Frequent attendance was also significantly associated with the presence of emotional symptoms and a history of mental health consultations. Logistic regression analysis identified seeing a hospital doctor, current illness, having days off school, a history of mental health consultations and younger age as independent predictors of frequent attendance. In addition to physical health problems, social factors and psychiatric difficulty are linked to and require attention in young people who are frequent attenders at primary care health services.Social Psychiatry 02/2012; 47(2):323-9. · 2.05 Impact Factor
- Developmental Medicine & Child Neurology 11/2011; 53(12):1157-9. · 2.68 Impact Factor
Article: The short-term outcome of depressive disorder in adolescents attending primary care: a cohort study.[Show abstract] [Hide abstract]
ABSTRACT: Depressive disorder is common amongst adolescents attending primary care, but little is known about its time course. To determine the 6-month outcome of depressive disorder in adolescent primary care attendees with regard to the time to recovery from (1) the date of index GP consultation and (2) the date of depressive episode onset, and to identify risk factors associated with time to recovery. A prospective cohort study of 13-18-year-olds attending a general practice in northwest London. Attendees were screened for depressive disorder at consultation: high scorers underwent a psychiatric research interview. Six months later, adolescents who were depressed at consultation were interviewed using a research psychiatric follow-up interview. Of the 274 young people who completed the baseline questionnaires, 26 had a depressive disorder at consultation; over 50% failed to recover by the 6-month follow-up. Median episode duration from illness onset was 13 months. Multivariate cox regression showed that fewer positive life events and more physical symptoms predicted a longer time to recovery from consultation. Younger age, fewer recent positive life events and more depressive symptoms predicted a longer time to recovery from illness onset. Adolescent depressive disorders in general practice attendees are persistent, highlighting the appropriateness of intervention.Social Psychiatry 10/2011; 46(10):993-1002. · 2.05 Impact Factor
Article: Managing child and adolescent mental health problems in primary care: taking the leap from knowledge to practice.[Show abstract] [Hide abstract]
ABSTRACT: In 2009, a conference at Imperial College London brought together experts on the primary care provision of child and adolescent mental health. The following paper highlights various themes from the conference, and particularly focuses on general practice. Despite international and national guidance, child and adolescent mental health provision in primary care is limited in the UK and globally. We argue that primary care services are in fact well placed to assess, diagnose, and manage child and adolescent mental health problems. The barriers to such provision are considered from the perspective of both service users and providers, and the possible ways to overcome such challenges are discussed. The paper is informed by various epidemiological and intervention studies and comparisons between different countries and health systems are explored.Primary Health Care Research & Development 08/2011; 12(4):301-9.
Article: Exon skipping and dystrophin restoration in patients with Duchenne muscular dystrophy after systemic phosphorodiamidate morpholino oligomer treatment: an open-label, phase 2, dose-escalation study.[Show abstract] [Hide abstract]
ABSTRACT: We report clinical safety and biochemical efficacy from a dose-ranging study of intravenously administered AVI-4658 phosphorodiamidate morpholino oligomer (PMO) in patients with Duchenne muscular dystrophy. We undertook an open-label, phase 2, dose-escalation study (0·5, 1·0, 2·0, 4·0, 10·0, and 20·0 mg/kg bodyweight) in ambulant patients with Duchenne muscular dystrophy aged 5-15 years with amenable deletions in DMD. Participants had a muscle biopsy before starting treatment and after 12 weekly intravenous infusions of AVI-4658. The primary study objective was to assess safety and tolerability of AVI-4658. The secondary objectives were pharmacokinetic properties and the ability of AVI-4658 to induce exon 51 skipping and dystrophin restoration by RT-PCR, immunohistochemistry, and immunoblotting. The study is registered, number NCT00844597. 19 patients took part in the study. AVI-4658 was well tolerated with no drug-related serious adverse events. AVI-4658 induced exon 51 skipping in all cohorts and new dystrophin protein expression in a significant dose-dependent (p=0·0203), but variable, manner in boys from cohort 3 (dose 2 mg/kg) onwards. Seven patients responded to treatment, in whom mean dystrophin fluorescence intensity increased from 8·9% (95% CI 7·1-10·6) to 16·4% (10·8-22·0) of normal control after treatment (p=0·0287). The three patients with the greatest responses to treatment had 21%, 15%, and 55% dystrophin-positive fibres after treatment and these findings were confirmed with western blot, which showed an increase after treatment of protein levels from 2% to 18%, from 0·9% to 17%, and from 0% to 7·7% of normal muscle, respectively. The dystrophin-associated proteins α-sarcoglycan and neuronal nitric oxide synthase were also restored at the sarcolemma. Analysis of the inflammatory infiltrate indicated a reduction of cytotoxic T cells in the post-treatment muscle biopsies in the two high-dose cohorts. The safety and biochemical efficacy that we present show the potential of AVI-4658 to become a disease-modifying drug for Duchenne muscular dystrophy. UK Medical Research Council; AVI BioPharma.The Lancet 08/2011; 378(9791):595-605. · 39.21 Impact Factor
Article: Unexplained physical complaints.[Show abstract] [Hide abstract]
ABSTRACT: Unexplained physical complaints are common in children and form the basis for childhood somatization (the manifestation of distress through somatic symptoms) and somatoform disorders. Emotional symptoms and anxiety disorders are often comorbid with both unexplained physical symptoms and somatoform disorders. Risk factors include stress sensibility and probably biologic vulnerability in the child, mood and somatization disorders in the family, parental overinvolvement, and possibly limited psychological "mindedness" in relation to physical symptoms. The best evidence of efficacy is for family behavioral cognitive treatments, but for especially severe cases a multidisciplinary, carefully coordinated approach has been found to be clinically helpful.Pediatric Clinics of North America 08/2011; 58(4):803-13, ix. · 1.78 Impact Factor
Article: P03 Exon skipping and dystrophin restoration in Duchenne muscular dystrophy patients after systemic phosphorodiamidate morpholino oligomer treatmentEuropean Journal of Paediatric Neurology 05/2011; 21. · 1.98 Impact Factor
Article: Siblings of young people with Duchenne muscular dystrophy--a qualitative study of impact and coping.[Show abstract] [Hide abstract]
ABSTRACT: Duchenne Muscular Dystrophy (DMD) is a progressively debilitating neuromuscular disorder markedly affecting family life. To obtain descriptive accounts from siblings about impact and coping with DMD and consider implications for psychological function. Semi-structured interviews with a purposive sample of healthy siblings of young people with DMD attending a regional centre. Main carers were interviewed for corroborative evidence. Interviews were recorded and transcribed verbatim prior to a thematic analysis. 35 siblings (18 girls, 17 boys from 29 families) and their parents were interviewed. Mean sibling age was 14.3 years (sd 2.4) (range 11-18). Young people with DMD were aged 5-22 years; most were wheelchair users and 3 required nocturnal ventilation. Six primary themes were identified. Knowledge about the nature of DMD had been acquired gradually and varied in breadth. Whilst siblings were involved and generally accepting of caring responsibilities, they were nevertheless able to pursue other activities and interests of their choice. Positive impacts included increased family cohesion, knowledge and maturity in siblings; negative impacts included inequality of parental attention/availability. Coping was aided by the normality of a situation gradually developing since early childhood, and by support from friends, relatives, teachers and mentors. Coping techniques included getting on with life one day at a time, proactively restraining negative emotions, humour, distractions, and physical relocation. DMD generates situations that have the potential to increase the risk of emotional problems in unaffected siblings, but its chronic course also provides opportunities for positive family psychological adjustment.European journal of paediatric neurology: EJPN: official journal of the European Paediatric Neurology Society 01/2011; 15(1):21-8. · 2.01 Impact Factor
Article: Sleep and well-being in young men with neuromuscular disorders receiving non-invasive ventilation and their carers.[Show abstract] [Hide abstract]
ABSTRACT: Nocturnal ventilation has improved the physical status and life span of childhood neuromuscular disorders: the purpose of this study was to assess the implications for sleep and well-being in patients and carers. Ten young men (age range 12-25 years) with neuromuscular disorders on assisted ventilation and/or their main carers completed questionnaires on sleep quality, physical and psychological well-being, family burden and function. Both patients and parents expressed satisfaction with ventilation treatment. Compared to standardised values patients reported reduced sleep quality, but their mental health was not substantially affected. Poor sleep quality in carers--but not in patients--was significantly associated with risk for emotional (anxiety and depressive) disorders, reduced physical/emotional health, family burden and difficulty. We conclude that patients were generally well adapted psychologically, but sleep quality was poor and in carers this was linked to reduced well-being and family burden.Neuromuscular Disorders 07/2010; 20(7):458-63. · 3.46 Impact Factor
Article: Unexplained physical complaints.[Show abstract] [Hide abstract]
ABSTRACT: Unexplained physical complaints are common in children, and form the basis for childhood somatization (the manifestation of distress through somatic symptoms) and somatoform disorders. Emotional symptoms and anxiety disorders are often comorbid with both unexplained physical symptoms and somatoform disorders. Risk factors include stress sensibility and probably biologic vulnerability in the child, mood and somatization disorders in the family, parental overinvolvement, and possibly limited psychological "mindedness" in relation to physical symptoms. The best evidence of efficacy is for family behavioral cognitive treatments, but for especially severe cases a multidisciplinary, carefully coordinated approach has been found to be clinically helpful.Child and adolescent psychiatric clinics of North America 04/2010; 19(2):199-209, vii. · 2.88 Impact Factor
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ABSTRACT: Duchenne muscular dystrophy (DMD) is a progressive, impairing, life-limiting disorder of childhood. Little is known about how siblings adapt to this. The aim of this study is to document psychosocial adjustment in siblings of patients with DMD. Healthy siblings (11-18 years old) of young people with DMD attending a specialist paediatric centre and their parent/main carer took part. Parents, siblings and teachers completed a battery of questionnaires: (i) to assess psychiatric risk the Strengths and Difficulties Questionnaire (SDQ), General Health Questionnaire (GHQ), Hospital Anxiety and Depression Scale (HADS); (ii) to measure general wellbeing: SF-36; (iii) to document DMD illness disability: Functional Disability Inventory (FDI); (iv) to assess family function and life stresses for the unaffected sibling: Family Assessment Device (FAD), Family Burden Interview Schedule and Life Events Checklist. Forty six/77 eligible siblings (24 females/22 males); (mean age 14 years (SD 2.3)) took part. Although their mean psychological functioning and wellbeing questionnaire scores were comparable to normative data, there was a trend for more siblings scoring at high-risk for psychological (mainly emotional) problems. Weak/moderate associations with psychological symptoms in siblings varied according to informant and included the following factors: closeness in age to the affected sibling; older sibling age; extent of wheelchair use, burden of illness on family interactions, and siblings reporting high impact of illness on their lives. Psychological symptoms were also associated with less sibling involvement in patient care, with broader psychosocial and family disadvantage and with life stresses. Siblings have an increased risk for emotional problems, which appears influenced by specific illness factors.European journal of paediatric neurology: EJPN: official journal of the European Paediatric Neurology Society 10/2009; 14(4):340-8. · 2.01 Impact Factor
Article: Local restoration of dystrophin expression with the morpholino oligomer AVI-4658 in Duchenne muscular dystrophy: a single-blind, placebo-controlled, dose-escalation, proof-of-concept study.[Show abstract] [Hide abstract]
ABSTRACT: Mutations that disrupt the open reading frame and prevent full translation of DMD, the gene that encodes dystrophin, underlie the fatal X-linked disease Duchenne muscular dystrophy. Oligonucleotides targeted to splicing elements (splice switching oligonucleotides) in DMD pre-mRNA can lead to exon skipping, restoration of the open reading frame, and the production of functional dystrophin in vitro and in vivo, which could benefit patients with this disorder. We did a single-blind, placebo-controlled, dose-escalation study in patients with DMD recruited nationally, to assess the safety and biochemical efficacy of an intramuscular morpholino splice-switching oligonucleotide (AVI-4658) that skips exon 51 in dystrophin mRNA. Seven patients with Duchenne muscular dystrophy with deletions in the open reading frame of DMD that are responsive to exon 51 skipping were selected on the basis of the preservation of their extensor digitorum brevis (EDB) muscle seen on MRI and the response of cultured fibroblasts from a skin biopsy to AVI-4658. AVI-4658 was injected into the EDB muscle; the contralateral muscle received saline. Muscles were biopsied between 3 and 4 weeks after injection. The primary endpoint was the safety of AVI-4658 and the secondary endpoint was its biochemical efficacy. This trial is registered, number NCT00159250. Two patients received 0.09 mg AVI-4658 in 900 microL (0.9%) saline and five patients received 0.9 mg AVI-4658 in 900 microL saline. No adverse events related to AVI-4658 administration were reported. Intramuscular injection of the higher-dose of AVI-4658 resulted in increased dystrophin expression in all treated EDB muscles, although the results of the immunostaining of EDB-treated muscle for dystrophin were not uniform. In the areas of the immunostained sections that were adjacent to the needle track through which AVI-4658 was given, 44-79% of myofibres had increased expression of dystrophin. In randomly chosen sections of treated EDB muscles, the mean intensity of dystrophin staining ranged from 22% to 32% of the mean intensity of dystrophin in healthy control muscles (mean 26.4%), and the mean intensity was 17% (range 11-21%) greater than the intensity in the contralateral saline-treated muscle (one-sample paired t test p=0.002). In the dystrophin-positive fibres, the intensity of dystrophin staining was up to 42% of that in healthy muscle. We showed expression of dystrophin at the expected molecular weight in the AVI-4658-treated muscle by immunoblot. Intramuscular AVI-4658 was safe and induced the expression of dystrophin locally within treated muscles. This proof-of-concept study has led to an ongoing systemic clinical trial of AVI-4658 in patients with DMD. UK Department of Health.The Lancet Neurology 09/2009; 8(10):918-28. · 23.92 Impact Factor
Top Journals
Newcastle University
Newcastle-on-Tyne, England, United Kingdom
- Institute of Genetic Medicine
University College London
London, ENG, United Kingdom
- • Department of Primary Care and Population Health (PCPH)
- • Institute of Neurology
Complejo Hospitalario de JaénJaén, Andalusia, Spain
Imperial Valley CollegeImperial, California, United States
Imperial College London
Londinium, England, United Kingdom
- Faculty of Medicine
West London Mental Health NHS TrustLondinium, England, United Kingdom
St. Mary's Hospital for ChildrenNew York City, New York, United States