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The national exposure registry: history and lessons learned.
IntroductionThe National Exposure Registry (NER) was created as a comprehensive group of data repositories that sought, over time, to relate specific environmental chemical exposures to registrants' health conditions. The NER's primary goal was to facilitate epidemiologic research by establishing multiple databases (subregistries) that contained demographic, environmental, and health information on large populations exposed to selected chemicals. The databases created by the NER were intended to provide information that would generate appropriate hypotheses for future activities, such as epidemiologic studies.
This article reviews the decisions and events that led to the formation of the NER. It cites the history, operations, accomplishments of the NER, and the les sons that can be learned from this enterprise. The lessons learned will, hopefully, serve as a guide for more meaningful and useful data collection and interpretation for all future exposure registries.
Formation of the National Exposure Registry
Legislative Background
In the late 1970s and early 1980s, public concern was increasing about the potential impact of human exposures to hazardous substances from waste sites and chemical spills on the health of communities (Harris, 1983; Levine, 1983). The 1978 Love Canal, New York, incident of soil contamination with over 200 hazardous substances; the 1983 Times Beach, Missouri, dioxin soil contamination; and the 1984 Battle Creek, Michigan, trichloroethylene (TCE) well water contamination were seminal events in the American public's perception of hazardous waste sites as a major environmental hazard. In response to these and related concerns, Congress passed the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). This law provided for liability, compensation, cleanup, and emergency response for hazardous substances released into the environment and the cleanup of inactive hazardous waste disposal sites. This legislation also created the Agency for Toxic Substances and Disease Registry (ATSDR). Congress created ATSDR to specifically address the potential public health problems associated with environmental exposures to hazardous substances from waste sites and chemical spills. ATSDR was given two mandates relating to registries. They were first, to establish and maintain a national registry of persons exposed to hazardous substances, and second, to establish and maintain a national registry of persons with serious diseases or illnesses resulting from these exposures.
In April 1981, a subcommittee of the U.S. Department of Health and Human Services (DHHS) Committee to Coordinate Environmental and Related Programs (CCERF) released a report on the use of longterm registries for health follow-up of populations exposed to toxic hazards. This report outlined several conditions necessary to establish and operate such exposure registries, e.g., a scientifically acceptable and feasible rationale; sustained institutional commitments for funding, analysis, and reporting; ethical constraints in recruiting and following such populations; and the kinds of information that needed to be collected. Two years later, in 1983, DHHS published in the Federal Register a statement of organization, functions, and delegations of authority for ATSDR (The Public Health and Welfare Chapter 103--Comprehensive Environmental Response, Compensation, and Liability Subchapter I--Hazardous Substances Releases, Liability, and Compensation, 1983).
FIGURE 1 Goals and Objectives of the National Exposure Registry Primary Goals: To fill data gaps for long-term-health effects, defined as persistent adverse health outcomes, lasting more than one year, which may be manifested at any point in time. Those health outcomes will be focused on medically confirmed diagnoses potentially related to exposures to hazardous substances and their mixtures. Goal 1: To facilitate epidemiologic or health studies. Objective 1.1: To create data files that will be of value in research related to verifying what are thought to be known adverse health outcomes (hypothesis testing). Objective 1.2: To create data files that will be of value in research related to identifying previously unknown, undetermined adverse health outcomes should they exist (hypothesis generating). Goal 2: To facilitate state and federal health surveillance programs by enabling the identification and tracking of participants in the programs and by maintaining information on the participants. Objective 2.1: To create data files that can be used for follow-up surveillance activities if needed. Goal 3: To provide information that can be used to assess the burden of the effects of an exposure or health outcome on a population. Objective 3.1: To provide, to appropriate health officials, health information necessary for any contingency planning (such as information on appropriate screening plans, available diagnostic or therapeutic facilities, and educational materials for health care providers and the general public). Objective 3.2: To provide appropriate officials with environmental information necessary for any contingency plans to reduce exposures to hazardous substances. Supplemental Goals: To provide service and to be of direct benefit to the registrants, in keeping with the dictates of a public health agency. Goal 4: Working with state and local health officials, to provide exposed persons with current relevant information about the hazardous substances to which they have been exposed. Objective 4.1: To provide important toxicologic and epidemiologic findings that become available. Objective 4.2: To provide medical information that encourages registrants to seek medical attention, if needed. Goal 5: To enable local, state, or federal health officials to notify registrants rapidly of the adverse health effects of an exposure, preventative measures, or therapeutic advances that were not understood or known when the registry was established. Objective 5.1: To continue to provide state-of-the-art scientific information related to the exposure(s). Objective 5.2: To promptly provide new information on screening, diagnostic, or therapeutic activities related to the exposure(s). Blue text indicates process not achieved in practice.
In 1984, a document was produced titled, Criteria and Methods for Establishing and Maintaining Exposure and Outcome Registries for Environmental Public Health Problems (Center for Environmental Health, 1984) that proposed criteria for the establishment of nonoccupational environmental disease and exposure registries to be established under CERCLA. It also presented discussions of the strengths and limitations of exposure and disease registries. The top priorities for ATSDR registries, as stated in this document, were as follows:
(1) Persons exposed outside the workplace to
A. persistent, measurable levels of hazardous agents in which animal studies or other evidence predicts significant adverse effects in humans; or
B. hazardous agents for which current methods exist to prevent an adverse outcome; or
(2) Persons with outcomes of interest where measurements of exposure to hazardous agents are available.
Of the two original CERCLA mandates published in 1980, the second one relating to the establishment and maintenance of a national registry of persons with serious diseases or illnesses was deferred in order to first concentrate resources on the establishment of an exposure registry. This second mandate was, in fact, never acted upon. Therefore, this review is concerned with only the first mandate--the formation of a national registry of persons exposed to hazardous substances--the NER. An additional mandate was created by the Superfund Amendments and Reauthorization Act of 1986 (SARA), which stated that the agency must consider establishing a registry as a follow-up action to a health assessment when a potentially significant risk to human health is indicated. Two exposure registries, the World Trade Center Health Registry and the Tremolite Asbestos Registry, were recently established by ATSDR, but neither was created in response to the SARA mandate and neither is part of the NER. They will, therefore, not be discussed in this review.
Defining the NER
The stated goals and objectives of the NER are shown in Figure 1. The purpose of the NER was to assess and evaluate the potential relationships between environmental exposure and adverse health effects for an exposed population, particularly the relationship between chronic health effects and long-term, low-level chemical exposures. Of particular concern when considering environmental health issues is the lack of information about the effects of low-level exposures of long duration on general populations (versus worker populations), such as those typically surrounding hazardous waste sites. Registries can be a valuable tool for assembling the information necessary to address the potential health outcomes of these types of exposures.
The NER's primary goal was to facilitate epidemiologic research by establishing multiple databases (subregistries) that contain demographic, environmental, and health information on large populations exposed to selected chemicals. The processes for establishing, maintaining, and terminating a registry are shown in Figure 2.
It is important to differentiate between an exposure registry and an outcome registry. An exposure registry, such as the NER, is a registry in which people with particular exposure histories are followed forward from a period of exposure to determine whether they develop one or more adverse health outcomes. An outcome registry is a registry in which people with particular health outcomes, such as a specific disease, are studied backward in time from the date of their first such outcome, or onset, or diagnosis, to determine whether they may have been exposed to a hazardous agent of interest.
When the NER was launched, an exposure registry was a relatively new approach, in contrast to the more established disease or outcome registries, e.g., cancer registries. The purpose and function of an exposure registry has been defined as follows (Schulte & Kaye, 1988):
1. Delineation of the population at risk.
2. Follow-up of a cohort to ascertain exposure-disease associations.
3. Follow-up of a cohort to ensure the institution of appropriate primary and secondary prevention and medical surveillance.
4. Follow-up of a cohort to allow for appropriate social, legal, and economic support.
5. Demonstrate societal concern for the cohort and provide a base for political action relevant to the exposure.
6. Notify a cohort of an exposure, preventive measures, or therapeutic advances, which were not understood or known at the time that the registry was established.
Establishing an NER Subregistry
Subregistries were established for dioxin in 1988, TCE in 1989, benzene in 1991, and trichloroethane (TCA) in 1992. The establish ment of an NER subregistry required several well-defined steps. They were (1) primary contaminants selection, (2) site selection, (3) population selection, (4) data collection, and (5) file creation and maintenance. Detailed descriptions of these steps are described elsewhere (Agency for Toxic Substances and Disease Registry [ATSDR], 1988, 1994; Burg, 1989; Burg & Gist, 1995, 1997; Gist & Burg, 1995; Gist, Burg, & Radtke, 1994).
Health Findings
ATSDR compared the NER data for people exposed to the hazardous substance to data for people in the U.S. who were not exposed to the hazardous substance. The comparison group for the NER subregistries was drawn from the National Health Interview Survey (NHIS). Five health conditions were reported in excess in each subregistry in at least one data collection period for some group of registrants. They were (1) anemia and other blood disorders, diagnosed in the past year; (2) all cancers, diagnosed in the past year; (3) skin rashes, eczema, or other skin allergies, diagnosed in the past year; (4) urinary tract disorders, including prostate trouble, diagnosed in the past year; and (5) stroke, ever diagnosed. Table 1 shows the health effects reported in excess when compared with national data (baseline or follow-up).
It is important to note that despite the many health effects observed to be in excess when compared with national norms, NER staff believe that the excess reporting of these health conditions might be explained by several factors including methodological differences in data analysis and reliance on self-reported, nonverified data. They further believe that these results do not identify relationships between the registrants' reported adverse health effects and their exposure to the chemicals studied in the four subregistries: TCE, benzene, dioxin, and TCA.
Design Issues
Many questions arise when designing an exposure registry. What constitutes adequate exposure measurement? How can exposed persons be adequately differentiated from nonexposed persons? What group could serve as a comparison group so that the disease experience of the exposed group can be evaluated? For how long should the group be followed? These questions can become quite technical, but often, even the most basic questions are the hardest to resolve. At least four important issues were never satisfactorily resolved in the design of the NER. They were adequacy of exposure measures, unverified self-reporting, appropriate control groups, and the use of biomarkers.
Inadequacy of Exposure Measures
The most important design deficiency of the NER was its inability to adequately assess exposure. Yet accurate exposure assessment is central to the utility of any exposure registry and is critical in establishing an association for health outcomes to a particular chemical of interest.
It is generally accepted that the four primary characteristics for the determination of exposure are (1) the nature of the agent, (2) the intensity of exposure, (3) the duration of exposure, and (4) the frequency of exposure. In the NER, the inability to measure the intensity, duration, and frequency of exposure to the chemicals of interest has been the most critical limiting factor in its design. In the TCE subregistry, for example, the exposure assessment was limited to the measurements obtained at the time of the U.S. Environmental Protection Agency (U.S. EPA) investigations and was usually based on a single measurement from a well. The probable day-to-day and seasonal fluctuation of TCE levels in well water also makes a single measurement questionable. A more adequate exposure assessment would have documented the level of TCE in a registrant's well; the routes of exposure, e.g., ingestion or showering; and the frequency and duration of exposure. These measurements would be the most important variables in quantifying an individual's exposure to TCE.
An accurate exposure history is also important in the identification of any other major sources of exposure to the chemical in question, notably occupational exposure. Asking for a full occupational profile would have been difficult, but it might have been helpful to have added a question to ascertain whether the individuals worked in the industry responsible for the contamination, in addition to living in the neighborhood.
Another concern in exposure assessment is the issue of multiple contaminants. Many sites have other chemicals present in addition to the chemical of concern. To address the possible roles of other contaminants, registrants might have been grouped as (a) persons exposed to specific chemicals, (b) persons exposed to chemically related compounds, or (c) persons exposed to chemicals known to produce similar effects by in vitro or animal data. Such a grouping might have improved the prediction of specific health outcomes of interest.
In order to deal with the problem of inadequate or erroneous exposure measurements, future exposure registries should use as extensive a battery of exposure measurements as possible. Multiple environmental measurements would improve the accuracy of assessment and direct human exposure measurements should be used whenever possible. The initial NER questionnaires should have had questions to assess the likely extent of exposure by route, duration, and any other relevant factors. In addition, the questionnaires should have included questions that addressed other possible risk factors for the health outcomes that may be associated with the chemical of interest, such as medication use, lifestyle choices, heredity, and exposure to other chemicals.
Appropriate Control Groups
It should be noted that a subregistry of unexposed persons was not routinely created for a given site concurrently with the subregistry of exposed persons. The basis for this decision was that at most sites an appropriate control group could not be identified at the time the exposure subregistry was created. The hypothesis to be tested either may not have been known or defined well enough to enable the identification of a valid control population at that time. An example of an inappropriate control group might be a control subregistry of older persons when the adverse outcome is later identified as a birth defect. In some instances where subregistries might be combined for research purposes, an existing source of national statistics may have sufficed. At some sites, an exception to not creating a control subregistry could have been made (e.g., where extensive information is known about the exposure and the expected outcome of this exposure). For most sites, however, the identification of an appropriate comparison group was considered part of the future research activity.
The comparison group for the NER subregistries was drawn from the National Health Interview Survey (NHIS). Both NER and NHIS are self-reported and nonmedically verified data collections. The validity of comparisons between the subregistry populations and the NHIS was dependent on comparability between the two populations and between the data collection instruments. Comparability between the two instruments may have been compromised since some of the questions had been phrased differently in the two surveys. In addition, comparisons might have been misleading if the subregistry population was more likely to be aware of and to report health conditions because of their exposure or because of being in the registry. "Dose response" was another issue. It was not known whether health outcomes occurred more frequently in groups with the highest exposure because the available data did not provide gradients of exposure based on duration, routes, frequency, and intensity. An issue of potential variation in exposure from site to site also arose, creating potential problems of comparability within exposed populations. All of these issues brought into question the adequacy of the control populations for the NER subregistries.
Unverified Self-Reporting
The validity of self-reported data was an important issue in the design of the NER. Verification of reported outcomes with medical records could improve the quality of health information; however, verification was not part of the NER design. Verification adds expense and is relatively difficult to interpret unless an appropriate control group is available. Inherent shortcomings of verification are also present--not contacting the correct medical provider, faulty memory of where and when a diagnosis was made, problems in getting old records, and accessibility to records of a retired physician.
Issue of Biomarkers
Biological markers, or biomarkers, are cellular, biochemical, or molecular measures that are obtained from biological media such as human tissues, cell, or fluids and are indicative of exposure to environmental chemicals. In addition to indicating exposure, biomarkers can also signal events in biologic systems indicative of susceptibility or effect. Biological markers of exposure have been used to study environmental contaminants such as lead levels in blood, teeth, and hair from the inhalation and ingestion of lead. Unfortunately, markers of exposure currently exist for only a small number of hazardous substances.
Lessons Learned
Lessons can be learned from both the strengths and the weaknesses of the NER experience. Some parts of the NER were well conceived, whereas other parts were not. Substantial thought and documentation went into creating the parameters for primary contaminant selection, site selection, population selection, and data collection. Less thought and documentation went into defining methods to measure adequately exposure to the chemicals of interest. This was the key missing element and the Achilles heel of the NER program. Questions about the adequacy of self-reporting and the absence of biomarkers cast doubts about the program's design. Another weakness of the NER program was that it did not adequately focus on minority and ethnic populations that are disproportionately impacted by exposure to the chemicals in question. Also, there were inadequate efforts directed to the scientific and public health communities to get their participation in follow-up studies based on NER's findings.
An abundance of excess health outcomes existed for each of the chemical entities studied. Five health conditions were reported in excess for the dioxin, TCE, benzene, and TCA subregistries during at least one data collection period among some group of registrants. Additional health conditions were reported in excess for some, but not all, of the subregistries during at least one data collection period among some group of registrants (Table 1). Many of the excess health outcomes are backed up by biologically plausible hypotheses gained from occupational medicine, clinical studies, and laboratory studies. Yet, despite the many health effects observed to be in excess when compared with national norms, NER staff believed that the excess reporting of these health conditions might be explained by methodological differences in data analysis and reliance on self-reported nonverified data. The NER staff further believed that these results do not identify relationships between the registrants' reported adverse health effects and their exposure to the chemicals studied in the four subregistries. Other risk factors for disease such as heredity, lifestyle factors (such as smoking), medication use, and exposure to other chemicals were not taken into account in the subregistries and may be responsible for observed disease.
The positive lessons learned from the NER experience have been the progenitor for the design of two recent exposure registries, the World Trade Center Health Registry and the Tremolite Asbestos Registry. Both of these exposure registries combine well-documented exposure information with personal health information. They are considerably simpler than the NER. In the case of the World Trade Center Health Registry, exposure was limited to one time and place and the public had a much greater awareness of that event than of the NER. In the case of the Tremolite Asbestos Registry, only one substance is of concern.
Creating and maintaining an exposure registry is a more difficult challenge than creating and maintaining an outcome registry, such as a cancer registry. The former looks prospectively, whereas the latter looks retrospectively. Hindsight is generally more accurate than foresight. In addition, expectations may have been set too high for the NER. These notions were expressed two decades ago by Dr. Vernon Houk, thendirector, Center for Environmental Health, Centers for Disease Control, when he addressed a workshop that was held in Atlanta about the proposal to establish the NER (ATSDR, 1987):
Registries cannot be used to give quick, conclusive answers to the many questions that people ask about the effects of toxic chemical exposures to their health, the health of their families, or the health of their future children. Even the most active and aggressively pursued studies using registries may require decades to produce meaningful results. It is also true that even when the results of long-term studies are made available, the findings are likely to be hotly debated by scientists with honestly different points of view. Other important limitations of registries are the infeasibility due to mobility of the population, privacy, ethics, and the inability to detect conditions with a low attack rate after exposure. Even cost must be considered. I point out these inherent limitations to registries to call your attention to the fact that expectations for registries being used as tools to answer in the near future the questions before us today may be unrealistically high.
In addition to the inherent limitations of exposure registries cited by Dr. Houk, the flawed design and methodologies of the NER resulted in data that could not be used to reliably answer questions about the relationships between registrants' exposures and adverse health outcomes that would lead to hypothesis-generated health studies.
The NER was one of the most comprehensive data repositories tracking specific en vironmental chemical exposures and registrants' health conditions over time. The methods developed by NER for primary contaminant selection, site selection, population selection, and data collection are worthy of emulation. The methods used to compare registrant health data trends to national trends have evolved and improved over time. The lack of adequate individual exposure measures has been the most limiting factor in the NER design. Other design issues of the NER that has limited the utility of the results are the competency of selfreport health outcomes, the lack of an adequate control population, and the absence of biomarkers. The NER experience will, hopefully, contribute to more meaningful and useful data collection for all future exposure registries.
Agency for Toxic Substances and Disease Registry. (1987, March). Public workshop on a national registry of persons exposed to toxic substances. Atlanta: U.S. Department of Health and Human Services, Public Health Service.
Agency for Toxic Substances and Disease Registry. (1988). Policies and procedures for establishing a national registry of persons exposed to hazardous substances. Atlanta: U.S. Department of Health and Human Services, Public Health Service.
Agency for Toxic Substances and Disease Registry. (1994). National Exposure Registry trichloroethylene (TCE) subregistry baseline technical report (Revised) (NTIS Publication No. PB95-154589). Atlanta: Author & U.S. Department of Health and Human Services, Public Health Service.
Burg, J.R. (1989). Policies and procedures for establishing the National Exposure Registry. Journal of the American College of Toxicology, 8(5), 949-954.
Burg, J.R., & Gist, G.L. (1995). The National Exposure Registry: Procedures for establishing a registry of persons environmentally exposed to hazardous substances. Toxicology and Industrial Health, 11(2), 231-248.
Burg, J.R., & Gist, G.L. (1997). The potential impact on women from environmental exposures. Journal of Women's Health, 6(2), 159-161.
Center for Environmental Health. (1984). Criteria and methods for establishing and maintaining exposure and outcome registries for environmental public health problems. Atlanta: Agency for Toxic Substances and Disease Registry.
Comprehensive Environmental Response, Compensation, and Liability Act, 42 U.S.C. [section] 9601-9657 (1980).
Gist, G.L., & Burg, J.R. (1995). Methodology for selecting substances for the National Exposure Registry. Journal of Exposure Analysis and Environmental Epidemiology, 5(2), 197-208.
Gist, G.L., Burg, J.R., & Radtke, T.M. (1994). The site selection process for the National Exposure Registry. Journal of Environmental Health, 56(6), 7-12.
Harris, J.S. (1983). Toxic waste uproar: A community history. Journal of Public Health Policy 4(2), 181-201.
Levine, A. (1983). Psychosocial impact of toxic waste dumps. Environmental Health Perspectives, 48, 15-17.
The Public Health and Welfare Chapter 103--Comprehensive Environmental Response, Compensation, and Liability Subchapter I--Hazardous Substances Releases, Liability, and Compensation, 42 U.S.C. [section] 9604 (1983).
Schulte, P.A., & Kaye, W.E. (1988). Exposure registries. Archives of Environmental Health, 43(2), 155-161.
Myron G. Schultz, MD, FACP
James H. Sapp II, MS
Caroline D. Cusack, MSPH
Jennifer M. Fink, MPH, cHES
Corresponding Author: Myron G. Schultz, Senior Medical Officer, Division of Health Studies, NCEH/ATSDR, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F-57, Atlanta, GA 30341. E-mail: email@example.com.
TABLE 1 Health Effects Reported in Excess Compared With National Data TCE Registry Anemia Cancer Skin rashes Urinary tract disorders Stroke Diabetes Liver disease Kidney disease Hearing impairment Speech impairment Benzene Registry Anemia Cancer Skin rashes Urinary tract disorders Stroke Diabetes Liver disease Kidney disease Respiratory allergies Arthritis GI ulcers Dioxin Registry Anemia Cancer Skin rashes Urinary tract disorders Stroke TCA Registry Anemia Cancer Skin rashes Urinary tract disorders Stroke Diabetes Liver disease Respiratory allergies
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Author: | Schultz, Myron G.; Sapp, James H., II; Cusack, Caroline D.; Fink, Jennifer M. |
Publication: | Journal of Environmental Health |
Date: | Feb 27, 2010 |
Words: | 4362 |
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A film in which a busy working mother frets over bringing a store-bought pie to a school bake sale could quite fairly be accused of focusing exclusively on First World problems. But then, if you're reading this, chances are you live a First World life and so may appreciate the juggling act required of the working moms in the domestic comedy I Don't Know How She Does It.
Adapted from the novel by Allison Pearson, the film stars Sarah Jessica Parker as the driven, über-capable Kate Reddy, who works for a high-powered investment firm and travels more than her supportive husband (Greg Kinnear) might like — he has just started his own business and is pretty swamped himself — but still manages to dote on her two young children.
Kate gets everything right, her best friend Allison (Christina Hendricks of Mad Men) tells us with a sparkling grin. All the other moms are amazed at Kate's ability to have it all, until suddenly cracks begin to show in her impressive veneer. Her obsessive list-making isn't enough to ward off the disasters ahead when the demands of a time-consuming career clash with kids who refuse to stop growing up while Mom's at the office.
That store-bought dessert is just the first step in Kate's downhill slide, which includes missing her son's first haircut and the dawning realization that one of the perils of business travel is that it can throw you into the circle of handsome businessmen like Jack Abelhammer (Pierce Brosnan), a patient, charming guy whose expensive suit is free of Cheerios spew and who doesn't seem to mind the fact that Kate is inevitably doing something foolish or embarrassing every time he sees her. For someone who's allegedly a genius in the tricky world of high finance, Kate seems dangerously inept at basic technology. Sending email to the right people, hiding text messages from prying eyes and knowing not to adjust your pantyhose while Skyping are really pretty simple rules by which to live.
I Don't Know How She Does It makes good use of the overused mockumentary style and occasionally allows Kate to freeze the frame in order to speak directly to the audience, little conceits we've seen before but still work well enough here. The humor tends to be broad, but the spritely pace doesn't allow for too much lingering on the jokes that don't land (really, we've seen enough morning sickness bits to make us gag).
Olivia Munn and Busy Phillips do some nice supporting work here as Kate's tightly wound assistant (Munn) and a nonworking mom just barely concealing her own stress (Phillips), and in its pleasantly sit-comish way, the movie makes a few pointed observations about the disparity of expectations for men and women in the workplace. The path Kate will eventually take is anything but surprising; no movie is going to come down in favor of work over family. Still, I Don't Know How She Does It does allow that some people — women, even! — are deeply fulfilled by their work and need their jobs for more than financial reasons. For a movie, it's pretty good at that balancing act Kate works so hard to achieve.
Cast: Sarah Jessica Parker, Pierce Brosnan, Greg Kinnear, Christina Hendricks, Kelsey Grammer, Seth Meyers.
Director: Douglas McGrath.
Screenwriter: Aline Brosh McKenna. Based on the novel by Allison Pearson.
Producer: Donna Gigliotti.
A Weinstein Co. release. Running time: 90 minutes. Vulgar language, adult themes. Opens Sept. 16 at area theaters.
[1] http://www.miami.com/movies/review
[2] http://www.miami.com/039leviathan039-r-article
[3] http://www.miami.com/039still-alice039-pg-13-article
[4] http://www.miami.com/039a-most-violent-year039-r-article
[5] http://www.miami.com/039black-sea039-r-article
[6] http://www.miami.com/039black-or-white039-pg-13-article
[7] http://www.miami.com/039the-humbling039-r-article
[8] http://www.miami.com/039mr-turner039-r-article
[9] http://www.miami.com/039cake039-r-article
[10] http://www.miami.com/039the-boy-next-door039-article
[11] http://www.miami.com/039the-wedding-ringer039-r-article
[12] http://www.miami.com/039paddington039-pg-article
[13] http://www.miami.com/039blackhat039-r-article
[14] http://www.miami.com/039two-days-one-night039-pg-13-article
[15] http://www.twitter.com/miamicom

subset: commoncrawl


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"...as all history informs us, there has been in every State & Kingdom a constant kind of warfare between the governing & governed: the one striving to obtain more for its support, and the other to pay less. And this has alone occasioned great convulsions, actual civil wars, ending either in dethroning of the Princes, or enslaving of the people. Generally indeed the ruling power carries its point, the revenues of princes constantly increasing, and we see that they are never satisfied, but always in want of more. The more the people are discontented with the oppression of taxes; the greater need the prince has of money to distribute among his partisans and pay the troops that are to suppress all resistance, and enable him to plunder at pleasure. There is scarce a king in a hundred who would not, if he could, follow the example of Pharaoh, get first all the peoples money, then all their lands, and then make them and their children servants for ever." ~ Benjamin Franklin
Vermont Voluntaryists
In October of 2011 I began the Vermont Voluntaryists page on Facebook, with the intention of creating a Vermont-specific internet hub for voluntaryist ideas, activism, communication, and strategies. To date, there are a mere 77 Likes -- the vast majority of whom, while either voluntaryists or those interested in voluntaryism -- do not reside in the Green Mountains. While all others are still most certainly welcome to remain on board and continue to join, I am seeking to build a greater body of Vermont residents who are interested in creating a voluntary society. If that's you, or you know of someone who might fill that criteria, please Like the linked page or forward the URL. As with this STR blog, I'm seeking to ramp up the level of awareness and interest in my own neck of the woods using a narrower focus as an additional resource. Thanks. Now back to drinking raw milk and eating pancakes slathered in maple syrup while carrying concealed with no license in the middle of a field full of cows. :-)
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- Alex R. Knight III's blog
Alex: I applaud you for your actions. Every person desirous to be rid of the kleptocracy Americans live under deserves to be thanked. The old saying "Action speaks louder than words" I forecast it will be a difficult job. I wish you the best at this endeavor.
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The Buffalo City Council will convene for their first meeting of 2015, and will have a new mayor and one new councilman sworn into office.
Johnson County's elected officials were sworn into their respective offices at a ceremony Monday morning at the county judicial center.
Judge William J. Edelman conducted the brief ceremony in the District Courtroom.
Johnson County's Commissioners, returning Commissioner Jim Hicks and newly-elected Commissioners Linda Greenough and Bill Novotny will have their first meeting of 2015 this morning at the historic courthouse on Main Street in Buffalo.
Officials with the Bighorn National Forest have announced that over the next couple of months, forest managers will be hiring for temporary, seasonal positions in a variety of specialized areas.
Swearing-in ceremonies for newly elected officials will be held today and all are open to the public.
Two witnesses testified yesterday in district court in the case against Frank Claybaugh. He is accused of stealing a steer and instructing his hired man to slaughter the animal.
P.O. News & Flagstaff Cafe in Sheridan will host a book signing this Wednesday, and local Buffalo Author Lois Slater will be available to sign copies of her new book, "Stem of the Wildflower."
At their last city council meeting, Buffalo City Councilman Russ Humphrey asked City Attorney Ben Kirven if the YMCA was still interested in using the city-owned indoor archery building near the outdoor pool at Washington Park.


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1st pregnancy compared with 2nd pregnancy
Comments (4)
Katelouise1092 · Original Poster
Posted 05/16/2013
Both are boys too.. and I've gained the exact same amount of weight..my son Logan was definitely lower though!
Posted 05/16/2013
That's really interesting! Goes to show how every pregnancy is different! I'm smaller this time around than I was with my first pregnancy but I weigh a lot more this time. So weird.
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Nicole + Steven May 14, 2008
Alaina Madison May 27, 2011
11:34AM - 7 lbs 13 oz 21 in
Serena Evelyn August 1, 2013
9:58AM - 7 lbs 12 oz 20 in
Posted 05/16/2013
Crazy! I am carrying a lot lower this pregnancy that with my first. My pictures would like like the opposite of yours, I'm sure!
Mama to two sweet little girls - 2/5/11 ♥ 7/27/13
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Your 18-month-old: Week 1
You may observe a spurt in physical development this month. Read More


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A third generation Harry Potter roleplay group taking place a little more than twenty years after the great war.
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We are a group of RC Enthusiasts in Singapore. Join us for our weekly RC Meet ups and ad hoc RC meets!
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We are a large group that is built upon patriotic like-minded law enforcement, military, and citizens. We are a Pro Law Enforcement Group. We are a group of Anti-Occupy Americans. We carefully study protesters for analysis. We believe our country has
occupy, police, thiefs, allowed, protest, ferguson, riot, cops, leos, anti, shut, down, bassem, masri, bella, eiko, domestic, terrorism, homegrown
hCG support group for the weight loss cure protocol.
For members and fans of BoulderAirsoft. comA group dedicated to the sport of Airsoft in the Boulder Colorado area.
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We are a group of like-minded people who come together to share ideas and encourage each other ... oh ... and we also enjoy the occasional swap as well ...
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A forum for the 'Balls of Steel' group running Midnight Campaign.
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HoudahSpot 3.9.8
A powerful search tool for Mac OS X that is based on Apple's Spotlight and offers you the possibility to perform detailed queries.
Add it to your Download Basket!
Add it to your Watch List!
What's new in HoudahSpot 3.9.8:
- Bug fix: "None" group - Fixes a bug where search could fail when using a "None" group.
malware send us
an update
- Trial
- Houdah Software
- Home \ Utilities
Apple's Spotlight engine can help you find files in no time but does not allow you to set up multiple rules for your searches, which translates in longer queries. HoudahSpot is a simple Mac app built on top of Spotlight that can take various elements into account when trying to find files and folders.
HoudahSpot allows you to create rules for a wide range of file attributes and for all the metadata indexed by Spotlight. Note that the results list includes all the information known to Spotlight, but also additional data provided by HoudahSpot.
Unobtrusive workflow
HoudahSpot stays out of your way at all times but you can easily access its interface any time you want. The app places a small icon in your status bar menu which provides access to the Blitz Search Window (a simplified version) or to the HoudahSpot menu (you can activated through a right click).Fast search tool
In the HoudahSpot Blitz Search window you get to perform quick searching by using different search templates. At the same time, you can activate basic criteria and match the query text to the file name, to any text content, or to included comments.Refine your queries
For more complicated tasks, you might want to navigate to the HoudahSpot main window and take advantage of everything the application has to offer. You can specify what are you looking for and where, and limit the results list by applying various rules. In addition, you can choose to exclude certain folders.HoudahSpot allows you to create rules for a wide range of file attributes and for all the metadata indexed by Spotlight. Note that the results list includes all the information known to Spotlight, but also additional data provided by HoudahSpot.
Complete search solution for Mac OS X
HoudahSpot offers a wide range of sorting capabilities that can help you find specific files in no time. The app is using the powerful Spotlight engine, but makes its own computations and allows you to set up countless tools to refine the queries and find what you were looking for faster.HoudahSpot was reviewed by Iulia Ivan, last updated on January 9th, 2015
Runs on: Mac OS X 10.6 or later (Intel only)
feature list requirements limitations
Add your review!


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Allowing your child to pretend that they are someone or something else will kick start their imagination and get them to discover new and exciting things. Costumes by Melissa and Doug will encourage your little one to play the role of a doctor, princess, pirate or veterinarian while in their Neat & Tidy Cottage by Step2. Your child will be the star of the show with the Step2 Puppet Theater. From a check-up to dress-up, BabyAge.com has a wide variety of highly rated toys for your child to pretend play every day of the week!
Pretend Play
Badger Basket Adventure Fire Station
$39.99$15.49 -
Outdoor Chef Mud Pie Kitchen with Cooking Accessories


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Narrow your search
With an 11-inch screen and low price, the HP x360 competes with Lenovo's own entry level Yoga, but a dim screen holds it back.
HP's Windows 8 hybrid is a cheaper version of Lenovo's offering
Borrowing a design trait from the Lenovo Yoga, the HP Pavilion X360 uses the same flip-over design to transform from laptop to tablet.
HP updates its Pavilion line with 11- and 13-inch hybrid laptops/tablets
The HP Pavilion Chromebook 14 feels more like a traditional laptop than other Chromebooks thanks to its bigger screen.
The AMD-powered HP Pavilion Sleekbook TouchSmart 15z is a slim, midsize laptop at a very reasonable price, and includes a touch screen.
The HP Pavilion 27xi looks more expensive than it actually is.
The HP Pavilion 27xi is a 1,920x1,080 monitor that looks like it's made from sterner stuff than it actually is.
A pair of pocket-sized PCs take aim at the Mac Mini and other small form-factor desktops.
Pricing not available
Eric Franklin takes a look at the HP Pavilion 27 xi IPS monitor, which includes a feature called HP Enhance Plus.


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Electronic Equipment, Instruments and Components
Company Overview of Norworks kft
Company Overview
Norworks kft manufactures components for communication antennas and system. The company is based in Budapest, Hungary. As per the transaction announced on January 31, 2008, Norworks kft operates as a subsidiary of Comrod Communication ASA.
Budapest, 1016
Key Executives for Norworks kft
Norworks kft does not have any Key Executives recorded.
Similar Private Companies By Industry
Company Name | Region |
Adaptive Recognition Hungary Kft. | Europe |
IBM Hungary Ltd. | Europe |
Elso Magyar Konszolidátor Zrt | Europe |
EnergoSolar S.A. | Europe |
NXP Semiconductors Hungary Ltd. | Europe |
Recent Private Companies Transactions
Type Date |
Target | |
No transactions available in the past 12 months. |
Most Searched Private Companies
Company Name | Geographic Region |
NYC2012, Inc. | United States |
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Sponsored Financial Commentaries
Sponsored Links
To contact Norworks kft, please visit --. Company data is provided by Capital IQ. Please use this form to report any data issues.
Our data partners will research the update request and update the information on this page if necessary. Research and follow-up could take several weeks. If you have questions, you can contact them at email@example.com.


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Days Inn Lake Charles
TripAdvisor Reviews Days Inn Lake Charles
Travel Blogs from Lake Charles
Exploring the Gulf Coast
... lots of biting insects.
The mosquitos and deer flies were going crazy attacking Gabi. He got several bloody bites on his legs, and pretty soon the enjoyment of nature was overtaken by the discomfort of him having to swat at himself constantly with his hat. It finally got to the point where he said, let's get the hell out of here, and we started walking back and Gabi sped back, not even wanting to stop for a photo. I ...
Dancing Zydeco in Cajun Country
The weather was uncharacteristically cool and cloudy so we decided to cancel our plan of going to a lake or the ocean today. I found a zydeco concert at a casino for us to go to in the evening! Randy and I went to Kroger's for ingredients for tonight's jambalaya and we ran into a friend of his, a man a little older than him who is also planning on going to the concert tonight!
Back home we did a ...
First Day in Lake Charles
... saw live crabs in there, and saw the boiling pots and seasoning in the back of the restaurant where they make crawfish boils, crab boils, etc. Cool!
After that we bought Randy some Duck Dynasty PJ's, which he adores, enjoyed yummy pralines (pecan candy), and watched the movie, Ray. It was a great movie, and the performance of the actress who played young Ray's mother made me cry several times.
Leaving the west behind
... time and every lane into San Antonio was at a standstill. The by pass was busy and before I got to I 10, it was a two lane road again under construction. The ride to Houston was pretty boring and warm, just the way I like it. Then I smartly took a break just before taking on Houston and it's I10. This was my reward for skipping the nature route, five lanes wide with an additional three HOV lanes. Every one of them was a fast lane, none were ...
Two hot cities
... bearing down from all sides is very intimidating. If I leave space for comfort, cars invariably cut through the group. the group passed the location I stopped at so I ended up behind them. after Houston, I took a detour by Winnie based on a recommendation from someone at a gas station and a review of the maps.


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Oct 23, 2013 Ahmed Humayun All News, Hardware News 0
Fractal Design's latest Arc Midi R2 swapped the side panel window with a solid side panel which is enough to give a new face to the device. The other changes made aren't that much visible nor enhanced the looks.
Jan 24, 2013 Bob Buskirk All News, Hardware News 1
Introducing the Arc Midi R2! As the newest member of the Arc family of airflow cases, the Arc Midi R2 is developed with high-performance computer systems in mind. Featuring three high performance Silent Series R2 fans and ample water cooling options, the Arc Midi R2 layout maximizes airflow throughout the case and keeps even the most demanding systems at cool temperatures. Designed to house even the thickest radiators in both the top and front panels without extensive modifications, the Arc Midi R2 offers all this within a mid size case.
Jan 30, 2015 0
Jan 29, 2015 0
Jan 28, 2015 1
Jan 27, 2015 0
Jan 26, 2015 1
Jan 22, 2015 0


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« previous Page 23 of 52 next »
If ever there was a case of "build it and they will come," the Lowndes County Master Gardeners found it. What they built is a 4,000-square-foot butterfly garden at the Columbus Riverwalk. And, indeed, the winged insects have come, clad in brilliant coats of autumn amber, ultramarine and buttercup yellow. The pipevine swallowtails, eastern tigers and little skippers, the Gulf fritillaries and monarchs. Cloudless sulphurs, buckeyes, too.
Emma Grace wants to become a ghost hunter, and the storied cemetery in her hometown seems the natural place to begin. Her adventure unfolds in the pages of Adele Elliott's debut novel, "Friendship Cemetery."
Not so long ago, Caterina Mendolicchio was studying and photographing the splendid architecture of the Neue Nationalgalerie in Berlin, the Chiesa dei Gesuati church in Venice and other stunning structures in storied cities like Milan, Sicily, Edinburgh and her hometown of Rimini, Italy.
« previous Page 23 of 52 next »


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Manziel Agrees To Contract With Browns
CLEVELAND (AP) – The Browns have agreed to terms with quarterback Johnny Manziel on his rookie contract.
Financial terms of the deal were not immediately available.
The Browns moved up in May's NFL draft to select the popular and polarizing Manziel in the first round with the No. 22 overall pick. The former Heisman Trophy winner will enter training camp next month as Cleveland's No. 2 quarterback behind veteran Brian Hoyer, who is coming off knee surgery.
Browns coach Mike Pettine recently stressed that Manziel has some catching up to do, but made it clear that Hoyer's lead was not "insurmountable."
Manziel went 20-6 in two seasons at Texas A&M, where he earned the nickname "Johnny Football" for his dynamic playmaking abilities and became the first freshman to win the Heisman. The Browns have signed four of their six 2014 draft picks.
(© Copyright 2014 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)
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- Plano Police Arrest Suspect With Possible Link To Burglaries
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- PHOTOS: Your Pet Pictures


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Before the game, Russell Westbrook was seen strolling around the Thunder locker room, without crutches or any sign of a limp.
OKC Thunder notebook: Russell Westbrook watches game from Thunder bench
Then during the game, for the first time since his surgery, Westbrook watched the game from the Oklahoma City bench.
A positive sign for the All-Star guard who had his knee scoped less than a week before.
When asked pregame if he was worried about Westbrook's three right knee surgeries in eight months, coach Scott Brooks said: "No, not at all."
Brooks has done plenty of lineup maneuvering throughout this season, tinkering his rotation game-to-game depending on opponent and feel.
On Thursday night, that meant an extended opportunity for the versatile but sporadically used Perry Jones, who played a season-high 30 minutes against a Nets team that went small.
Jones played well for most of the night, scoring 11 points on 4-of-7 shooting, including 3-of-5 on threes, but struggled to defend Paul Pierce late.
Continue reading this story on the...
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- 6391Oklahoma Parole Board grants few approvals


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Global Diversity Research Executive Summary: 203 Data Submissions in 46 Countries
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Have you been asked to take your U.S. diversity initiative global? Here's what you should do first.
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Download our A to Z of Winter in Scotland guide now for attractions, events, activities and more!
Scotland offers a range of caravan parks and camping sites to suit all budgets, tastes and itineraries whether you are looking for a fun family break with activities or a relaxing holiday away from it all.
Scotland's great outdoors is one of its biggest attractions and one of the best ways of experiencing the beautiful scenery is on a caravan or camping holiday.
There is an extensive range of high quality caravan parks to choose from, many of which are open all year round, in just about every corner of Scotland.
If you're looking for a flexible break, why not bring your tent, touring caravan or motorhome, or if you want take it easy and explore just one particular area, why not rent a modern caravan holiday home or a lodge in one of Scotland's many caravan parks?
It's not just kids who love the sense of adventure of staying on a caravan park. Many parks have activities and indoor leisure facilities on-site or nearby, so there is always plenty to do regardless of the weather. Caravan holidays are a good option for couples too, giving a chance to recharge your batteries in the great outdoors.
If you're in need of a reviving break then why not try a caravan holiday park, whether along Scotland's coasts or inland in its dramatic landscapes?
Browse VisitScotland Quality Assured caravans and holiday parks in Scotland.
Self Catering
Discover the incredible west coast of Scotland, Loch Lomond and the Highlands and Islands with a holiday, or by becoming a resident, at Rosneath Castle Park in Helensburgh.
Holiday Park
Caravan Holiday Home
Nestled under the mighty Ben Cruachan and bordered by the River Awe, Loch Awe Holiday Park is in a great position for exploring western Argyll.
Holiday Park
Turnberry Holiday Park is small and tranquil, but spectacularly located just 300 metres from the nearest beaches, in the heart of rural parkland and close to many historic attractions.
Touring Park
The Clachan Caravan Club Site is a wooded wonderland, rich with abundant alpine wild flowers and a spectacular range of bird life - curlew, buzzard, golden plover and kestrel are just a few of the varieties to be seen.
Holiday Park
Pitlochry and Highland Perthshire
Faskally is a family run caravan park situated in the centre of Scotland. We enjoy stunning views of the Perthshire countryside and are an ideal base for exploring the local area and beyond Local attractions include golf, cycling and hill walking.
Touring Park
Touring Park
Nestled on the shores of Loch Naver with a direct view of Ben Klibreck, Altnaharra Caravan Club Site (formerly Grummore) in Lairg is perfect for those wanting to get away from it all - the nearest shops are 20 miles away.
Touring Park
Our Holiday Park is small and friendly with the emphasis on a relaxing short break or holiday.
Touring Park
Situated just a short walk from the town, the Park is located within The Pickaquoy Centre complex and offers an impressive range of leisure facilities.


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Welcome to Village Pointe. Within the gates of our community there is a serene reconnection with nature and a return to the classic era of living, a time when people mattered, neighbors cared, and award winning customer service was a way of life. We offer unique apartment homes including Studio, One, Two and Three Bedrooms in a beautiful garden setting. Contact us today to schedule your personalized tour of Village Pointe Apartment Homes.
Around Here
Features & Amenities
- Pool
- Fitness Center: Free
- On-Site Management
- Carport
Pet Policies
- Cats Allowed
Additional Information:
Indoor cats and birds. Maximum of two pets. $400 pet deposit, additional pet $200. No monthly pet rent.
Lease Length
- 3 months
- 4 months
- 5 months
- 6 months
- 7 months
- 8 months
- 9 months
- 10 months
- 11 months
- 12 months
Property Information
- BuildingType: Apartment
- Number of Floors: 2
- Number of Units: 258
- Housing Type: Short Term Lease
Office Hours:
Weekdays: Mon: 9:00 AM-6:00 PM, Tue: 9:00 AM-6:00 PM, Wed: 9:00 AM-6:00 PM, Thu: 9:00 AM-6:00 PM, Fri: 9:00 AM-6:00 PM, Saturday: 9:00 AM-6:00 PM, Sunday: 9:00 AM-6:00 PM
Management Company:
E & S Ring Management Corp.
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4 star hotel Anemon Hotel Izmir Located 100 metres for the train station and minutes from Izmir International Fair, Anemon Hotel features free Wi-Fi and a complementary airport shuttle service. Free private parking is also available... $53
Hotel Walk In Hotel Located in the city centre, Walk In Hotel is only a 3-minute walk from Izmir Fair Centre. The hotel offers 24-hour front desk service, and modern rooms with air conditioning and free Wi-Fi... $38
Hotel Oglakcioglu Park Boutique Hotel Located 100 metres from Basmane Train and Metro Stations, Oglakcioglu Park Boutique Hotel has rooms with free Wi-Fi and modern amenities. Hotel also offers complimentary late breakfast... $48
4 star hotel Ege Palas Ege Palas is situated right by the Aegean Sea and offers spacious rooms with a balcony and 24-hour room service. There is a panoramic restaurant and bar overlooking Izmir Bay... $80
4 star hotel Best Western Plus Hotel Konak This 4-star luxury hotel overlooks the Aegean Sea. All rooms are elegantly furnished and include air conditioning, cable TV and free Wi-Fi. Free parking is available on site... $76
4 star hotel Double Tree By Hilton Izmir Alsancak Only a 2-minute walk to the Izmir International Fair, DoubleTree by Hilton Izmir - Alsancak features an outdoor pool and a spa and wellness centre. Free private parking and WiFi throughout the building are available... $96
Hotel Nil & Alav Hotel Located centrally in Izmir, just a few steps from Dokuz Eylül Square, Nil & Alav Hotel features a restaurant. Free WiFi and a 24-hour front desk are available... $34
Bed and breakfast Isik Hotel Located in the heart of popular Konak, Isik Hotel offers free WiFi in rooms. The 24-hour reception provides daily maid service... $29
Apartment Apartment Red Located in Bornova, Apartment Red offers a garden. This self-catering accommodation also features free WiFi. Free on-site parking is also offered... $63
4 star hotel Hotel Marla Located in Izmir's historical Konak district, the Hotel Marla is only 50 metres from the Aegean Sea. It has 2 restaurants and offers air-conditioned guestrooms with free Wi-Fi... $63
4 star hotel Susuzlu Atlantis Hotel Susuzlu Hotel offers affordable 4-star accommodation in the heart of Izmir. It is a short walk from Basmane Subway Station and Izmir International Fair. It offers free parking and a 24-hour restaurant... $79
Hotel Izan Hotel Located in the heart of Izmir, Izan Hotel is a modern accommodation with free WiFi access throughout. You can enjoy city view from the rooms... $40
2 star hotel Mini Hotel Mini Hotel is located in the heart of Izmir, just 200 metres from Kemeraltı Bazaar. Hotel Mini's front desk is open 24-hours a day, and both free Wi-Fi and private parking are available... $34
Hotel Marlight Boutique Hotel Located in the heart of Izmir, this hotel offers free Wi-Fi, free private parking and rooms with LCD TV. The hotel has an on-site sauna and a Turkish bath... $50
Hotel Blue City Hotel Located in Karsiyaka district of Izmir, Blue City Hotel has a stylish bar with extensive views of the bay. The hotel offers 24-hour front desk service, and modern rooms with air conditioning and free WiFi... $113
3 star hotel Hotel Vera Palas Located in the heart of Izmir in Alsancak, this hotel is 200 metres from the seafront. It offers free Wi-Fi, a spa centre with an indoor swimming pool and air-conditioned rooms with LCD TV... $50
Hotel Villa Levante Located in the centre of Bornova, Villa Levante has a peaceful garden and soundproofed rooms. Set in a renovated mansion built in 1831, it offers 24-hour front desk service and free private parking on site... $82
3 star hotel Susuzlu Hotel Renovated in 2009 the Susuzlu Hotel offers contemporary accommodation in central Izmir, 700 meters from the waterfront. The hotel features free Wi-Fi and free parking at a location nearby... $45
4 star hotel Aksan Hotel This hotel in Old Izmir is a short walk from Izmir's museums, shops and transport links. It has a Turkish bath and massage services. Free Wi-Fi is available... $47
Hotel Nk Hotel Located in Konak, NK Hotel offers an à la carte restaurant. Free WiFi access is available throughout the property. Free on-site car parking is also offered... $45
Hotel Ustun Hotel Located in the city centre, Ustun Hotel is within walking distance from Izmir's famous Kordon area on the coast. The hotel offers a terrace restaurant and air-conditioned rooms with free Wi-Fi... $33
Bed and breakfast Way Hotel Located at the heart of Alsancak district, Way Hotel offers air-conditioned rooms with free Wi-Fi. Free private parking is possible on site... $62
Hotel Guzel Izmir Hotel The hotel is located in Izmir city centre, only 100 metres from the historic Izmir-Basmane Train Station and the metro station. Izmir International Fair is within walking distance from the hotel... $32
Hotel Hotel Zeybek Free Wi-Fi and wall-mounted flat-screen TVs are standard in all Hotel Zeybek's rooms... $38
2 star hotel Ege Guneş Hotel Located in Bornova district, Ege Guneş Hotel offers air-conditioned rooms with free Wi-Fi access. You can start the day with a rich buffet breakfast at the on-site breakfast room... $38
Hotel Grand Corner Boutique Hotel Located in the city centre, this hotel is just a 5-minute walk from Izmir International Fair Centre... $47
Hotel Dokuz Eylul Hotel Offering a restaurant, Dokuz Eylul Hotel is located just a short walk from the seaside in Kucukyali district of İzmir. WiFi is available in all areas and is free of charge... $44
Hotel Ontur Izmir Otel Located in the city centre, Ontur Izmir Otel offers luxury, spacious accommodation, top-class service and a wealth of excellent facilities, including an indoor swimming pool, sauna and massage... $62


text:
Leading U.S. carrier in the Pacific, Matson, Inc., informs it will release its financial results for the Second Quarter 2014 on Thursday, July 31, 2014.
President and Chief Executive Officer Matthew Cox and Senior Vice President and Chief Financial Officer Joel Wine will discuss the results for the second quarter through a conference call that will occur after financial results are released. The earnings conference call is scheduled at 4:30 p.m. EDT/1:30 p.m. PDT/10:30 a.m. HST. The call will be broadcast live along with a slide presentation on the Company's website at www.matson.com; Investor Relations. A replay of the conference call will be available approximately two hours after the call through Thursday, August 7, 2014 by dialing 1-855-859-2056 or 1-404-537-3406 and using the conference number 68999372. The slides and audio webcast of the conference call will be archived on the Company's Investor Relations page of the Matson website. About the Company Founded in 1882, Matson is a leading U.S. carrier in the Pacific. Matson provides a vital lifeline to the island economies of Hawaii, Guam, Micronesia and select South Pacific islands, and operates a premium, expedited service from China to Southern California. The Company's fleet consists of 18 owned and three chartered vessels including containerships, combination container/roll-on/roll-off ships, and custom-designed barges. Established in 1987, Matson Logistics extends the geographic reach of Matson's transportation network throughout the continental U.S. Logistics services include domestic and international rail intermodal, highway brokerage and warehousing. Additional information about Matson, Inc. is available at www.matson.com
Residents of Islampur, a remote village in the northern Bangladeshi district of Naogaon, were stunned one night last summer when the darkness was suddenly illuminated
Indian Prime Minister Narendra Modi said a climate deal between the United States and China does not put pressure on India, but that global warming itself was reason to take action.
The United States and India have reached a breakthrough on two issues holding up civil nuclear cooperation between them, U.S. President Barack Obama told a news conference in New Delhi on Sunday.
With just a week of bargaining left until the national contract for U.S. refinery workers expires, the United Steelworkers union (USW) said talks with oil company
In a fresh bid to make India an enduring strategic partner, U.S. President Barack Obama lands in New Delhi on Sunday for a highly symbolic parade and to nurture
Federal Maritime Commissioners Richard A. Lidinsky, Jr. and William P. Doyle met with transportation officials from China on January 14, 2015 in Washington, D.C.
Nils Andersen, chief executive of AP Møller-Maersks, has warned that global trade will never return to scorching pre-crisis growth rates, in part because western
India's shipping ministry is asking for a tax holiday and more incentives for the shipbuilding industry in the upcoming Union budget, according to a report in the Economic Times.
Inmarsat, the leading provider of global mobile satellite communications services, will complete another significant milestone in the delivery of its transformational
Last month, POSH Xanadu, the largest purpose-built floatel to date was delivered at PaxOcean in Zhoushan. POSH Xanadu is a ship-shaped column stabilized semi-submersible accommodation platform,
Fugro N.V. announces that the Supervisory Board of Fugro nominates Mrs. P.H.M. Hofsté and Mrs. A.H. Montijn for appointment as members of the Supervisory Board
Hiab, part of Cargotec, is set to launch the biggest crane to date in its high capacity range, the HIAB X-HiPro 1058. This signposts the first in a series of launches,
Technip and EDGE Certified Foundation announce today that Technip in Brazil, in France and in Italy, including flexible pipe manufacturing plants in Brazil and France and Group's headquarters,


text:
All Run: Page 1
adidas Unveils New Ultra Boost Running Shoe
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- Published 4 days ago
Push Through A Running Plateau
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How supercompensation training can take your fitness to the next level.
Dispatch: Paula Findlay's Winter Running Tips
- By Holly Bennett
- Published Jan 15, 2015
A native of Edmonton, Canada and currently living in Boulder, Colo. Olympian Paula Findlay knows a thing or two about cold winter weather.
Video: Pete Jacobs Talks Running Technique
- By Steve Godwin
- Published Jan 14, 2015
Pete Jacobs discusses the importance of running technique and how he learned about the most efficient way to run.
Early-Season Hill Work Equals Race Day Speed
- By Lance Watson
- Published Jan 14, 2015
- Updated Jan 14, 2015 at 8:41 AM UTC
While hill training is valuable all year, it is particularly useful early in your preparation to gain strength and muscular endurance.
One-Hour Workout: Early Season Two-Minute Run Efforts
- By Jené Shaw
- Published Jan 13, 2015
This run workout is great for triathletes of all distances, because it has lower intensity mixed with some quicker turnover intervals.
Is The Maximalist Running Shoe Trend For You?
- By Scott Boulbol
- Published Jan 12, 2015
Maximum cushioned, or "fat" shoes, are gaining momentum in all categories of running and could be the next craze in triathlon too.
Get Up And Running After An Off-Season Break
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Use these three guidelines to avoid getting hurt when you start running again.
Garmin Announces New Wearables For 2015
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- Published Jan 6, 2015
- Updated Jan 6, 2015 at 4:10 PM UTC
These watches attempt to combine performance capabilities with wear-all-the-time fashion.
8 Hot Running Shoe Trends For 2015
- By Brian Metzler | Competitor.com
- Published Jan 5, 2015
Competitor's Brian Metzler shares some of the key trends in running shoes based on the new products that will be debuting in 2015.


text:
Bon Firé | E1 5c | ||
18m. A great little expedition. Climb Rough Boys then move right and up before traversing rightwards across the lip of the big upper roof. Finish straight up. © ROCKFAX FA. Crispin Waddy, Dave Thomas 4.89 Apr/1989 Submit a new photo of this climb. | |||


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by United States Congress Senate
OCLC Number: (OCoLC)49945203 Excerpt: ...As our transportations systems become more congested and if the causes of transportation accidents continue ... Show synopsis OCLC Number: (OCoLC)49945203 Excerpt: ...As our transportations systems become more congested and if the causes of transportation accidents continue to increase in complexity, their safety recommendations will become even more critical.Lately, the NTSB and its staff have been lauded for their expertise and devotion while some of the NTSBs techniques and practices have come under scrutiny. The Rand Report, commissioned by the NTSB itself, is complimentary but expresses concern that the NTSB is stretched to capacity. This is certainly something we should heed--the NTSB is highly regarded for its integrity and investigative acumen. It would be a mistake to allow them to become overburdened by too many extensions of their original mission or through understaffing. I look forward to listening to the nominees' statements and their potential contributions to the NTSB, as well as their thoughts on improving the NTSB.Senator Hutchison. Thank you, Senator Hollings, and thanks for the offer to work with us and cosponsor the reauthorization. We will take you up on it. Thank you.Senator Breaux.STATEMENT OF HON. JOHN B. BREAUX, U.S. SENATOR FROM LOUISIANASenator Breaux. Thank you, Madam Chair. I just want to add my word of endorsement in support for Carol Carmody, who was raised in New Orleans, at least, and has a Louisiana connection. At a time when many people are looking for ways to get out of public service and out of Federal service, it is always terrific that we have someone who has made a career in public service and wants to continue in that capacity, and who brings to this position a great deal of background and experience in both international civil aviation as well as the practical politics of serving on the Commerce Committee. She has an understanding of how we make the laws, and how we like to see them followed through and enforced, and that combination of practical, real world e... Hide synopsis
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Chicago, IL (Sports Network) - A five-run sixth inning proved to be the difference in the Astros' 11-9 win in the rubber match of a three-game set against the White Sox.
"We've beaten some teams this year that, you know, we caught off guard," White Sox first baseman Paul Konerko said. "Sometimes you catch teams and they kind of caught us this weekend. We had a good game yesterday, but they just did everything a little bit better."
Jose Altuve went 2-for-5 with a two-run homer and three runs batted in for the Astros, who had dropped their previous four series.
J.D. Martinez, Justin Maxwell and Brett Wallace all homered off of Philip Humber (2-4), who allowed six runs -- five earned -- on six hits and two walks in 5 1/3 innings. Humber did manage to strike out nine.
"It's hard to work your way out of it if you don't pitch," White Sox manager Robin Ventura said. "Whether that's starting or in the bullpen, I don't know. It has to get better."
Lucas Harrell (6-4) picked up the win despite giving up five runs in 7 1/3 innings.
"He threw great," Konerko said. "He would have been tough today against anybody. It had nothing to do with anything else. He would have been good against anybody today. He was hitting his spots and that was the story."
Houston opened up a 9-3 lead with its big sixth inning. With one out, Wallace hit a solo shot, which Chris Johnson followed with a single to end Humber's day. After Nate Jones got Brian Bogusevic to fly out for the second out of the inning, four straight Astros reached base, leading to three more runs. Houston capped its scoring outburst with a double steal, in which Altuve stole home while Brian Bixler went to second.
Martinez's solo homer in the second gave Houston an early lead. The Astros added a second run on a Maxwell single.
The White Sox tied the game in the third with two runs and took the lead in the fourth on an Alexei Ramirez sacrifice fly.
After Bogusevic led off the fifth with a base hit, Houston regained the lead on a long home run down the left-field line by Maxwell.
"I was just looking for a pitch to drive," Maxwell said. "I had already seen pretty much every pitch he had to offer so, I was able to get one up and get a good swing on it."
Adam Dunn crushed his 20th home run of the season to left field to make it a five-run game in the sixth, but Altuve responded in the eighth with a two-run blast to give Houston a seven-run lead.
The White Sox made things interesting after Konerko closed the gap to five with his 12th home run in the eighth and Orlando Hudson pulled a three-run shot to make it a two-run game in the ninth.
After Hudson's blast, Brett Myers entered and retired Alejandro De Aza and Gordon Beckham to pick up his 15th save of the season.
Beckham has recorded hits in 14 of his last 16 games...Humber is 1-4 with a 7.50 earned run average in nine starts since throwing a perfect game on 4/21 at Seattle...Humber is 0-7 with a 5.92 ERA in his last 14 starts at home...The White Sox are hitting .384 (58-for-152)...Jed Lowrie did not homer for the first time in three games...The Astros have scored 49 runs in their last nine games this month (5.4 per game)...Harrell leads major league rookies with 76 1/3 innings pitched...Houston went 3-for-7 with runners in scoring position and left only four runners on base.
FCS running backs found the end zone in the Reese's Senior Bowl on Saturday.
IndyCar Series drivers Scott Dixon and Tony Kanaan as well as NASCAR Sprint Cup Series competitors Jamie McMurray and Kyle Larson gave Chip Ganassi Racing the victory in Sunday's 53rd running of the Rolex 24 at Daytona.
Troubled Cleveland Browns wide receiver Josh Gordon is in hot water with the NFL once again after reportedly failing a test for alcohol, which could trigger a suspension for the entire 2015 season.
The Oakland Athletics and left-handed pitcher Fernando Abad agreed to terms on a one-year contract Friday, avoiding arbitration.
The Detroit Pistons have confirmed that point guard Brandon Jennings suffered a ruptured left Achilles tendon during Saturday's game against Milwaukee and will miss the remainder of the season.
John Tavares recorded four goals and Jakub Voracek followed with three scores and three assists, as Team Toews walked away with a 17-12 decision over Team Foligno in the 2015 All-Star Game from Nationwide Arena, the highest-scoring mid-season event in league history. The 2001 event in Denver held the previous mark of 26 combined goals in a 14-12 North American victory over the World, but the new record was set when Jonathan Toews put his own team ahead by a 16-11 count with 5:39 remaining in the contest. Toews and Patrice Bergeron each ended up with a goal and four helpers, with Filip Forsberg, Rick Nash and Tyler Seguin adding two strikes apiece. Corey Crawford -- the last of three goaltenders to give up four goals -- stopped 14-of-18 shots in the third period to earn the win. Ryan Johansen from Team Foligno picked up the MVP award, pacing his side with two goals and as many assists. Patrick Kane and Steven Stamkos added two goals and one assist apiece, while Claude Giroux totaled three points on a tally and two helpers. Marc-Andre Fleury took the loss, charged with seven goals on 16 shots in the second period.


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152, Mukim Sungai Karang Balok, Balok, Kuantan, Malaysia 26100 (Show on map)
Book now!
based on 198 reviews
Area recommended for:
family fun
Distance to airport:
Sultan Ahmad Shah Airport (23.4 Km)
Customer comments:
"Beautiful swimming pool", "Big breakfast spread", "Excellent location to the beach"
Top attractions in the area:
Baluk River (3.7 Km)
Institute Latihan Perindustrian Kuantan (4.7 Km)
Wisma KPC Building (7.3 Km)
Lembaga Pelabuhan Kuantan (7.3 Km)
Note: Distances are measured as a straight line, calculated from a starting point to a destination point.
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airport transfer
business center
car park
coffee shop
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smoking area
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Guests over 11 years old are considered as adults.
Extra beds are dependent on the room you choose, please check the individual room policy for more details.
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from 198 reviews
M.S. Garden Hotel Kuantan
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Prices and availability are subject to change from the time and date that you print this page.
1/31/2015 7:33:42 PM. For Customer Service, please call
Crate and Barrel Exclusive
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The Story
Brushed stainless steel overlaps to wrap napkins in silvery dazzle.
Details and Dimensions
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Wrap Silver Napkin Ring is rated out of 5 by 1.
Rated 3 out of 5 by stephb from Elegant, but tarnish quickly I bought these right after my wedding and loved getting to use them to host my family for Thanksgiving. They are elegant and simple and go great with my Crate & Barrel cloth napkins. However, a few of them started to tarnish after only a few weeks. I'm hoping they are just the exception and I can exchange them for new ones.
Date published: 2014-03-25


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MMAgCh made this in-between sips of margaritas and bites of Arby's roast beef sandwich.
Mr. Zour is a dancing queen, young and sweet, only seventeen.
IZO's kind of love is an ugly love.
zoink2000 will be your safe word for today.
Hows about you, me, and five uncomfortable minutes in my basement apartment next to the dusty Christmas tree that's still up from my last visit with my estranged children.
The Upper Kitchen Cabinet Where Your Roommate Keeps His Food: You'll 'need the footstool' to reach your roommate's 'fine selection' of 'stale cereal,' but he'll never notice if 'only a little is missing from each box.' Feel less guilty by reminding yourself that Jeff 'acts weird around your girlfriend,' and always 'asks about her.' What a 'creep.'
Take a look back with us at some of the best and worst awful movie moments of the year!
Pictures of cute animals are taking the Internet by storm! (It's a very destructive storm.)
This ain't your daddy's globe...! .... or is it?!
Photoshop Phriday showcases the tremendous image manipulation talents of the Something Awful Forum Goons. Each week they tackle a new theme, parodying movies, video games, comics, history, and anything else you can think of. If you want in on the action, join us on the Something Awful Forums!
Copyright ©2015 Rich "Lowtax" Kyanka & Something Awful LLC.


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