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Food Sunday: Trying to Master Sourdough While Contemplating Catastrophic Global Warming
12:26 pm in Uncategorized by EdwardTeller
I. One of my new year's resolutions is to become a decent bread baker. In many ways I'm close to being a gourmet cook, but bread making is something I've neglected.
I buy bread at the store. I'm getting increasingly frustrated, though, at the lack of excellent bakery bread available in stores in southcentral Alaska. When we travel to Seattle, Portland, Oregon or California, the excellent Italian and French style breads readily available from local bakeries overwhelms me so much, I stuff loaves to bring north into empty coolers that brought seafood down from Alaska.
The kind of bread I crave the most that one cannot get here, is the rustic sourdough loaf, with a crunchy crust, big bubble holes in the bread itself, and a tangy, sourdough taste. So, I've started trying to make that.
In the past, I've tried various sourdough starter recipes – some using yeast, some using yoghurt, some just relying on time itself to create a usable, somewhat stable lactobacillus.
In light of the new year's resolution, I searched the web for the most interesting sourdough starter recipe. One that seemed quite strange, but fascinating, involved whole wheat flour and pineapple juice. I decided to try it. The site that had both that method and good word and video backup is called Breadtopia.
Supposedly, the pineapple juice starter initiator method was created by Debra Wink, back in early 2008.
Breadtopia's sourdough starter recipe takes a couple days or more longer to get going than many others, but it goes like this:
Step 1. Mix 3 ½ tbs. whole wheat flour with ¼ cup unsweetened pineapple juice. Cover and set aside for 48 hours at room temperature. Stir vigorously 2-3x/day. ("Unsweetened" in this case simply means no extra sugar added).
Step 2. Add to the above 2 tbs. whole wheat flour and 2 tbs. pineapple juice. Cover and set aside for a day or two. Stir vigorously 2-3x/day. You should see some activity of fermentation within 48 hours. If you don't, you may want to toss this and start over (or go buy some!)
Step 3. Add to the above 5 ¼ tbs. whole wheat flour and 3 tbs. purified water. Cover and set aside for 24 hours.
Step 4. Add ½ cup whole wheat flour and 1/4 to 1/3 cup purified water. You should have a very healthy sourdough starter by now.
Back in early February, I did just that. I even juiced my own pineapple for freshness. The starter evolved just as it was supposed to. I tried it.
The first time was a failure – the bread did not rise much at all over a twelve-hour period. It didn't taste tangy. I figured the house wasn't warm enough.
The second time, the bread rose some, but was still brick-like. It tasted a bit tangy.
The third time, I tried mixing in rye flour. The bread rose a bit more, and tasted tangier. I didn't call it a success, though, just "progress." I turned most of the loaf into croutons for a King crab Caesar salad.
The fourth time, shown at the top of the article, was considered a success, by everyone who tasted it, and the loaf disappeared quickly. I followed this recipe like a fundamentalist Christian might follow the Book of Numbers.
Here's what the replenished starter looks like today. Yesterday, shortly after adding flour and water, it brewed over.
How have you done at sourdough bread making, or at artisan bread baking?
Read the rest of this entry →


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Subterranean LyricsArtist: In FlamesAlbum: Subterranean From the longlasting pain When I look at your eyes My heart just dies Beauty divine I hope you'll be mine Open your arms For all time All dressed in white Bringer of light Spend time with me All through the night Beauty divine Your tears taste like wine Come to me For all time My spine shivers with the touch of your lips... My pale skin turns red when we kiss... Piercing your nails deep into my back... As I slowly kiss your ivory neck... I started to cry after hours of joyful sin... My tears turned to roses as they embraced your skin... I gathered them to a bouquet of the most beautiful flowers... A bouquet of the most secret and ancient powers... My amber heart started to glow as I died really slow...
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Pharmacological interventions for ADHD
Pharmacological treatments and ADHD: Key learning points
- Should only be initiated by child and adolescent psychiatrist or paediatrician with special training
- Clinicians should measure and record child's height, weight, blood pressure and pulse as a baseline prior to starting any medication
- First line drugs include:
- Methylphenidate (Ritalin, Equasym, Equasym XL, Concerta XL)
- Dexamphetamine (Dexadrine)
- Atomoxetine (Strattera)
- Second line drugs include:
- Antidepressants e.g. TCA's
- Clonidine
- N.B. medication is only one element in a multi-modal treatment plan
When behavioural intervention at home and at school alone is insufficient to reduce core ADHD symptoms and improve educational achievement and peer relationships, a trial of medication is usually indicated. In addition, in the presence of severe ADHD, pharmacological interventions are the treatment of first choice (NICE, 2008).
The American Academy of Child and Adolescent Psychiatry have published a practice parameter for the assessment and treatment of children and adolescents with Attention-Deficit/Hyperactivity Disorder (2007) which gives up to date recommendations on the pharmacological management of ADHD. Additional information relevant to UK practitioners is now available from the National Institute for Health and Clinical Excellence who have produced guidance for the assessment and management of ADHD (see www.nice.org.uk/CG072).
Evidence base for use of medication for ADHD
There is a huge evidence-base to support the use of stimulant medication, at least in the short term, in the management of ADHD with about 75-80% of patients having clinically meaningful benefits (Joughin and Zwi 1999; Greenhill et al. 1999; Lord and Paisley, 2000; Jadad et al. 1999; Swanson et al. 1998).
Stimulant medications available in the UK such as methylphenidate and dexamphetamine act by reducing the core symptoms of hyperactivity, inattention and impulsivity and can also have a beneficial effect on conduct problems, aggression, social skills, academic performance and executive functioning. Beneficial effects in the classroom include a reduction in interrupting, fidgetiness and finger-tapping and an increase in on-task behaviour. In the home setting, stimulants improve parent-child interactions, on task behaviours and compliance. In social settings, stimulants improve peer nomination rankings of social standing and increase attention in sports activities. Despite the efficacy of stimulant medications in improving behaviours, many children who receive them do not demonstrate fully normal behaviour as a consequence. Tricylic antidepressants and atomoxetine offer non stimulant alternatives in the treatment of ADHD. Up to 70% of children show significant improvement when treated with TCA's compared wth 10% with placebo (Biederman et al, 1989).
The multi-modal treatment study of children with ADHD (MTA) has helped to clarify the efficacy of both pharmacological and behavioural interventions and their place in the overall management strategy of children with ADHD (Jensen et al. 1999a; Jensen et al. 1999b). In this study, 597 children with ADHD-combined type were randomly allocated to one of: medication only; an intensive behavioural treatment involving parent, child and school; a combination of the medication and behavioural intervention; and standard community care. Although sizeable reductions were seen in ADHD symptoms over time in all four groups, there were significant differences between the groups in the degree of the change, with the children in the combined medication and behavioural intervention and the medication only groups doing the best of all. Interestingly, the medication only group achieved a greater reduction of core ADHD symptoms than those receiving standard community care, even though most of these latter children were receiving medication. The difference was put down to the careful titration of medication based on close collaboration between parents, teachers and clinicians in the medication only group and this finding is likely to alter clinical practice in this area.
Behavioural interventions thus add little to optimized medication regimes but can be of value in certain individuals. In addition behavioural interventions may reduce the dose of medication required. Children with severe combined type ADHD or hyperkinetic disorder are likely to require a trial of medication, especially if a short trial of behavioural treatments does not lead to any significant improvement. A further analysis of the MTA trial data when broken down into co-morbidity subgroups (Jensen et al, 2001) showed that:
- Children with ADHD and anxiety disorders (but not ODD or CD) were likely to respond equally well to the MTA behavioural and medication treatments;
- Children with ADHD only or ADHD with ODD/CD (but without anxiety disorders) responded best to MTA medication treatments (with or without behavioural treatments), while
- Children with multiple co-morbid disorders (anxiety and ODD/CD) responded optimally to combined (medication and behavioural) treatments.
The National Institute of Health consensus statement on ADHD (National Institutes of Health, 2000) notes that (consistent with MTA findings), combined treatments may offer some modest advantages over medication treatments alone, in particular that lower total daily doses of methylphenidate seem to be effective and that parent satisfaction is higher.
Further information on the clinical effectiveness of methylphenidate in children, adolescents and adults can be found via http://www.rcpsych.ac.uk/traindev/cpd/adhd/drug/mpd8.htm
Additional information on the clinical effectiveness of methylphenidate, dexamphetamine and atomoxetine can be found in the National Institute for Health and Clinical Excellence Review of technology Appraisal 13- methylphenidate, atomoxetine and dexamphetamine for attention deficit hyperactivity disorder (ADHD) in children and adolescents available via www.nice.org.uk/TA098
See also Remschmidt by the Global ADHD working Group (2005) for consensus statement on current best practice in the treatment of ADHD and treatment algorithms for ADHD and associated co-morbidities.
Indications for the use of psychopharmacological treatment for ADHD
According to the European clinical guidelines for hyperkinetic disorder- first upgrade (Taylor et al, 2004, p15) these are as follows:
- The patient meets the DSM-IV criteria for the ADHD syndrome and
- Psychological treatments are insufficient alone or the criteria for the primary use of medication are met i.e. children whose problems are severe enough to receive a diagnosis of hyperkinetic disorder.
The American Academy of Child and Adolescent Psychiatry's summary of the practice parameters for the use of stimulant medications in the treatment of children, adolescents and adults (Greenhill et al, 2001, p.1353) adds that:
- "only those patients with moderate to severe impairment in two different settings should be considered for stimulant treatment. A child with ADHD, predominantly inattentive type, with severe academic problems at school and during homework, may be considered for stimulant treatment, even if his or her peer relationships and family functioning and not otherwise effected".
The National Institute for Health and Clinical Excellence Review of technology Appraisal 13- methylphenidate, atomoxetine and dexamphetamine for attention deficit hyperactivity disorder (ADHD) in children and adolescents available via www.nice.org.uk/TA098 states that
- "The central nervous system (CNS) stimulants methylphenidate and dexamphetamine have been used in the treatment of ADHD for many years. Atomoxetine has been introduced more recently. Clinicians sometimes prescribe tricyclic and other antidepressant drugs, although these has not been licensed for ADHD" (p.6).
Further information on the clinical indications and usage of methylphenidate can be found via http://www.rcpsych.ac.uk/traindev/cpd/adhd/drug/mpd20.htm
Further information to guide the clinician before starting medication for ADHD can be found in the National Institute for Health and Clinical Excellence Review of technology Appraisal 13- methylphenidate, atomoxetine and dexamphetamine for attention deficit hyperactivity disorder (ADHD) in children and adolescents available via www.nice.org.uk/TA098. This states that
- "Where drug treatment us considered appropriate, methylphenidate, atomoxetine and dexamphetamine are recommended, within their licensed indications, as options for the management of ADHD in children and adolescents.
The decision regarding which product to use should be based on the following:
- The presence of comorbid conditions (for example tic disorders, Tourette syndrome, epilepsy)
- The different adverse effects of each of the drugs
- Specific issues regarding compliance identified for the individual child or adolescent by, for example problems created by the need to administer a mid-day treatment dose at school
- The potential for drug diversion (where the medication is forwarded on to others for non-prescription uses) and/or misuse
- The preferences of the child/adolescent and/or his parent or guardian
The document goes on to say that "If there is a choice of more than one appropriate drug, the product with the lowest cost (taking into account cost per dose and number of daily doses) should be prescribed" (pages 4-5).
First line pharmacological options in the treatment of ADHD
(http://www.clinicalevidence.com/ceweb/conditions/chd/0312/0312.jsp). (Ramchandani et al, 2002).
These include the following stimulant medications:
- Immediate Release Methylphenidate (trade names Ritalin and Equasym) - short acting (4 hours). Usually required on a twice or three times daily basis. Maximum dose as per British National Formulary (BNF) is 60mg per day in divided doses. Tablet sizes available: 5mg, 10mg and 20mg. Methylphenidate is usually the first choice drug for ADHD in the UK. It is licensed for use in children over 6 years as part of a comprehensive treatment programme for attention deficit hyperactivity disorder when remedial measures alone prove insufficient (under specialist supervision). It is not recommended for use in children under this age.
- Dexamphetamine (trade name Dexadrine) - short acting (4-5 hours). Usually required on a twice or three times daily basis. Maximum dose as per BNF is 20-40mg per day in divided doses depending on age. Tablet sizes available: 5mg. Some patients who do not respond to methylphenidate will respond to dexamphetamine and vice versa. Dexamphetamine is licensed for use in children over 3 years for narcolepsy and as adjunct in the management of refractory hyperkinetic states in children (under specialist supervision). The BNF does not recommend it is used in children under the age of 6 for hyperkinesia.
- Modified Release Methylphenidate (OROS- methylphenidate. Trade name Concerta XL). Lasts 12 hours. Maximum dose as per BNF is 54mg as a once daily dose at breakfast time. The license may be increased to 72mg daily. Tablet sizes available: 18mg, 36mg. A 54mg tablet is due for release soon. It is licensed for use in children over 6 years as part of a comprehensive treatment programme for attention deficit hyperactivity disorder when remedial measures alone prove insufficient (under specialist supervision). It is not recommended for use in children under this age. The main indications for it's use over and above that of immediate release (IR) methylphenidate are to improve compliance (potentially a problem in secondary school children) and where behaviour deteriorates between doses of IR methylphenidate.
- Modified Release Methylphenidate (Trade name Equasym XL). This formulation is designed to provide ADHD symptom relief during the school day, delivering an initial peak in methylphenidate plasma concentration after 90 minutes. The capsules contain 30% immediate-release methylphenidate and 70% extended-release methylphenidate. Capsule sizes are 10mg, 20mg, and 30mg taken before breakfast. Doses above 60mg are not recommended. It is licensed for use in children over 6 years as part of a comprehensive treatment programme for attention deficit hyperactivity disorder under supervision of a specialist. A small evening dose of immediate release methylphenidate may be given if the effects wear off too early in the evening.The capsules can be opened and the contents sprinkled on food- which can be helpful for children who have difficulty swallowing.
- Prolonged Release Methylphenidate (Trade name Medikinet XL). Total duration of action approximately 8 hours. A 2-stage formulation containing 50% rapid release and 50% delayed-release methylphenidate. Uncoated pellets dissolve within 30 minutes and the coated pellets dissolve 3-4 hours later giving comparable methylphenidate plasma levels in both the morning and early afternoon (if the medication is given in the morning). Capsules should be taken during or after breakfast and can be opened and the contents sprinkled onto suitable food such as stewed fruit or jam. Tablet sizes available are 10mg, 20mg, 30mg and 40mg. Doses above 60mg daily are not recommended or licensed. Licensed for children over 6 years as part of a comprehensive treatment programme for ADHD under supervision of a specialist.
Further up to date information about stimulant medications and other pharmacological treatments for ADHD can be found in the British National Formulary which is updated every 6 months. Clinicians can register to access the contents of the current BNF on line (www.BNF.org).
Single drug options should be considered before combinations of drugs are tried.
Side effects of stimulants such as Methylphenidate, Dexamphetamine and Concerta XL, Equasym XL and Medikinet XL
- Decreased appetite is the most prominent side effect.
- Many children when starting stimulants can become tearful and irritable for a few weeks. This is usually a transitory phenomenon.
In addition to this, but to a lesser extent the following side effects may occur:
- insomnia
- stomach ache
- drowsiness
- dizziness
- headache
- scalp hair loss
- possible cardiovascular risks including sudden death, heart attacks or strokes
Many 'side effects' presented, on further questioning, may actually be found to be present pre-treatment. Use of a stimulant drug side effects rating scale both at baseline (before initiating treatment) and thereafter at each follow up appointment will help distinguish new symptoms from those which were pre-existing. Most of the side effects which do occur are dose related and short term. They often reduce within 1-2 weeks of starting treatment and usually disappear if treatment is discontinued or the dose is reduced. Side effects are more likely to occur in pre-school aged children.
For further information on contraindications, drug interactions and unwanted effects of methylphenidate can be obtained via http://www.rcpsych.ac.uk/traindev/cpd/adhd/drug/mpd21.htm
Psychostimulant side effects and suggested management options
(adapted from SIGN guidelines (2001) - Section 5 pharmacological therapy (http://www.sign.ac.uk/guidelines/fulltext/52/index.html)
Side effect |
Management options |
Anorexia, nausea, weight loss |
Monitor carefully, give medication with meals, give calorie supplements
or snack late in the evening |
Growth concerns |
If significant (rare in long term) or causing parental anxiety,
attempt weekend or holiday medication breaks |
Sleep difficulties |
Monitor carefully, reduce or omit late afternoon or evening medication
(but note that some patients improve with added evening medication) |
Dizziness and headache |
Monitor carefully (check blood pressure). Ensure medication is taken
with meals and encourage fluid intake |
Involuntary movements, tics and Tourette's syndrome |
Reduce or
if persistent discontinue medication, consider alternative (e.g.
TCA) if symptoms are severe * |
Loss of spontaneity, dysphoria, agitation |
Reduce or discontinue medication (discontinue if thought disorder
or psychosis suspected- this is rare) |
Sadness |
The clinician should first re-evaluate the diagnosis, reduce the
dose of stimulant and consider changing to a modified release formulation
(e.g. Concerta XL, Equasym XL) because the peak of immediate release
formulation may be causing more depressive effects. |
Irritability, behavioural rebound |
Monitor carefully, reduce or overlap afternoon dose, consider modified
release formulation (e.g. Concerta XL, Equasym XL or Medikinet XL ), revaluate for
co-morbidity (ODD/CD) |
* Also consider converting to atomoxetine
Contraindications to use of psychostimulants:
- Schizophrenia
- Hyperthyroidism
- Cardiac arrythmias
- Angina pectoris
- Glaucoma
- Previous drug hypersensitivity
Caution is required where the following co-exist:
- Hypertension
- Depression
- Tics (or family history of Tourette's syndrome)
- Autistic spectrum disorder
- Severe mental retardation
- Epilepsy
- History of drug dependence or alcoholism
Prescribing guidance for controlled drugs
Clinicians are reminded that all formulations of Methylphenidate and Dexamphetamine are controlled drugs and prescriptions should be written out in accordance to the relevant requirements (see current version of British National Formulary for further up to date guidance on prescribing controlled drugs).
Summary of guidance on writing prescriptions for controlled drugs (BNF: 49, March 2005)
- Prescriptions should be written in ink, must be signed and dated by the prescriber and specify the prescriber's address.
- Prescriptions should state in the prescriber's own handwriting:
- The name and address of the patient;
- In the case of a preparation, the form and where appropriate, the strength of the preparation;
- The total quantity of the preparation in both words and figures;
- The dose.
Dose equivalents of the Methylphenidate, Dexamphetamine, Equasym XL and Concerta XL
Immediate Release Methylphenidate dose |
Equivalent dose of Concerta XL |
Equivalent dose of Equasym XL |
Equivalent dose of dexamphetamine |
5mg twice or three times daily |
18mg once daily at breakfast time |
10mg once daily |
2.5mg twice or three times daily |
10mg twice or three times daily |
36mg once daily at breakfast time |
20mg once daily at breakfast time |
5mg twice or three times daily |
15mg twice or three times daily |
54mg once daily at breakfast time |
30mg once daily at breakfast time |
7.5mg twice or three times daily |
20mg twice or three times daily |
72mg once daily at breakfast time N.B. above BNF recommended limit currently |
40mg once daily at breakfast time |
10mg twice or three times daily |
Non stimulant drugs used as first line treatments for ADHD.
Atomoxetine HCL (Strattera) Atomoxetine has been shown to be comparable to methylphenidate on core symptom efficacy (Heilengenstein et al, 2000). It is the first non stimulant to be licensed for ADHD in the UK and is licensed for the treatment of ADHD in children of 6 years and older and adolescents. It is also licensed in adults who were diagnosed with ADHD as children or adolescents. It should be initiated by a specialist physician experienced in managing ADHD. Atomoxetine is a non-controlled, highly selective noradrenaline re-uptake inhibitor (NRI). It is a once daily preparation. It is available as 10mg, 18mg, 25mg, 40mg and 60mg capsules. The starting and maintenance dose of Atomoxetine is determined by the child's weight (see section on starting Atomoxetine)
Side effects of Atomoxetine
Side-effects are generally mild-moderate and transient. The most common are:
- Somnolence
- Loss of appetite
- Nausea
- Vomiting
- Irritability or agitation
- Increased risk of suicidal thoughts and behaviour
- There is also a risk of rare, but sometimes severe, hepatic disorder estimated at below 1 in 50,000 patients treated
- Sexual dysfunction i.e. erectile and ejaculatory dysfunction and dysmenorrhoea
Patients who experience side effects when taking atomoxetine as a single daily dose may benefit from taking it as twice daily evenly divided doses in the morning and late afternoon/ evening.
Calculating the correct dose of Atomoxetine
For children and adolescents less than 70kg body weight |
0.5mg/kg/day |
1.2mg/kg/day |
1.4mg/kg/day or 100mg (which ever is less) |
Approximate starting dose (minimum of 7 days) |
Daily target dose |
Maximum total daily dose evaluated for safety(after an additional 2-4 weeks) |
For children and adolescents over 70kg body weight |
Approximate starting dose is 40mg (taken for a minimum of 7 days) |
Daily target dose is 80mg /day |
Maximum total daily dose evaluated for safety |
Other drug groups as second or third line pharmacological options in the treatment of ADHD:
These are unlicensed and their usage should be restricted to specialist practitioners. They include:
- Tricyclic antidepressants
- Buproprion
- Clonidine
- Guanfacine
- Venlafaxine
- SSRI's
- Neuroleptics e.g. risperidone
Tricylic antidepressants (TCA's)
In the past TCA's have been widely used as a non stimulant alternative in the treatment of ADHD. Recent concerns about the potential for overdose e.g. accidentally in younger siblings, the necessity for ECG monitoring and the availability of longer acting stimulants and atomoxetine seem to have reduced their popularity in recent years. TCA's have a narrower margin of safety than psychostimulants and a wider range of potential side effects. TCA's used in the treatment of ADHD include: imipramine, desipramine, amitriptyline, nortriptyline and clomipramine. TCA's are usually considered when stimulants have been ineffective or have made tics wore. None of the tricylic antidepressants are licensed for use in ADHD.
Side effects of TCA's
- Loss of appetite
- Dry mouth (with a sour metallic taste)
- Dizziness
- Drowsiness
- Lethargy
- Insomnia
- Potential cardiotoxicity
- Anxiety
- Blurred vision
Clonidine is an alpha-2-noradrenergic agonist which acts presynaptically to reduce noradrenaline release. It tends to be used when stimulant medications or tricyclic antidepressants have been ineffective or are contra-indicated. Clonidine is not licensed for use in ADHD. Usage of clonidine tends to be based upon clinical experience and expert opinion as the evidence base for it's use is quite poor (Ramchandani et al, 2002) ( http://www.clinicalevidence.com/ceweb/conditions/chd/0312/0312.jsp). The National Institute for Health and Clinical Excellence guidelines on diagnosis and management of ADHD in children, young people and adults ( 2008, p.35, www.nice.org.uk/CG072 ) suggest that before starting clonidine treatment for ADHD, a cardiovascular system examination and ECG should be carried out.
Side effects of clonidine:
- Postural hypotension
- Fatigue, sedation or drowsiness
- Yawning
- Depression
- Cardiac arrhythmias
Contraindications to clonidine include:
- Cardiac arrhythmias
- Depression
Caution in:
- Renal impairment.
Adjunctive pharmacological treatments sometimes used in children and young people with ADHD.
Melatonin is prescribed widely by child psychiatrists and paediatricians in the UK. The main indication is for children with sleep-wake cycle disorders including those that co-occur with ADHD. It can also be used to relieve the insomnia side effect of stimulant medication. Prior to prescribing, the clinician should have paid attention to the child's sleep hygiene (e.g. advising measures such as a fixed bedtime routine, a quiet bedroom, a warm bath before going to bed, physical affection and avoiding watching exciting films or playing on computer games before bed) and have considered implementing a behaviour management programme.
Armour and Paton (2004) identified five placebo-controlled studies and several case studies examining the use of melatonin in the treatment of insomnia in children and adolescents. These studies tended to focus on children with learning disabilities including those with Rett's syndrome and autism as well as in children with visual impairment. A few children in the studies were also taking methylphenidate as treatment for ADHD. They concluded that melatonin reduces sleep latency, but does not consistently improve other aspects of sleep disturbance. Safety, particularly in the medium-and long-term, is poorly evaluated; short term concerns include exacerbation of epilepsy and asthma.
Melatonin cannot currently be recommended for routine long term use and it is not licensed in the UK.
The optimal dose is unknown. Reported studies have used a dose of between 2.5 - 25mg (1-2mg for infants) of the fast release formulation (a slow release formulation is also available). Infants are usually started on 1mg - 2.5 mg and older children on 2.5mg - 5mg. The usual reported dose seems to be between 5-10mg of the fast release formulation given 30 - 60minutes before bedtime. Improvement in sleep can occur within days but may take weeks. Depending on the response during the first few days and weeks, the dose can be adjusted to find the optimal amount. Once improvement in sleep pattern has occurred it may be possible to withdraw melatonin or at least reduce the dose. The lowest effective dose should be sought and treatment should be stopped at least once a year (e.g. in the holidays) to find out if the sleep problem has been cured in the meantime (Smits et al, 2001).
Side effects reported:
- Short term side effects such as headaches, drowsiness, confusion, nausea, tachycardia and pruritis are few and it is difficult to know if these are really due to melatonin.
- Increased seizure frequency in neurologically disabled children. It is not known whether seizure threshold is affected in the general population.
- Potential to increase symptoms in asthmatics
- Contraceptive properties which may affect the onset of puberty
- Long term safety of melatonin is still to be established
Parents should be warned of the uncertain long-term effects on growth and sexual maturation. Height and weight baselines should be established with monitoring every 6 months. This is in line with routine medication monitoring intervals for other medications which may be prescribed for children and young people with ADHD.
"Further information to guide the clinician before starting medication for ADHD can be found in the National Institute for Health and Clinical Excellence's: Final Appraisal Determination. Methylphenidate, atomoxetine and dexamphetamine for attention deficit hyperactivity disorder (ADHD) in children and adolescents via http://www.nice.org.uk/page.aspx?0=260402. This states that
The decision regarding which product to use should be based on the following:
- The presence of comorbid conditions (for example tic disorders, Tourette syndrome, epilepsy)
- The different adverse effects of each of the drugs
- Specific issues regarding compliance identified for the individual child or adolescent by, for example problems created by the need to administer a mid-day treatment dose at school
- The potential for drug diversion (where the medication is forwarded on to others for non-prescription uses) and/or misuse
- The preferences of the child/adolescent and/or his parent or guardian
The document goes on to say that "If there is a choice of more than one appropriate drug, the product with the lowest cost (taking into account cost per dose and number of daily doses) should be prescribed".
Useful web based sources of information on pharmacological treatment of children with ADHD (see also after sections on starting medication and ADHD and co-morbid disorders)
- Royal College of Psychiatrists ( http://www.rcpsych.ac.uk/traindev/cpd/adhd/therapy.htm) The Royal College of Psychiatrists has just launched a detailed online knowledge base containing information on the pharmacological treatment of Attention Deficit Hyperactivity Disorder (ADHD). The Therapy section contains information on pharmacological treatments (graded), available guidelines, algorithms and protocols, and drug therapy with methylphenidate.
- Attention Deficit and Hyperkinetic Disorders in Children and Young People. Sign Publication No.52 ( http://www.sign.ac.uk/guidelines/fulltext/52/index.html)
- The Children's Medication Algorithm website (CMAP) has tactics tables for the use of: stimulants, tricylic antidepressants, bupropion, alpha agonists and SSRI's. ( http://www.dshs.state.tx.us/mhprograms/adhdpage.shtm)
- Clinical Evidence. This is a BMJ publication. In the child health section is a section on ADHD (Ramchandani et al, 2002). Treatments for ADHD including methylphenidate, dexamphetamine, clonidine, psychological and behavioural treatments are evaluated and categorized according to the evidence on their benefits and harms. The information can be accessed via http://www.clinicalevidence.com/ceweb/conditions/chd/0312/0312.jsp.
- National Institute for Health and Clinical Excellence Review of technology Appraisal 13- methylphenidate, atomoxetine and dexamphetamine for attention deficit hyperactivity disorder (ADHD) in children and adolescents available via www.nice.org.uk/TA098
- National Institute for Health and Clinical Excellence (www.nice.org.uk/CG072).
- Further up to date information about stimulant medications and other pharmacological treatments for ADHD can be found in the British National Formulary which is updated every 6 months. Clinicians can register to access the contents of the current BNF on line (www.BNF.org).


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All content below is taken in its entirety from the CDC Shingles Vaccine Information Statement (VIS): http://www.cdc.gov/vaccines/hcp/vis/vis-statements/shingles.html
CDC review information for Shingles VIS:
Content source: National Center for Immunization and Respiratory Diseases
Shingles is a painful skin rash, often with blisters. It is also called Herpes Zoster, or just Zoster.
A shingles rash usually appears on one side of the face or body and lasts from 2 to 4 weeks. Its main symptom is pain, which can be quite severe. Other symptoms of shingles can include fever, headache, chills and upset stomach. Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitits) or death.
For about 1 person in 5, severe pain can continue even long after the rash clears up. This is called post-herpetic neuralgia.
Shingles is caused by the Varicella Zoster virus, the same virus that causes chickenpox.
Only someone who has had chickenpox -- or, rarely, has gotten chickenpox vaccine -- can get shingles. The virus stays in your body, and can cause shingles many years later.
You can't catch shingles from another person with shingles. However, a person who has never had chickenpox (or chickenpox vaccine) could get chickenpox from someone with shingles. This is not very common.
Shingles is far more common in people 50 years of age and older than in younger people. It is also more common in people whose immune systems are weakened because of a disease such as cancer, or drugs such as steroids or chemotherapy.
At least 1 million people a year in the United States get shingles.
A vaccine for shingles was licensed in 2006. In clinical trials, the vaccine reduced the risk of shingles by 50%. It can also reduce pain in people who still get shingles after being vaccinated.
A single dose of shingles vaccine is recommended for adults 60 years of age and older.
A person should not get shingles vaccine who:
Someone with a minor acute illness, such as a cold, may be vaccinated. But anyone with a moderate or severe acute illness should usually wait until they recover before getting the vaccine. This includes anyone with a temperature of 101.3°F or higher.
A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. However, the risk of a vaccine causing serious harm, or death, is extremely small.
No serious problems have been identified with shingles vaccine.
Mild problems
Like all vaccines, shingles vaccine is being closely monitored for unusual or severe problems.
What should I look for?
Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination.
What should I do?
VAERS is only for reporting reactions. They do not give medical advice.
Vaccine information statement: Shingles vaccine. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/vaccines/hcp/vis/vis-statements/shingles.pdf . Accessed March 5, 2014.
David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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Childress and WorthyUpdated September 6, 2000 |
Lee Childress 2006 - 33rd Street #1 Everett, WA 98201-4475 United States (425) 258-5049 email@example.com |
Edit Your Page |
Surnames in my family tree includes Childress, Worthy, Rodgers, Weeks, Burgess, Grantland, Cook, Rosson, Green, Dobbins, McCoy, Kirby, Lowe, et al. Most of these families migrated from the Virgina area thru either the Tennessee River Valley or thru Georgia to Northeast Alabama then westward to Arkansas, Texas & Oklahoma by the early 1900's. A few names are as far North as Kentucky, but most center around Jackson, DeKalb & Cullman counties of Alabama, Knox & Blount counties of Tennessee, and Upson county, Georgia. I have a deadend with my paternal grandmother Annie Mae Weeks that any help would be appreciated. Marriage certificate of 1917, Jackson Co, AL states she was 17 and an orphan aat that time. She had at least 2 brothers & one sister, Elsie who died in Oklahoma, location and married name unknown. Supposedly, this family came from the Mobile area, but I cannot find any census records for them. |
The content shown on this page has been submitted by a Genealogy.com customer, and is not subject to verification by Genealogy.com. Neither Genealogy.com nor its affiliates are responsible for the accuracy of any information contained on this page. The opinions expressed on this page are the author's alone and not the opinions of Genealogy.com.
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Hitler. The Unabomber, Manson, Castro and Osama bin Laden. These people are insane.
read more
Osama goes green. In his latest audiotape mass murderer Osama Bin Laden lashes out at the US for global warming. The AP reported: Al-Qaida leader Osama bin Laden has called in a new audiotape for the world to boycott American goods ... Read Post
Billboards posted on the Eisenhower Expressway (I-290) near Maywood, Ill., liken those who believe in global warming to Ted "Unabomber" Kaczynski, Charles Manson and Fidel Castro. [ more › ] Read Post
That billboard that you're looking at above is a real billboard. It's actually on display right now, over the Eisenhower Expressway in Chicago — according to the Guardian — courtesy of the Heartland Institute. That's Ted Kaczynski, ... Read Post


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Three movies filmed by Subhash V.K. were premiered in the Marche du Film section in this year's Cannes Film Festival.
From Vypeen to Cannes, Subhash V.K. has surely come a long way. Self-trained, Subhash has had to rough it out. Starting out as a videographer of weddings and other functions, Subhash has evolved into one of the most sensitive cinematographers in the film industry.
Subhash has cranked the camera for three of Rupesh Paul's films that were premiered in the Marche du Film section in this year's Cannes Film Festival. The three films – 'Pithavum Kanyakayum', 'Janthu' and 'Kanni' – have won rave reviews for its candid cinematography.
Movies for thought
"The theme and treatment is something that will make you ruminate. The first one is in Malayalam and talks about a middle-aged man who spends the night with a girl who happens to be his daughter's classmate. 'Janthu' is in the Adiya tribal language. 'Kanni' is a Tamil film that I have shot using a Canon 70 still camera. I think this is the first time a full, 90-minute, feature film, has been shot using a still camera. The result has been amazing," says Subhash who has also scripted and directed some hard-hitting micro, short and documentary films.
Armed with nothing, not even professional equipment of his own, except perhaps a will to work and oodles of confidence, Subhash has had to slog it out in a fiercely competitive field.
The turning point was finding the right 'guru'. He joined veteran cameraman Vipin Dass as assistant and worked in some of his projects. "What I learned from him was invaluable. In between I also worked with Sunny Joseph, M.J. Radhakrishnan and others, which helped me gain a lot of experience."
He got his first full-length commercial film – 'Oliver Twist'. "It was a very satisfactory work but unfortunately the film has not been released yet."
Micro films
Perhaps the most creative of his works are the micro films he has made. Four of his films were screened and won awards at various international micro film festivals. These films, of approximately three minutes each, have sharp themes that hit you like a sledge-hammer. The most striking of them is 'Balimrugangal', on a festival of the Nishi tribes of Arunachal Pradesh where they have a brutal ritual of killing a Mithun, a semi-domesticated animal. The killing dissolves into a collage of newspaper cuttings on genocide in our country. 'Teacherless Classrooms' is on the attempt of tribal students in a remote village of Jharkhand to study.
"Both these films were developed from what I shot during my travels for other projects. The other two – 'Athirukal Illaathakunnathu' and 'Prey and Hunter' – shot nearer home took me a lot of time and took me to the edge of my patience."
Before focussing on a career with the movie camera, Subhash had ventured a lot in the field of still photography, even attempting to specialise in fashion.
'Shaan-e-Hindustan', a music video album on Sachin Tendulkar shot in various locales and based on a song in 20 languages, and a documentary 'Kadamakudi: The Dying Islands' were widely lauded. He also shot the music album 'Polu Hotu' (Moonlight) directed by Prabhul Gopinadh in Nyshi language of Arunachal.
Recently, Subhash has worked on two important documentaries – 'Akkitham' a 54-minute film on eminent poet Akkitham Achuthan Namboodiri, scripted and directed by G. Prabha and 'Making of a Maestro' on Kalamandalam Gopi. "The first one has already been screened. The second one is in its post production stage. Scripted and directed by Meena Narayan, it is essentially a docu-fiction."
Subhash, who did not pursue studies after his pre-degree, now lectures on cinematography and multi-media in various colleges in the State, Loyola College, Chennai, and S.N. College, Coimbatore.
Among his forthcoming projects are Kasturi Raja's Tamil film and Suresh Gopi's 'Ring Tone', where he has worked on the second unit. Then there is his dream project: "a film of my own. The story is ready, a rough script too. I have formed the visuals in my mind. I'm on the lookout for a producer".
Keywords: Subhash V.K., Cannes Film Festival, Pithavum Kanyakayum, Janthu, Kanni, Malayalam cinema


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Start Date: Mar 01, 2009
End Date: Feb 28, 2010
Eleven (11) of the most promising recombinant M. paratuberculosis proteins (MAP0865, MAP0857c, MAP3817c, MAP3155c, MAP2077c, MAP3761c, MAP4014, MAP2166c, MAP3735c, MAP0900 and MAP1272c) will be evaluated by ELISA using a set of well-defined Johne's disease-infected cattle sera as well as sera from control cattle. Additional recombinant proteins may be selected and screened based on preliminary data on antigenicity and specificity. Methodologies that will be used in this project include genomic and bioinformatics analysis techniques, immunological assays (Western blot and ELISA), and molecular cloning, as well as recombinant protein expression and purification, diagnostic test development and optimization. Proprietary PRIONICS ELISA technology will be used in this project, as well as a process for mass production of recombinant proteins developed by ARS.


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Sights From the Soggy Tax Day Tea Party in Fort Lauderdale
Categories: Politics
Michael J. Mooney |
I went to the same event last year, and there was considerably less fervor this year. And less hysteria. There were plenty of people selling T-shirts, plenty of people eating hot dogs and protesting health-care reform from lawn chairs, a brass band playing in the rain, and a lot of horses' asses. There was not, however, an enormous amount of racism or horribly misspelled signs.
Michael J. Mooney |
Sponsor Content


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Pack 1099 needs to develop a Committee to Schedule and run our Cubmobile Race 2011.
While boys get to race cars that they carved in the Pinewood Derby, the boys actually get to drive the Cubmobiles.
These wooden cars use gravity to race down the hill in the Settles Bridge Parking lot. Each boy will get to race again and again all afternoon.
The event starts out with a Best-in-Show competition to select the best looking cars.
Next, the boys take turns drag racing down the hill to see who is the fastest.
Location: Dobbs Creek Park in Cumming, 875 Dahlonega Hwy Cumming GA 30040
Fee Structure
Early Regsitration by 10/30 - $5
Regular fee by 11/14 - $7
On-site fee - $10 Per Scout
See the Registration Forms
Each boy is required to wear their uniform, closed-toe shoes, and a helmet (bicycle helmet is best). More Rules and Regulations
See Cubmobile plans to build a Cubmobile.
(updated 10/20/2010)


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Will This Downgrade Hurt Perrigo (PRGO) Stock Today?
Story updated at 9:55 a.m. to reflect market activity.
NEW YORK (TheStreet) -- Perrigo (PRGO - Get Report) was downgraded to "outperform" from "top pick" by RBC Capital Thursday.
Perrigo gained 0.3% to $130.98 in morning trading.
The firm set a price target of $160 for the company. Perrigo lacks near-term catalysts according to RBC Capital analysts.
Must read: Warren Buffett's 10 Favorite Growth Stocks STOCKS TO BUY: TheStreet Quant Ratings has identified a handful of stocks that can potentially TRIPLE in the next 12 months. Learn more. -------------- Separately, TheStreet Ratings team rates PERRIGO CO PLC as a Buy with a ratings score of B. TheStreet Ratings Team has this to say about their recommendation: "We rate PERRIGO CO PLC (PRGO) a BUY. This is driven by a number of strengths, which we believe should have a greater impact than any weaknesses, and should give investors a better performance opportunity than most stocks we cover. The company's strengths can be seen in multiple areas, such as its revenue growth, largely solid financial position with reasonable debt levels by most measures, expanding profit margins and solid stock price performance. We feel these strengths outweigh the fact that the company has had sub par growth in net income." Highlights from the analysis by TheStreet Ratings Team goes as follows:- The revenue growth came in higher than the industry average of 2.3%. Since the same quarter one year prior, revenues rose by 10.9%. This growth in revenue does not appear to have trickled down to the company's bottom line, displayed by a decline in earnings per share.
- The current debt-to-equity ratio, 0.39, is low and is below the industry average, implying that there has been successful management of debt levels. To add to this, PRGO has a quick ratio of 1.51, which demonstrates the ability of the company to cover short-term liquidity needs.
- 43.25% is the gross profit margin for PERRIGO CO PLC which we consider to be strong. It has increased from the same quarter the previous year. Regardless of the strong results of the gross profit margin, the net profit margin of -8.79% is in-line with the industry average.
- PERRIGO CO PLC has experienced a steep decline in earnings per share in the most recent quarter in comparison to its performance from the same quarter a year ago. This company has reported somewhat volatile earnings recently. But, we feel it is poised for EPS growth in the coming year. During the past fiscal year, PERRIGO CO PLC increased its bottom line by earning $4.67 versus $4.18 in the prior year. This year, the market expects an improvement in earnings ($6.61 versus $4.67).
- Compared to where it was a year ago today, the stock is now trading at a higher level, regardless of the company's weak earnings results. Looking ahead, the stock's rise over the last year has already helped drive it to a level which is relatively expensive compared to the rest of its industry. We feel, however, that the other strengths this company displays justify these higher price levels.
- You can view the full analysis from the report here: PRGO Ratings Report
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Gluten free and loving it.
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Find out which of your favorite Special K® products are now gluten free.
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text: MPN: W90RUP EAN: 5012512131016 Bring your carpets back to life with the Vax W90-RU-P Rapide Ultra 2 carpet washer.Revive colours and remove stubborn dirt from heavy traffic areas with Vax's Dual V technology and rotating brushbar – it's cheaper than buying new carpets! The Vax W90-RU-P Rapide Ultra 2 carpet washer features PowerJet technology that powers water jets to loosen dirt while a rotating brushbar reaches deep into carpet fibres for a really effective clean. As well as looking after you carpets, you can also use this versatile Vax carpet washer to clean upholstery and sucks up spills. The Vax W90-RU-P Rapide Ultra 2 carpet washer features a large 4.5-litre clean water capacity and a 3-litre dirty water capacity, so you can clean a large carpet quickly without a lot of maintenance. This powerful Vax carpet cleaner also comes with Ultra Plus cleaning solution and a pre-treatment kit for use on stubborn stains before you wash. Useful info:


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HS2 to bisect Burton Green village in Warwickshire
The route for the proposed £17bn high speed rail route between London and Birmingham goes through the village of Burton Green, near Kenilworth, Warwickshire.
It follows a disused railway line and cuts across Cromwell Lane. Amendments have already been made and the line will go through a tunnel where it is close to houses.
Felicity Davies' home lies within sight of the route.
She has taken part in anti-HS2 protests and said: "Sometimes when I think about it, it makes me feel physically ill."
One of her greatest concerns is that it could destroy The Greenway - a tree-lined walkway that follows the line of a disused railway track - which currently bisects the village.
The former Woodland Trust member said: "The Greenway is beautiful, I take my granddaughter walking down there and it has to be preserved for the next generation.
"We could lose that, and all for what? To save 20 minutes on a journey you could make on the Chiltern Line anyway.
"I don't like change though, that's my problem."
'Not affected'Her husband Keith said he took a different view.
"You'll still be able to go walking there, it's not going through all of it, just one section and it won't really be affected anyway because they are going to build a tunnel beneath it.
"Most of the people around here will be dead before it is up and running so in a way, it doesn't make any difference," he added.
Richard Smith, a 39-year-old arable and beef farmer, has lived at Burton Green Farm his entire life.
He said he was not worried about the effect on the village but the high-speed rail plan duplicated existing services for little extra benefit.
"I can see the point for commuters during Monday morning rush hour, but who are all these people who are supposed to be taking this the rest of the time? They reckon there will be a service running every four minutes or so. I can't see that happening.
"Perhaps if it ran from Birmingham to France and linked up with the Channel Tunnel to the rest of Europe, then it would be worth it but for shorter journeys, I can't see the point."
Accountant Steve Kingman, 47, lives further along Cromwell Road. His firm has offices in Coventry, Birmingham and London, which should make him one of HS2's target customers, except that he too will not be using it.
He said: "My company wouldn't pay those prices for me. It might help politicians with their MPs' expenses to zip around the country but companies and the rest of us are going to want to take cheaper travel options.
"I travel less business-wise than I used to now that I can video conference and use emails and telephone conferencing. When I have to travel I don't mind the extra 20 minutes, because I can work on my laptop."
Through gardenA few doors down, 63-year-old John Levett has made his views on the subject clear for all to see, prominently displaying "Say No to HS2" banners on his house and garage.
BBC Midlands science & environment correspondent David Gregory
You can make environmental arguments both for and against HS2.
The problem really comes when you try to get a detailed understanding of the positive or negative environmental impacts of the scheme because to be honest we just cannot know at the moment.
For the most part, rail travel compares very favourably to road and air travel in terms of emissions.
But what about pollution from high speed rail compared to traditional trains? HS2 will need much more power than a traditional train and is likely to produce perhaps twice as much in terms of emissions.
In the end you can say the train remains the green option, but the extra speed in HS2 comes at a cost.
But the actual construction of the route and the trains carries an environmental cost too. I've yet to see any really convincing numbers showing what that might involve, there are just too many variables.
The government has revealed it will be planting some two million trees along the route which certainly carries an environmental benefit. But not enough of one to convince those who oppose the scheme that the environmental sums add up in HS2's favour.
He is a member of the Burton Green HS2 Action Group and said he was sceptical of the business need for the link.
He said he did not believe it would bring new jobs to the West Midlands, because the French equivalent had not solved Lille's unemployment. He said this was still higher than in most other parts of France despite the arrival of high speed rail.
The experience of campaigning against the plans has left him wholly disillusioned with the democratic process in England too, he said.
"Once it's installed it probably won't be too bad, I imagine it will be quite liveable because of the tunnel, it's the construction phase that will be awful," he added.
Mr Levett had hoped to downsize but said he held out no hope for selling his house because of the HS2 plans.
Despite being vehemently against it he said: "In a way I hope that it does go through my garden because if it goes through part of your property you can get the government to buy the whole plot. That's probably the only way we are going to be able to move now."
Some estate agents believe the development could help home owners in the neighbouring village.
Anita McKeogh, director of Connells Estate Agents in nearby Balsall Common, said: "For those who live too close to the line it will have a negative impact on their ability to sell, but for other people in Balsall Common I think it could help house prices.
"Homes have been selling well here and we had a good year last year.
"People want to buy here because of the good schools, it's close to the motorway and close to the train stations too.
"You can get to Birmingham from Berkswell train station in 15 minutes and then pick up the high speed rail, so yes, it could make it more desirable to have better rail connections."


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News Release 159
Boone County Regional Sewer District receives $12.2 million loan for wastewater improvements
Volume 39-159 (For Immediate Release)
For more information: 573-751-1010
The Missouri Department of Natural Resources has awarded the Boone County Regional Sewer District a $12.2 million low-interest loan for two sewer improvement projects.
The Rocky Fork Sanitary Sewer improvement project includes closing treatment plants within the project area and constructing a centralized facility to treat the sewage. The Route HH Sanitary Sewer improvement project will include closing local treatment plants within the project area and constructing a pressure collection system to move the sewage to Columbia's sanitary sewer collection system.
Funding for the loan comes from the Missouri Clean Water State Revolving Fund. The fund provides assistance to communities with wastewater infrastructure needs. This funding will help the district protect residents and the environment by making necessary wastewater improvements.
The Department of Natural Resources' Water Protection Program will administer the loan funds and is committed to working closely with communities to assist with funding efforts that support water and wastewater infrastructure improvement projects as well as provide a financial savings.
For more information, visit the department's Water Protection Financial Assistance Center online at www.dnr.mo.gov/env/wpp/srf.


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Found the same room at a different price? Tell us, and we'll offer to match it.
Hotel Veneto Palace Roma
Very close to main bus routes and subway, leading you quickly to the Coliseum and the Vatican City, and nearby the main train station, where even the airport shuttles stop, the Hotel Veneto offers the highest standard in hotel comfort and technology. Rich in architectural and decorative details the hotel guaranties a pleasant and relaxing stay.
All 70 rooms consist in multifunctional classic rooms, suitable deluxe rooms and splendid junior suites for special occasions and come with refined beds with handcrafted headboards. Wi-Fi throughout is free.
Tours, museum tickets, restaurant reservations, car rentals and transfers can be arranged by the concierge service. Hotel Veneto Palace serves a sweet and savoury american buffet breakfast daily.


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Vijay has not received any gifts yet
Hey V, sounds Great ! Call me when you have a minute to discuss plans.
I belong to Braemer Country Club and have courts where I live.
Ira 310 409-5018
hey vijay,
avail weeknites around LA area.
can also play @ valley area, on weekends.
© 2015 Created by Mark / The Mayor.


text:
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February 24th, 2015
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MJM is THE best online magic store that I've every shopped at. Their prices are the lowest around and their shipping is unbelievably fast. In...Read More ->
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text: Prison Rabbit gamesBookmark the permalink. Release date: Oct 5th, 2011 Price: Free Version: 1.9 Seller: Zgame Inc. Buy Now STP SCORE: Not yet reviewed Description Related Games SXPD Metal Slug Defense Godzilla – Smash3 WreckMan: Rise of a Hero Warhammer 40,000: Carnage The Amazing Spider-Man 2 Monument Valley Threes! Bardbarian RoboCop


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Birthdate - June 12, 1945
FAST FACTS * Owned Shirley Feed & Supply, which he sold to work as an unpaid assistant to Dennis Brida. * Also credits trainers Everett Pratt and Tom Miles for helping him make the transition from retail to thoroughbred training. * Started breeding and owning racehorses in 1983; saddled his first starter as a trainer in 1994. * Sent out Dr. Kure All to a pair of dead-heat victories during a 27-day span in 1994
Meese Rocks: Broadway (2011); Iroquois (2010); Union Ave. (2010)
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A new Quest for fun
By ELIZABETH GOLDEN
The Center for Health Improvement at Hays Medical Center is attempting to help children turn off the television and walk, bike, run or play this summer.
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By ELIZABETH GOLDEN
The Center for Health Improvement at Hays Medical Center is attempting to help children turn off the television and walk, bike, run or play this summer.
The second annual Kids Quest rewards children in pre-kindergarten through eighth grade for staying active.
The goal is 30 miles. Rewards are given as the child hits a milestone. Prizes include fruit from Dillons, a smoothie from CHI, a pool pass for Hays Aquatic Park or a salad from McDonald's.
"It's an incentive to get kids active throughout the summer," said Jonna Dinkel, youth coordinator at CHI. "They reach a new destination and are able to get a prize. The prizes are all healthy to encourage healthy lifestyle choices. We wanted sponsors who offered some sort of health benefit."
Throughout the summer, participants are on their own to complete the 30 miles. An hour of activity equals 1 mile. More than 150 children are registered. Kids Quest resembles a program in Columbia, Mo., where Dinkel and Kelly Flaska, aquatic and fitness supervisor, first saw the idea.
"This was necessary to keep kids healthy during summertime," Flaska said. "They lose a lot of activity levels because they're sitting at home. Then school starts, and it's that much harder for them to get active. So, we saw the idea for the program and decided to make it our own."
The program is free to participate, and children can register at any time before Aug. 7.
"My favorite part is seeing the kids just moving and enjoying it," Flaska said. "And the thing is, it's the kids who really want to do it. Some of the parents said it also helped them stay active, and that's really what our goal is."
"We want to make it a family affair, so they're thinking about moving more. If you instill active activity in kids now, they're going to be a lot more likely to be active as they get older."


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Rowe receives culinary arts certificate
Written by Staff Reports Saturday, November 24, 2012 12:00 pm
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CAPE MAY COURT HOUSE ŌĆō Justin Rowe of Rio Grande received a certificate from the Academy of Culinary Arts at Atlantic Cape Community College Nov. 14.
He received a certificate during an awards ceremony in CaremeŌĆÖs, the student-run gourmet restaurant at the Academy.
The noncredit culinary arts training program was for five months, and Chef Jon Davies of Cape May, an adjunct instructor, taught the course.
The next course begins Monday, Jan. 7, at Atlantic CapeŌĆÖs Cape May County Campus, 341 Court House-South Dennis Road, in Cape May Court House. Restaurateurs can sponsor a employee with a scholarship for the program.


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Colbert and Fallon had a huge ice cream battle last month over their flavors. If you missed it, you can watch it here.
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The four glass reinforced fins are adjustable forward and back for a loose or tight ride on the CWB Kink wakeboard. Double wing tail sits deeper in the water, and large center spine offers softer landings. System 80 core is dampening and durable. Nexus base with flex material. Subtle 3-stage rocker. Kink 134: 52.8"L x 16.9"W. Weighs 7.7 lbs. For riders up to 155 lbs. Kink 140: 55.1"L x 16.9"W. Weighs 7.9 lbs. For riders over 145 lbs. Kink 146: 57.5"L x 17.0"W. Weighs 8.1 lbs. For riders over 165 lbs.Venza Boots have a thick EVA footbed with lace adjustment and lycra-lined molded heel and toe. Dual gorilla grips. Light, functional, and simple. Men's sizes: S/M(5-8), L/XL(9-12), 2XL(12-14).


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Dragon Scroll : Mobox Labs is set to launch its new title on the iTunes Store in Q1 of 2013. View Teaser: http://youtu.be/A8NUaeKBMIA A true warrior is the one who is capable to understand the quests of life in every situation. Find the warrior within yourself. Inspired from pool, Dragon Scroll gives you a striker marble and your aim is to collect all the target marbles on the screen. There will be obstacles, some you must avoid and some you may use. **5 Different worlds. **Over 180 Levels and 40 game elements that will test your skills. **Game Center, Challenges, iOS 6 features **Multiplayer **Custom Levels **Hidden Levels How to Apply? Step 1 : Like our Facebook page : www.facebook.com/moboxlabs Follow us on Twitter : www.twitter.com/moboxlabs Join our testing team on TestFlight : http://tflig.ht/Xup7MF If you are selected ? Give us 5 pointer feedback for:- 1. What did you not like about the game? 2. What did you like about the game? 3. Top 5 suggestions to improve the game ? Lastly, tweet about the game when the game goes live with @moboxlabs and #dragonscroll Do the above to get 3$ worth of games free from us this Christmas. Wish you all Happy Holidays and Merry Xmas. Note: Contest is applicable Worldwide Contest Application Ends on Jan 16th Last edited by ankushgupta05; 01-05-2013 at 04:47 AM.. Reason: Added TestFlight Team Joining Link & contest End Date & Removed Cap on No. of Applicants |
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Page 113
[Recipe]. Rad. Columbo. [half ounce].
"Zengeb [half ounce].
Fol Senna. [1 dram]
Aq. bullient. O i
This given in doses of a
wine glass full 3 times
a day, is the most effectual
remedy we have found
in the permanent cure
of a disposition to the
accumulation of flatus
in the bowels.
Wood & Bache. P. 255
[Recipe]. Columto [sic] frequently com
bined with pow. Ginger,
Carb. Ferri. & Rhubarb.
Wood & Bache
Page 114
Anthelmentic Solution.
[Recipe]. Spigelia [half ounce]
Senna [2 drams]
Manna. [1 ounce]
Faniculi [2 drams]
Aq. bullient. O i. M.
Macera per horam in vace
Leviter clause et cola.
Dose. wine glass full to a child
from 2 to 4 year old. 3 or 4
times a day.
Wood & Bache.
Oleaginous Mixture.
[Recipe]. Olei Recini f. [1 and a half ounces]
Tinct Opii [illegible symbol] XXX
Pulv Acacia Gum
Sacch Alb. aa [2 drams]
Aq. Menth Viridis. f [6 ounces]


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Payroll update
We're making great progress with the integration of full payroll into Xero for our Australian customers. All going to plan we're hoping to launch this in late April. Yay!
As part of the transition we'll also be including Paycycle in your Xero subscription from 01 March. For a small number of customers who currently use both Xero and Paycycle, an upgrade to another Xero pricing plan may be needed.
This is because each Xero plan will allow for a different number of payroll employees, and on the Large plan you also get automated super payments.
The good news is that even if you need to upgrade, most customers will pay less than when you subscribed to each application separately.
Shortly we'll be contacting everyone who uses both Xero and Paycycle to explain exactly what the changes will mean for you and next steps.
If you're an accountant or bookkeeper and keen to see a preview of the integrated Payroll, be sure to register for our nationwide roadshow.
Or if you're keen to try Paycycle in the lead up to it becoming integrated Payroll in Xero go here.
Not long now!
27 comments
So jealous for Australian people:( Hope in the future it will include Global user such as in Malaysia.
This is very exciting. Cant wait for it to be fully integrated
Agreed I hope we see this NZ. Im kind of surprised to see the aussie version progressing faster than the original nz one?
The payroll looked great at the Newcastle Roadshow. Really looking forward to getting in an using it.
Are National Bank feeds down as none of yesterdays transactions have shown up?
Can't wait to see something like Paycycle on the go here in NZ. I have eager clients wanting the simplicity of an accounting/payroll all rolled into one – plus the added ease of reconciling and coding all those wage lines!!!!! I would have several immediate sign ups!!!!
Woo Hoo!!!
I'm using both, but with different email addresses, will I still get notified?
Hi @Andrew and @Jamie, as mentioned before we have no plans to do Payroll in NZ. We have a simple PayRun feature in the NZ version of Xero and a number of specialist Payroll partners that integrate with Xero http://www.xero.com/accounting-software/payroll
Not very encouraging to hear that you not planning an integrated payroll in NZ, integrated partners just don't cut it! Sorry.
I'm with @Steve. What's the logic behind that decision?
@Rod, Completely with @Zane, @Rosemary and @Steve would hugely benefit from having a full payroll as part of Xero in NZ.
It's a bit sad to see NZ customers getting the shaft here. I know the logic – protecting your partner relationships etc, but keep in mind that this is at the expense of your NZ consumers.
I fear that not bringing this sort of integrated payroll to NZ users is the start of Xero abandoning NZ users and focusing more on delivering a better product for users in countries that have a larger potential customer base eg Australia & USA.
I fully agree with these posts, i think if Xero seriously want accounting firms to move all their clients onto Xero so we can be "modern practices" then there should be a bit more focus from them into finishing off the NZ product. Obviously It has great potential. Add ons are all well and good but I feel Xero dont understand how much harder it is telling people they need three separate subscriptions to have an accounting system that does payroll and inventory. The current pay run feature is a waste of time and just a hassle to have to tell our clients "no, it isnt what you think". Im sure the time spent on developing that might have been better spent on something useful like budgeting against tracking codes which i hope isnt far away.
Thanks for the update, our customers will be extremely happy to see this .
As for the bad sentiments, NZ has always had choices as Xero's ecosystem and new addons spawn in NZ (or have done historically). You guys always get the best stuff (i.e. Tax included in Workflow Max) first. As somewhat of an early adopter, it was a massive struggle early on and we made it!
My suggestion… Why not focus on the fact that Xero is going forward and we're ahead of the global pack! It is a global market. Embrace it!
This is exciting news! Will the Paycycle API still be available or will the Xero API be extended to include the integrated payroll?
We'd love to integrate our HR software with Xero for our growing Australian customer base.
The reason Australia got an integrated payroll is simple. MYOB SME product has had an integrated payroll for as long as I can remember. Any new kid on the block (i.e. Xero) who wants to take a bite out of the MYOB market share needs to have a integrated payroll to even be looked at as a conversion option, you are never going to move to a product with fewer features/modules. MYOB SME has never had an integrated payroll in NZ, it has always been an add-on. While NZ xero users may feel "shafted" Xero have simply rightly or wrongly extended the status quo.
This is great news and so many of my clients will love getting their invoices next month getting the same great products cheaper! Xero is becoming more and more marketable to small business.
Any feature overview for April release? I really wish tracking can be integrated in pay runs.
Would like to change from Cash Manager Online to Xero as I am sure many other rural clients would, but lack of "Paycycle feature" only deterrent.


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On the Ropes
Have you ever wanted to swing like a monkey climb like Tarzan? Here is your chance to hang, climb, and swing through the air. Spend time each day challenging yourself on the high and low ropes course. Test your skills out in the Taos gorge, learning the ropes from expert climbers. Spend time hanging around camp doing archery or a craft. Leave with a new sense of adventure.
Take the Reins (Novice)
In this advanced-beginner level riding program you will continue learning about horse care and safety and develop riding skills both in the arena and on the trail. You will also have the chance to participate in traditional camp activities like arts and crafts, nature exploration, archery, songs and s'mores around the campfire.
E3: Trailblazers (Intermediate)
Hit the trails in this intermediate western riding program! You will spend time perfecting the control of your horse at a walk and trot in the arena before hitting the trails, exploring new parts of camp. Learn about grooming, tack, and care of your four-legged friend and participate in the rest of the magic of camp…laughing with friends in the dining hall, singing around the campfire and more!
Wrangler In Training
Ever wonder what it takes to manage horses and younger girls at the same time? Do you want to one day work at camp in the riding program? This program will help you develop your leadership skills as well as polish your riding and horse care knowledge. You will learn how to assist our Equestrian staff with arena lessons, trail rides, ground school, and care for the horses and burros. Step outside the riding ring and also learn what it takes to plan programming and even plan at all camp event with your WIT friends. Prerequisite: Completion of "Rancheras" or equivalent riding experience. Separate application required. Campers will return home between sessions.


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Ongoing Volunteer Opportunities
Notes to Students:
- Don't forget to come by the VKSU office to pick up your Service Verification Form.
- Agency contact info will be provided with your Service Verification Form.
- Students must then contact agency directly for days/times of volunteering availability.
- Most agencies that deal directly with people on a one-on-one basis require a background check.
- You cannot get credit for volunteering at your place of employment.
- You cannot have family members to serve as your site supervisor!
Amedisys Hospice Service | Lawrenceville |
Work with hospice patients, family members, and staff members through direct care, running errands, reading, yard or house work, or clerical/administrative support.
Boys & Girls Club - Gwinnett County | Lawrenceville & Duluth & Norcross | Volunteers are needed to serve as tutor/homework helpers, includes grade levels 1st - 12th, with the greatest need in the elementary grade levels! Also, volunteers are needed to assist Club staff with various recreational programs.
Center for Pan Asian Community Services (CPACS) | Metro Atlanta | CPACS offers health and social services to Asians and Pacific Islanders (API) in the greater-Atlanta area. Volunteer opportunities are available to assist with Youth Programs. Volunteers will serve as tutors/homework assistants at various locations in Dekalb, Fulton, Cobb, and Gwinnett counties. Volunteers opportunities to also enter data into the agency database, assist with administrative duties around the office, and work directly with the clients if possessing Asian language skills. Requirements & Hours:
Furkids | Buford Norcross | Two opportunities are available:
Gentiva Hospice | Gwinnett | End of life hospice care - visit patients and assist families with various needs!
Important Information:
Georgia Organics | Loganville | Help local farms and farmers with general farm duties! Great opportunities to get some fresh air!
General Information:
Georgia SPCA | Suwanee and Buford | Four opportunities:
Global Soap Project | Norcross | Sort, clean, cut, and package soap. The purpose of the program is to improve global health and save lives by providing discarded/recycled soap to vulnerable populations.
Service Hours:
Goodwill of North Georgia | Duluth |
Duties include the following:
Gwinnett County Public Library | Various locations in Gwinnett | Work in various areas within the library. Hours vary according to branch location. |
Habitat for Humanity | Lawrenceville | Need volunteers to work in the ReStore location. Volunteers will be responsible for cleaning, organizing, and assisting the customers.
Junior Achievement of Georgia | Various schools | Help in providing services to educate and inspire young people to value free enterprise, understand business and economics and be workforce ready. Kindergarten through 6th grade students are involved with learning economic concepts which are presented in a series of 7 themes. More Information |
Math Is My Friend, Inc. | Suwanee | Math Is My Friend, Inc. is a non-profit agency dedicated to providing math skills training to Elementary, Middle, and High School students. Our programs help students improve their Math scores on standardized tests and grades in Math.
General Information:
Norcross Cooperative Ministries | Norcross | Volunteers will assist in the food pantry, clothing closet, receive and sort donations, perform various office duties, and help with client intake.
Parkwood Farms Therapy Center | Snellville | Parkwood Farms Therpay Center is a multi-discipline therapy center that offers non-tradional therapies in both a clinical setting and Therapeutic riding and Equine Assisted Activities. Programs provide therapies for children with special needs including austism, Down Syndrome, Cerebral Palsy, emotional-behavioral problems and learning disabilities.
Current Needs:
General Requirements:
Session Hours:
SNAP-2 IT | Duluth & Buford | Volunteers care for the basic needs of the animals at the Adoption Center, shelter, or adoption days by providing love, fresh food and water, and cleaning the cages. Adoption volunteers will also assist with setting up and taking down cages.
Two Volunteer Options:
SOS - Daffy's Pet Soup Kitchen | Lawrenceville | A pet food bank serving North and Central Georgia. Helping to feed hungry pets and keep families together. Volunteers are needed to assist in the warehouse sorting and handing out pet food.
St. Vincent de Paul Society | Duluth, Lawrenceville, Lilburn | Volunteers are needed for a number of programs, including food pantries, clothing closets, counseling services, after-school programs, health care needs, housing, and English-as-a-second-language classes.Programs vary according to the location. More Information |
The Chelsea Foundation, Inc. | Metro Atlanta area | Looking for someone who is well versed in social media and would like to use The Chelsea Foundation as their method of jump starting a career. Must be savy in all forms of social media!
The Sheltering Arms | Various Metro Atlanta Locations | Volunteers assist teachers in the classroom, provide children one-on-one attention as they participate in learning activities, and read to children. By giving a young child your undivided attention, you help them to see the connection between block building and math, between feeding fish and science, between hearing a story and learning to read.
Wellspring Living Thrift Store | Duluth | Volunteers will sort and price donations (clothes, accessories, and furniture), help customers on the sales floor, and run the cash register. The proceeds that are collected from the sales at the thrift store help assist women involved in human trafficking.
Volunteer Gwinnett | Gwinnett County | Volunteers are needed to work in a variety of different areas including the following: enviroment, senior services, human services, and children related activties. For more information, please visit: www.gwinnettcounty.com - click on the Volunteer Gwinnett link. Long-term and short-term opportunities are available. |


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B.a.(hons.) in mathematics ignou
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What is the scope of b.com(hons)?
Its not like it will be easier for me getting a good job i wanna know what all jobs i can get and what will b the salary ? what all can i do after b com hons
Adhunika Naithani
answered a question for
B.a.(hons.) in mathematics ignou
which is
Added on March 29, 2012 at 10:32 AM
Who all can apply for Psychology hons couses?
The eligibility criterion to do graduation in Psychology is only passed in 10+2 with minimum 45-50% marks depending on the university criteria in any stream- it could be science, commerce or humanities or students of International Board can also apply.
The criteria for selection in each university are different like some conduct an entrance test and then the interview where as in some universities there is only a merit base selection criterion. So you can see and apply accordingly.
So you need not worry and apply for it can study the same. Some of the good universities to study Psychology in are:
1. University of Delhi
2. Jamia Millia Islamia University
3. Punjab University
4. University of Calcutta
5. Kurukshetra University
You can fill the forms for the university you want to apply in.
Best Wishes!
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1 Answer
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Added on March 29, 2012 at 10:32 AM
Deepti Sharma
answered a question for
B.a.(hons.) in mathematics ignou
which is
Added on February 13, 2012 at 07:31 PM
What is the scope of b.com hons(correspondence) along with a foreign language?
If you are really interested in foreign language so just go for it. Though the languages that are in demand presently are Japanese, German, French, Chinese, Spanish.. Every foreign language has its own advantage.
Foreign language courses can be studied after 10+2 as a 3 years graduate course or even as 5 years integrated language course in the universities offering such courses.
Career in Foreign Language::
Translators find job with industries, publishing houses, government and research organizations. Other job opportunities for language specialist lie with the travel and tourism sector, hotel industry, exhibitions and fairs, airlines offices, export agencies, radio stations and trade organizations..
On other side there are also lots of option after 12th for commerce students such as:: B.com, BBA, BCA, BBM, some computer courses like: Tally, Computer Accounting, SAP financial module, Basic Microsoft elements etc..
CA, CS, ICWA are some professional courses.
All the best
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1 Answer
1129 View
Added on February 13, 2012 at 07:31 PM
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I am persuing ca along with regular bcom hons from delhi university should i do llb also if i want
I am shamim alam completed bcom accounts hons in 2010 from ranchi university and want to take
I am doing economics hons from duwhich course should i go for in post graduation to have a b
I am a chemistry hons student in second year and i am interesed in joining a couse where i can earn
I am weak in mathematics but strong in technical work i learn quickly may i persue diploma in engg
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