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Treatment disparities for disabled medicare beneficiaries with stage I non-small cell lung cancer
ABSTRACT Treatment disparities for disabled Medicare beneficiaries with stage I non-small cell lung cancer.
To compare initial treatment and survival of nonelderly adults with and without disabilities newly diagnosed with non-small cell lung cancer.
Retrospective analyses; population-based cohorts.
Eleven Surveillance, Epidemiology, and End Results cancer registries.
Persons with disability Medicare entitlement (n=1016) and nondisabled persons (n=8425) ages 21 to 64 years when diagnosed with stage I, pathologically confirmed, first primary non-small cell lung cancer between January 1, 1988, and December 31, 1999.
Not applicable.
Initial cancer treatments (surgery, radiotherapy), survival (through December 31, 2001). Multivariable logistic regression and Cox proportional hazards regression estimated adjusted associations of disability status with treatments and survival.
Persons with disabilities were much more likely to be male, non-Hispanic black, and not currently married. Although 82.2% of nondisabled persons had surgery, 68.5% of disabled persons received operations. Adjusted relative risks (RRs) of receiving surgery were especially low for persons with respiratory disabilities (adjusted RR=.76; 95% confidence interval [CI], .67-.85), nervous system conditions (adjusted RR=.86; 95% CI, .76-.98), and mental health and/or mental retardation disorders (adjusted RR=.92; 95% CI, .86-.99). Persons with disabilities had significantly higher cancer-specific mortality rates (hazard ratio [HR]=1.37; 95% CI, 1.24-1.51) than persons without disabilities. Observed differences in cancer mortality persisted after adjusting for demographic and tumor characteristics (adjusted relative HR=1.23; 95% CI, 1.10-1.39). Further adjustment for surgery use eliminated statistically significant differences in cancer mortality between persons with and without disabilities across disabling conditions.
Persons with disabilities were much less likely than nondisabled Medicare beneficiaries to receive surgery; statistically significant cancer-specific mortality differences disappeared after accounting for these treatment differences. Future research must explore reasons for these findings and whether survival of disabled Medicare beneficiaries with early-stage, non-small cell lung cancer could improve if surgical treatment disparities were eliminated.
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ABSTRACT: Disability is increasing among middle-aged adults, and, reversing earlier trends, increasing among older adults as well. Disability is experienced disproportionately by Black and lower socioeconomic status (SES) individuals. We used Medical Expenditure Panel Survey data to examine health care disparities in access to health care for middle-aged (31-64 years of age) and older (65+ years of age) adults with disabilities by race and ethnicity, education, and income (n=13,174). Using logistic regression, we examined three measures of potential (e.g., usual source of care), and three measures of realized (e.g., counseling related to smoking) access. Middle-aged and older minority individuals with disabilities had lower relative risks of having usual sources of care and higher relative risks of having suboptimal usual sources of care (e.g., a place rather than a person) than White adults with disabilities. There were SES effects observed for middle-aged adults with disabilities across most measures that were, for certain measures, more pronounced than SES effects among older adults with disabilities. These findings are important, since health resources (e.g., a usual source of care) may mediate relations among disability, morbidity, and mortality. Policy actions that may mitigate the disparities we observed include financial incentives to support access to an optimal usual source of care and mechanisms to foster behavioral interventions related to smoking and exercise. Ensuring that these actions address the specific concerns of individuals with disabilities, such as physical accessibility and provider cultural competency, is essential.Journal of Aging & Social Policy 07/2014; 26(4). DOI:10.1080/08959420.2014.939851 · 0.60 Impact Factor
Article: Insurance Status Is Associated with Treatment Allocation and Outcomes after Subarachnoid Hemorrhage.[Show abstract] [Hide abstract]
ABSTRACT: Subarachnoid hemorrhage (SAH) is a particularly devastating type of stroke which is responsible for one third of all stroke-related years of potential life lost before age 65. Surgical treatment has been shown to decrease both morbidity and mortality after subarachnoid hemorrhage. We hypothesized that payer status other than private insurance is associated with lower allocation to surgical treatment for patients with SAH and worse outcomes.PLoS ONE 08/2014; 9(8):e105124. DOI:10.1371/journal.pone.0105124 · 3.53 Impact Factor
Article: The Relation Between Health Insurance and Health Care Disparities Among Adults With Disabilities[Show abstract] [Hide abstract]
ABSTRACT: Objectives. We examined disparities among US adults with disabilities and the degree to which health insurance attenuates disparities by race, ethnicity, and socioeconomic status (SES). Methods. We pooled data from the 2001-2007 Medical Expenditure Panel Survey on individuals with disabilities aged 18 to 64 years. We modeled measures of access and use as functions of predisposing, enabling, need, and contextual factors. We then included health insurance and examined the extent to which it reduced observed differences by race, ethnicity, and SES. Results. We found evidence of disparities in access and use among adults with disabilities. Adjusting for health insurance reduced these disparities most consistently for emergency department use. Uninsured individuals experienced substantially poorer access across most measures, including reporting a usual source of care and experiencing delays in or being unable to obtain care. Conclusions. Although health insurance is an important enabling resource among adults with disabilities, its effect on reducing differences by race, ethnicity, and SES on health care access and use was limited. Research exploring the effects of factors such as patient-provider interactions is warranted. (Am J Public Health. Published online ahead of print December 12, 2013: e1-e9. doi:10.2105/AJPH.2013.301478).American Journal of Public Health 12/2013; 104(3). DOI:10.2105/AJPH.2013.301478 · 3.93 Impact Factor


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Study: Leaner nations bike, walk, use mass transit
Richards rekindled his love affair with a two-wheeler a few years ago while visiting bike-friendly Sweden.
Back home, he has a couple of things going for him. Richards lives in a medium-size Southern city where police officers can be found patroling on bikes and the mayor sometimes cycles to city hall.
The car is still king here, like most places in the United States, but Knoxville has developed a 41-mile greenway system that keeps Richards mostly on paved trails and off city streets.
He also works for an environmentally conscious employer. The country store-themed Mast General Stores of Valle Crucis, N.C., pays Richards and his co-workers $4 a day to ride, walk or catch a bus rather drive than their car.
After a year, his annual checkup shows the results: his heart rate, blood pressure and cholesterol all are down.
"I just love riding," he said. "It's like a double-shot of caffeine in the morning."

subset: commoncrawl


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End-Stage Renal Disease:
Medicare Payments for All ESRD Services, Including Injectable Drugs, Should Be Bundled
GAO-07-266T: Published: Dec 6, 2006. Publicly Released: Dec 6, 2006.
Additional Materials:
- Full Report:
- Accessible Text:
(202) 512-3000
Office of Public Affairs
(202) 512-4800
This testimony discusses highlights from GAO's report entitled "End-Stage Renal Disease: Bundling Medicare's Payment for Drugs with Payment for All ESRD Services Would Promote Efficiency and Clinical Flexibility." The report examines Medicare payments for certain drugs provided to patients with end-stage renal disease (ESRD), a condition of permanent kidney failure.
Through Medicare's ESRD benefit, patients receive a treatment known as dialysis, which removes excess fluids and toxins from the bloodstream. Patients also receive items and services related to their dialysis treatments, including drugs to treat conditions resulting from the loss of kidney function, such as anemia and low blood calcium. The Centers for Medicare & Medicaid Services (CMS), the agency that administers the Medicare program, divides ESRD items and services into two groups for payment purposes. In the first group are dialysis and associated routine services--such as nursing, supplies, equipment, and certain laboratory tests. These items and services are paid for under a composite rate--that is, one rate for a defined set of services. Paying under a composite rate is a common form of Medicare payment, also known as bundling. In the second group are primarily injectable drugs and certain laboratory tests that were either not routine or not available in 1983 when Medicare implemented the ESRD composite rate. These items and services are paid for separately on a per-service basis and are referred to as "separately billable." Over time, Medicare's composite rate, which was not automatically adjusted for inflation, covered progressively less of the costs to provide routine dialysis services, while program payments for the separately billable drugs generally exceeded providers' costs to obtain these drugs. As a result, dialysis facilities relied on Medicare's generous payments for separately billable drugs to subsidize the composite rate payments that had remained nearly flat for two decades. In addition, the use of the separately billable drugs by facilities became routine, and program payments for these drugs grew substantially. In 2005, program spending for the separately billable drugs accounted for about $2.9 billion. Medicare's payment for these separately billable drugs is the focus of my remarks today. The remarks are based on the information included in our aforementioned report.
Mar 30, 2015
Children's Health Insurance Program:Effects on Coverage and Access, and Considerations for Extending FundingGAO-15-348: Published: Feb 27, 2015. Publicly Released: Mar 30, 2015.
Mar 27, 2015
Children's Health Insurance:Coverage of Services and Costs to Consumers in Selected CHIP and Private Health Plans in Five StatesGAO-15-323: Published: Feb 25, 2015. Publicly Released: Mar 27, 2015.
Mar 25, 2015
Health Care Funding:Federal Obligations to and Expenditures by Selected Entities Involved in Health-Related Activities, 2010-2012GAO-15-270R: Published: Mar 20, 2015. Publicly Released: Mar 25, 2015.
Mar 24, 2015
Drug Discount Program:Status of GAO Recommendations to Improve 340B Drug Pricing Program OversightGAO-15-455T: Published: Mar 24, 2015. Publicly Released: Mar 24, 2015.
Mar 23, 2015
Private Health Insurance:Early Evidence Finds Premium Tax Credit Likely Contributed to Expanded Coverage, but Some Lack Access to Affordable PlansGAO-15-312: Published: Mar 23, 2015. Publicly Released: Mar 23, 2015.
Medicare:Payment Methods for Certain Cancer Hospitals Should Be Revised to Promote EfficiencyGAO-15-199: Published: Feb 20, 2015. Publicly Released: Mar 23, 2015.
Mar 13, 2015
Medicaid Financing:Questionnaire Data on States' Methods for Financing Medicaid Payments from 2008 through 2012 (GAO-15-227SP, March 2015), an E-supplement to GAO-14-627GAO-15-227SP: Published: Mar 13, 2015. Publicly Released: Mar 13, 2015.
Medicaid Financing:States' Increased Reliance on Funds from Health Care Providers and Local Governments Warrants Improved CMS Data Collection [Reissued on March 13, 2015]GAO-14-627: Published: Jul 29, 2014. Publicly Released: Jul 29, 2014.
Mar 9, 2015
Comparative Effectiveness:Initial Assessment of the Patient-Centered Outcomes Research InstituteGAO-15-301: Published: Mar 9, 2015. Publicly Released: Mar 9, 2015.
Mar 4, 2015
Healthcare.gov:CMS Has Taken Steps to Address Problems, but Needs to Further Implement Systems Development Best PracticesGAO-15-238: Published: Mar 4, 2015. Publicly Released: Mar 4, 2015.
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Speaker ISPOR 13th Annual European Congress Invited Issue Panel Session Reimbursement Issues In Cancer Drugs: Do We Have To Pay For All Cancer Drugs? Optimising the managed entry of new cancer drugs in Europe Prepared by Brian Godman Brian Godman Laboratory of Regulatory Policies, Mario Negri Institute, Milan, Italy, Division of Clinical Pharmacology, Karolinska Institute Huddinge Hospital, Stockholm, Sweden University of Liverpool Management School, Liverpool, UK 2 ISPOR Prague Resource pressures growing with the continued launch of new expensive drugs 1. Introduction New expensive drugs account for over 50% of in-patient drug budget in Marseilles hospitals - growing at over 20% per year New biological drugs with acquisition prices over $50,000 to $100,000/ patient/ year are adding to resource pressures across Europe, some with only marginal health gain 2. 2 Ongoing developments across Europe The pressures will intensify with the next generation of cancer drugs estimated by one UK expert to cost up to £50billion a year within 4 years - raising UK basic tax by 15% New models are required to continue funding new innovative cancer drugs within an ageing population in Europe. These are 3. Conclusions evolving 3 ISPOR Prague 4 ISPOR Prague Ref: Lee 2008, Sikora 2008, Sermet, Andrieu, Godman et al 2010 The cost of new cancer drugs has been a concern in Sweden. This is being addressed Drug Total cost and estimated increase in survival $80352 Cetuximab 1.2 months (NSCLC) $90816 Bevacizumab 1.5 1 5 months (Metastatic breast cancer – not statistically significant) $15752 Erlotinib 10 days (pancreatic cancer) $34373 Sorafenib 2.7 months (renal cell carcinoma) 5 ISPOR Prague Ref: Specialist drug project, Godman 2009 6 ISPOR Prague Ref: Fojo and Grady 2009 1 Developments are ongoing across Europe to help fund new cancer drugs Ongoing developments include: 1. Introduction Releasing resources through encouraging use of generics at lower prices OECI (Organisation of European Cancer Institutes) and OECI/ Piperska initiatives 2. 2 Ongoing developments across Europe New models for optimising the managed entry of new drugs including horizon scanning, forecasting, critical drug evaluation and follow-up activities Defining 'risk sharing schemes' and suggesting where most beneficial from a 'payer' perspective 3. Conclusions 7 ISPOR Prague 8 ISPOR Prague Supply and demand side reforms are improving efficiency – room for improvement in some % change for the statins in Europe - 2007 vs. 2001 500 Planned activities include: E IE Development of targeted approaches through improved science x 400 p and potential biomarkers. Initiative started in Sweden in 2009 e 300 and being progressed including: n Potential EU/ pharmaceutical company funding d 200 accreditation of cancer centres PT i t 100 TR Instigation of European Academy of Cancer Sciences – just u FR UK starting Vision and Mission r 0 ES The Piperska group lending support as part of its drive to e 0 200 400 600 800 DE SE ‐100 improve the managed entry of new medicines (greatest Utilisation challenge to comprehensive and equitable healthcare) 9 ISPOR Prague 10 ISPOR Prague Ref: Godman, Shrank et al 2010 Proposed models to optimize managed entry Improved forecasting helping to create budgets start with Horizon Scanning pre launch for new cancer drugs – Stockholm, Sweden Industrial drug development Phase II Phase III Approval Phase IV Time Horizon HTA HTA scanning pre-launch post-launch Observational Structured studies on Forecasting introduction effectiveness, programmes safety and health economy 11 ISPOR Prague 12 ISPOR Prague Ref: Wettermark, Godman, Eriksson, van Ganse, Joppi, Malmstrom, Paterson et al 2010 Ref: Wettermark, Person, Wilking et al 2010 2 We recently defined risk sharing schemes from a Potential risk sharing schemes for new cancer payer perspective to reduce confusion drugs include transparency and good science Proposed definition Key payer criteria for proposed risk sharing schemes 'Risk sharing schemes for pharmaceuticals should be The objectives and scope are explicit and transparent considered as agreements concluded by payers and The new drug is: pharmaceutical companies to diminish the impact on the A novel treatment with envisaged health gain payer's budget of new and existing medicines brought Few effective treatments currently available about by either the uncertainty of the value of the With/ without long term safety concerns medicine and/ or the need to work within finite Translational science suggests good effectiveness and delaying budgets' treatment may not be in key stakeholders' interest The likely health gain can be determined within a limited time frame Using this definition, the various schemes can be subdivided Patient access schemes substantially lower health service costs into: having factored in all administrative costs especially processes Financial/financial-based models to claim refunds/ rebates Outcome/performance-based models 13 ISPOR Prague Ref: Adamski, Godman et al 2010 14 ISPOR Prague Ref: Adamski, Godman et al 2010 Concerns with patient access schemes (PAS) include administrative burden and logistics Logistic concerns with PAS Whether the system can cope with the time scales for refunds, 1. Introduction e.g. time between monitoring disease progression and the next physician visit to stop therapy Whether the national health system is set up to receive free goods/ rebates from pharmaceutical companies Whether refunds to hospitals/ hospital trusts are passed back t th 'payers' in practice to fully realise the benefits to the ' 'i ti t f ll li th b fit 2. 2 Ongoing developments across Europe Administrative concerns with PAS schemes Capacity to manage PAS schemes without funding additional staff Time taken to administer schemes Communication between physicians and pharmacists to ensure 3. Conclusions refunds/ rebates, e.g. every missed claim for bortezomib loosed GB£12000 15 ISPOR Prague Ref: Williamson 2010; Williamson and Thomson 2010 16 ISPOR Prague A number of activities are in progress to Minimum improvements in survival for funding improve funding for new cancer drugs premium priced cancer in UK hospitals A number of activities are ongoing to improve funding for new Minimum effectiveness and data quality for new cancer drugs cancer drugs and these will continue. This includes improved Effectiveness Criteria processes to 'manage their entry' A Median survival improved > 9months + improved QoL B Median survival improved 3 - 6 months + improved QoL Increasingly critical evaluation of the health gain that C Improved QoL but no impact on overall survival constitutes 'added value' for new cancer drugs (raising the D Minimal impact QoL and no impact on overall survival bar). clinical bar) This builds on discussions in the UK in the late Data Quality Criteria 1990s alpha + Meta analysis or two high quality RCTs alpha - One high quality RCTs and supporting Phase II data beta One poor quality RCT and/or several Phase II studies Future funding helped by less rhetoric and greater collaboration between pharmaceutical companies, diagnostic Ferguson and colleagues believed only new products with A companies and others to improve targeting. In addition, and B effectiveness criteria and alpha data quality should be greater involvement and transparency with payers pre-launch funded at premium prices This study involving key stakeholder provide direction to others 17 ISPOR Prague Ref: Barker 2010 18 ISPOR Prague Ref: Ferguson et al 2000 3 19 ISPOR Prague 20 ISPOR Prague Thank You godman@ marionegri.it; Brian.Godman@ ki.se; firstname.lastname@example.com 21 ISPOR Prague 4
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Videos tagged "ungdommens røde roede rode kors"
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A couple of weeks ago, you could be forgiven for not ever having even heard of webOS, but now after HP CEO Leo Apotheker confirmed that starting in 2012, every HP PC will include the ability to run webOS in addition to Windows, if you profess to having any understanding of mobile platforms you have to profess to have at least some understanding of what webOS is and why it is important.
466 search results for "citrix"
User Virtualization makes your user's information manageable and portable. With User Virtualization the components of a desktop relating to the user are decoupled from the operating system and applications. Goldman Sachs investment is not to gain market share per se, but to allow AppSense to rapidly expand to meet the demand that their product has generated and helps drive a rapidly expanding desktop virtualization and management market.
Desktop Virtualization ...
What to look for in a mobile OS if you are serious about desktop virtualization
• • 0 Comments
The phenomenal growth of the tablet market has left many industry analysts scrambling to reassess sales forecasts for both tablets and PCs. Last week Gartner was forced to acknowledge that its previous forecasts were way off the mark when it issued a revised 2011 sales forecast that reduced its November 2011 PC sales growth estimate by a staggering 25%. Gartner research director, Ranjit Atwal, said his company had not fully appreciated the impact that tablet devices were having on the market, and the new figures "reflect marked reductions in expected near-term unit growth based on expectations of weaker consumer demand, due in no small part to growing user interest in media tablets such as the iPad." Given that this is the same Gartner that in September 2010 instructed CIOs everywhere to go out and buy iPads, it shows just how badly it underestimated the tablet's impact on the PC market. As tablet sales (and for the moment we can read that as being almost exclusively iPad sales) continue to cut in to sales of PCs and laptops, PC manufacturers are under pressure to offer their own alternatives and IT organizations are under similar pressure to provide ways to integrate tablets into their core service offerings.
Given all the past ingenuity and accomplishment why is it, in 2011, the mere task of assigning valid licenses to desktop virtualisation should appear an arcane process?
How do different virtualization models impact how you license your desktop services? What are the current licensing models and do they apply in all instances of desktop virtualisation? Do the models impact on provisioning of services be they laptops, thin clients, Bring Your Own Computer (BYOC), or mobile devices?
Is desktop virtualization licensing an intentionally complex process and what other options could there be?
Business Agility ...
RES Software Ships Virtual Desktop Extender: standalone reverse seamless now available
• • 1 Comment
RES Virtual Desktop Extender (VDX) is now available as a standalone offering. Priced at $15 / seat RES VDX is an incredibly useful enabler for virtualised desktops. It delivers on improving the user experience and better matching the needs of the user by allowing access to applications they need to use in their workspace.
With Microsoft reporting that Windows 7 VDI environments can be up to 11% more expensive than Windows 7 with traditional desktops when will desktop virtualisation give you a return on investment? Will performance taxes, license taxes and complexity taxes mean that desktop virtualisation will never be more than a niche service regardless of the clamour from VDI vendors hailing 2011 as the year for VDI as they did in 2010?
Or, is it that the taxation can be accommodated, all be it without short term gains because your business will benefit from the representation of a user's application set not simply from their cubicle's monitor?
Bad weather conditions should not stop your workforce. Keep your employees safe at home and being productive for you at the same time.
Wanova has today announced general availability of Mirage 2.0, the newest release of its distributed desktop virtualization platform. Mirage 2.0 is a significant milestone for Wanova, extending the platform from a limited scalability solution better suited to LAN-based deployments to a true enterprise class platform capable of supporting multiple remote branch offices without requiring a either high capacity WAN links or a WAN acceleration appliances.
Desktop Virtualization ...
The Virtual Desktop Design Maxim: Start With User Requirements
• • 3 Comments
When considering a Virtual Desktop Design a good architect needs to ask "what is the best solution for this environment?" For many, once you've considered the needs of your users, it is a combination of desktop delivery models – some virtual, some physical. Ideally the user is unaware of which model is being delivered to them, they consume that service on an appropriate device, at an appropriate time. Ringcube perhaps first to market for this type of solution with their Workspace Virtualization Engine.


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The Best iPhone & iPad Games of 2014
91d ago - TTP writes: "With 2015 just around the corner, it's time to look back at the great year that's ab... | iPhone
10 Best Android RPGs
238d ago - Games Reviewer lists the 10 best Android RPGs. Check out the list which is composed of the top ro... | Android
Visit CGMagazine: The Culture of Games
Now - CGM is for the mature audience of comics and games that wants more out of their media than just a review score. | Promoted post
Top 5 Mobile RPGs
281d ago - MGL has compiled a list of the top 5 RPG games available on the mobile market. | iPhone
The Best RPGs On Android
289d ago - Hardcore Droid takes an updated look at the Android RPGs actually worth your time and money. | Android
Video games to play alongside Game of Thrones this season
356d ago - upplement your Games of Thrones addiction with these 10 games | Culture
5 Best Android Story Driven Games
441d ago - If you are looking for Android games with a compelling story, then look no further as GameWoof ha... | Android
Saturday Android Sales for December 14th, 2013
470d ago - Triverse writes, "We all survived Friday the 13th so why not celebrate with some great games at g... | Android
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485d ago - Triverse writes, "Since there are a lot of games going on sale for a limited time we figured it w... | PSP
Android Saturday Sale for November 30th, 2013
485d ago - Triverse writes, "Since Google has yet to implement an option for publishers to offer their apps... | iPhone
The Best Android RPGs of All Time: Hardcore Droid
527d ago - Every game is an adventure, whether you're spin-kicking the mullets off of street fighters or lay... | Android
Humble Bundle with Android 7 Released
531d ago - Hardcore Gamer For $1, you can get Ticket to Ride, Greed Corp, Incredipede, and Anodyne along wit... | PC
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653d ago - Video games are like movies and music. There are some classics that we just can't get enough of.... | Android
The Most Hardcore Android RPGs Ever Made | Hardcore Droid
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The Best Android Games of 2012 | Hardcore Droid
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AR: The Bard's Tale Review
835d ago - AR: The Bard's Tale needs little introduction, but I'm sure you'll indulge me anyway. This gam... | Android
The Bard's Tale Review | Hardcore Droid
852d ago - The Bard's Tale is an action-adventure concerning the Bard, a medieval hero less noble than most,... | iPhone
Tips, Tricks and Strategies: The Bard's Tale Part I | Hardcore Droid
854d ago - How to Get the Most Out of Being an Ass The Bard's Tale takes a simplified approach to its RPG... | iPhone
DG: The Bard's Tale Review
873d ago - DG: I missed The Bard's Tale when it came out in 2004, but did play it a bit through the OnLive s... | Android
inXile Celebrating its 10th Year in Business with a Digital Garage Sale
895d ago - Games are discounted for one week on iTunes, Steam, Mac App Store, Android digital stores and mor... | PC
The Best Video Games Over 25 Years: My Top 10 Video Games of 1985
898d ago - Nan Rymer of RantGaming writes: "Covering the best video games over the past 25 years of my life... | Culture
Find out when Uncharted 4 releases on PS4
Now - Start tracking Uncharted 4 at Releases.com to get important updates about this game release. | Promoted post
Android Police: The Bard's Tale Review: 3.5GB Of Awesome Quests, Laughs, And Cleavage
920d ago - Android Police: Android gaming is becoming a bigger deal all the time with high-end games launchi... | Android
inXile launches The Bard's Tale for Mac
1033d ago - Featuring iCloud saved games so players can move smoothly between Mac and iOS | iPhone
Top 5 Exploration Games on iPhone
1042d ago - The Quality Index champions the best exploration games on iPhone. | iPhone
Five great alternatives to Diablo III this generation
1046d ago - Digitally Downloaded writes: "So you might be playing Diablo III. Or you might be seeing the numb... | PC
Top 5 Fantasy RPGs for iPad
1071d ago - The Quality Index champions the best fantasy role-playing games on iPad. | Casual games
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Saint Mary`s, Antigua and Barbuda Hotels & Resorts - The Hotel is Situated On a Natural Hill and Full of Colourful Flora, Provides the Perfect Backdrop To Make Unforgettable Stay. It is Holder of Bordered
Saint Johns, Antigua and Barbuda Hotels & Resorts - The Dickenson Bay Cottage is a small complex situated in a garden on a hillside overlooking the Caribbean Sea.
Five Islands, Antigua and Barbuda Youth Hostels - Pinkshack Studio Cottage is a comfortable, bright guest cottage situated just outside the village of Five
Antigua, Antigua and Barbuda Hotels & Resorts - Renovated in 2009, This Beach Hotel Offers a Garden and a Terrace and Comprises a Total of 82 Spacious Suites, All With Fresh Interiors and Ocean Views.
St. John's, Antigua and Barbuda Vacation Rentals - Valley Creek Holiday Apartments Rental offers self catering accommodations like at home but with much more opportunities for adventure.
St. John's, Antigua and Barbuda Bed & Breakfasts - 3 Martini Beach Bar Restaurant & Apartments is a beautiful ocean view accommodations.
Seatons, Antigua and Barbuda Vacation Rentals - Ellen Bay Cottages is set one minute's walk away from the local jetty, in the picturesque fishing village of Seatons, located on the northeastern coast of Antigua.
Seatons, Antigua and Barbuda Youth Hostels - Ellen Bay Inn s not just a vacation, it's an experience.
St. John's, Antigua and Barbuda Youth Hostels - In the picturesque archipelago of the Caribbean, located on the North West Coast of the Beautiful Island of Antigua, you will find Inn La Galleria, a small hotel with 12 rooms and superb views at budget prices.
, Antigua and Barbuda Sight-Seeing Tours - Antigua Service: Travel Services
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Antigua and Barbuda Vacations - Travel guide to Antigua and Barbuda accommodations and vacation packages. Visit Antigua and Barbuda for getaways and adventure travel. Plan your Antigua and Barbuda vacation today.
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text: Second time at the hotel stayed 3 nights, very friendly and helpful staff, good room, everything worked as it should, a few things in close proximity, easy access to freeway. Plenty of parking, internet OK. Uncle Mikes pub about 1 mile away has more than 80 beers on draught, recommended. Would stay again.


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I am just wondering if this is normal. My DD is typically pretty well behaved, although fairly strong willed and obviously still acts like a toddler and not perfect or anything. But his week her behavior has been pretty awful. She is whiny, melts down at little things frequently, gets an "attitude" easily, throws fits at bedtime, and is defiant in a way that is not at all typical for her. She acts like this when she's about to be sick, but it's been four days and she hasn't come down with anything. She also acted like this when she cut her eye teeth a while back, but I can't feel any new teeth coming either. (The only ones she has left to get are the 2 year molars.)
So, I'm just curious if anyone else's LOs just kind of goes through little spurts of days when they act like this? Or maybe we're just reaching a new level of toddlerhood? :) It was just so sudden and isn't like her at all...We also have been slightly off her sleep schedule for several days due to an illness and death in the family (grandparent), so could that be causing this too? She really hasn't been any more off schedule than she has been in the past, but maybe it's because it was for more than just a day here and there? I am kind of at a loss, just going crazy and looking for others who maybe have experienced this!


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Description: Licensed to Quilting Treasures by Classic Media Inc. this soft book panel features the story of the tawny scrawny lion. This panel may be used as a soft book or fussy cut for a snuggly quilt. The panel measures 35'' ...
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9/11 – A Personal Tribute
September 11, 2011 by Marty Rouse, National Field Director
When I was in High School on Long Island, NY, a friend's younger brother told me and everyone he knew that he wanted to grow up and be a pilot. He was around 12 years old then and I remember him being, smart, polite and full of energy and excitement about life.
A few weeks after 9/11, I learned that he was the First Officer on United Airlines Flight #93 that was hijacked on 9/11 and crashed in Pennsylvania.
This past July, I was back in New York to help celebrate the first day of marriage equality. In downtown Manhattan, I was standing outside with hundreds of others to cheer as the first gay and lesbian couples legally married in New York exited the City Clerk's office smiling broadly and holding up the their marriage certificates. At one point I looked back over my left shoulder and saw the bright blue sky, and for a moment I shuddered remembering that the twin towers used to be standing there in that background.
As New Yorkers, as Americans, and people around the world remember the events of a decade ago, I know that I have grown to have a greater appreciation for every breath I take and cherish the time I have with my family and try to connect with the world in a more meaningful way.
Today I think of Leroy and am so proud of him for having fulfilled his dream. My thoughts of him inspire me to make a difference every day.
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February 18, 2015


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Last Saturday for Tamamta Katurlluta, the gathering of Alaska Native traditions, a small fleet of skin-on-frame kayaks and one big umiak landed at the Pier One Theatre beach on the Homer Spit (see photo, page 1). Traditional Native boats return again this weekend for the 21st annual Kachemak Bay Woo...Thu, 09/05/2013 - 6:21am
From Nanwalek elder Nick Tanape's desire to let people know "who we are that existed in Cook Inlet, Kachemak Bay and Prince William Sound, who were the first people here," comes "Tamamta Katurlluta: A Gathering of Native Traditions." The celebration began in 1997 and has occurred almost ev...Wed, 08/28/2013 - 5:00pm
If you built a raft with a big sea anchor and pushed off from Point Pogibshi, you'd drift east along Kachemak Bay on the south shore, turn left at the Homer Spit and eventually circle around the north shore and go west toward Bluff Point, spinning back around in a big gyre. Or, maybe not. Yo...Wed, 08/21/2013 - 5:14pm
Call them what you will — privies, johns, earth closets, the shack out back or nooshniks if you live in Ninilchik — outhouses are an Alaska tradition. Equipped with a candle to brighten winter's darkness, a Styrofoam seat positioned for maximum warmth, a little reading material, an open door t...Wed, 08/14/2013 - 3:14pm
By land and sea, world explorers often visit Homer on their way north for further adventures or an end-of-the-road finish from points further south. Last Thursday, a 50-foot silver sailboat slipped into the Homer Harbor on an expedition that outshines anything else by comparison....Wed, 08/07/2013 - 6:27pm
Think "garden," think flowers or vegetables or grasses or trees. Think sweeping landscaped areas or a single pot of flowers. Think acres or a tiny balcony. Gardens are all that and more. The Homer Garden Club's seventh annual Gardeners' Weekend is a good way to see multiple meanings fo...Wed, 07/31/2013 - 1:07pm
On the Homer side of Kachemak Bay, finding a good, short hike can be a challenge. Across the bay, Kachemak Bay State Park has some marvelous hikes — if you have a boat and can afford a water taxi. If you're a visitor or local, the Center for Alaskan Coastal Studies has a little gem of a hike off...Wed, 07/24/2013 - 12:42pm
"You can't see the forest for the trees" is a great description for what happens when you live in a place for long. The day-to-day stuff gets so distracting you don't see the eagle nest on the Spit, the sea otter bobbing on the bay or the eagle outside your car window as it glides beside the...Wed, 07/17/2013 - 4:11pm
OK, first let's get the obvious question out of the way. What do men — and women — wear under their kilts at the Kachemak Bay Scottish Highland Games? If you were one of about 450 people who watched the 30 athletes compete at Karen Hornaday Park last Saturday, the way those kilts swirled about...Tue, 07/09/2013 - 11:38am
With so much boat traffic in and out of the Homer Harbor, it's easy to think the harbor is all about fishing. Not true. The Center for Alaskan Coastal Studies' twice-daily Creatures of the Dock tour offers an hour with a naturalist to learn about the intertidal life existing in the harbor. The P...Tue, 07/02/2013 - 3:58pm
Homer News ©2015. All Rights Reserved.


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Initial D fans, rejoice! No longer will you have to go to the local arcades, undoubtedly dying away, to get your fix of the racing game/TV show. Soon it will be hitting the PS3, not only looking better, but packing in all the features you'd expect from a standard console racer. Meaning online play, big solo campaign, etc.
What's the bad news? It's listed as a Japan-title only so far, with no release date or information about a possible US or European launch date. So if you're a Japan local or just plan on importing, this summer is the time to wait for.
As for whether there's a 360 version planned...it's hard to tell. Obviously it would sell poorly in Japan, but in the US it would be the reverse. Sega, developer and publisher of the title, will undoubtedly think long and hard about this, but if the game comes out worldwide, I doubt it will be a PS3 exclusive. Unless Sony has something to say about it.
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Initial D coming to PS3
29 February 2008 | By jess
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The Irwin S. Chanin School of Architecture Registration Instructions
Sprint 2015 Registration Instructions
Registration advising (and pre-registration for Architecture electives) will take place in the School of Architecture Office according to the following schedule:
Current M.Arch II students & Current 5th year students
Wednesday 12 November
registration opens for you at 12:01AM on Tuesday 18 November 2014*
Current 3rd & 4th year students
Thursday 13 November
registration opens for you at 12:01AM on Wednesday 19 November 2014*
Current 2nd year students
Thursday 13 November
registration opens for you at 12:01AM on Wednesday 19 November 2014*
Current 1st year students
registration opens for you at 12:01AM on Friday 21 November 2014*
*Online registration starts at 12:01AM on Tuesday 11/18 and is prioritized by year. The closer you are to graduation the earlier you register. Your registration day starts at 12:01AM. Once your registration day begins, you can register at any time -- but the longer you wait the fewer options you will have -- until registration closes at 11:59PM on Monday 11/24.
Registration is now managed through the Student Self-Service Portal. A step-by-step illustrated guide can be viewed here.
Registration Rules, Regulations, Dates and Deadlines
(1) Anyone who does not complete his/her online registration by 11:59PM on Monday 11/24 will be required to register on Tuesday, January 20, 2015 and a late registration fee of $100 will be imposed.
(2) Schedule changes may take place, via the Student Self-Service Portal, during the one-week drop/add period at the start of the Spring semester, 20-28 January. The School of Architecture Office must approve schedule changes. Beginning Thursday 29 January, no courses may be added but students may withdraw from a course by payment of a $25 fee with permission of the Dean of the School of Architecture and the instructor. If the student is passing the course at the time of withdrawal, the designation of "W" will appear on the record. If the student is failing the course, a grade of "WF" will be recorded.
(3) No classes may be added after Wednesday, 28 January. Students may WITHDRAW from courses, with the appropriate authorization, until the end of the sixth week of the semester (Friday 27 February) by following the above procedure.
(4) You will not be permitted to register if: (a) you have an outstanding financial obligation to The Cooper Union or The School of Architecture (b) you have not completed your paperwork - personal history forms, available in Admissions; medical forms, available in Student Services; etc. (c) you have a Shop/Printmaking debt - payable (cash or check) in the School of Architecture Office prior to or during registration.
(5) If you have an outstanding financial obligation to The Cooper Union, e.g. student fee, international student fee, lab fee, graduation fee, medical insurance fee, etc., you can find this information on the new registration program (24/7 and before registration). If you have a Shop/Printmaking debt or owe money to the School of Architecture, you will be notified before registration and your Ed Plan will not be approved until you have made your payment in the School of Architecture Office. Meeting your financial obligation BEFORE REGISTRATION will allow you to register on time when you will potentially have the most options.
(6) The Spring 2015 semester begins on Tuesday 20 January and followws a Monday schedule of classes.
(7) View the 2014-2015 Academic Calendar and Holiday Schedule


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1. Preheat the oven to 375° F.
2. In a shallow baking pan, spread shallots and garlic in a single layer.
3. In a small nonreactive saucepan, mix broth and lemon juice.
4. Bring the broth to a boil over high heat.
5. Pour the boiling broth over the shallots and garlic in the baking pan.
6. Sprinkle sugar, salt, and pepper.
7. Cover with baking pan with aluminum foil and bake for 45 minutes.
8. Uncover the pan and stir gently.
9. Bake uncovered for 20 – 30 minutes until the shallots and garlic are very tender.
10. In a large nonstick skillet, melt butter over medium heat.
11. Add the cooked shallots and garlic along with all the cooking liquid.
12. Increase the heat to medium-high.
13. Shake the pan frequently while cooking and cook for 5-7 minutes until the shallots and garlic are golden brown and caramelized.
14. Serve hot in a serving dish.


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CC support both competitive and non-competitive, on and off-road
cycling. Prospective new members, please browse the site and
find more information on the "Join Us!"
Tuesday 31st March: training night at Stourport circuit. 7pm. All SCC members welcome.
Tuesday 14th April: the first in the SCC time trial series - first rider off at 7pm, Halfpenny Green.
16th March, AGM: Wally Fowler becomes a life member, Bryan Hedges is Club Member of the Year, Anthony Wheatley wins Wag's Kup. Club kit to be changed, see the club clothing page.
1st February Congratulations to all SCC riders who toook part in the WM cyclo-cross league this year. In particular Anthony Neave, winner of the junior category, Kevin Payton 2nd vet 50+, Tom Payton and Dan Harris 2nd and 4th seniors, Jayne Cheslin 4th lady vet.
31st January: Hannah Payton finishes 34th in the World Cyclo-cross Championship in Tabor, Czech Republic.
10/11th January 2015: National cyclo-cross championships - 6 SCC first or second claim members rode: Isla won the vets race. Our riders: Kevin, Tom and Hannah Payton, Jayne Cheslin, Anthony Neave.
Cycling Club is
affiliated to: British Cycling, Cyclists
Touring Club, Cycling Time Trials, SSSCCRRL, WMCCL and is a Go-Ride accredited club


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ARLINGTON, Texas –- A's catcher John Jaso won't be taking the field again this season, and outfielder Craig Gentry also appears a long shot, according to manager Bob Melvin.
Programming note: For all the day's sports news, tune in to SportsNet Central tonight at 6 p.m., 10:30 and midnight on Comcast SportsNet Bay Area
OAKLAND -- The A's announced a move Thursday that had long been speculated about, agreeing to a four-year deal to transfer their Triple-A club to Nashville.
OAKLAND – The only thing more painful than hitting rock bottom is thinking you've hit it, only to find out there's still more room to sink.


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Kristin - posted on 07/05/2010 ( 11 moms have responded )
My 3 month old son has had red, dry cheeks for the last few days. At first I thought it might have just been a reaction to fabric softener that I used on my shirt but it hasn't gone away. I did put some baby sunscreen on him and I've also started him on rice cereal. Could either of those things cause his little cheeks to become red and dry?
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All gave some, some gave all.
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SK-II prefers their campaign faces to have a certain luminous quality — which just makes good beauty sense. The newest on a roster that also includes Cate Blanchette is Kate Bosworth. The announcement of the 30 year old actress is accompanied by a video where she discusses the necessity of great skin on an actress and "leading the life you want to lead without compromising your skin." Bosworth also pinpoints some of her favorite products, the Pitera Essence Set, including the Facial Treatment Clear lotion, the Facial Treatment Mask and the Facial Treatment Essence.
Luminous Litmus Test: Kate Bosworth Named New Face of SK-II
Why Orange Juice is Better Than Green Juice
Steven Macari of SLVRBK explains why good quality old school OJ might be just what you're missing.
How to Age Backward
The results are in: Take these steps to start turning back the clock now.
Jamie Chung on the Best Beauty Trick She Learned in the 'Real World' House
The actress, blogger and Jergens spokeswoman talks skin care, reality television and where to get the best Asian food in NYC.
Ciara's Chic & Surprising New Way to Do a Ponytail
BAZAAR's beauty expert reveals the tricks and must-have products behind the prettiest hair and makeup looks on the red carpet.
More From Beauty


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|SUMMARY: Jeanne Hopkins of Symmetricom had the budget for a full in-house marketing team. Instead she chose to hire half a dozen independent contractors. Did it work? The virtual team got out more than 100 marketing campaigns last year to one of the toughest business-to-business niche markets we know of. Here's the story (including samples, results data and useful vendor hotlinks) of three of their best campaigns. P.S. If you're interested in search marketing, email or landing pages, this Case Study is a definite read
Get the latest research on email, lead gen, and social media along with MarketingSherpa updates and promotions.
Designing Slides That Dont Suck: 20 questions to ask before you present
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MarketingSherpa Webinar: Special live test clinic
March 25, 4:00 - 5:00 p.m.
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Buyer Personas by Adele Revella


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"I just want to reach out to you to express my sincere thanks for all of your help with my mortgage. Your efforts are greatly appreciated. Thanks for living up to your motto, 'We help with housing!'"
"I just wanted to thank you for all the phone calls and pep talks you gave me when I was ready to throw in the towel. I truly appreciate all you did to help my daughter and I purchase our home."
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03.26.15 Spring House Invitational Golf & Track Outing
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Castellani Parkhotel
No availability found through our partners. Please contact the business directly or check some of our recommended alternatives.
How has this hotel rated in the past?
- Suites
- Continental Breakfast
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Historical Traveler Reviews Castellani Parkhotel Salzburg
Great hotel in a great city!
We stayed in this hotel for 2 nights in November, and got a very good deal on an internet special. The hotel is immaculate throughout, the rooms are quite spacious and clean. The location is very good, only about a 5 minute walk to the old town, and also bus stops just out the front to get to the train station. The buffet breakfast was excellent, as were the staff and their service. I highly recommend this hotel.
Modern Classic
We stayed 4 nights till New Year's Eve 2004/2005. Very nice hotel, modern and pleasant. Many guests our age (30s) which was nice. Great breakfast buffet with something for everyone and very fresh. Service was very friendly but always in a rush. Room service was good but twice our room wasn't cleaned when we returned in the afternoon for a nap. Our room was very good, large and very well furnished.
A pity was the 20-minute-long walk to the old town and the main points of interest along a busy four-lane road. After trying this once we preferred taking the bus (bus stop 5 minutes from hotel) that was going every five minutes during the day and every 20 minutes after 7 PM. Two excellent (and pricey) restaurants in the hotel, we tried the Austrian nouvelle cuisine which was outstanding at any rate! I was missing a sauna (steam bath had to be turned on upon request and you had to change there which was inconvenient to me) and public internet access.
I would go there again although I would prefer to stay at a more central location.
Best Western Castellani Parkhotel
We stayed at the Best Western Castellani ParkHotel. It was about a five minute walk to the downtown area. The hotel was modern, clean, and had the best buffet breakfast (included in the room price) that I can remember having. The hotel has a surface parking. Very enjoyable stay.
TripAdvisor Reviews Castellani Parkhotel Salzburg
Travel Blogs from Salzburg
Venice - Floating in Italy
... in San Marco square. This place was a true gem. Behind the palace walls was room upon room of the most decadent artwork covering the walls and ceilings. It is also home to the largest piece of artwork in the world. This museum was much more than a palace - it included a rich history of Venice's politics and the royal family and included access to the old prison cells and weapons used in war. This city has a colourful history and through my walking ...
Alstadt, Hohensalzburg Fortress, Mirabell Palace
... played an old ring toss game before deciding to move on.
Since we had been exploring for a while, we decided to grab lunch at a local restaurant with Italian influences. I tried the seafood and garlic panzerrotto which was easily one of my favorite meals during my trip.
After a hearty lunch, we decided to take advantage of our Salzburg Cards and went beer tasting at the Stiegl-Brauwelt. My favorite beer was a grapefruit infused beer, which was sweet and light. We ...
Mozart meets the Sound of Music
... a tip but forgot our back pack which holds our clothes and camera, etc. We stopped at an outdoor market, bought some meat and cheese...Glenn didn't realize he forgot the backpack until we were walking through the gardens on our way back to the hotel.
Supper-ing on our newly bought meat and cheese...soon to find out that we went way over board in ...
... and then sit and eat or play cards or in our case do both! The locals even have their own special cupboard where they can store their own steins for when they visit! Also walked around admiring the very many shops specialising in flogging Mozart memorabilia to the tourists though we did actually go to his place of residence and his birthplace. Wanted to see a perfomance but they were only on on the ...


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Version: 5.0R0 Build 191
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text:
The 100th episode of Radio Free Charleston. "M.C. Escher Shirt" features music from The Hellblinki Sextet, The Nanker Phelge, Eva Elution and Jeff Ellis. There are short films from Scott Elkins, The No Pants Players and "Courting Disaster." We also have the animated short, "Stark Charleston number one" by Rudy Panucci, with music by David Synn.
Hosted by Rudy Panucci with Chelsea Cook. Host segmens recorded at Henry Eldon's famed "Top O' Rock" in Charleston, West Virginia.
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Ahh the 10/20/30 rule. I remember this when you gave your speech at the NYLF Tech forum this year. I found this part to be very useful. - read more
There are several PowerPoint presentations available within the Guide to Grammar and Writing. These presentations make for rather hefty files and downloading may take ... - read more
Please vote if the answer you were given helped you or not, thats the best way to improve our algorithm. You can also submit an answer or search documents about 6 x 6 rule powerpoint presentations.