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• G Y N A E C O L O G Y • How To Treat Menstrual Disorders Cindy Farquhar, MBChB, MD, DipObst, MRCOG, FRANZCOG I n this article, the causes and intervals between menstrual periods much of this section uses informa- treatment of heavy menstrual is common in puberty and as women tion contained in that guideline bleeding, painful periods, and near the menopause. Anovulatory (http://www.nzgg.org.nz/library/ irregular or absent menses are menorrhagia may also be present gl_complete/gynae_hmb/index.cfm). discussed. in women with polycystic ovaries who often have irregular and Aetiology MENORRHAGIA heavy menses. Differential diagnoses of heavy A Guideline for the management menstrual bleeding that should be Menorrhagia is defined as heavy of heavy menstrual bleeding was considered include uterine pathology menstrual bleeding. The term 'dys- published in 1998 by the New such as fibroids and hyperplastic functional uterine bleeding' refers Zealand Guidelines Group and endometrium, complications of early to menorrhagia where no obvious pathology is present. Although menorrhagia is not usually life threatening, it can cause disruption and discomfort for many women. Over a 4-month period in the UK, one-third of women patients consulted their family doctor about their heavy periods. In New Zealand, it accounts for 10% of all specialist referrals from GPs. It may occur at any time between puberty and the menopause and is described as either ovulatory or anovulatory. A history of heavy menstrual bleeding with regular menstrual cycles is usually associated with ovulation whereas an anovulatory Figure 1. An ultrasound scan of thickened endometrium. pattern of bleeding with erratic JOURNAL OF PAEDIATRICS, OBSTETRICS AND GYNAECOLOGY NOV/DEC 2002 39 H O W T O T R E AT M E N S T R U A L D I S O R D E R S • GYNAECOLOGY • pregnancy such as miscarriage, carci- presenting with excessive blood noma of the cervix and endometrium loss, as many as 50% were losing (rarely), and exogenous hormones amounts within the normal range. taken for menopausal symptoms. The amount of bleeding is more Fibroids are present in about likely to be excessive if hourly pad 40% of women with menorrhagia, and tampon changes are necessary although they are probably only or sleep is disturbed by flooding. responsible for menorrhagia when Neoplastic causes of bleeding Figure 2. Taking a pipelle sample. they cause an enlargement of the are highly unlikely in anovula- endometrial cavity or when they tory menorrhagia associated with are submucous fibroids. In rare puberty and, provided pregnancy the possibility of fibroids and to cases, disorders of coagulation has been excluded, therapy can be exclude hyperplastic endometrium. may be present. commenced without the need for (Figure 1) In many women, no obvious vaginal examination or endometrial Endometrial sampling to exclude cause is found for heavy menstrual sampling. In all other women neoplastic causes is usually restricted bleeding. Specialist referral is recom- presenting with heavy menstrual to those women at increased risk of mended if the Hb is very low, the bleeding, a pelvic examination, endometrial hyperplasia, such as uterus is greater than 12 weeks in including a cervical smear, should women over the age of 45 years or size or if the menstrual cycles are be performed. Anaemia should be those who weigh more than 90 kg. irregular. excluded by a full blood count; it is If endometrial thickness is greater also an indication of the severity of than 12 mm on ultrasound exami- Diagnosis and Investigations the menstrual blood loss. Women nation, an endometrial sample Subjective assessment by a woman with Hb <120 g/L are more likely should be taken. The least invasive regarding the amount of blood to have blood loss >80 ml/cycle technique of sampling is a pipelle loss can be misleading; studies than women with a normal Hb. sample. (Figure 2) Dilatation and have shown, when menstrual blood An ultrasound scan is only indi- curettage are only indicated when loss was quantified among women cated if there is concern about other sampling techniques fail. Table 1. Effective Medical Management of Menorrhagia Options Dosages Reduction in Menstrual Blood Loss (%) • NSAIDs Mefenamic acid 250-500 mg tid 25-45 Naproxen 250 mg qid 25-45 Diclofenac 75 mg bid 25-35 • Antifibrinolytic agents Tranexamic acid 1 g tid/qid 47 • Combined OC pill 30 µg EE + desogestrol 43 • Danazol 200 mg/day 50 • Levonorgestrel IUD 20 µg/day 86 40 JOURNAL OF PAEDIATRICS, OBSTETRICS AND GYNAECOLOGY NOV/DEC 2002 H O W T O T R E AT M E N S T R U A L D I S O R D E R S • GYNAECOLOGY • Hysteroscopy is indicated when intrauterine pathology, such as polyps or fibroids, is suspected. (Figure 3) Women reporting with heavy menstrual bleeding 50% of women have menstrual blood loss >80 ml/cycle Medical Management Full menstrual history • Examination • Full blood count There are many effective options for the medical management of Yes Prolonged menorrhagia (Table 1), but the irregular cycles symptoms often return once therapy No is stopped and long term therapy Abnormal Refer Yes may be necessary. exam uterine specialist size >12 weeks No NSAIDs mild or treat severe moderate Anaemic anaemia Endometrial prostaglandins are <80 g/L (80 –115 g/L) elevated when menstruation is exces- No sive. NSAIDs reduce prostaglandin low levels by inhibiting the enzyme Assess risk of risk Unexplained Offer medical endometrial hyperplasia heavy menstrual therapy cyclo-oxygenase. Randomized con- • bodyweight=90 kg < 2% bleeding have 90% of women trolled trials have consistently • age=45 years shown that NSAIDs decrease • other risk factors endometrial • levonorgestrel hyperplasia intrauterine system menstrual blood loss by between • tranexamic acid 30 and 40%. Mefenamic acid, > 8% have • nonsteroidal anti- ibuprofen, naproxen and diclofenac inflammatory agents Assess endometrium normal have all been shown to be effective. • norethisterone • transvaginal ultra- endometrium long course NSAIDs are also helpful for sound (TVS) or • OC pill women who have dysmenorrhoea • endometrial biopsy if • danazol endometrium=12 mm and up to 70% of women experience or if TVS not available if one medical therapy fails, others can be used significant relief of pain. The com- mon side effects reported are headaches and gastrointestinal Treatment disturbances, including dyspepsia, Hyperplastic success? endometrium or nausea, vomiting and diarrhoea. carcinoma These disturbances can be avoided by taking the medication with No Yes food and are unlikely to occur if Refer to specialist for taken for a short time or inter- hysteroscopic evalua- Continue medical Refer specialist mittently. Women with a previous tion and consideration therapy for surgery history of gastrointestinal ulcera- tion or a history of bronchospasm with aspirin should not be given Figure 3. Algorithm for treating women reporting with heavy menstrual bleeding. NSAIDs. JOURNAL OF PAEDIATRICS, OBSTETRICS AND GYNAECOLOGY NOV/DEC 2002 41 H O W T O T R E AT M E N S T R U A L D I S O R D E R S • GYNAECOLOGY • pill has the additional advantages Case Study: History of Heavy of reducing dysmenorrhoea and Bleeding providing contraception. Presentation: A 47-year-old woman pre- Danazol sented with a 6-month history of increas- Danazol is a synthetic steroid ingly prolonged and heavy menstrual with mild androgenic properties. It periods. There was no dysmenorrhoea. Her cycle was 14 days of bleeding every causes atrophy of the endometrium 30 days. and is therefore useful in the Examination/investigations: An examina- treatment of dysfunctional uterine tion was undertaken and the pelvic organs bleeding. Although it is an effective were normal. A cervical smear was taken agent in reducing menstrual blood and the cervix looked normal. The FBC was normal. An ultrasound scan demon- loss, adverse side effects (even at Ultrasound scan of endometrial strated a normal uterus with no fibroids lower doses) such as weight gain, polyp. but a prominent endometrial echo sug- depression, acne and headaches, gested an endometrial polyp 11 x 10 mm. limit its usefulness. Treatment: Hysteroscopy, dilatator and curettage were performed under gen- eral anaesthesia. An endometrial polyp was found and removed with polyp for- ceps. Histology found a benign endometrial polyp. Progestogens Outcome: At 3 months' follow-up, her menstrual periods had returned to their Progestogen therapy given in the previous pattern. However, 12 months later, the patient returned with increas- luteal phase has been widely used ingly heavy periods – although only for 8 days a month. An ultrasound scan of in the treatment of dysfunctional the endometrial echo was normal (7 mm). Tranexamic acid (1 g three times a uterine bleeding for many years. day) was prescribed and the periods became more manageable. However, randomized controlled trials have shown it to be repeatedly Antifibrinolytic Agents 19 years, this was shown to be no ineffective in ovulatory menorrhagia. Treatment with tranexamic acid, higher than would be expected in One study has even shown that it an antifibrinolytic agent, results in the normal population. Although it causes a 20% increase in menstrual decreases in menstrual blood loss is currently restricted in New blood loss. It can be used to manage of 30 to 50%. The mode of action Zealand to specialist prescribing, it irregular anovulatory cycles as it involves depression of the fibri- is hoped this will change. The will induce a regular withdrawal nolytic activity of peripheral blood dosage is 1 g three or four times a bleed when given for 7 days of each through the inhibition of plasmino- day on the days of heavy bleeding. calendar month. Once menstrua- gen activation. Nonspecific side tion commences, other therapies effects are reported in approximately Oral Contraceptives may be given such as NSAIDs or one-third of women and include The combined OC pill is useful tranexamic acid. nausea and leg cramps. There is no in reducing menstrual blood loss Although progestogen therapy impact on dysmenorrhoea. and establishing regular cycles, no longer has a place in the main- There have been two cases of but the reduction in menstrual tenance therapy of regular heavy intracranial thrombosis reported in blood loss is less certain, as only periods, it still has an important Finland, but in a large epidemio- one randomized clinical trial has role in emergency suppression of a logical population-based study over addressed this. Use of the OC heavy, extended menstrual bleeding 42 JOURNAL OF PAEDIATRICS, OBSTETRICS AND GYNAECOLOGY NOV/DEC 2002 H O W T O T R E AT M E N S T R U A L D I S O R D E R S • GYNAECOLOGY • episode. This is achieved by giv- have been shown to reduce men- ing norethisterone (15 mg/day) strual blood loss by almost 90% in or medroxyprogesterone acetate women with menorrhagia after the (30 mg/day) for 3 to 4 weeks. The first few months of use. They also dosage can be decreased once bleed- provide very effective contracep- ing has ceased. Bleeding should tion with a low pregnancy rate stop in the first week but if it does (PEARL index <1) and are effective not, the dosage can be increased. in reducing dysmenorrhoea. The Figure 5. Thermal ablation technique. Once the patient has been free reported infection rate is lower of bleeding for 3 to 4 weeks, than that reported with other progestogen can be stopped and a IUDs. In New Zealand, they are term follow-up studies of effective- withdrawal bleed should occur. not funded unless provided within ness are awaited. A US trial com- Maintenance therapy can then be a public hospital. paring roller ball ablation with instituted. balloon therapy ablation has Another regimen is to give Surgical Management shown similar results for amenor- medroxyprogesterone acetate There are two main surgical rhoea at 6 months. About 10 to 10 mg/day initially and increase options for menorrhagia: 15% of women who undergo the dosage each day until the • endometrial destruction by ablation continue to have heavy bleeding has stopped. either laser or resectoscope, roller menstrual periods but the remain- ball ablation or thermal balloon der either have hypomenorrhoea Levonorgestrel IUD ablation; (35%) or amenorrhoea (50%). Medicated intrauterine devices • hysterectomy. At 4 years of follow-up, 25% (Figure 4) which release levo- of women who have had ablation norgestrel in a controlled manner Endometrial Destruction by resectoscope or roller ball will The hysteroscopic methods of laser, have had a hysterectomy either for resectoscope or rollerball have continuing heavy menstrual bleed- become well established over the ing or cyclical pelvic pain. Women past 5 years as methods of removing who have endometrial ablation endometrium. The procedure takes need HRT with both oestrogen and 30 to 60 minutes and is usually progestogen when they reach the done under general anaesthesia. menopause. Complications of haemorrhage, perforation and fluid overload Hysterectomy have been reported. There are three major techniques for The thermal balloon ablation performing a hysterectomy: vaginal, system is relatively new in New total abdominal and laparoscopi- Zealand. It is simple to use and cally assisted. Providing the uterus avoids major complications that is not larger than 12 weeks, the Figure 4. Photo of levonorgestrel accompany other techniques. (Figure majority of hysterectomies should be IUD. 5) It can also be performed under performed through the vaginal route. local anaesthesia. However, long The abdominal route is restricted JOURNAL OF PAEDIATRICS, OBSTETRICS AND GYNAECOLOGY NOV/DEC 2002 43 H O W T O T R E AT M E N S T R U A L D I S O R D E R S • GYNAECOLOGY • to those women with severe pelvic AMENORRHOEA Thyroid or adrenal dysfunc- disease such as endometriosis or tion or increased production of large fibroids. The laparoscopic route Although the absence of menstrua- androgens or prolactin may is particularly suited to those women tion may be welcome, it can indicate interfere with the menstrual cycle. who have no descent of the cervix severe disturbance of the hypothala- Pregnancy must always be excluded such as nulliparous women and those mic-pituitary axis. Amenorrhoea is in any woman complaining of with moderate endometriosis. Some defined as an absence of menstrua- amenorrhoea. 70% of hysterectomies can be per- tion for longer than 3 months. formed through the vaginal route. A woman with irregular periods Diagnosis It is possible to remove ovaries which occur more frequently than The 'amenorrhoea sieve' can be via the vaginal route. Total abdomi- 3 months is described as having used to filter possible diagnoses nal hysterectomy is usually necessary oligomenorrhoea. Primary amen- when assessing a patient with in 15% of women and the remain- orrhoea is defined as the absence amenorrhoea: der can be performed laparoscopi- of periods up to the age of 16 • uterus and outflow tract; cally. The cervix is usually removed after reaching 50 kg, whereas • the ovary; at hysterectomy although some secondary amenorrhoea is the • pituitary and hypothalamic women may choose to conserve it. absence of periods after sponta- centres; Women who decide to keep the neous menarche. • inappropriate or excessive cervix require either an abdominal An understanding of the production of thyroxine, prolactin hysterectomy or CASH procedure physiology of menstruation is or androgen; (classical Semm hysterectomy using necessary to understand the causes • pregnancy. laparoscopic techniques). Women of amenorrhoea and oligomenor- who retain their cervix need to rhoea. Menstruation depends on Disorders of the Uterus or continue to have cervical screening. oestrogen production from the Outflow Tract (Rare) Over 95% of women are satisfied ovary, the presence of a responsive These are commonly anatomical with the operation of hysterectomy endometrium, and a patent out- anomalies and include the following: but it does involve a 4- to 6-week flow tract. (Figure 6) Paramesonephric duct anomalies. convalescent period and in a few Failure of complete development per cent of women, there is dissatis- of the genital tract can result in faction because of new or ongoing primary amenorrhoea in the symptoms. presence of normal secondary sex Although it is not clear if characteristics. If any endometrium removal of the ovaries prevents is present, the patient will develop the recurrence of endometriosis, haematocolpos or haematometra consideration should be given to and cyclical abdominal pain. removing both ovaries at the time Androgen insensitivity (testicular of hysterectomy for women with feminization). These patients present endometriosis or pelvic pain other at puberty with primary amenor- than menstrual pain. If the ovaries rhoea and lack of sexual hair (no Figure 6. Physiological requirements are removed, HRT is given which of menstruation. androgen receptors), but do have is usually oestrogen alone. breast development due to the 44 JOURNAL OF PAEDIATRICS, OBSTETRICS AND GYNAECOLOGY NOV/DEC 2002 H O W T O T R E AT M E N S T R U A L D I S O R D E R S • GYNAECOLOGY • action of oestrogen secreted by the Hypothalamus. Hypothalamic testes. They have a male karyotype disorders are the most common and are sterile but otherwise lead a cause of secondary amenorrhoea and normal female life. Disclosure of include: weight loss-related amen- the karyotypic gender is a difficult orrhoea in athletes, dancers and in issue, as is gonadectomy. anorexic disorders; treatment with Endometrial destruction. Curettage phenothiazines which interfere with Figure 7. Normal ovary (left) and of the uterus may very rarely totally hypothalamic-pituitary function; and polycystic ovary (right). denude the uterus of endometrium. rare destructive hypothalamic lesions. Intrauterine adhesions form and Pituitary. Pituitary adenomas amenorrhoea follows. produce excess prolactin which Thyroid disease. Only gross dis- interferes with ovarian function. turbance of thyroid function will Ovarian Disorders (Rare) Galactorrhoea may be present. interfere with menstruation. Raised gonadotropin levels are the Rarely, anterior pituitary failure hallmark of ovarian absence or occurs following severe postpar- Management failure. tum haemorrhage. Treatment will depend on the Gonadal agenesis. The gonads cause of amenorrhoea and will fail to develop and no secondary Inappropriate or Excessive need to take into account a number sex characteristics appear. The Hormone Production of factors including the patient's karyotype is 46XX. The feedback mechanisms are age, desire for fertility and diagno- Gonadal dysgenesis. Turner's deranged. sis. There is no need to induce syndrome (46XO, mosaics) is the Polycystic ovarian syndrome. menstruation prior to evaluation; most common of these disorders. This disorder of the hypothalamic- it may confuse the clinical picture. Features include short stature, pituitary-ovarian axis is characterized webbed neck, shield chest and by raised LH and testosterone levels Weight Related Amenorrhoea increased carrying angle. Some in 50% of cases. The ovaries are This is usually treated by psychother- functional ovarian tissue may be enlarged by a peripheral ring of apy and use of antidepressants such present leading to a degree of follicles and stromal hypertrophy. as fluoxetine. Menstruation will secondary sex development. Oligomenorrhoea (less commonly, usually commence spontaneously Premature ovarian failure. The amenorrhoea) and hirsutism occur. once a BMI of 19 is achieved. cause of ovarian failure before the The common symptoms of andro- Excessive exercise programmes age of 40 years is usually unknown gen excess, hirsutism and acne are need to be reduced to under 3 but it may be an autoimmune most frequently seen in the poly- hours a week. Where the patient disorder. FSH levels are consistently cystic ovarian syndrome. BMI >30 cannot gain weight, oestrogen raised. usually worsens the problem due should be given as either HRT or to excess androgen production in the combined OC pill. This will Disorders of the Hypothalamic- adipose tissue. (Figure 7) protect the skeleton from stress Pituitary Axis Rare androgen secreting tumours fractures or osteoporosis in the The pelvic organs are normal and of the ovary or adrenal. Adrenal future, a problem that may occur the fault lies within the hypothala- hyperplasia and Cushing's syn- in athletes with low bone mineral mus or pituitary gland. drome lead to amenorrhoea. density. JOURNAL OF PAEDIATRICS, OBSTETRICS AND GYNAECOLOGY NOV/DEC 2002 45 H O W T O T R E AT M E N S T R U A L D I S O R D E R S • GYNAECOLOGY • Polycystic Ovarian Syndrome Regular withdrawal bleeds can be Drug Therapy induced by using luteal phase NSAIDs Medroxyprogesterone progestogen such as medroxy- For menorrhagia, dysmenorrhoea • Provera progesterone acetate or norethis- Diclofenac sodium Norethisterone terone (days 19 to 26) or the oral • Voltaren, Voltaren SR • Noriday 28 contraceptive pill. • Diclax, Diclax SR • Primolut N If fertility is desired and anovula- tion is established by a low day-21 Mefenamic acid Danazol • Ponstan For menorrhagia/dysmenorrhoea serum progesterone, then ovula- (use for several months then review) tion induction is indicated with Naproxen • Danocrine clomiphene citrate as the first choice. • Naprosyn, Naprosyn enteric, Naprosyn SR Bromocriptine Mesylate It is important to ensure the patient • Naxen For amenorrhoea has a BMI <32 as clomiphene is • Noflam, Noflam EC • Parlodel more likely to be successful. The Tiaprofenic acid Clomiphene Citrate role of metformin in helping with • Surgam For polycystic ovarian syndrome weight reduction and return of • Surgam SA • Clomid ovulatory cycles is as yet unproven Combined Oral Contraceptive Pill Hormone Replacement Therapy and randomized controlled trials For menorrhagia, dysmenorrhoea, For premature ovarian failure (if are awaited. The usual starting dose polycystic ovarian syndrome. ovulation not required). If the patient is 25 to 50 mg of clomiphene citrate Different combinations in relation to has intact uterus and is less than from days 2 to 6 of the cycle. Eighty different needs, eg. lowest dose that 2 years from her last menstrual would be effective for suppression of period (LMP), use a sequential per cent of women will ovulate ovulation, especially for young women. oestrogen/progestogen combination with clomiphene citrate in increas- Mercilon is the only one available in to induce a monthly withdrawal ing doses up to 150 mg/cycle. New Zealand with 20 µg of oestrogen bleed. If intact uterus but more than – all others have 30 µg or more. 2 years since LMP, then continuous Women who fail to ovulate with Diane-35 has the anti-androgen agent oestrogen/progestogen preparations clomiphene citrate can be offered for acne, hirsutism, etc. can be prescribed. It seems likely either gonadotropin therapy (given HRT can be used indefinitely, but Levonorgestrel IUD certainly for 5 years after either by IM or SC injections daily For menorrhagia menopause (ie. LMP), if there are no in the follicular phase) or the newer • Mirena contraindications to its use in the treatment of laparoscopic ovarian first place. Tranexamic Acid drilling. For menorrhagia Laparoscopic ovarian drilling • Cyklokapron probably works by destroying some Progestogens of the androgen-producing cells For irregular cycles – in order to within the stroma, and overall the induce regular withdrawal bleeding ovarian volume decreases. The cost (taken cyclically days 19 to 26 if of gonadotropin therapy varies from contraception not required) or for emergency suppression of prolonged NZ$1000–4000 per cycle and is or heavy menstruation. therefore restricted to women who are resistant to clomiphene citrate. 46 JOURNAL OF PAEDIATRICS, OBSTETRICS AND GYNAECOLOGY NOV/DEC 2002 H O W T O T R E AT M E N S T R U A L D I S O R D E R S • GYNAECOLOGY • sequential preparations, continuous Case Study: Magazine Self-Diagnosis preparations can also be given. Other conditions causing Presentation: A 36-year-old woman reads in a popular women's magazine about oligomenorrhoea are rare. a syndrome where women have irregular periods and problems of excessive facial hair. She consults her doctor telling her that she hasn't had a period for 5 years. Prior to this, she had had three to four periods a year since menarche at age DYSMENORRHOEA 14. She had an increasing facial hair problem and spent a considerable amount of money having weekly electrolysis. However, she still had a lot of facial hair. Dysmenorrhoea, or painful men- Examination/investigations: Her hormone results were: LH 17.6 IU/L; FSH strual cramps, is a common and 8.4 IU/L; testosterone 2.4 mmol/L; SHBG 36; free testosterone 56; prolactin often debilitating problem that can 251 mmol/L. cause a major disruption to a An ultrasound scan confirmed the suspected diagnosis of polycystic ovaries and the endometrial thickness was 10 mm. woman's life. Approximately 70% Treatment: A withdrawal period was induced with Provera 5 mg for 5 days and of adolescents experience dysmen- the patient was commenced on an anti-androgen, cyproterone acetate, for 10 orrhoea and of these about 10% days a month in conjunction with an oral contraceptive pill. Fertility was not lose significant time from school or desired. Follow-up was arranged at 3/12. The patient was warned that no work because of incapacitating improvement was likely for at least 3 months. pain on a monthly basis. There are two categories of dysmenorrhoea Where hirsutism is present, the pituitary are indicated. The described; primary dysmenorrhoea management will differ. Anti-andro- patient may initially experience some occurring in the absence of pelvic gens are effective treatment for hir- nausea and vomiting and therefore disease and typically in adoles- sutism; their mechanism of action is the initial dosages of bromocrip- cents, and secondary dysmenor- to suppress ovarian androgen pro- tine are low at 2.5 mg bid and then rhoea, where identifiable pelvic duction and to block the androgen gradually increased. Surgery is rarely pathology is usually present, most receptors in the hair follicles. Acne indicated for hyperprolactinaemia. often arising as a new problem for starts to improve within 6 weeks of a woman in her 30s and 40s. therapy. Hirsutism usually takes 4 Ovarian Failure Symptoms may include cramp- to 6 months to improve because of Premature ovarian failure is indi- ing, lower abdominal pain, pain that the length of time of the hair growth cated by persistently elevated FSH radiates to the back and upper cycle, and treatment is usually neces- levels (>20 mmol/L). If fertility is thigh, nausea or vomiting, diar- sary for 12 months. A contracep- desired, then referral to a fertility rhoea, headache and fatigue. Pain tive pill containing 35 µg ethinyl clinic to discuss ovum donation pro- can occur several hours before estradiol and cyproterone acetate grammes is appropriate. HRT with bleeding starts. It is usually most can be used as maintenance therapy. both oestrogen and progestogen severe on the first day of bleeding. should be commenced to treat the Primary dysmenorrhoea typically Hyperprolactinaemia short term problem and avoid the only starts on the first day of bleed- This is managed by lowering pro- long term consequences of prema- ing and is not prolonged. lactin levels with either bromocrip- ture menopause such as osteoporo- tine or cabergoline. When repeated sis. Although most women with Aetiology and Diagnosis levels of prolactin are greater than premature ovarian failure prefer In women under the age of 20, period 1000, then a CT scan or MRI of to have regular periods by using pains are unlikely to be associated JOURNAL OF PAEDIATRICS, OBSTETRICS AND GYNAECOLOGY NOV/DEC 2002 47 H O W T O T R E AT M E N S T R U A L D I S O R D E R S • GYNAECOLOGY • with pathology. Studies indicate advantage of reducing the men- therapy. If symptoms persist follow- that many women with primary strual blood flow in women with ing surgical therapy, medical therapy dysmenorrhoea have increased heavy menstrual bleeding. They can be started. abnormal uterine activity which is are usually started with the onset First choice of medical therapy secondary to increased release of of menstrual bleeding. should be the oral contraceptive endometrial prostaglandins at the Contraindications to their use pill, medroxyprogesterone acetate time of menstruation. This abnormal include a past history of gastroin- (depot or oral), gestinone or danazol activity leads to uterine ischaemia. testinal ulcers and bronchospastic (limited to 6 months' use). If these In secondary dysmenorrhoea, the reaction to aspirin or aspirin-like medications are unsuccessful at con- pain typically begins several days drugs. trolling painful symptoms, then the before the onset of menstruation more expensive gonadotropin- and other symptoms such as dys- Oral Contraceptives releasing hormone agonists can be pareunia and menorrhagia may be Oral contraceptive pills reduce given for a maximum of 6 months. present. the pain of primary dysmenor- Hot flushes are almost universal The aetiology of secondary dys- rhoea by reducing menstrual fluid (98%) and in some women it may menorrhoea includes endometriosis, prostaglandins as a result of an be necessary to 'add back' oestro- the presence of an IUD and pelvic overall decrease in menstrual blood gen. Prolonged use beyond 6 months congestion. Specialist referral for flow. The endometrial atrophy should be limited owing to negative diagnostic laparoscopy should be results in less endometrial shedding impact on bone mineral density. considered in women who present and bleeding. They do not suppress Pelvic congestion can be visualized with dysmenorrhoea for the first prostaglandin production through at laparoscopy in the absence of time in their 30s who do not the enzymatic pathway. They are other pathology. Typical symptoms respond to simple measures such as very effective and 80% of women are secondary dysmenorrhoea, anti-inflammatory drugs or the treated with oral contraceptive pelvic pain symptoms clustered in combined oral contraceptive pill. pills will have a significant reduc- the luteal phase, dyspareunia and tion in pain. postcoital ache. Treatment is usually Management A trial of therapy with oral con- by suppressing ovulation with Management of primary dysmen- traceptive pills and anti-inflamma- medroxyprogesterone acetate. orrhoea is centred on two therapies: tory medication should be given to NSAIDs and the combined OC pill. those women with primary dysmen- orrhoea and those with secondary NSAIDs dysmenorrhoea where pelvic exami- NSAIDs are used only for the days nation appears to be normal prior of the menstrual cycle on which to specialist referral. symptoms occur. Clinical trials have Where endometriosis is found, shown efficacy with most NSAIDs then laparoscopic ablation or excision including mefenamic acid, ibupro- is often undertaken at the time of About the Author fen, naproxen and diclofenac. the diagnostic laparoscopy. This has Dr Farquhar is an Associate Professor in Complete to moderate pain relief been shown to be more effective than Reproductive Medicine, Department of Obstetrics and Gynaecology, School of Medicine, University is achieved in 70% of patients. no therapy although no trials have of Auckland, National Women's Hospital, New These agents will have the added compared surgery with medical Zealand. 48 JOURNAL OF PAEDIATRICS, OBSTETRICS AND GYNAECOLOGY NOV/DEC 2002
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text: Share: Grilled Chicken Recipes Looking for grilled chicken recipes? Find grilled chicken recipes including grilled chicken breast recipes, grilled chicken salad recipes, and more grilled chicken recipes. Recipe Spotlight Herbed Beer Can Chicken Our July Fourth tradition is to grill chickens that stand up on a can of beer. It's a fun conversation piece. — Karen Barros, Bristol, Rhode Island View Herbed Beer Can Chicken Recipe Sign up for Our Recipeof the Day Newsletter New recipes and fan favorites delivering daily inspiration! SIGN UP More Grilled Chicken Recipes Sort: Highest Rated Alphabetical Contest Winning Newest < prev | 1 | 2 | 3 | 4 | 5 | ... | next > Grilled Huli Huli Chicken Grilled Huli Huli Chicken I got this grilled chicken recipe from a friend while living in Hawaii. It sizzles with the flavors of brown sugar, ginger and soy sauce. Huli means "turn" in Hawaiian. —Sharon Boling, Coronado, California View Recipe Spinach and Mushroom Smothered Chicken Spinach and Mushroom Smothered Chicken Chicken breasts stay nice and moist tucked under a blanket of melted cheese. It's extra special to serve but is not tricky to make. —Katrina Wagner, Grain Valley, Missouri View Recipe Baja Chicken & Slaw Sliders Baja Chicken & Slaw Sliders Between the flavorful sauce and colorful, crunchy slaw, these hand-held sandwiches demand attention from party-goers. —Janet Hynes, Racine, Wisconsin View Recipe Advertise with us ADVERTISEMENT Chicken and Asparagus Kabobs Chicken and Asparagus Kabobs These Asian-flavored kabobs, served with a tasty dipping sauce, are special enough to make for guests at your next backyard get-together. Sometimes I substitute salmon for the chicken. —Kelly Townsend, Syracuse, Nebraska View Recipe Sausage & Chicken Kabobs Sausage & Chicken Kabobs "My husband created this marinade while experimenting in the kitchen. It's a perfect combination. Hope you enjoy it." —Diane Mateer, Florence, Kentucky View Recipe Honey-Glazed Chicken Kabobs Honey-Glazed Chicken Kabobs "This is my husband's favorite 'special day' meal. I serve it with rice pilaf, salad and grilled garlic bread." —Tracey Miller, Aiken, South Carolina View Recipe Blackened Chicken Blackened Chicken This spicy standout packs a one-two punch of flavor. The grilled chicken is basted with a peppery white sauce—there's plenty of extra sauce left over for dipping. —Stephanie Kenney, Falkville, Alabama View Recipe Grilled Basil Chicken and Tomatoes Grilled Basil Chicken and Tomatoes Here's the perfect recipe for midweek summer barbecues! Relax after work with a cold drink while your savory chicken marinates, then toss it on the grill. Enjoy! —Laura Lunardi, West Chester, Pennsylvania View Recipe Jalapeno Chicken Wraps Jalapeno Chicken Wraps These easy appetizers are always a hit at parties! Zesty strips of chicken and bits of onion sit in jalapeno halves that are wrapped in bacon and grilled. Serve them with blue cheese or ranch salad dressing for dipping. —Leslie Buenz Tinley Park, Illinois View Recipe Quick Garlic-Lime Chicken Quick Garlic-Lime Chicken After tending the farm and growing our own produce, I don't have much time left for cooking. I've found this easy-to-prepare chicken is ideal for my many hectic days.—Doris Carnahan, Lincoln, Arkansas View Recipe Chicken 'n' Veggie Kabobs Chicken 'n' Veggie Kabobs I threw this recipe together for a party, and it was a huge success. Everyone commented on the meat's tenderness. —Becky Wiesmore, Rochester, New York View Recipe < prev | 1 | 2 | 3 | 4 | 5 | ... | next > Advertise with us ADVERTISEMENT Advertise with us ADVERTISEMENT


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The leather-and-lace trend illustrates a founding fashion principle: edgy and girly are best when combined. Nothing pulls off the contrast better than this intriguing new scent from BCBGMAXAZRIA. Inspired by the label's Fall collection, it mixes a tough-as-nails rocker sensibility with feminine accents. Wear it and be prepared to turn heads.
I am picky when it comes to scents because I associate scent with everything and this stuff is PERFECT. I love the smell, can be used for formal events or just the daily routine. I find it fitting for anything and always get compliments when I wear it. This stuff works. Good.5
I had stopped wearing perfume after so many scents just really bothered me. Then I got a sample of this, and I liked it. I wore it all day and still LOVED it. I wear it every day that I remember to apply it. This is me! Just bought the large size and it's pleasing to see on my dresser top.5


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UW Engineering in the Media
Note that links to media stories occasionally expire. Some may no longer be operational.
March 27th, 2015 | Daily Journal of Commerce
March 26th, 2015 | The New York Times
Drones Beaming Web Access Are in the Stars for Facebook Ed Lazowska, CSE
March 26th, 2015 | EE Times
Nanolaser enables on-chip photonics Arka Majumdar, EE
March 25th, 2015 | The Guardian
Igniting a revolution in scientific research and development
March 25th, 2015 | xconomy
UW Moves Toward 'Innovation Transfer'—Not Just Tech Transfer
March 25th, 2015 | R&D Magazine
Building a nanolaser using a single atomic sheet Arka Majumdar, EE; Xiaodong Xu, MSE
March 23rd, 2015 | KUOW
UW Injectable Polymer Could Help Stop Internal Bleeding Suzie Pun, Leslie Chan, BioE
March 20th, 2015 | The New York Times
How to Make Landslides Less Deadly Joe Wartman, CEE
March 19th, 2015 | Engineering.com
Insect Wings May Function As Gyroscopes Annika Eberle, ME
March 18th, 2015 | KING 5
Lecturer bakes more than 1,000 cookies for UW class Stuart Reges, CSE
March 18th, 2015 | GeekWire
What moths, bats and butterflies can teach us: New center to study their flight to develop better drones
March 18th, 2015 | Crosscut
Can Rep. Suzan DelBene keep your fridge from launching spam attacks? Shyam Gollakota
March 14th, 2015 | Seattle Times
UW Professor Gaetano Borriello, 56, dies Gaetano Borriello
March 12th, 2015 | Puget Sound Business Journal
UW researchers develop injectable polymer to prevent severe blood loss
March 11th, 2015 | GeekWire
University of Washington engineering student builds crime-predicting model for Seattle Jay Feng
March 11th, 2015 | KING 5
UW research: Injectable polymer could save bleeding patients Leslie Chan, BioE
March 11th, 2015 | KIROTV
UW researchers develop polymer to stop bleeding Suzie Pun, Leslie Chan, BioE
March 7th, 2015 | GeekWire
March 6th, 2015 | BloombergBusiness
Want a job in Silicon Valley after Yale? Good luck with that Ed Lazowska, CSE
March 5th, 2015 | KPLU
Injectable goo developed in Seattle could help stop trauma patients from bleeding to death Suzie Pun, BioE
March 5th, 2015 | The Scientist
Polymer helps blood clot Suzie Pun, BioE
March 5th, 2015 | Wired.Co.UK
March 5th, 2015 | RedOrbit
New injection helps stop traumatic blood loss Suzie Pun, BioE
March 4th, 2015 | The Verge
A simple injection could one day stop people from bleeding to death Suzie Pun, BioE
March 2nd, 2015 | GeekWire
Big data gets huge in Washington: Study ranks state 2nd in big data-related jobs Ed Lazowska, CSE
February 28th, 2015 | Everett Herald
Landslide Forum aims to bridge knowledge gap Joe Wartman, CEE
February 25th, 2015 | GeekWire
Tech leaders lobby for $40M in state funding for new UW computer science building
February 25th, 2015 | The Seattle Times
Geologists press for better maps to avoid 'the next Oso' Joe Wartman, CEE
February 24th, 2015 | KING5
February 22nd, 2015 | Crosscut


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May 05, 2015Organizations should treat social media as they would any other electronically stored information and assume it is potentially discoverable. Und...
April 07, 2015If content is king, then certainly customer experience is an integral part of the royal court. As companies everywhere invest in content marketi...
March 19, 2015It's no surprise social customer service demand is on the rise. To stay ahead of the game, your brand must formalize a streamlined and scala...
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Jun 23 Posted 9 months ago
These Facebook mobile and app stats are not surprising, though they are indeed interesting to know.
We're in the digital age nowadays, and there's no denial that Facebook and mobile devices have dominated the social networking world. Facebook has been the leading social media site with a million of users, while mobile devices have been widely used as an internet-based device.
Even I, myself, installed the Facebook app on my smartphone. Aside from this, I usually use my smartphone to read emails when I do not have my laptop with me. The same thing applies with a few of my friends and acquaintances.
This is just a proof that many people are now using Facebook mobile. I must say that using Facebook mobile is convenient and handy, and I know that other people will also agree with my reason.
Thanks for the post! :)
By the way, I found this post shared on Kingged.com


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DEFINITION of 'Manufacturer's Suggested Retail Price - MSRP'
The amount of money for which the company that produces a product recommends that it be sold in stores. MSRP does not necessarily correspond to the price retailers actually use or to the price customers are willing to pay. Retailers may need to set their prices below MSRP to move inventory, especially for items with low demand or in a sluggish economy.
INVESTOPEDIA EXPLAINS 'Manufacturer's Suggested Retail Price - MSRP'
One industry in which MSRP is frequently used is in car sales, where it must be displayed on a sticker on the car's windshield or on a spec sheet on one of the car's windows. The MSRP can help the customer determine a fair price to pay for the vehicle. The concept of MSRP exists in many industries, but outside of the auto industry it often has a different name, such as "list price."
Wholesale Price Index - WPIAn index that measures and tracks the changes in price of goods ...
Consumer Price Index - CPIA measure that examines the weighted average of prices of a basket ...
Retail Prices Index - RPIOne of the two main measures of consumer inflation produced by ...
Personal Consumption Expenditures ...A measure of price changes in consumer goods and services. Personal ...
InflationThe rate at which the general level of prices for goods and services ...
Producer Price Index - PPIA family of indexes that measures the average change in selling ...
12 Car Insurance Cost-CuttersIf car costs are dragging you down, find out how to free yourself from some of the extra weight.
Personal Finance
Top 10 Ways To Get Top Dollar For Your CarFind out what steps you can take to reduce the depreciation of your vehicle.
Options & Futures
Beginner's Guide To Auto InsuranceFind the perfect policy that suits both your coverage and budgetary needs.
Options & Futures
The Consumer Price Index: A Friend To InvestorsAs a measure of inflation, this index can help you make key financial decisions.
Options & Futures
Top Tips For Cheaper, Better Car InsuranceAccident, theft, vandalism - make sure your coverage will protect you when you need it most.
Options & Futures
Your Car: Fixer-Upper Or Scrap Metal?Sometimes buying a new car can be cheaper than shelling out for repairs.
The True Cost Of Owning A CarDriving is often the most convenient way to get around, but it'll cost you.
Personal Finance
Why Are Tesla Cars So Expensive?What makes Tesla cars so expensive? Short supply and pricey parts is a good place to start.
Why Are Consumers In Hesitation?Diverging monetary policy globally and a stronger dollar continued to be key drivers of the recent underperformance and last week's tumble in U.S. stocks.
Stock Analysis
3 Things I Learned From lululemon Athletica's 10-KLululemon athletica has emerged not only as one of the nation's fastest-growing retailers, but also as one of the market's favorite growth stocks.


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Get inspired on Snohomish wedding tour
You can visit chapels, ballrooms and rustic farms, sample foods, hear DJs and speak with wedding planners to help you make decisions for your 2015 wedding.
Get tickets, $5 per person, at www.MySnohomishWedding.com. On tour day, check in at Snohomish Center, at 506 Fourth St. The first 50 couples will get a special swag bag.
For a preview of the day's events go to MySnohomishWedding.blogspot.com. Connect before and during the tour on Twitter: @MySnohomishWed. Hashtag for this event is #snohomishweddingtour.
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Sinnergy V2(wip)
Credits & Info
- Date
- 10/12/2012
- File Info
- Song
- 4 min 4 sec
- Score
- 4.00 / 5.00
Licensing Terms
- Attribution:
- You must give credit to the artist.
- Noncommercial:
- You may not use this work for commercial purposes unless you make specific arrangements with the artist.
- Share Alike:
- If you alter, transform, or build upon this image, you may distribute the resulting creation only under a license identical to this one.
- Score:
- Rated 4.00 / 5 stars
- Plays & Downloads:
- 160 Plays | 22 Downloads
- Share Links:
- Genres:
- Electronic - Video Game
- None
Author Comments
Rated 5 / 5 stars
hey man this is an interesting piece. it was poping a lot from what i could hear especially around and after 2.50. but i dont really have any complaints...i could definetly see this as some awesome music for some sort of boss fight keep up the work man!
Kyleadam89 responds:
yeah this is a really rough version, trying to clean it up and get rid of the popping noise sounds, lol, but the reason after 2:50 is probably due to the synth I used after that point, it was a new one that needs to be fine tuned, but anyways thanks for listening and reviewing, always helps!


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Home > News > The Evolution of Frankenfoods?
July 18th, 2005
The Evolution of Frankenfoods?
PETA science consortium to present at Society for Risk Analysis meeting December 10th, 2014
PETA science consortium experts to present at international nanotechology workshop: PETA International Science Consortium, Ltd., Is a Sponsor of Nano Risk Analysis II September 12th, 2014
PETA science consortium to present hazard testing strategy at nanotoxicology meeting: High tech field ripe for use of sophisticated non-animal testing strategies April 22nd, 2014
Scientists disagree on responsible research April 8th, 2014
Preparing for Nano
Durnham University's DEEPEN project comes to a close September 26th, 2012
Technical Seminar at ANFoS 2012 August 22nd, 2012
Nanotechnology shows we can innovate without economic growth April 12th, 2012
Thailand to host NanoThailand 2012 December 18th, 2011
Possible Futures
Nanotechnology in Medical Devices Market is expected to reach $8.5 Billion by 2019 March 25th, 2015
Nanotechnology Enabled Drug Delivery to Influence Future Diagnosis and Treatments of Diseases March 21st, 2015
Nanocomposites Market Growth, Industry Outlook To 2020 by Grand View Research, Inc. March 21st, 2015
Nanotechnology Drug Delivery Market in the US 2012-2016 : Latest Report Available by Radiant Insights, Inc March 16th, 2015


text: Social Tumblr updates Android app with a radical new look April 10, 2012 4:01 PM JVG 0 Gaming execs: Join 180 select leaders from King, Glu, Rovio, Unity, Facebook, and more to plan your path to global domination in 2015. GamesBeat Summit is invite-only -- apply here. Ticket prices increase on April 3rd! Hot blog-baker Tumblr has cooked up a zany and colorful update to its Android application. Five-year-old, New York-based Tumblr is the go-to blogging platform for the young and hip. The company now powers more than 51 million blog sites and reaches well over 120 million people each month. The Android release, out now, includes a radical new design and interface, loads faster, spits out notifications for multiple blogs in one place, prettifies the photo-browsing experience, and supports animated gifs. The update also comes with Tumblr Radar, the curation engine that spotlights top posts on the network. Tumblr's new do is getting rave reviews from Android users who appreciate the app's unique sense of style. A few commenters, however, have called out some outstanding flaws. "There are several things it is now missing, such as seeing the replies to posts, ability to see the last time someone posted when looking at people you follow, among other things. Not to mention the fact that it randomly logs the user out," one Google Play store customer wrote. With the update, Tumblr for Android now looks drastically different from the startup's iPhone application, but a company spokesperson told VentureBeat that the iPhone app is also in the process of being reimagined. VentureBeat's VB Insight team is studying email marketing tools. Chime in here, and we'll share the results.


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Team Assist
Closed - This job posting has been filled and work has been completed.
Job Description
Work with a growing and enthusiastic team trying to do more with less.
No experience necessary, willingness and ability to learn quickly a must.
Honest and hard working.
We prefer to have students or those who have recently completed school.


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now its really time up upgrade to comoblog 1.1 from my well running easymoblog 0.51 ...
I move to a new dedicated server ( my ISP warned me for too much traffic ... )
and I move from early php4 to new php5 now and got like apparently many ten thousands
( see google
how many sites actually display that erorr .. )
it seems to have to do with incompativble PHP4 code used in easymoblog
hence my question:
is anyone using successfully comoblog in a current PHP5 system ??
as posted much earlier
all attempts to upgrade failed due to modified table with background
I have now removed that table entry using
DELETE FROM easymoblog_preferences WHERE pref_name='CFG_BG_IMG_REPEAT';
and my heavily SEO-modified version should now be fully compatible for upgrade to comoblog on new server using apache2 / PHP5
if comoblog is running PHP5
any successful YES or howto would be apreciated
miracles come sooner than expected
the php5 issue seems no php issue but a character set issue
having googled and saw that many have the same error as the blog gives
in one of the few solution posts found in google
i saw a post having the same error about the time funtion in php for vbulletin forum
and the vbulletin man suggested a reinstall using ASCII charset
hence i restored my mysql blog db using ascii instead of iso-8859-1 as charset of original file and see
it all works with php5
Google analytics always shows my blog pages ( all my own system is utf8 ) as ASCII eventhough my (ex-) host (1AND1.COM) insisted to have all mysql in iso-8859-1 collation swedish
Mark Wallis (aka serialmonkey)
Glad to hear you have it up and running.
I know that the Setup Wizard has problems with PHP5 that stops someone doing a clean install or an upgrade on a PHP5 system, but by the sounds of things the rest of the application works fine from your tests.
>>>I know that the Setup Wizard has problems with PHP5 that stops someone doing a clean install or an upgrade on a PHP5 system,
dont suppose you know what it is do you? i've been bitten by the bug again and am having a go at getting the next release out of the door, but im on php5 now so i cant install ;-(
Mark Wallis (aka serialmonkey)
Man, I REALLY need to find a decent host that is running php5 so I can play with it to find out.
From memory, it's todo with the way we are handling the session as it's where we store what page we are up to ....


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Vt. farmer charged in drug ring
BURLINGTON A Vermont farmer has been charged in a large marijuana trafficking ring involving drugs that federal officials believe were smuggled across the U.S.-Canadian border.
Kirt Westcom of East Fairfield pleaded not guilty late last week to conspiring to distribute more than 100 kilograms of marijuana.
Westcom, who owns a 140-acre farm, is the fourth man to be charged in the case.
Jeffrey A. Donna, who owns T.J.s Country Store in Montgomery; Roy L. McAllister II, vice president of McAllister Fuels Inc. of Richford; and Jesse J. Soule, a Montgomery dairy farmer, pleaded not guilty on May 29 to marijuana trafficking conspiracy charges.
McAllister and Donna would often drop off marijuana at Westcoms property between 11 p.m. and 2 a.m., a confidential informant told authorities, according to a police affidavit.
Westcom allegedly often hid the pot in hay bales in his barn, the affidavit said.
When the three other suspects were arraigned last month, federal drug agents searched Westcoms home and found evidence of marijuana and a marijuana grow room, court records show.
Law enforcement inquired about his source of supply, and Westcom suggested that he wanted to talk to a lawyer, the affidavit said.
Westcom was arrested on Thursday, the Burlington Free Press reported.
Federal agents alleged the marijuana was smuggled across several spots on the Vermont-Quebec border.MORE IN This Just InNEW YORK Emergency workers found a body Sunday in the mass of rubble left behind by an apparent... Full StoryHALIFAX, Nova Scotia An Air Canada plane made a hard landing short of the runway at the Halifax... Full StoryWASHINGTON The National Security Agency considered abandoning its secret program to collect and... Full Story
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Weekend Snapshots
How was your weekend? Mine flew by way too fast. This is my last weekend at home before I go to Virgina... Read More
Friday's Fab Five – Weekly Inspiration Board
I'm so happy it's Friday! What are you all up to this weekend? Any fun plans? Here are a few other things... Read More
Winter Tablescape
We're finally having our first cold day here in Florida. It got down to a super low of 55 degrees lol, just... Read More
Manicure Mondays – Candy Cane Nails
I've been wanting to do a candy cane manicure for the past couple of years now. As you probably already know, I... Read More
Weekend Snapshots
Did you all have a good weekend? Mine was relaxing and so productive! My man was in town which is rare for... Read More
Game Day Slow Cooker Chili
It's college game day, as evidenced by my husband waking me up bright and early singing the college game day song {we're... Read More
Friday's Fab Five – Weekly Inspiration Board
Happy Friday! Do you have any big plans for the weekend? I'm finishing up a tablescape that I hope to share with... Read More
ruche's homemade holiday guide
Ruche just released their "A Homemade Holiday" guide to crafts, recipes, fashion and manicures. It's a DIY overload full of so many... Read More
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Compare hundreds of teachers based on the criteria that matter to you, including background checks, age and experience.
When you've found the perfect match, schedule your lessons online using the teacher's real-time availability.
Your teacher will welcome you with a personalized curriculum to meet your specific goals and you'll be able to manage your entire schedule through our free online account.
Zero travel time is great for a busy schedule.
Typically priced lower than local lessons.
Online students stick with lessons as long as local students.
For over 10 years Amy has dedicated her time to offering full-service music lessons to both beginner and advanced students of all ages. She provides a complete lesson program where students learn every aspect of music including: history, theory, composition and technique in playing skills. *** Lesson Details *** Ms. Amy utilizes a variety of curriculum based on each students abilities, interests and learning styles. Alfred, Faber and Schaum are the most popular and are integrated with a variety of unique books and music tailored to each student. After 6 months, beginner students will have a working knowledge of reading staff music, scales and more. *** Studio Equipment *** Roland . Fender . Epiphone *** Travel Equipment *** I will bring books that the student would reimburse me for. ...
I've been teaching professionally to all ages and levels for over 10 years throughout the Chicagoland area. I have been playing for about 19 years. Music is my passion. I even own and run an all ages music venue. Teaching is my biggest love and I love seeing students learn! There isn't a style I will not teach. All music to me is fascinating:) *** Lesson Details *** All lessons start with the basics (assuming the student doesn't already know them). This includes: reading music and chord diagrams (usually using a book for students under the age of 15), understanding rhythm, basic music theory, etc. Meanwhile, we apply this knowledge to songs of the student's choice- this way they're learning songs they like, and more about guitar and music at the same time. As time goes on we'll get into ...
I have performed professionally on stage and in the studio for over 20 years. I studied music with a double major in guitar and bass guitar. I also play flute and keyboards. I began my musical training at 10 years old learning how to play guitar. I have a deep love for music and began to teach what I know to others and found that teaching music is very rewarding. I like to help others discover the joy that comes from learning and playing a musical instrument. I am great with young students just starting out and make sure that learning their instrument is a fun experience. With teenagers and adults, I not only teach guitar methods, but also the basic principles required to "jam" with other musicians. I also work with bands and ensembles teaching basic performance techniques ...
I am a graduate of Northern IL University with a Bachelor's Degree in Music Education. I have 22 years of teaching experience where I have traveled to the homes. Students enjoy my passion that I have with the instrument. I started teaching in 1991 and have been teaching several students since then. Attending teacher workshops keep me at a current updated level and I want to help the students learn to the best of their potential. *** Lesson Details *** I am very thorough in my teaching, which includes lesson, theory, technique, and performance methods. I use a very easy, flexible approach when it comes to the kids and their personalities. I expect a lot out of my students, yet still want them to learn and have fun. After three months with me, they will have learned how my
Hello! My name is Kimberly and I teach: -Beginner to Intermediate Guitar -Beginner to Intermediate Piano -Beginner through Advanced Vocals As a participant in All State choir in high school, the only female in the U-46 district to make District 9 state Jazz choir, and the recipient of over 20 awards for singing, I'm at a place where I can use my experiences to help you start your journey! I've been singing and playing my instruments for all of my life. My talents have taken me across the United States and back, even singing the National Anthem on Fox for the World's Strongest Man competition. Having a passion for music, I picked up piano and guitar at a young age and studied both for years, finding new ways of combining the two with voice and also being able to play them ...
I just graduated from Columbia College Chicago in May 2014 with a BA in Music Composition. I studied under composers: Drew Baker, Kenn Kumpf, Ilya Levinson, and Marcos Balter. I've had performances and worked with members from the groups, Del Niente and Chicago's Composer's Collective. I'm a self taught guitarist who has been playing for 14 years. I have played in numerous bands and ensembles ranging from jazz to folk to rock. I've been writing music for the same length of time. Song-writing, counterpoint, orchestrating, arranging, music theory, and composing are subjects I'm well versed in and would love to teach to other people. I'm experienced with all kinds of music software, such as: Pro Tools, Logic, Garage Band, Cubase, FL Studio, Finale, Sibelius. If you want to learn ...
Take your voice to the next level. Download free video tutorials to start singing like the star you are!
Getting Started with Music Lessons guides you through selecting a teacher & preparing for your first lesson.
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Our online tools make booking, managing your schedule and paying for lessons easy and hassle-free.
Easily search and compare teachers in your area, including past student reviews and background checks.
If you're not completely satisfied, we'll help you find a new teacher or refund any unused lesson credits.
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The Hot Sheet
BY Advocate.com Editors
December 10 2010 9:00 AM ET
The Tempest — Shakespeare's turbulent Prospero, a wizard in exile, gets a sex change and makes the story a vehicle for the formidable Helen Mirren (as Prospera). Julie Taymor's imaginative adaptation of the one of the bard's most magical plays is full of sound and fury, but when Mirren isn't on-screen, it's mostly plodding. Mirren's scenes with androgynous Ben Whishaw (as the sprite Ariel) are, well, sprightly, but Russell Brand, Djimon Hounsou, and the rest of the cast seem lost at sea.
The Tourist — Both Angelina Jolie and Johnny Depp look gorgeous, but neither can compete with the beauty of Venice's Grand Canal. The superstars surprisingly fail to spark much heat in this romantic escapade, an unsatisfying English-language remake of a 2005 French film. What seems like an homage to Hitchcock's still-spellbinding North by Northwest is undone by the deadly pacing.
- Backlash Continues: Angie's List Cancels Indiana Expansion
- Time to #BoycottIndiana? Celebs Blow Up Social Media
- After Indiana, 23 More States Could Pass Discrimination Bills
- 6 Bad Behaviors for HIV-Positive People
- 7 Immediate Examples of Backlash to Indiana's 'Religious Freedom'
- Trixie Mattel on Drag Race Elimination: 'It Was Rude'


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Posted on Thursday, March 19, 2015 - 11:23 by 523_8
In the next few months YPRL will be launching a new look website! Our website CMS is being upgraded and as a result we will have a completely redesigned user experience. THE DETAILS: The front page will be organised into decks so that you can explore our collection and services in different ways - through genre, audience, format and more. But, don't worry, all the . . . more »


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100-degree heat grips the South, Midwest
DALLAS The temperature setting is stuck on broil across a swath of the Midwest and South, with Dallas and Oklahoma City sweltering through 100-degree heat for at least 10 days in a row.
Forecasters warned on Monday that the extreme heat could continue for most of the week and perhaps beyond. At the same time, many people won't be able to cool off by taking a dip: Swimming pools in some cities have closed because of budget cuts.
Heat advisories and excessive-heat warnings were issued Monday for 17 states in the Midwest and South. For Tuesday, the National Weather Service issued heat advisories for much of the East Coast, from Georgia to Connecticut, where temperatures are expected in the upper 90s but will feel as hot as 105 because of the humidity.
"It says a lot when you are dealing with such an expansive area of heat alerts," said National Weather Service spokesman Chris Vaccaro.
Hutchinson, Kan., had reached 103 by Monday afternoon after hitting a scorching 112 on Sunday. (Records haven't been kept there long enough to tell if it was a new high for the date.) The mercury hit 99 in Joplin, Mo., by the afternoon after topping out on Sunday at 106, breaking the record of 104 for the date, set in 1980.
Oklahoma City has hit 100 degrees or higher - 110 on Saturday - every day since June 29, including Monday, making it 13 in a row. The record there is 22 consecutive days of 100 degree-plus weather, set in 1936.
Dallas recorded its 10th-straight day of 100-degree weather Monday. The city hit 100 for nearly three straight weeks as recently as 2006, and the National Weather Service issued a heat advisory Monday afternoon for the Dallas-Fort Worth area for the first time since June 18. The advisory will remain in effect until Wednesday night.
In 1980, the Dallas-Fort Worth area endured 42 days in a row of 100-degree-and-over heat.
Triple-digit highs are expected through the weekend in Dallas, and there is little chance of rain to cool things down.
"It's breaking daily records, but when you're talking about a record string of days - we're not there yet," Vaccaro said. "We're in the midst of a heat wave that's not over yet."
On Monday, 87-year-old R.F. Lanham was taking the heat in stride as he picked weeds in his shaded front yard in Dallas. "I've seen a lot of hot summers," he said.
As 40-year-old Sally Smith loaded two of her children into her minivan as she left a spin class at a Dallas YMCA, she said that even though she had lived in Texas for 18 years, the hot weather was hard to get used to.
"You feel like your skin is baking," the Michigan native said.
In Fort Worth, all of the city's pools are closed because of budget cuts. Through a partnership with the YMCA, Fort Worth residents can swim at four of its pools for two hours a day without a membership.


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what should a normal gravity reading for an american pale ale after 10 days in the primary. I racked to secondary and took a hydrometer reading and got 1.005. Thanks
It depends on the starting gravity and the recipe and the ingredients. That seems low. Did you add sugar? What was the recipe?
It depends on your recipe, but I think an 'average' final gravity for a pale ale is anywhere from 1.010 - 1.018
1.005 seems pretty low, but someone with more experience could give better info. I think the lower the final gravity the dryer the beer will be and the higher the ABV% will be.
according to beersmith 1.010-1.015
Speaking of hydrometers, I'm about to buy one but am a bit confused. I was thinking of getting this triple scale hydrometer:http://www.austinhomebrew.com/produc...roducts_id=801
Do I need to buy the test cylinder too?
No, but unless you plan on putting the hydrometer directly in the fermenter, it's the best thing for reading a sample. You need a container that is deep, but very narrow so that you don't waste much beer. Puting the fermenter in a bucket is easy, but hard to take a reading. A carboy is easy to read, but har to get it in and out. Get the hydrometer jar...
My first pale I did it fermented to 1.004. It's really dry. Guess my yeast was extra fresh and awesome when I didn't want it to be.
As for the hydrometer, yes, I too would recommend the jar.
You have probably mashed on too low temperatures. 1.005 is way too low and the beer will be dry and dull. What was your mashing temperature? If you did a two stage @58C and @66C with well modified malt, you will get about 1.003-1.005 FG. Perhps you could achieve so low a FG with single infusion mashing as well, but you would have to go really low, like 63-64C or something and use really well modified malt.
In a nutshell: your FG has nothing to do with yeast or fermentation temps, you just got too much fermentable sugars. Buy a better thermometre and check your mashing temps.


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Nadine Tarbouriech's series of abstracts on recycled paper is a recreation of her memories
The strips of green and brown with black lines evoke the image of rolling grasslands with little fences enclosing lush fields. Shades of light green represent the grass while the dark green, trees. The brown could be soil or the earth or even tree trunks.
And that's what Nadine Tarbouriech, who has displayed a series of works "Vernissage" at the Galerie De'Arts hopes to do. Through her work on recycled and handmade paper mainly in tempera and pigments, Nadine hopes to evoke the viewers' memories of things they have seen in their lives, just as her own works are a reflection of the impressions she has gathered in her travels.
"I do not really have a concept in my works. I am not trying to figure anything, I am just working with my senses and emotions, through my memories of light, colours or shadows that I have witnessed, to recreate them. I am not trying to communicate anything. My work simple expresses what I have witnessed or have been sensitive to," says the French artist who divides her time between Paris and India.
The current series of works is based in the Cholamandal artists' village where Nadine works.
"We often have friends staying with us and they leave paper bags which I found when looking for paper. So I used some of the paper and recycled a part of it. It had lovely texture and responded to light and shade," says Nadine.
They also responded to the tempera water colours, making the colours appear bright, she adds.
And so Nadine's works, which are made of strips of paper put together, feature shades of red, orange, yellow, pink, rose and brown in abstract strokes.
The series also features her work on handmade paper simply using pigments of colour, mainly green, red and orange, which spread on paper producing a vivid texture and visual quality.
"Vernissage" will be on view until February 18 at Galerie De'Arts, 11 floor, Barton Centre, 84, M.G.Road. For details, contact 9343368450.


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An interesting side-story if touring the frescoes....
Be sure to check the details, but there's a route suggestion here...
The "greatest picture in the world" (Aldous Huxley) can be seen at the wonderful Museo Civico di Sansepolcro, along with many other of Piero della Francesca's works such as the polyptych "Madonna della Misericordia" and "San Giuliano"!
Thank you, Peter, for posting the link.
But 18 months ago...
Sadly the second link is no longer working (hint, hint!)
Fellow travelers,
As my wife and I are in Tuscany only 4 nights, would you consider the towns of the Casentino Hllls a worth a day's tour?
We have toured south from Siena to Montepulciano; west as far as Lucca and driven the Chianti roads. We will use a tour company for the tour.
Opinions? Good Experiences? Not so good?
Markettime-San Diego
Wow. Talk about a perfect example of when NOT to piggyback on an existing thread. MarketTime, you should start a new one since your question is about as off-topic as possible.
Yes, worth a day's tour. You were mentioning before stopping in Sansepolcro and I had suggested adding Monterchi and Arezzo - that would make for a full day. However, if you have yet another day, you could add on Citta di Castello, Anghiari, and possibly head all the way up to Chiusi della Verna to see La Verna, the sanctuary of St. Francis and where he received his stigmata. A stunningly beautiful and quite peaceful place.
In Anghiari, you can visit Busaatti Linens and tour their "factory". http://www.busatti.com
They make incredibly beautiful things. At the very top of Anghiari, there is a small shop of various art pieces. , in there sits a woman you can watch making lace. For lunch, go to one of my favorites (unless it is a Tuesday, they are closed) - Da Alighiero
Oh, just saw your note that you are doing with a tour company. What is their Itinerary?


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Programs and artists are subject to change without notice. The El Paso Symphony is made possible with the support of the City of El Paso Museums and Cultural Affairs Department and the Texas Commission on the Arts.
Featured Musicians
Upcoming Events
Downtown KidsPalooza
March 28, 2015 Downtown El Paso
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Labor activists are torn, over whether or not to use the Super Bowl as a venue to bring attention to Indiana's Right-to-Work law.
Many activists view the huge sporting event as a great opportunity to bring attention to the controversial law, but others worry that angering sports fans during the big game could backfire. Click here for The Wall Street Journal's article, detailing the arguments over whether to use the Super Bowl as a venue to protest the law.
It's Crunch Time for Organized Labor
Labor unions are facing the most direct challenge to their political and financial clout since Ronald Reagan broke the air-traffic controllers union 30 years ago. Across the industrial Midwest Republicans are trying to roll back the powers of not just public-employee unions but also the bargaining and dues-collecting power of groups that represent auto workers and carpenters. WSJ's Neil King brings us up to date. Download MP3
Whitens, Brightens and Confuses
It should be so easy: Buy toothpaste. But few shopping trips are more bewildering. WSJ's Ellen Byron breaks down the toothpaste aisle. Download MP3
Germanwings flight co-pilot 'deliberately' crashed plane but questions remain, self driving cars are almost here but only for 1 per-centers and Dean Smith willed $200 to each of his former players.
Jet audio shows one of the Germanwings' pilots locked out of cockpit, Sgt. Bowe Bergdahl is charged with desertion and when two minutes isn't really two minutes.
The search for clues continues in Germanwings crash, a new app hopes to change the face of the 2016 presidential race and the one place where Kentucky basketball is only OK.
Ted Cruz lays out his conservative agenda, police can't confirm alleged University of Virginia rape and will we see $2.00 gas again.
Ted Cruz announces 2016 GOP Presidential bid, why the U.S. prefers drone strikes and what you are missing in your taxes.
Wake up with America's first news – The Wall Street Journal This Morning. Host Gordon Deal and news anchor Gina Cervetti go beyond the headlines with the day's first look at news and business news from the U.S. and around the world; bringing a lively blend of intelligent information, humor, and expert analysis to morning radio.
Gordon Deal Before taking the helm at The Wall Street Journal This Morning in November 2005, Gordon was well-known to New York City radio listeners, having worked at both WINS-AM and WCBS-AM where he honed his writing skills and developed his distinctive on-air reporting style. He also served as New York City bureau chief for Metro Networks where his reports aired on WOR-AM and WABC-AM.
Gina Cervetti has an extensive radio news anchoring and reporting background including several years at Boston NPR affiliate WBUR-FM where she anchored the local production of "All Things Considered" and "Here and Now." Gina is an Associated Press Award-winning broadcaster, whose reports have been heard all over New England, including WRKO Boston and WTAG Worcester. She graduated from Boston University.
Mike Gavin oversees the production of the show which includes coordinating segments with WSJ reporters, editors, and outside newsmakers. He also oversees the sound and content of the show including all music and sound elements. Mike had spent a decade in radio programming and production before finding a home at WSJ Radio in 2007. He lives at the Jersey Shore with his wife and son.


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Sisleya-Elixir sounds like a youth elixir if there ever was one (there have been thousands over the years since we began reviewing products, and none have ever turned back time by even one day). The main ingredients in this serum are water, glycerin, algae, wax, and potato extract. Who knew such commonplace ingredients could plump up the dermal layer and restart the process and reflexes of young skin? Actually, they cannot do this, and the only reason to invest in these vials is if you thoroughly enjoy wasting your money on empty promises.
A skin renewal program whose innovative concept is to send the skin targeted messages to restart the natural mechanisms and reflexes of young skin: repair the dermo-epidermal junctions, fight stress, reactivate the synthesis of lipids and plump up the dermal layer. The results are spectacular.
Water, Glycerin, Algae Extract Paraffin, Solanum Tuberosum Extract, Salix Alba (Willow) Leaf Extract, Cyclopentasiloxane, Hydrolyzed Malt Extract, Ginkgo Biloba Leaf Extract, Tocopheryl Acetate, Propylene Glycol, Arginine, Phenoxyethanol, Acrylates/C10-30 Alkyl Acrylate Crosspolymer, Xanthan Gum, Sodium Methylparaben, Sorbic Acid, Tetrasodium EDTA, Butylene Glycol, Fragrance (Aroma), Chlorphenesin, Methylparaben, Ethylparaben, Butylparaben, Propylparaben, Linalool, Limonene
Sisley Paris At-A-Glance
Strengths: Most of the sunscreens offer sufficient UVA protection; a unique lip balm; impressive foundations; good loose powder, blush, and eyeshadows; their most expensive mascara provides beautifully defined results.
Weaknesses: Exceedingly expensive, and the prices are not justified; several products contain irritating plant extracts or fragrant oils, most of which have no substantiated proof of benefit for skin; no AHA or BHA products; no products to address acne or oily skin (at least without causing irritation); jar packaging; poor concealer; standard eyeliner and brow options (at Sisley's prices, they should raise the bar); mostly average lipsticks.
Here are some of the more far-fetched claims this company makes, with my responses in parentheses. "The Botanical Floral Mist can help skin sustain the effects of the sun." (No way, it doesn't even contain appreciable amounts of antioxidants.) Another claim is that their All Day All Year moisturizer, which carries a paltry SPF 8 rating, blocks "90% of UVA and UVB rays for 8 hours." Another is that their sunscreen products protect skin while allowing a tan to develop "gently and gradually." (We guess they don't know or won't acknowledge that any amount of a tan is a sign of skin damage and isn't the least bit healthy.)
The company also claims that all of their products are subject to strict research to measure their efficacy, but of course, the results of the "research" are not available to the public, and Sisley's counter personnel are quick to rebuff any questions about the validity of their claims. That's not surprising, as there is no way most of the claims can be legitimately proven and, for the most part, Sisley salespeople are accustomed to well-heeled women simply believing everything they have to say about the products, pricing be damned.
What is perhaps most distressing is that the Sisley formulations are some of the most embarrassingly ordinary and insultingly overpriced we've seen. We can emphatically state that there is nothing in these products you can't find at the drugstore from lines such as Nivea, Pond's, Neutrogena, Dove, and Olay. Actually, those lines have products with far more interesting formulations than this one does. For those who prefer shopping in upscale department stores where Sisley resides, there are several other companies at the counters in those lofty areas that offer far better products than Sisley. For example, Chanel's skin-care products are assuredly expensive, but at least some of their formulas approach state-of-the-art. The Lauder-owned lines seem cheap in comparison to Sisley, yet most of the Lauder products are far more advanced and formulated with current skin-care research in mind.
You may indeed find some Sisley products to love, but those who cannot afford this line needn't worry for a second that their wrinkles are not getting the crème de la crème. In fact, most of Sisley's skin care is the equivalent of a plain doughnut, with empty calories, and nothing worth savoring.
Note: All Sisley products contain fragrance, and we mean a lot of fragrance, unless otherwise noted.
For more information about Sisley Paris, call (914) 251-0032 or visit www.sisley-cosmetics.com.
Sisley Paris Makeup
Sisley's makeup is a bit more straightforward than its skin care, at least in terms of exaggerated claims. However, the shockingly high prices are still intact. It would be nice if the prices were even a little justifiable, especially for their best products (the makeup has improved in a few key areas since its last review), but that is simply not the case. I wouldn't encourage you to consider any item in this list, unless you like to overspend for results that range from average to great (with the best products easily being replaced by considerably less-expensive options). You'll come across a lot of claims for the plant extracts in Sisley's makeup, but their contribution is minor compared to the standard, efficacious cosmetic ingredients comprising the bulk of the formulas. If you absolutely must devote a portion of your cosmetics budget to Sisley makeup, at least the reviews should prove helpful and allow you to focus on the best that this overpriced makeup collection has to offer.
The Beautypedia Research Team is dedicated to helping you find the absolute best products for your skin, using research-based criteria to review beauty products from an honest, balanced perspective. Each member of the team was personally trained by Paula Begoun herself.
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Real Techniques by Samantha Chapman Stippling Brush
260 reviews
83% would repurchase
Package Quality: 4.3
Price: $$
Package Quality: 4.3
Price: $$
on 7/12/2013 10:51:00 PM
Age: 25-29
Skin: Combination, Fair-Medium, Warm
Hair: Brunette, Straight, Fine
Eyes: Hazel
This is a fabulous brush. Yes, it has smaller bristles compared to other stippling brushes but I think that it's definitely a beneficial detail of this brush. I tried using this with a foundation and to be honest it did not work for me very well (I think you will need it to be much bigger for foundation application). But I do absolutely love to use it while applying my cream blushes and highlighters. It blends them very well and makes your face look flawless without streaking.
For the price you absolutely cannot beat it. I also love waiting for special deals on these brushes at ULTA that way you can buy more of them and save more money. Who needs MAC or SIGMA, pshhh ;)
on 7/9/2013 8:42:00 PM
Age: 19-24
Skin: Oily, Medium, Warm
Hair: Black, Straight, Medium
Eyes: Brown
I would've given this brush 5 lippies because I love how easy and flawless it puts my liquid foundation on. However, after about a year and a half of using it, all of a sudden the brush hairs started falling out! I took care of this brush, so I don't know why all the hairs are starting to fall out, I have to go buy a new one now /:
on 6/26/2013 4:58:00 AM
Age: 19-24
Skin: Combination, Fair-Medium, Neutral
Hair: Brunette, Straight, Medium
Eyes: Green
Bought this brush over the Mac due to the reviews on MUA and can say that I am impressed. The brush is great and gives you a air brushed and even finish. The handle is also quite sturdy and thicker at the end to get a good grip when applying. Would repurchase and will be checking out the other brushes from Real Techniques.
on 6/25/2013 1:54:00 PM
Age: 18 & Under
Skin: Sensitive, Fair-Medium, Warm
Hair: Black, Relaxed, Medium
Eyes: Brown
Love love love
on 6/25/2013 12:15:00 AM
Age: 18 & Under
Skin: Combination, Fair, Not Sure
Hair: Brunette, Other, Other
Eyes: Brown
on 6/23/2013 10:57:00 AM
Age: 18 & Under
Skin: Dry, Tan, Not Sure
Hair: Black, Other, Other
Eyes: Brown
MY ABSOLUTE FAVORITE FOUNDATION BRUSH!!!! would recommend to anyone
on 6/22/2013 6:29:00 PM
Age: 18 & Under
Skin: Very Oily, Tan, Not Sure
Hair: Brunette, Other, Other
Eyes: Hazel
I love this brush! I use it for blush, bronzer, powder, and liquid foundation. It doesn't shed and it looks super cute!
on 6/11/2013 5:37:00 AM
Age: 19-24
Skin: Oily, Fair-Medium, Not Sure
Hair: Black, Straight, Fine
Eyes: Brown
I'm not very use to stippling brushes, but nonetheless I do like it. I use it for cream foundation. I feel like it distributes the foundation really well and doesn't make me look cakey.
on 6/6/2013 1:23:00 PM
Age: 19-24
Skin: Combination, Fair-Medium, Neutral
Hair: Brunette, Straight, Medium
Eyes: Hazel
Personally, I think this is the best brush I have ever found.
It applies my NARS Sheer Glow absolutely flawless, almost like a soft focus.
I dont know where I would be without it!
Go buy it!!!
on 5/31/2013 5:10:00 PM
Age: 19-24
Skin: Acne-prone, Olive, Warm
Hair: Brown, Straight, Medium
Eyes: Brown
I bought this brush because I have read some good reviews about it. I use this to apply my liquid foundation. Honestly, I still prefer my MAC 187 brush as it is very quick to use and gives me that airbrushed look. For some reason, I find this difficult to use when blending my foundation into my skin and it makes my foundation look streaky and un-natural. The bristles also feel like its too spikey and not soft enough to be able to blend foundation. I tried to use it for my blush which is a highly pigmented blush but it seems to find it difficult to pick up colour and blend. I'm sure this brush will last me a few more years so I won't repurchase. Tbh, I probably won't use it so it's just gonna sit on my dressing table.
I'd say invest on a MAC 187 or try other stippling brushes. I've used the "Expert Face Brush" and that one is excellent for foundation - gives a high coverage and easy to use.
Popular Makeup Brushes


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A huge and powerful strike of British dockers against low pay, unsafe conditions and casual, precarious employment contracts which, with international solidarity, won nearly all its demands and...
In keeping with tradition, the following is an interview with Turkish IWW member Yusuf Cemal about the Soma mining disaster.
Some quick thoughts on the need to respect picket lines and the challenge of the anti-strike laws and multi-union workplaces.
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Basement Crack Repair
Even the most stable of basements will sooner than later need to be repaired, especially when it comes to basement crack repair. Here's a quick do-it-yourself guide.
By: Caroline Shannon-Karasik
Basement cracks can be caused by a variety of reasons, including leaks, a shifting foundation or mistakes in mixing or pouring the concrete. But basement crack repair doesn't have to be a difficult task; in fact, all it requires are a few simple tools.
Start the repair by removing any pieces of loose concrete that may be wedged within the crack. Use a wire brush and shop vacuum to do the most thorough job. Make sure the surface is also free of dust, oil and dirt.
Apply a concrete patch to the crack, making sure there are no gaps or bubbles. Smooth the patch with a putty knife. If the crack is fairly deep, then the crack may require a second patch. If so, then wait for the first layer to dry before applying the second coat. Seal the concrete patch and allow it to dry for several days.
There are certain cracks that could be the root of structural damage and might require the help of a professional. For example, if a floor crack runs along the foundation walls or a wall crack is causing the wall to shift, then the issue is most likely much deeper than simple do-it-yourself repair.
See also: Planning a Basement Remodel
More: Basement Crack Repair
Next Up
Kitchen Island Countertop Considerations
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Kitchen Island Carts
Mobility is just one factor that makes a kitchen island cart a flexible option for your space.
Kitchen Island Cabinets
Add the finishing touches to your storage space with these tips for choosing kitchen island cabinets.
Choosing Kitchen Countertops
Granite or laminate? Get tips on how to find the right surface for your remodel.
Precast Foundation Walls
Save time and money with these guidelines for building a warmer, drier basement.
Build a Movable Butcher-Block Kitchen Table/Island
Stock cabinetry, store-bought butcher block and staircase posts come together to create a multipurpose table and work space.
Kitchen Islands
Learn about different types and use our checklist to see if this independent structure will work for you
Recycled Kitchen Cabinets
Get information on recycled kitchen cabinets, an environmentally and budget-friendly way to redesign your kitchen.
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There are more options for your addition than those rolls of pink fiberglass
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The Council Directive 2001/88/EC amends the Council Directive 91/630/EC laying down minimum standards for the protection of pigs and aims in particular to :
- Ban the use of individual stalls for pregnant sows and gilts during a period starting from 4 weeks after service to 1 week before the expected time of farrowing and the use of tethers,
- Improve the quality of the flooring surfaces,
- Increase the living space available for sows and gilts,
- Allow the sows and gilts to have permanent access to materials for rooting,
- Introduce higher level of training and competence on welfare issues for the stockmen and the personnel in charge of the animals,
- Request new scientific advice in relation to certain issues of pig farming.
From 1 January 2003 these requirements are applicable to all holdings newly built or rebuilt. From 1 January 2013 these provisions shall apply to all holdings.
In parallel, the Commission has adopted Directive 2001/93/EC amending the Annex to Council Directive 91/630/EEC on the welfare of pigs. Supplementary improvements have seen achieved for all categories of pigs. The Standing Veterinary Committee supported the proposal of the Commission aimed to introduce improved standards concerning the following issues:
- Light requirements and maximum noise levels,
- Permanent access to materials for rooting and playing,
- Permanent access to fresh water,
- Additional restrictive conditions to carry out mutilations on pigs,
- Minimum weaning age of four weeks.
The Member States have to apply the new requirements from 2003 on.
The two Directives were initially proposed by the Commission on the basis of the Scientific Committee 's report " The Welfare of Intensively Kept Pigs"
EFSA has adopted a number of scientific opinions on the welfare aspects of pig farming:
- Scientific Opinion on the welfare aspects of the castration of piglets
- Scientific Opinion on the welfare of weaners and rearing pigs: effects of different space allowances and floor types
- Scientific Opinion on animal health and welfare in fattening pigs in relation to housing and husbandry
- Scientific Opinion on the animal health and welfare aspects of different housing and husbandry systems for adult breeding boars, pregnant, farrowing sows and unweaned piglets
- Scientific Opinion on the risks associated with tail biting in pigs and possible means to reduce the need for tail docking considering the different housing and husbandry systems
- Scientific Opinion on Food safety aspects of different pig housing and husbandry systems
ALCASDE Study - Final report
The European Commission launched a Call for tender concerning a "Study on the improved methods for animal-friendly production, in particular on alternatives to the castration of pigs and on alternatives to the dehorning of cattle" (SANCO/2008/D5/018) in 2008.
Please find here the final report of the study:
Further initiatives on the welfare of pigs are foreseen in the framework of the action plan (2009).
Q-PorkChains - EU funded project of the EU 6th Framework Program


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VFW Women's Auxillary To Hold Huge Garage Sale
Sunday, September 7th is the date for a giant INDOOR garage sale at the Veterans of Foreign Wars (VFW) Hall, next to Morvant's in Youngsville, starting at 7am.
Sunday, September 7th is the date for a giant INDOOR garage sale at the Veterans of Foreign Wars (VFW) Hall, next to Morvant's in Youngsville, starting at 7am.
Youngsville is a wonderful town to live in, and the collective patriotism is strong. Youngsville honors fallen veterans at one of their roundabouts year-round.
The servicemen and women of our country make huge sacrifices to fight battles on our behalf and keep the freedoms we hold dear. One of those sacrifices is being away from their families and loved ones for long periods of time.
This weekend we observe Memorial Day, a day to reflect upon those souls that were lost defending our country.
You really ought to know the way to San Jose.
Because news doesn't stop for Mardi Gras.
Harold Percival served as a Royal Air Force ground crewman and helped with raids during the Second World War, and he died last month with no known friends or family. What happened today was amazing....
Across the country on Monday, Americans observed Veterans Day, commemorating the service of its military men and women, active and retired, or killed in action.
The Livingston Parish Veteran's Parade rolled through Walker Saturday, and I was able to participate in the event...
Monday is veterans day and it is really sad that in this country we haven't taken care of these heroic men and women. This is a story about one homeless vet who was found by volunteers that took him off the street for a complete makeover. These wonderful people gave one man the will to go on by just giving a little of their time.
The local Patriot Guard Riders is holding a care package drive, and 99.9 KTDY is one of the drop-off locations. The drive is to collect personal hygiene products for veterans in our local nursing homes.
The public may purchase a memorial brick, engraved with the name of the veteran they wish to honor.


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More On Legal & Compliancefrom The Advisor's Professional Library
- The Custody Rule and its Ramifications When an RIA takes custody of a clients funds or securities, risk to that individual increases dramatically. Rule 206(4)-2 under the Investment Advisers Act (better known as the Custody Rule), was passed to protect clients from unscrupulous investors.
- Meeting and Exceeding Clients and Regulators' Expectations Although it can be difficult, there are ways for RIAs to meet or exceed client expectations, increase customer satisfaction, and help firms retain current clients and attract new ones.
The Securities and Exchange Commission announced Thursday that Kevin Goodman had been named national associate director of the broker-dealer examination program in the Office of Compliance Inspections and Examinations.
Goodman, who's been the acting national associate director of the program since May while also serving as acting regional director and associate director for the Denver regional office, will oversee a staff of approximately 300 lawyers, accountants and examiners responsible for inspections of U.S.-registered broker-dealers.
"Kevin has excellent judgment and experience," said OCIE Director Andrew Bowden, in a statement. "As national associate director, he will work with our dedicated broker-dealer examination staff to further full compliance with the laws and fair treatment of investors by broker-dealers."
Goodman began his SEC career in 1992 as an attorney-advisor in the Los Angeles Regional Office and was promoted to branch chief, senior special counsel, and assistant director. Before coming to the SEC, he practiced corporate and securities law in the private sector. He graduated from Purdue University in 1982 with a degree in accounting and received his law degree from Indiana University in 1985.