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Whole grains can pack a nutritional punch when featured as part of a balanced, plant-heavy diet. They have been linked to a reduction in the risk of diabetes, heart disease and strokes, and are a wise choice when trying to lose weight or maintain a healthy weight. If you're looking for ways to incorporate or add even more whole grains into your diet, take a look at the recipes below. As you'll notice, these are extremely adaptable ingredients that can be used in sweets, snacks and entrees. With so many ways to use them in cooking, you'll find one more reason to love whole grains.
Peanut Butter Crispy Rice Treats by Ellie Krieger
These rice crispy treats are much healthier than the store-bought version, but just as delicious. Natural sweeteners are used in this recipe, as well as brown rice cereal, making it a great snack choice. They are simple to make, too, and use ingredients that you may have in your pantry already.
Per serving: 200 calories, 7g fat, 4g protein, 2g fiber
Easy Homemade Granola by Matt Lewis and Renato Poliafito
Bring it back to wholesome, natural basics with this sweet granola. Ingredients such as cinnamon, honey and vanilla garnish almonds, hazelnuts, raisins and cherries for a satisfying snack. This granola only needs to be baked for 15 minutes, making it easy to prep whenever needed. Keep a bag in your desk at work to avoid less healthy afternoon snacking!
Per serving: 184 calories, 7g fat, 26g carbohydrates, 4g protein, 3g fiber
Tagine of Squash and Chickpeas With Mushrooms by Judith Finlayson
Need a reason to use your slow cooker? Try out this Mediterranean dish. Free of dairy and meat, this dish uses hearty vegetables to make for a filling meal. While this recipe does not include whole grains, it's a perfect companion to them, and can be served with whole grain couscous, barley or quinoa.
Per serving: 199 calories, 3g fat, 39g carbohydrates, 7g protein, 7g fiber
Seven Grain Bread by Victoria Blashford-Snell & Brigette Hafner
Nothing is quite as comforting as the aroma of freshly baked bread. This bread is as filling and hearty as it is high in protein and fiber. Serve it as a side with your next dinner, or use it to give your sandwiches an extra healthful kick.
Per serving: 258 calories, 4g fat, 49g carbohydrates, 9g protein, 5g fiber


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Twice a year, Summit High School (SHS) music students get to experience the music industry first-hand thanks to pianist Rieko Aizawa and Grammy-nominated violinist Jesse Mills. The musicians return to the high school today to talk about music as a career and to play and discuss the work of classical composers.
"It helps the students to hear musicians of this caliber performing live," said Linda Shea, director of instrumental music at SHS. "They always present their workshops in a way that is 'up close and personal' and very informative as well. It's always a learning experience for the students, whether they learn more about the composers of the pieces being presented or the instruments that are being played or just what it takes to play at such a high level like Rieko and Jesse do."
Aizawa and Mills have been the artistic directors of the Alpenglow Chamber Music Festival since 2010, and members of the festival since its start in 1998. Held annually in September, the festival features a series of public chamber music concerts as well as soirees in private homes. Workshops have been hosted for more than a decade to foster arts appreciation in the community via outreach to younger generations.
According to spokesperson Barbara Vandeventer, one of the workshops' benefits is the interaction between high school students and music professionals. "Just the fact that they're there makes the students forget about the 'awe' factor for them being renowned. The students are just in awe with their technique, of course," she said.
"Rieko and Jesse are world-class musicians and these students are so lucky to have a chance to hear them twice a year for each year of high school," Shea said. "These musicians are also some of the nicest people I've ever met so it is very comfortable to have them here at our school where the students feel like they can ask any questions and not feel out of place for not knowing something already. We always look forward to their performances."
Tonight, Aizawa and Mills also will perform a concert for Alpenglow Chamber Music Festival supporters in a private home in Silverthorne.
For more information, visit www.alpenglowchambermusic.org, call (970) 262-1633 or email firstname.lastname@example.com.


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When there isn't a Whitman album that perfectly fits your collecting needs, make your own album using the Whitman Universal Binder and Whitman Blank Pages. This blank page has nine holes for 39 millimeter coins or medals and can be mixed or matched with additional pages and the Universal Binder to create your own custom album. Use the Whitman Album New Date Transfer Sheets to add dates to your blank album pages.
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Miniature quilts are an art unto themselves. Many are suitable for framing and add a special elegance and charm to the room they grace. They are just what the name implies – smaller versions of large quilts. You will typically find traditional quilt blocks in miniature quilts.
Because of their size, miniatures are a great tool for practicing your hand sewing. They are perfect take-along projects. Of course, if you are a confirmed machine only sewer (and many of us are!) there isn't any reason you can't construct these quilt on your machine.
The patterns shown here from The Galloping Pony are collages that use miniature quilt blocks and are made to be framed. Personalizing and modifying the design to your liking is easy and encouraged by the designer. Virginia Cole has instructions for several embellishments
Since cutting out little strips of fabric is cumbersome with your large rotary cutter and large ruler, there are smaller versions available, like the 1" X 6" Creative Grids Ruler and the 28mm Olfa Rotary Cutter
Item Code: GPS107D |
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Item Code: SEU387 |
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Item Code: SEU389 |
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Item Code: ATN907 |
Item Code: GPS109D |
Item Code: DNDWMD701 |
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Item Code: TWBS25 |
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text:
Chi's New Address 28
Category: Chi's New Address
- Download Chi's New Address 28 with new episodes added weekly.
- Check out the ultimate coolest items store online
Video not playing? Click here and clear your browser cache, it can solve 95% of the video loading problem. |
Version 1 Version 2


text:
PRE SET FOR HEATING SYSTEMFor even more comfort and warmth our HP models can be fitted with the heating system. The special construction of the rear of the boot enables easy installation of the battery pack, which is connected with a special footbed positioned inside the liner. |
FLEX REGULATORForward flex control can be modified with simple adjustments according to the skiing style and snow conditions. The flex regulator enables two positions - hard flex for more aggressive skiing on compacted snow, and soft flex for less aggressive skiing in soft snow conditions. |
CANTINGThe best skiers demand a perfect stance. The canting adjustment setting allows for the lateral alignment of the boot to be adapted to individual preferences, which enables the skier to develop a perfect technique. |
LITE FRAMEThe new frame provides exceptional comfort while assuring better torsion stability, instep grip, and heel grip. Light and comfortable where you want it to be, stiff and powerful where it needs to be for optimal performance. |
SHOCK ABSORBING INSERTThe Shock Absorbing insert will allow the skier to land big air more safely and comfortably with more control. |
4DRY LINERThe new 4DRY liner enables breathability, drainage and ventilation, while also being water-resistant. All these features help keep the boot ultra-dry, while the feet stay nice and warm. |
BUCKLE ADJUSTMENTThe cuff of the ski boot can be simply and efficiently adapted to the shape of the foot with an adjustable buckle that can be lengthened or shortened by up to 20mm. |
EASY ENTRY SYSTEMBoth the specially designed construction of the instep and the innovative Easy Entry system allow skiers to put on and take off their boots easily, and quickly. |
WATER SEALThe carefully constructed plastic part at the front of the boot acts as an additional water seal. |
ANATOMIC FOOTBEDA special, anatomically designed footbed composed of three different materials assures a perfect fit and even distribution of force. |
PU HEEL & TOE PLATESHeel and toe plates are made of firm and durable PU material. |
FLEXXI BE3 SHELL CONSTRUCTIONThe new Flexxi Be3 technology allows for a better transfer of force to the ball of the foot, leading to improved control over vibrations and less stress on the knees, thighs and spine, and thus on the entire body. Due to the Flexxi`s composition, the foot is kept in motion, maintaining the heat inside the boot. |
SKI/WALK/PLAYFeaturing the innovative Flexxxi technology, the Be3 boots are perfect for playing in the snow, skiing and walking. They are comfortable, warm, easy to use and durable. |
VOLUME CONTROL PLATE (VCP)We can adjust the volume of the liner for young skiers and at the same time improve grip. By alternating the specially designed plastic Volume Control Plate (VCP) between the left and right boots, we can adjust the size of the boot. This allows young skiers to use the same ski boots for a longer period of time. |
SKI WALK SYSTEMThe Ski-walk system is an easy-to-use function integrated in BOOM boots that can be activated simply by unclasping the upper buckle. Unbuckle the boot for comfortable walking, and buckle it up for safe skiing. |
CHANGEABLE HEEL & TOE PLATEHeel and toe plates are made of durable and firm PU material. If damaged, both plates can be replaced with new ones for extended durability. |
OPTIGRIP SOLE DESIGNThe profile of the sole has been designed with care to ensure a safe step and to prevent children from falling. |
EASY ENTRY & EASY TO USEThe construction of Zoom and Be3 boots is specially adapted for easy access. The tongue, shell and liner are designed for easy unbuckling and opening. The young skier can put the boot on and take it off without the help of the parents. |
THERMO INSULATIONFor children`s carefree enjoyment on the snow, we have developed a soft liner with thermo insulation, to keep their feet warm. |
4DRY MATERIALThe top quality 4DRY material provides water resistance and breathability, making sure that humidity is transported from the inside out, keeping the feet dry and warm. |
THE SINGLE PIECE OVERBOOTThe overboot covers the shoe completely. Like tight lining, it surrounds the boot from the sole to the top of the upper edge. The single piece overboot is of waterproof elastic material and as such adapts to the various foot shapes and sizes. |
ELASTIC CALF ADJUSTMENTAn elastic adjustment provides maximum comfort and fit relation over the ankle. |
CUFFCuff made with profiled surface to assure additional strength, better and stronger lateral support. Upper zone embraces just above the ankle and gives more comfort and better leg support. |
LASTSophisticated feet analyses like scanning gave birth to a completely reinvented boot last that serves various feet shapes and assures equally great fit to the high, low, wide or narrow feet. |
HEEL GRIP - HEEL REGULATORThe regulator enables adjustable foot retention. The top of the heel cup can be modified, which results in an optimal fit of the shoe, greater comfort and functional grip of the foot. |
HEEL COUNTERStrong and rigid multifunctional heel counter accommodates various types of heel, provide strong support, prevents from heel in and out movement and minimizes the take of shoe effect. Heel counter highly improves the torsional stability of the shoe sole. |
LACING SYSTEMA unique combination of laces and textile hooks provides an easy on and off function. Add a superior pull tightness and precise forefoot to foot control and what you get is a maximum comfort and fit relation. |
ANATOMIC (RACING) FOOTBEDAn anatomically designed footbed is composed of three elements: perforated foam that allows for the transmission of water, a special breathable mesh to facilitate air flow, and, for perfect ventilation and drainage, a perforated felt lining with integrated channels. |
Soft flex zoneThe high quality sole on the boots, along with the midsole, provide a soft and flexible boot. The boot permits the natural movement of the foot, easier skiing and more comfortable walking. |
ALPITEX mambraneThe top quality Alpitex membrane provides additional protection from snow, water and cold. It allows for a high degree of comfort, even in extreme weather conditions. |
THINSULATE INSULATIONThinsulate insulation guarantees the best conditions for the feet, making them twice as warm as in other linings. It allows the foot to breathe, and provide extra comfort and warmth even on unusually cold or humid days. |
UPPER LININGAn open air mesh works together with the water resistant foam padding and breathable lining, guaranteeing good air ventilation and maximizing the dry effect. |
FRONT LININGThe ultra dry lining with breathable foam does a great job transporting moisture from the feet to the outside of the liner, protecting the feet from wetness and freezing. |


text:
Bragallot wrote:A Warhead vs. Mini-Warhead battle report
mr.duckie wrote:SirCheese wrote:I will be neutral. (Cuz I don't want to make enemies)
Get Him!!!!
Silverdream wrote:Pretty cool. Now you must build a gyro-fleet.
RunsWithLegos wrote:Aweomswork yet again marhead!
also, havent seen you here in awhile delta v.
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Top Definition
BAYMM is Bay Media Magazine, a television series in the San Francisco Bay Area from Emmy award winning broadcast pioneer Jan Yanehiro. BAYMM uses students from the Academy of Art University's School of Multimedia Communications to host and present videos from around the world. Some of these videos come from online and others are shot by the students themselves.
Hey mom, I want to watch BAYMM tonight.
af frenchjr25
18. april 2011


text:
As Kay King was traveling for a short trip over the weekend, she couldn't help but notice a trend of particular relevance to Morehouse Parish.
"Car after car had a kayak strapped to the top of it," she said.
Read the full story in Tuesday's print edition of the Enterprise.


text:
Snapdeal brings you a stylish range of Joe Black frames which adds glamour to your look. Give your face the new look with this stylish and light weight optical frame. Look classy, look different and earn appreciation. Each Joe Black frame is designed to perfectly fit on your face and to render you great stylish look.
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text:
San Francisco 49ers Gear
San Francisco 49ers Mens
San Francisco 49ers Mens Home Office & School
$40 to $60
(1 items)
Product ID: 652235
Main Content
This item ships within one business day.
Order as many items as you like with our $4.99 flat rate shipping.
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When you're getting ready to host a watch party for your 49ers, make sure you set up the one item that will stand out - this 49ers 24" x 96" banner! Forget the streamers, this banner can be hung anywhere: the wall, the door, a column – the possibilities are endless! It features the 'Niners logo and wordmark with team colors, so you can decorate your house in scarlet and gold! It is UV resistant, water repellant and has grommets for easy attachment to any surface. Party in style and the next time San Francisco has a game, don't be surprised to get a call asking you to host another party!
- Approximately 24" x 96"
- Grommets included for easy hanging
- Imported
- Indoor or outdoor use
- Officially licensed NFL product
- Quality embroidery
- Team colors and logo
- Water repellent and UV resistant
49ers Customers also liked:
Special event items are produced by manufacturers only after the outcome of a game
or event. These are advanced sale items and will ship immediately after they are
received in our warehouse.
Manufacturer direct items are shipped directly from the manufacturer. These items
are not available for international or expedited shipping.
Customized items can be personalized with options such as your name, your favorite
number, and/or designs. Some options may be limited by league rules.


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With few words, Duke Realty Corp. says goodbye to Northeast Ohio
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Closing the energy work force gap through dynamic partnerships
Blog Entry:
March 29, 2013 4:30 AM | Author: BILL HAGSTRAND
William E. Hagstrand
serves as a Senior Consultant for NorTech and is responsible for driving engagement in cluster opportunities from inception to successful completion. This includes identifying and cultivating potential opportunities for participating organizations and recruiting organizations to the advanced energy cluster.
Amidst news of persistently high unemployment rates, one fact rarely makes headlines these days: We have a talent shortage in the U.S. The advanced energy industry in Northeast Ohio is not immune to this problem, but several initiatives in the region are working to close the gap.
Intriguing results from the
2012 ManpowerGroup Talent Shortage Survey
illustrate a gap between workforce skills and industry needs. The survey reveals that "49 percent of U.S. employers are experiencing difficulty filling mission-critical positions within their organizations. " Two of the 10 most difficult jobs to fill are skilled trades and engineers. Employers cite lack of available applicants and lack of experience as some of the reasons for the deficit.
The successes of the advanced energy initiatives in our region depend on qualified employees and suppliers. Just as critical are the roles industry and academia must play in order to close the workforce gaps in Northeast Ohio. Many companies and educators are becoming more proactive as leaders and advocates to fulfill immediate growth objectives and to develop a sustainable, regional economic ecosystem that benefits employers and employees in the long term.
An initiative led by regional energy companies and supported by
Lorain County Community College (LCCC)
is focused on building an energy workforce strategy for Northeast Ohio. LCCC is working with industry leaders and a Talent Consortium to develop a career pathway framework. Partners in this initiative include Columbia Gas, Dominion, Cleveland Public Power and First Energy. These established utilities have reached out to forge new collaborations with non-traditional energy companies, such as Quasar Energy Group, LG Fuel Cell Systems and Vadxx.
The energy consortium facilitated by LCCC is driving to develop an efficient system created by collaboration rather than each company developing workforce efforts on its own. The knowledge of the group creates the capability to apply what is learned to specific challenges. The
Arizona Sun Corridor Consortium
is an example of a developed group working to train trade-impacted workers and other adults for high-skill, high-wage employment in advanced energy.
Energy workforce development initiatives are timely for the region. The Advanced Energy Economy Ohio July 2012 report,
"Employment in Ohio's Advanced Energy Industry "
, states that Ohio is home to a robust and diverse advanced energy industry with over 25,000 employees in over 400 companies. Universal challenges include talent development and an aging workforce. Advanced energy companies are discovering that they share development needs with traditional utilities. The goal is to define the broad energy workforce requirements of the region as a whole, rather than thinking of these needs in silos.
The Northeast Ohio consortium is working with design guidance from
The Center for Energy Workforce Development (CEWD)
, which has developed a nationally recognized
"Get Into Energy"
career pathway initiative. CEWD consists of electric, natural gas, and nuclear utilities and their associations. The groups have developed a model of working together to develop solutions for the forecasted workforce shortage in the utility industry, and share best practices and tools to reach target audiences.
Terri Burgess Sandu, Director of the Entrepreneurship Innovation Institute and Executive Director of Workforce Development at Lorain County Community College, is deeply committed to energy workforce development.
"We're talking about energy careers for adults as well as getting information out to students, parents and teachers. There are great careers to be had in the energy sector, right here in our community. Key to this is giving individuals opportunities, skills and exposure to a variety of options, whether it's in wind, shale, utilities, the supply chain or even starting their own business," she says.
There are other entities in the region that are working together to close workforce gaps. Stark State College offers a fuel cell technology major and works directly with LG Fuel Cell Systems to fill internships within that company. It's a win-win situation for both the students and for LG Fuel Cell Systems. The students gain real world experience while the company gains the work and knowledge of interns trained specifically in fuel cell technology.
Workforce development is most effective if it's not created in a vacuum. The partnerships and alliances built between industry leaders, higher education and non-profit partners are striving to address the common needs for a skilled workforce in the energy, advanced energy and energy–impacted sectors. The collaboration to align the supply and demand for talent in Northeast Ohio can result in tools and strategies that have a highly positive effect on our long-term economy and employment outlook.
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EVOSHIELD Batter's Leg Guard
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Members of The League get 5% back when you spend $100! (see promotion details) |
Product Details
The EVOSHIELD® batter's leg guard offers a high level of protection for the shin, ankle, and foot. Lightweight, ultra-thin, and breathable, the custom-molding shields form uniquely to your body, providing comfortable protection from foul balls and wild pitches. Remove the shields from the foil bag to air-activate the custom-molding process; the Gel-to-Shell technology transforms the soft inserts into protective shields in minutes.
- Custom-molding pads begin soft and flexible, transforming into hard, protective shields in minutes
- Designed to provide a comfortable, custom fit for protection that doesn't interfere with performance
- Impact is dispersed, not absorbed, providing better protection than traditional protective gear
- Once formed, shield provides season-long protection
- Shields are hand washable; air dry
- Includes 1 custom-molding leg shield, 1 custom-molding foot shield, 2 elastic leg straps, and 1 elastic foot strap
Product Recommendations
Product Reviews
Reviewed by 2 customers
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- Durable
- Lightweight
- Protective
- Versatile
- Gets dirty easily
Best Uses
- Big Game
- Casual Use
- Practice
- Weekend Game
Comments about EVOSHIELD Batter's Leg Guard:
This product is great. I have broken my ankles numerous times and this thing helps. I have taken many foul balls of my shin/ankles and it hurts. Now that I have this Evoshield guard, i don't feel anything. It customizes the molding on your ankle very well. I'm a switch hitter, and it works on both feet very feel. I love this product.
- Was this a gift?:
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Comments about EVOSHIELD Batter's Leg Guard:
its great
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Displaying reviews 1-2


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Has the Church Misunderstood Justification?
For all their differences concerning the doctrine of justification, Protestants and the Roman Catholic Church have agreed on this: justification fundamentally concerns the salvation of the sinner. To draw this observation is not, of course, to minimize the importance of …Read More
A New Luther?
The accusation that systematic theology (doctrinal formulations of the Reformation period in particular) overly governs (distorts) exegesis is not new, and Bishop N.T. Wright trots it out with renewed zeal in his latest book, Justification: God's Plan and Paul's Vision …Read More
Wright Is Wrong on Imputation
Is the imputation of Christ's righteousness to the believer an artificial construct, an idea from systematic theology that does not truly come from the Bible? N.T. Wright argues that the traditional view of imputation veers away from the Pauline meaning.Read More
"Faith" and "Faithfulness"
The Greek word pistis can mean, in English translation, both "faith" and "faithfulness"; no one disputes that fact (for the latter, see Rom. 3:3). N.T. Wright, however, takes two steps that cannot be fairly evaluated without understanding how they are …Read More
The "Nonsense" of Justifying the Ungodly
There are at least three problems with N.T. Wright's claim that imputing God's righteousness to a defendant is a category mistake and "makes no sense." First, Wright's definition of the righteousness of God is too shallow. He fails to go …Read More
Christ, Our Righteousness
N.T. Wright in his advocacy of a "new perspective" on Paul and his teaching makes a special plea that "justification" should relate to the question "who belongs to God's covenant with the world?" rather than "how can you be saved?" …Read More
Salvation and the Life After Life
How do we estimate what a person is primarily interested in? Perhaps by seeing how often they return to the subject, or what they mention on important occasions. And perhaps, also, by the manner in which people write about things: …Read More
Two Birds, One Stone
When error comes into the church we face a set of obligations. First, we must confront the error. The world has embraced a live-and-let-live relativism that will accept any foolishness, but will not accept the wisdom of calling foolishness by …Read More
The New Perspective on Paul: Calvin and N.T. Wright
Despite the fact that Qohelet tells us that there is nothing new under the sun (Eccl. 1.9), in recent years a school of Pauline interpreters have raised their banner declaring they have a new perspective on Paul. What exactly is …Read More
Five Arguments Against Future Justification According to Works (Part II)
Argument #4: The future judgment of believers consists only of reward and praise. Those who support future justification according to works will cite the numerous Bible passages that in one form or another state that we must all stand before …Read More
Browse select Tabletalk articles and columns exploring themes and topics across a spectrum of relevant issues.Topics
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CRKT Pazoda Knife
A simple yet stylish knife, the CRKT Pazoda features a Combined Razor-Sharp and Triple-Point Serrated edge, sleek design, and an attractive price point.Features/Benefits:
- Premium stainless steel blade: 8Cr14MoV, 58-59 Rockwell hardness; gray titanium nitride coating
- Combination blade has both Razor-Sharp and Triple-Point Serrated edges
- Oval blade hole provides easy, one-handed opening
- Frame-lock folder design ensures the knife stays open while in use
- Stainless steel clip allows for easy-access pocket storage
- Stainless steel frame is also given a gray titanium nitride coating, as well as a brushed finish on the outer surface to provide a perfect space for engraving
- Blade thickness: 0.1 in. (2.5 mm)
- Please note: This product cannot be shipped to a New York State address due to shipping restrictions.
Country of Origin: Imported
CRKT Pazoda Knife
Blade Material Stainless steel Blade Length 2.6 in. Blade Type Straight/Serrated Closed Length 3.75 in. Flat Screwdriver(s) No Handle Material Stainless steel Can Opener No Has Clip Yes File No Lanyard Ring No Locking Components Yes Pliers No Saw Blade No Scissors No Has Sheath No Tweezers No Wire Cutters No Knife Blade(s) 1 Open Length 6.5 in. Phillips Screwdriver(s) No Tool Material Stainless steel Number of Tools 1 Weight 3.1 oz.


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Item #91988
Product Description
Our Box-Edge Deluxe Chaise Outdoor Cushion features double welting and a luxuriously plush foam fill. This thick 4" outdoor replacement cushion is available in a variety of Sunbrella®, Outdura® and polyester fabrics. Sunbrella® and Outdura® are 100% solution-dyed acrylics. All our fabric options are resistant to UV rays, stains and mildew for long life and lasting color. Coordinate your outdoor seating with our outdoor market umbrellas, curtains, throw pillows and poufs.
Product Details


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Red Crystal Star Brooch
Give the gift of glamour this year with this versatile red crystal star brooch by Parkside. The brooch has a small loop on the reverse allowing it to also be worn as a pendant.
Approximately 35 mm by 35 mm
Price: £25.00
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While we make every effort to give accurate descriptions of our products, the dimensions, colour and other specifications sometimes change. Consequently, dimensions quoted should be treated as a guide only. We charge a flat rate £3.99 for postage and packaging in the UK, regardless of quantity, size, or value. Postage and packaging to the EU ranges from £7.00 to a maximum of £20.00, and Worldwide from £9.00 to £25.00. Prices, which include VAT where appropriate, may also vary from those in our shops. All items are subject to availability at the time of ordering, so please allow a maximum of 10 working days for any item that is out of stock.
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Duffel and backpacks for Karate clothes. Whether you are in Taekwondo, Karate, Kung Fu, Judo, or any other martial arts there is a lot to keep track of. These bags will help you carry all your martial arts supplies.
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The Department of Health and Human Services (HHS) issued a final rule last week implementing several consumer protections under the Affordable Care Act (ACA) to prevent insurance companies from discriminating against people with preexisting conditions and protect consumers from insurance company abuses.
Under these reforms, all individuals and employers have the right to purchase health insurance coverage regardless of health status. In addition, insurers are prevented from charging discriminatory rates to individuals and small employers based on factors such as health status or gender, and young adults have additional affordable coverage options under catastrophic plans.
These 5 key provisions are applicable to nongrandfathered health plans:
In preparation for the health insurance marketplaces and to streamline data collection for insurers and states, the final rule amends certain provisions of the rate review program. HHS has increased the transparency by directing insurance companies in every state to report on all rate increase requests. A new report has found that the law's transparency provisions have already resulted in a decline in double-digit premium increases filed, from 75% in 2010 to, according to preliminary data, 14% in 2013.


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A Designer and a Marketer Walk Into a Bar...
We're consumers in a media-driven world. And, as such, we've grown used to product placement, telemarketing, "advertorials," and celebrity endorsements. We like football, but we love Super Bowl ads. And we know there's no shame in choking up over a credit card commercial. But treat us like just another "consumer segment," and we'll turn on you in a heartbeat. It's a classic love/hate relationship.
But when did marketing become the Evil Empire? Why is it that marketers are seen as crass manipulators, battling to the death with their pure-hearted UX counterparts? What if you're trying to do both, and doing it for the good of your users?
Why They Gotta Hate on Marketers?
Granted, there are a few bad apples in the world of marketing who have given the rest a bad name. But I'm troubled by the intensity and persistence of the ongoing discord between design and marketing.
First, a little Marketing 101.
Marketing, as a whole, is a big nut to crack. It comprises a lot of sub-specialties such as advertising, market research, media and public relations, pricing, packaging, lead generation, social media, and word-of-mouth. Anything that a company does to establish and grow relationships with their consumers fits under the larger marketing umbrella.
In the past, marketers relied on a few tried and true methods to promote sales. There are the classic "Four P's": product, price, placement, and promotion—promote the right product in the right place at the right price. Then there's AIDA: Awareness, Interest, Desire, Action. Create the awareness, interest, and desire, and drive the desired action: the purchase.
While marketers were out trying to make the sale, their design counterparts were immersed in the creative process, developing concepts and bringing them to life. And then along came experience designers, claiming that users would ultimately reject any product or service that wasn't easy to use, no matter how pretty it was or how hard it was being sold.
Can't We All Just Get Along?
Experience designers and marketers both have the same end goal in mind: a happy client and a satisfied (and maybe even gobsmacked) customer who will return over and over and tell everyone she knows about her experience.
Good marketers and good designers both ask, "Why?," and "What if?" Why do people choose to buy one product over another? Why do people fall in love with a brand? What would happen if we changed this feature or added that functionality? Good marketers and designers also ask, "How?" How do we get our brand to stand out in people's minds? How do we create a great user experience? If we answered these questions collaboratively, great user experiences would be the norm, not the exception.
It turns out that experience designers and marketers can agree on one thing: ideally, a product's meaning, utility, and value are driven by the needs and wants of that product's user base. Concepts such as customer experience (CX) and relationship marketing have emerged from the marketing industry, while terms like interaction design and user experience have come out of the design industry. But on close examination, it's clear that both terms have a lot in common: they all bring collective focus to winning customers and building loyalty by delivering positive experiences.
Power to the People
Users/consumers are more powerful than ever before. They can post unfavorable reviews online. They can write and promote a negative blog post about a company, product, service, or event. They can share their opinions on Facebook and Twitter.
Some companies rushed to create a Facebook profile and a Twitter feed, and after announcing the arrival of their "social media presence," they called it a day. Smarter companies used Twitter and Facebook to give their fans a voice, and to gather their thoughts, opinions, suggestions, and criticisms. Social media marketing, when used in this way, can be a highly successful approach. Why? Because great marketing—and yes, there is such a thing!—comes from truly understanding who your customers are and what they want or need to do. Does that sound anything like experience design?
Who's Doing It Right?
Below is a short list of companies that are effectively joining experience design and marketing. What do these companies have in common? They know that every impression or every click is a win, even if no financial transaction takes place. They lead with messages that illustrate why they exist and why they created their products or services. And their sites feature prominent calls-to-action with plenty of supporting information that explains the benefits of taking action.
Netflix delivers everything that's great about movies. The site is designed to suck you in and keep you browsing, reading user reviews, and sharing your likes and dislikes with other movie fans. You can lose yourself for hours on the site, and not because you can't figure out how to contact customer service.
Netflix nailed branding, with its ubiquitous red envelopes and spot-on name. And, as if movies delivered to our mailbox in postage-paid return envelopes wasn't convenient enough, the geniuses in marketing came up with Instant Watch. Netflix gives us options: discs or no discs, Blu-Ray or regular, streaming through game consoles or Internet-ready TVs, one at a time or all-we-can-watch. It's easy to change plans or report a problem, and losing a disc every once in a while is okay.
ZipCar wants to change the world by providing sustainable solutions to the problem of traffic congestion and pollution by offering members "cars on demand." ZipCar marketers promise that car sharing can be as easy and convenient as car ownership. This promise is kept both in real life, as members get 24/7 access to shared vehicles, and via ZipCar's online and smartphone interfaces.
Disney marketers know how to spin a once-in-a-lifetime childhood treat into an experience that people want to repeat again and again. Disney "magic" is evident from the minute you arrive at your hotel. The agony of long lines is mitigated by the presence of costumed characters or plasma screens with pre-ride shows. Visitors can avoid lines altogether with Disney's FastPass or MobileMagic. Smart crowd control means everybody exits through the gift shop, where they'll snap up a souvenir or two. And once they've returned home, they'll receive reminders to start planning their next Disney vacation—the experience was enchanting, so why wouldn't they want to rebook?
What Doesn't Work
I recently bought a Toyota Highlander. A few weeks after the purchase, I got a letter from Toyota's head of "Customer Retention." How is that supposed to make me feel good? What a missed opportunity to start building a long-term relationship with the customer!
There have been times when I've been working with clients and have had to step in and speak from the user's perspective. Like the time they wanted to label the "contact us" button "the 411" when their audience might not be familiar with that lingo. As a marketer, I'm familiar with the temptation to be cool and edgy. But, as an experience designer, I also know that the bottom line is, what will work best for the user?
Why We Can't Go It Alone
In this economy, most companies can't create just for the sake of creating or allow their designers to design something that's beautiful but no one knows about.
Marketers accuse designers of being dogmatic and snobby. Designers accuse marketers of being sleazy, manipulative, pushy, and unethical. I don't understand why both sides aren't more focused on what really matters: endearing customers and building loyalty by delivering positive experiences.
Marketers need to understand that features and functions on their own don't motivate decision-making behavior. But when they're combined with good design, they can. Designers have to come to terms with the fact that, to paraphrase Don Draper, they're not artists, "their job is to solve problems with design." And pleasing a creative director isn't as important as creating something that produces measurable results.
Kumbaya, People!
I think that user needs, business needs, best practices and great design should carry equal weight. I wish that marketers would understand the entire design process and not hurry it along. I would love to put an end to the approach that says, "Hey, look at us! We're the best because we say so!" I know that we absolutely have to approach our customers with candor and honesty and treat them like people, not consumer segments.
I know that users (customers, patients, employees) would be better served if marketing and design could work more collaboratively. I'm pretty sure that working together would reduce workplace stress and improve inter-cubicle relationships. I believe that combining our areas of expertise and our understanding of the wants and needs of our users would make us more powerful. Together we can create a holistic customer experience built on the emotions the brand evokes and the actual physical experience of using a site, app, or interface.
And when we accomplish that, we all win.
Add new comment
Thanks for sharing an article that brings a great topic into discussion.
I'm also interested in your research on successful collaborative teams to help address @Dennis and @James' questions.
I can share this from my experience, however. @Simon has got it right: Marketing and UX should start collaborating from the beginning of the process. I think that's where some of the discord lies. Oftentimes, marketing doesn't get to share input in a product or website until it's almost done. It's not fun to be invited to a party when there's hardly any cake left to share.
Our marketing team is in constant communication with engineering to review customer feedback, product specs, etc. Then engineering comes up with use cases, wireframes, and eventually prototypes to get their needs and specifications across and shares them with marketing. We then give feedback and discuss the why's or why not's for areas. All the while, keeping communication lines open.
Visualization is a big part of that by bringing everyone onto the same page with little to no misinterpretations. It may not be easy at first to stick with the process, but the more you do it, the easier and more fluid it becomes, and the quicker marketing and UX can be on the same team.
Echoing those who find themselves engaging in both marketing and UX.. I would be interested to hear people's tips for making this work in practice, as the potential commonalities seem (to me at least) to be quite apparent.
I come from a market research background but spent more time in user experience research in recent years - two industries that tend to either dismiss or ignore one another. While user experience research and market research have different philosophical starting-off points, there is a great deal of crossover in methods of practice.
Megan & Tracy - if you started a group looking at this I would be interested in joining.
Thx for writing about this.
I agree With Dennis Nordstrom's comment. This is the second article about mkt & ux relationship I read on the site that does not offer what I expected and covers the matter only superficially.
Anyway keep 'em coming, I'm trying to put the pieces together.
Wow, Megan, you've taken on a huge topic and it's nice to hear from someone else who walks the line. I'm a marketing person with a passion for UX (and process). Would love to connect with you!
I am the CEO of a Dutch company which builds usable software by design. One of the previous articles was about leadership and UX. This article is about the same thing. If leadership is not there, then it will be informal, random and fragmented amongst the employees. However when that leads to the situation that collaboration is less then the sum of its parts because teams don't align well, formal leadership actions are appropriate.
My company delivers usable and engaging solutions by starting the designprocess, focusing heavily on iteration of fast cheap test methods, partipatory design and visualisation during the whole process. The product of the design process is a building plan which has to be monitored on conformance of design during the development as it must be a 1-to-1 representation of the design. So it cannot be marketed in a traditional software way, with a featurelist checklist mentality. You can only market it focussing on the quality of the solution in a user context and the user experience. Also they have to focus using visualisation so customers have a wysiwyg insight and secondary the features.
This is our corebusiness. And I think those companies that still not get the leadership right will become extinct.
I appreciate your article on this subject.
However, from reading your bio it sounds as if you are in a "hybrid" position between UX and marketing.
This is not a position that most designers or marketers find themselves in.
So although I agree with you in that marketers' and designers' goals and objectives certainly are the same, I would still strongly argue that marketers and designers have fundamental differences in their views on how to achieve these goals and objectives.
The real value of your article could have been to offer ways of reconciling such differences. You mention a few examples of companies, who you think have done a good job of combining marketing and UX. But I still miss to see an explanation of how these companies' marketers and designers got along. Maybe they didn't. By showing a good end-result, you have not necessarily proved that the process to get there was smooth, collaborative, and ideal.
I am really interested in this subject, and would love to see a follow up article describing specific ways in which you believe collaboration between marketers and designers can be fostered (workshops, meetings, division of labor, research, hybrid-roles between marketing and design, etc).
Simply "get along" does not provide me with much advice on how marketers and designers can best use each others' expertise to collaboratively develop a product or service that delivers a near perfect user-experience.
Great article and I totally agree with your examples of companies doing it right: Netflix, Zipcar & Disney. I keep pushing for the opportunities to combine market and usability research and help to focus more on the similarities in our objectives rather than the differences.
Marketers are seen as evil because the collective impression is that they would sell their soul to make a buck.
Also, in the "battle" between UX and Marketing, it's the Marketer that asks for users to enter their address on the sign-up form and the UX guy that advises against this.
Which version do you think is better for human users?


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A Personal Approach to Care
Helen Hayes Hospital is a national leader in the provision of superior physical rehabilitation services. Our patients benefit from a level of expertise unmatched for effectiveness and efficiency, which is why the HHH Outpatient Rehabilitation Center is the referral center of choice by healthcare professionals and patients.
The Outpatient Rehabilitation Center provides a comprehensive range of therapeutic services to adults and children, all customized to meet an individual's specific needs and goals. Occupational therapy services are provided in dedicated outpatient therapy suites outfitted with state-of-the-art equipment. In addition, all outpatients have access to specialized services within the physical rehabilitation hospital, such as Aquatic Therapy, the Prosthetic Orthotic and Wellness Center, and the Center for Rehabilitation Technology, which may complement their therapeutic program.
Who Can Benefit
The need for outpatient occupational therapy may arise from a traumatic or repetitive injury, an orthopedic or neurological disorder, or a chronic or congenital illness. Individuals with a new injury, or those with a progression of a recurring problem that causes limitations in function, can all benefit from therapy. Our therapists treat persons with a wide range of conditions, including:
Orthopedic Conditions
- Upper extremity injury
- Cumulative trauma
- Post-surgical rehab of the upper extremities
- Shoulder pain
- Sports or work related injuries
- Fracture or sprain
- Arthritis
- Lymphedema
- Osteoporosis
- Total joint replacement
Neurologic Conditions
- Acquired brain injury
- Spinal cord injury
- Multiple sclerosis
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- Guillain Barre
- Amyotrophic Lateral Sclerosis
- Stroke
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- Cerebral palsy
- Cognitive disorders
- Developmental delay
Our Staff
The Outpatient Rehabilitation Center is staffed by a team of highly skilled and licensed occupational therapists. Therapists excel at evaluating a person's capabilities and developing an individualized treatment plan designed to improve functional performance. Specialists on staff include:
- Certified hand therapists
- Certified lymphedema therapists
- Certified aquatic therapy specialist
- Experienced driver rehab specialist
- Trained SaeboFlex clinicians
Occupational Therapy
The goal of Occupational Therapy is to enable an individual to carry out their activities of daily living, which include those performed at work, home, school and the community, as independently as possible. Following a thorough evaluation, which includes an assessment of physical function, as well as cognitive and daily living skills, if appropriate, an occupational therapist will tailor a treatment plan dedicated to restoring your maximum functional ability. Your therapist will work individually with you and will closely monitor your progress and modify your program as required.
Occupational Therapy provides a broad scope of therapeutic services, including:
- hand therapy
- cognitive rehabilitation
- upper extremity rehabilitation
- splinting
- adaptive equipment recommendation & training
- aquatic therapy
- therapeutic modalities
- Baltimore Therapeutic Work Simulator (B.T.E.)
- SaeboFlex Arm Training
- Bioness H-200
- FES cycling
Adapted Driving Program: provides comprehensive driving assessments to individuals who have physical or cognitive limitations that may interfere with their ability to drive safely.
Lymphedema Management Program: intensive therapy to alleviate discomfort, reduced function and mobility due to severe swelling of an extremity, provided by therapists certified in Complete Decongestive Physiotherapy (CDP).
Helen Hayes Hospital is JCAHO & CARF Accredited
Call Us
The Outpatient Rehabilitation Center accepts referrals from physicians and other healthcare professionals, who will be provided with a thorough follow-up report on your progress. For additional information, or to make an appointment, call:
West Haverstraw Orthopedic O.T. 845-786-4194
West Haverstraw Neurological O.T. 845-786-4306


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nice thanks so much guys
nice thanks so much guys
Hi new here
Hi guys n Gals. I am new here. How's everyone.
hello to everyone
Hello all, untrax here to help and learn
hi all, nice to be on board.. lets play some fifa 13
cool site
Last edited by saints42; 11-09-2012 at 08:46 AM Reason: Automerged Doublepost
signing up to get some help
Hello everyone,
Call me hyperjinxz. I from UK. I registered with you a while ago. I don't yet have a PS3... Actualy I am trying to get one for "free" but I am in the begining of that. And that PS3 is 40 GB, I want the 60 GB one, anyway it will come soon and I will be full member of this scene. I had a PS2 v7 with dms4 pro and three v3's I think... in pieces... but all good things become parts and pieces of junk in time... I felt like writing and here looked like a good spot.
Anyway nice to meet you all I hope we will have fun together in the future.
Hello, I'm mukademukwa (means black bear in odawa). I have finally decided to join a site since I couldn't ask any questions without joining, and there is way to much stuff to sift through on google. I hope I can find all the answers I need here. Can't wait to play some ps3!


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Santana looking to keep Royals in line vs. Tribe
Ubaldo deals for Cleveland as KC aims to move over .500 mark
After receiving yet another strong starting pitching performance and making the most of their opportunities at the plate and on the bases late in Monday's narrow 2-1 victory at Cleveland, the Royals will try to jump above .500 on Tuesday night in the second of three games at Progressive Field.
Right-hander Ervin Santana will get the ball for the Royals as he opposes Indians righty Ubaldo Jimenez. Kansas City holds a half-game lead over Cleveland for second place in the American League Central standings.
Strong pitching is directing both teams right now. The Royals, who own the best ERA in the league, have compiled a 1.80 ERA in June. Meanwhile, in five of the Indians' last six games, they have held opponents to three runs or fewer and they've won four of those contests.
"We've been pitching pretty good lately, too," Indians center fielder Michael Bourn said. "I always think -- I mean, I don't want to put any pressure, but it's the truth -- pitching always wins. That's just the name of the game. It's been that way since day one and it's going to be that way until it's over with. That's just how it is. We have a good offense, too, but I always think that pitching wins."
Santana is 5-5 with a 2.74 ERA in his first year with the Royals. He's coming off back-to-back wins after a no-decision followed four straight losses. He held the Rays to one unearned run on five hits in 7 2/3 innings as the Royals cruised to a 10-1 victory last Thursday.
"I was very happy," Santana said after the game. "I just didn't think about having that many runs and tried to keep putting zeros on the board."
Santana allowed zero walks for the sixth time this year and has walked just six in 92 innings with 71 strikeouts.
Jimenez is 5-4 with a 4.79 ERA in 13 starts. He defeated Kansas City on April 29, allowing only three hits in seven innings with two walks and four strikeouts.
In his last start, Jimenez held the Rangers to one run in four innings, but threw 101 pitches. He is 2-1 with a 2.25 ERA in three June outings.
"All night, I don't think he had his best command," manager Terry Francona said. "To his credit, I thought he competed. They were very patient, and for the most part he worked ahead, even though he didn't really command the ball. He kind of stayed away all night."
Royals: Holland secures win over Indians
Closer Greg Holland picked up his 15th save on Monday night -- allowing one hit with one strikeout. He's had 17 save opportunities this season.
The hard-throwing right-hander has logged 26 innings with 41 strikeouts and a 2.08 ERA. With his help, the Royals' bullpen has held opponents to just two earned runs in its last 35 1/3 innings
Indians: Swisher nursing shoulder injury
For the second straight game, outfielder Nick Swisher watched from the dugout on Monday night while recovering from a shoulder injury.
He received a cortisone shot on Monday, but has not been placed on the disabled list and is slated to return on Friday. Swisher missed three games from April 30 to May 3 and aggravated the injury on Saturday.
Before the injury, he was struggling through a bit of a slump -- going 6-for-64 in his last 15 games. On the season, Swisher is hitting .237 with seven home runs and 24 RBIs.
Worth noting
• Right-hander James Shields extended his streak to 28 games with six or more innings in Monday's no-decision.
• The Royals have scored at least once in the eighth inning or later in their last five games.
• The Indians fell to 26-14 when their starting pitchers go at least six innings.
Kathleen Gier is an associate reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.


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Motorcyclist doesn't know how to motorcycle. (i.imgur.com)
submitted 2 years ago by streetshark2015
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[–]egoslam 414 points415 points416 points 2 years ago (1 child)
Under da sea
[–]stebaaan 30 points31 points32 points 2 years ago (0 children)
Wow. I'm not creative enough to even think of something like this
π Rendered by PID 9522 on app-65 at 2015-05-07 05:49:34.996878+00:00 running 74742f0 country code: US.


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just copped low straights as well down 1 size in the one wash. so far my favorite fitting jeans i have ever owned and ive had a wide array from RRL slim fits to APC to Diors etc. these are solid denim, very mature fit. not too slim but still with a low enough rise and not too wide of a leg opening. all im hoping for is some more stretch in the waist
fit pic


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What a truly sad news.
My deepest condolences to his family.
Phoronix: Intel Loses One Of Their Linux Driver Developers
Several Phoronix readers have written in that Eugeni Dodonov, a former Mandriva developer who since last year has been working for the Intel Open-Source Technology Center on their Linux graphics driver, lost his life this weekend...
What a truly sad news.
My deepest condolences to his family.
Youch, the guy must have had a death wish bicycling on the roads in Brazil. It's of the most dangerous places for driving on the planet.
That is very sad to hear. For all of his family, friends, and co-workers, you have my condolences.
i dont know about you, but i think that the headline is misplaced...
most of the community may have known him as "AN intel developer" but thats how i think one should address a man who died: a lost developer. thats almost zynical.
"Intel developer dies" would be "better" - its just not like he quit because he had better things to do.
or "intel loses dev - forever" maybe even that...
Last edited by jakubo; 07-09-2012 at 12:14 PM.
This is so sad. I interacted with him in this forum a couple of times, he seemed like a really nice guy. As an avid cyclist myself, I've had my share of accidents, including hit by a car once. Thank god, never with such severe consequences.
Damn it. This is a great loss for Intel and I'm sure for the greater Linux community in general. May Mr. Dodonov rest in peace.
This is a very sad news
Intel: GMA45, HD3000 (Core i5 2500K)
OMG!! He was awesome, especially in his interactions with the community.
My condolences to his family and friends.
It's really sad to hear that. I did not know him much, just a few posts here and he was in the #intel-gfx channel as well i think. Did not know that he was so young. Really a sad year, a few weeks ago a Kanotix user/supporter died as well and was not even 40. R. I. P.


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3 more definitions
Literally 'sure'. Usually follows fo', which is a bastardisation of the english preposition "for". Can be used in conjunction with 'heazy'.
Fo' sheazy! ... You know, off the heazy?
de what-the-shit
4 décembre 2003
Modification of the ebonic word "sho" based on English word "sure." All phrases containing two consecutive words ending in an "O" sound should be modified so that the second "O" becomes "eazy."
Fo Sho becomes Fo Sheazy
Mo Fo becomes Mo Feazy
Yo, Ho becomes Yo, Heazy
Mo Fo becomes Mo Feazy
Yo, Ho becomes Yo, Heazy
de Safran
7 mai 2003


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I think it's very promising. The Xonontic benchmarks are very pleasing.
I am guessing from the benchmarks is that there is still some stuff falling back to software that is killing performance for certain things. With some optimization to applications and filling in some missing pieces in the drivers and we are golden. Once open source gets within about 70-80% of proprietary then I'd call it success.
Hmm, I've got a couple traces from games and my own stuff(20-70fps, 100-400MB). And they take about the same time.
Just did a quick run with vdrift about 2min, 130MB trace. Frame rate without tracing is about 22fps, with tracing 17fps, retracing 15fps(68% of original fps). Are my results atypical?
As I see it, the slowdown would be the same for all benchmarked cards and we are interested in the relative performance only.
Buy lots of RAM and store the apitrace in a Snappy or LZ4-compressed ramdisk That should provide for a faster load time for the apitrace...
Indeed. The thing about open source drivers is that they can be debugged. It is possible to find out where they are slow, and then further optimise those parts of the code.
After adding HiZ and doing some further chasing down of performance bottlenecks in the open source code, performance can be expected to reach perhaps 80% of the closed binary drivers. Since almost no-one needs 200 fps performance, and the difference between 160 fps and 200 fps is all but imperceptible anyway, the perfromance issue with open source drivers will essentially be solved.
Bridgman, given than GCN moved to hardware scheduling, I assume lacking an advanced compiler in Mesa becomes less of a bottleneck. How would you estimate the effect of that move?
E.g. do you see GCN cards getting to 80% of catalyst, where earlier can get 70% etc?
Yeah, I don't have any real numbers but from a pure shader compiler POV my guess is that half the gap between open source and proprietary driver might go away with GCN.
For compute the impact will probably be even greater (since graphics is naturally short-vector work while compute is naturally scalar). We're also picking up some compiler improvements at the same time by using LLVM, so it could get interesting.
The bigger question is how much of the performance delta today comes from shader compiler rather than things like HyperZ, since the impact of both of them increase with display resolution.
Last edited by bridgman; 03-24-2012 at 12:03 PM.
I also think the opposite will happen with nouveau/kepler, because they removed hw scheduling there. Half the fps on a newer gen card there, on a shader-heavy workload?


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Midwest Living Review
After an extensive two-year renovation by a couple of local firemen, Richmond's original circa-1800s fire station in the historic Depot District emerged as a hopping restaurant-music venue. Open since January 2012, Firehouse BBQ and Blues maintains the building's architectural integrity but also adds lifelike murals and other interesting touches to create a unique dining atmosphere. Barbecue seems the ideal cuisine to serve here; the one-page menu details several appetizers, salads, desserts and barbecue options, including pork, brisket, chicken and ribs. Customers can opt for lunch special meat sandwiches with one side or dinners of meat with two sides and a jalapeno corn bread muffin anytime of day.
The barbecue nachos ($7.95) are delicious: crunchy tortilla chips topped with pulled pork, baked beans, cheddar cheese, barbecue sauce, jalapenoes and diced onion. Likewise, the pulled pork and brisket dinners ($9.95 and $10.95, respectively) are top-notch, offering tender, flavorful meat. The cheesy potatoes are the best of the side items, with baked beans and slaw running close behind, all served in cute half-size Mason jars. The specialty Smokin' Hog sandwich ($6.95 for the lunch, $9.95 for dinner) consists of a smoked sausage on a bun with pulled pork, cheese and onions. It was good, but not as good as the plain pulled pork without the additional toppings. Firehouse serves lunch and dinner daily and stays open late on weekends to showcase a solid lineup of musical acts from Richmond and the region; the crowd is 21 and up only after 7 p.m. on Friday and Saturday nights.


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by Rosalyn Carson-DeWitt, MD
Understanding Heart Failure
In heart failure, the heart is unable to pump the right amount of blood throughout the body. This causes blood to back up in the veins. Depending on which part of the heart is affected, this can lead to a buildup of excess fluid in the lungs, feet, and elsewhere. Heart failure can worsen with time, which may lead to the use of many treatments. Because of this, doctors are aggressive in treating heart failure to try to prevent it from worsening.
The leading causes of heart failure are:
Other common causes include:
Other less common causes include:
Symptoms include:
Factors that increase your chances of getting heart failure include:
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
Your heart may be examined. This can be done with:
Heart failure may be caused by another condition. Treating this condition should improve your heart failure or prevent it from getting worse.
The following lifestyle changes can help treat the symptoms of heart failure and slow down its progression:
Your doctor will most likely prescribe a combination of medicines, such as:
You may also be given medications to:
Your doctor may advise you to take supplements, such as coenzyme Q10. Follow your doctor's advise regarding taking any supplements.
If heart failure worsens, you may need medical devices to help your heart pump blood properly. If you have heart failure, follow your doctor's instructions .
The best way to prevent heart failure is to reduce your risk of:
Take these steps to reduce your risk:
American College of Cardiology
American Heart Association
American Academy of Family Physicians
Health Canada
Heart and Stroke Foundation of Canada
ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009;119(14):1977-20016.
Congestive heart failure. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Congestive-Heart-Failure_UCM_307111_Article.jsp. Updated January 24, 2011. Accessed March 21, 2013.
Dambro MR. Griffith's 5-Minute Clinical Consult. Philadelphia, PA: Lippincott Williams & Wilkins; 2001.
Heart failure. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated March 18, 2013. Accessed March 21, 2013.
Heart failure exercise/activity guidelines—exercise. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/disorders/Heart_Failure/hic_Heart_Failure_Exercise-Activity_Guidelines.aspx. Updated January 27, 2012. Accessed March 21, 2013.
Hunt, SA, Abraham, WT, Chin, MH, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2005;112:e154.
Hunt SA, Baker DW, Chin MH, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult. American College of Cardiology Foundation (ACCF). 2005;46(6):e1-82.
Lifestyle changes for heart failure. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Lifestyle-Changes-for-Heart-Failure_UCM_306341_Article.jsp. Updated August 20, 2012. Accessed March 21, 2013.
Paterna S, Parrinello G, Cannizzaro S, et al. Medium term effects of different dosage of diuretic, sodium, and fluid administration on neurohormonal and clinical outcome in patients with recently compensated heart failure. Am J Cardiol. 2009;103:93-102. Epub 2008 Oct 17.
Physical changes to report. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Physical-Changes-to-Report_UCM_306356_Article.jsp. Updated August 20, 2012. Accessed March 21, 2013.
What is heart failure? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Hf/HF_WhatIs.html. Accessed March 21, 2013.
4/16/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Nilsson BB, Westheim A, Risberg MA. Effects of group-based high-intensity aerobic interval training in patients with chronic heart failure. Am J Cardiol. 2008 Nov 15;102:1361-1365. Epub 2008 Sep 11.
7/6/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Levitan EB, Wolk A, Mittleman MA. Consistency with the DASH diet and incidence of heart failure. Arch Intern Med. 2009;169:851-857.
8/31/2009 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Djoussé L, Driver JA, Gaziano JM. Relation between modifiable lifestyle factors and lifetime risk of heart failure. JAMA. 2009;302:394-400.
3/5/2013 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Dinicolantonio JJ, Pasquale PD, Taylor RS, et al. Low sodium versus normal sodium diets in systolic heart failure: systematic review and meta-analysis. Heart. 2013 Jan 24. [Epub ahead of print.]
11/25/2013 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Madmani ME, Solaiman AY, et al. coenzyme Q10 for heart failure. Cochrane Database Syst Rev. 2013 Sep 18;9.
Last reviewed September 2013 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.


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Interpretive Handbook
89391 :
Hereditary Hemorrhagic Telangiectasia, ENG Gene, Known Mutation
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is an autosomal dominant vascular dysplasia characterized by the presence of arteriovenous malformations (AVM) of the skin, mucosa, and viscera. Small AVMs, or telangiectasias, develop predominantly on the face, oral cavity, and/or hands, and spontaneous, recurrent epistaxis (nosebleed) is a common presenting sign. Symptomatic telangiectasias occur in the gastrointestinal tract of about 30% of HHT patients. Additional serious complications associated with HHT include transient ischemic attacks, embolic stroke, heart failure, cerebral abscess, massive hemoptysis, massive hemothorax, seizure, and cerebral hemorrhage. These complications are a result of larger AVMs, which are most commonly pulmonary, hepatic, or cerebral in origin, and occur in approximately 30%, 40%, and 10% of individuals with HHT, respectively.
HHT is inherited in an autosomal dominant manner; most individuals have an affected parent. HHT occurs with wide ethnic and geographic distribution, and it is significantly more frequent than formerly thought. It is most common in Caucasians, but it occasionally occurs in Asians, Africans, and individuals of Middle Eastern descent. The overall incidence of HHT in North America is estimated to be between 1 in 5,000 and 1 in 10,000. Penetrance seems to be age related, with increased manifestations occurring over one's lifetime. For example, approximately 50% of diagnosed individuals report having nosebleeds by age 10 years, and 80% to 90% by age 21 years. As many as 90% to 95% of affected individuals eventually develop recurrent epistaxis.
Two genes are most commonly associated with HHT: the endoglin gene (ENG), containing 15 exons and located on chromosome 9 at band q34; and the activin A receptor, type II-like 1 gene (ACVRL1 or ALK1), containing 10 exons and located on chromosome 12 at band q1. Mutations in these genes occur in about 80% of individuals with HHT. ENG and ACVRL1 encode for membrane glycoproteins involved in transforming growth factor-beta signaling related to vascular integrity. Mutations in ENG are associated with HHT type 1 (HHT1), which has been reported to have a higher incidence of pulmonary AVMs, whereas ACVRL1 mutations occur in HHT type 2 (HHT2), which has been reported to have a higher incidence of hepatic AVMs. It has been suggested that HHT1 has a more severe phenotype compared to HHT2.
ENG gene, known mutation testing is for the genetic testing of individuals who are at risk for an ENG mutation that has been previously identified in the family. If the familial mutation is not known, the familial proband should be screened for ENG and ACVRL1 mutations via full gene analyses (HHTP / Hereditary Hemorrhagic Telangiectasia, ENG and ACVRL1 Full Gene Analysis). Once a mutation has been identified in a family, known mutation analysis can be performed in at-risk family members.
HHT is phenotypically heterogeneous both between families and amongst affected members of the same family. Furthermore, complications associated with HHT have variable ranges of age of onset. Thus, HHT can be diagnostically challenging. Genetic testing for ENG and ACVRL1 mutations allows for the confirmation of a suspected genetic disease. Confirmation of HHT diagnosis will allow for proper treatment and management of the disease, preconception/prenatal counseling, and family counseling. In addition, it has been estimated that genetic screening of suspected HHT individuals and their families is more economically effective than conventional clinical screening.(1)
Useful For Suggests clinical disorders or settings where the test may be helpful
Genetic testing of individuals at risk for a known endoglin gene (ENG) familial mutation (associated with hereditary hemorrhagic telangiectasia)
Interpretation Provides information to assist in interpretation of the test results
An interpretive report will be provided.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Patients who have received a heterologous blood transfusion within the preceding 6 weeks, or who have received an allogeneic blood or marrow transplant, can have inaccurate genetic test results due to presence of donor DNA.
Absence of a mutation does not preclude the diagnosis of hereditary hemorrhagic telangiectasia (HHT) unless a specific mutation has already been identified in an affected family member. Mutations in ACVRL1 and ENG occur in approximately 80% of individuals with clinically defined HHT.
Any error in the diagnosis or in the pedigree provided to us, including false-paternity, could lead to erroneous interpretation of results.
Rare, undocumented polymorphisms may be present which could lead to false-negative or false-positive results.
Other targeted mutation analyses available:
-ACVK / Hereditary Hemorrhagic Telangiectasia, ACVRL1 Gene, Known Mutation
-HHTM / Hereditary Hemorrhagic Telangiectasia, ENG and ACVRL1 Large Deletion/Duplication, Molecular Analysis
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
An interpretive report will be provided.
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Cohen JH, Faughnan ME, Letarte M, et al: Cost comparison of genetic and clinical screening in families with hereditary hemorrhagic telangiectasia. Am J Med Genet 2005;137A:153-160
2. Sabba C, Pasculli G, Lenato GM, et al: Hereditary hemorrhagic telangiectasia: clinical features in ENG and ALK1 mutation carriers. J Thromb Haemost 2007; 5:1149-1157
3. Abdalla SA, Letarte M: Hereditary haemorrhagic telangiectasia: current views on genetics and mechanisms of disease. J Med Genet 2006;43:97-110
4. Guttmacher AE, Marchuk DA, White RI Jr: Hereditary hemorrhagic telangiectasia. N Engl J Med 1995;333:918-924
5. Bayrak-Toydemir P, Mao R, Lewin S, et al: Hereditary hemorrhagic telangiectasia: an overview of diagnosis and management in the molecular era for clinicians. Genet Med 2004;6:175-191


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Top Definition
The act of gaining a boner out of excitement over a person that has just entered your general area.
see also spiderman ass see also websling dong
from the second your mom walked in the room dude! my spidey senses are tingling in every direction possible.
מאת Peter Russo
8 ביוני, 2007


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Screenshots & demos wanted!
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Post a link to a screenshot, and a link to your site here. If you've modified the look or functions of your new navbar, either by editing the plugin itself or your own css, include a few details of how you got it done.
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TRUCKEE, Calif. - On Saturday Oct. 6, 2012, Switchback PR + Marketing hosted the ninth annual Downtown Truckee Wine, Walk & Shop. The event brought more than 1,000 people to historic downtown Truckee and raised money for the Family Resource Center of Truckee, the nonprofit beneficiary. After wine tasting, food sampling and shopping, guests were invited to vote on their favorite restaurant, shop and winery.This year, 42 merchants in downtown Truckee participated in the wine walk, making 2012 the biggest wine walk to date. Each shop featured one winery for tasting, with 19 food stops offering a food and wine pairing.When the votes were counted, Dragonfly flew to the top of the chart taking first place, with Trokay Caf following as a strong second. White Buffalo and The Niche tied for favorite shop. Participants chose Lucchesi Vineyards and Winery as the top winery with Rombauer a close runner up. The Downtown Truckee Wine, Walk & Shop is a fundraising event produced by Switchback PR + Marketing, Inc.Switchback PR congratulates the winners and thanks participating shops, restaurants, wineries, volunteers and sponsors.This year's sponsors included Tahoe Mountain Club, The Weekly, Sierra Sun, Sierra Heritage Magazine, Truckee Chamber of Commerce, White Buffalo, Chase International, Canyon Springs of Truckee, Downtown Truckee Merchants Association, Northstar California, Morrison Sales Team, Mountain Home Center, Aspen Leaf Interior Design, Keller Williams, The Truckee Sports Exchange, The Rock Garden, Martis Camp Community Association, Teichert/Stonebridge Properties, and The Office BOSS.For more information visit www.TruckeeWineWalk.com or call 530-550-2252.
- North Lake Tahoe casino win dips 15 percent in March
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- Future of North Lake Tahoe parking focus of public workshop Monday