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Satisfaction and Patient Outcomes of a Telephone-Based Nurse Triage Service
Satisfaction and Patient Outcomes of a Telephone-Based Nurse Triage Service
MANAGED CARE July 2001. ©MediMedia USA
Purpose: Describe patient satisfaction and patient-reported outcomes after voluntary use of a telephone-based nurse triage service.
Methods: A random sample of symptomatic callers who contacted the triage service in 1999 was identified. A computer-assisted telephone survey was conducted, resulting in a response rate of 58.9 percent and a sample size of 35,374.
Summary: Overall satisfaction with the service was 90.4 percent and did not vary greatly when stratified by demographic and health-status characteristics. Of all callers who reported following the triage recommendation to use self-care instructions while monitoring the condition for change (n=12,037), 11.5 percent scheduled an office visit and 1.5 percent used hospital emergency-room (ER) services for further care.
Conclusions: Overall satisfaction with telephone-based nurse triage services was high and did not vary substantially by caller characteristics.
Key terms: nurse triage; program evaluation; satisfaction; outcomes
In recent years, consumer use of internet and telephone-based services to obtain health information and advice has increased dramatically. As the use of such services continues to rise rapidly, it becomes increasingly important to improve understanding of these services. This study examines satisfaction with a telephone-based nurse triage service and describes self-reported patient outcomes.
Over 75-million people in the United States, as well as many people in other countries, have access to telephone triage services.1-7 Health plans and employer groups provide these services to improve access to medical information and advice. Triage nurses typically use clinical tools to assess callers' acute medical complaints and to make recommendations as to the level of care that is needed and how soon treatment should be sought. Use is voluntary, and the majority of calls occur during evenings and weekends.
Although high levels of satisfaction with nurse triage services have been reported previously, only one study was of a United States population.8-11 Due to limited sample sizes, no studies to date have stratified satisfaction by demographic and health characteristics that may have an effect on patient-caller satisfaction.8,9,11 Moreover, information describing caller outcomes (e.g., agreement and compliance with the nurse-recommended course of care, post-call utilization of medical services, and medical-complaint resolution) is limited.
The data in this study include a random sample of nurse triage callers from 40 health plans located throughout the United States. The health plans contracted with one provider of telephone-based nurse triage services and agreed to participate in the outcomes survey. Health plan members were able to contact the service 24 hours a day, 7 days a week at no cost through toll-free numbers. The primary reason to contact the triage service is to have a registered nurse assess medical symptoms; these callers are classified as symptomatic.
The triage service's clinical-decision architecture uses more than 570 symptom-based algorithms to evaluate callers' medical complaints and suggest appropriate management. Other callers contact the nurse triage service to obtain provider referrals, general health information, or information concerning specific health plan coverage and services.
Participation in the study was limited to symptomatic callers. Biweekly, data on a random sample of symptomatic callers were generated and sent to an independent research company throughout 1999. Specially trained representatives contacted callers within two to four weeks of having used the nurse triage service. Interviewers conducted a computer-assisted telephone survey that was monitored to ensure quality. In addition, health plan staff were able to monitor survey administration.
The research firm attempted to contact triage service users a minimum of five times during a two-week period, including Saturdays, and at various times of the day. The survey methodology resulted in an overall reach rate of 58.9 percent. Representatives attempted to call triage service users at the phone number from which they contacted the nurse triage service. Since callers may have been at another location when they contacted the nurse triage line, attempts to reach some callers were unsuccessful. Thirty percent of callers were not contacted during any of the five attempts made, and seven percent declined to participate when contacted. Data for 35,871 symptomatic callers were obtained.
Those surveyed were asked to respond to a series of questions concerning satisfaction with the nurse triage service, agreement and compliance with the algorithm recommended course of care, and the level of medical service sought after the call. Health plan administrators participated in the development of the survey instrument. If a person participated in the survey but did not answer the first two questions concerning overall satisfaction and satisfaction with the nurse's medical knowledge, the individual's data were excluded from the analysis (n=497). Otherwise, differences in the reported sample size for each question indicate that some people were nonrespondents for a particular question.
Interviewers spoke directly with the health plan member who contacted the triage service. In most instances (n=21,651), people called about their own health. A person could have called, however, about a medical complaint of their child (n=5,714), parent (n=193), spouse (n=1,003), grandparent (n=26), or a person with another type of relationship to the caller (n=400).
Survey responses pertaining to satisfaction were recorded using a scale of 1 to 5, where 1 represents "very dissatisfied" and 5 represents "very satisfied." Only responses of 4 ("satisfied") and 5 ("very satisfied") were considered to express caller satisfaction. An alpha code was assigned to responses given for agreement and compliance with the algorithm recommendation and resolution of medical condition.
Caller satisfaction is reported by a number of patient characteristics. Information concerning age, gender, and the caller/patient relationship are routinely collected during the nurse-caller interaction. Data concerning caller race/ethnicity and educational attainment was obtained during survey administration. Due to the sensitivity of the questions, several health plans requested that this demographic data only be gathered for four weeks of the yearlong survey. Therefore, caller demographic data on race/ethnicity and education level were voluntarily collected for roughly 8,000 callers during 1999. Information concerning type of plan coverage was available for 17,409 callers, due to variations in the coding of different types of plan coverage in the triage database.
Satisfaction was also evaluated by caller-redirection status. Triage callers are provided with a recommended course of care that includes a referral to the ER or urgent care center; to schedule a physician appointment; to speak with the on-call medical provider; or to use self-care instructions while monitoring the patient's status for any changes.
During triage assessments, callers are asked what type of care they would have sought if the triage service had not been available to them. Depending on symptom severity, the algorithm may recommend a more acute, similar, or less-acute level of care than the patient had intended to seek. If the algorithm recommendation differs from the caller's intended approach to obtaining medical care, this is called redirection. We used these data to describe satisfaction by type of caller redirection.
Logistic-regression analysis was used to determine the statistical significance of variations in satisfaction by caller characteristics. Three models were estimated, due to data limitations for some characteristics. The first model, the base model, included age, gender, patient/caller relationship, triage recommendation, and redirection as independent characteristics. The second model included the base model with the addition of race/ethnicity and education, and the third model included the base model with type of coverage.
The satisfaction survey sample of 35,374 callers was similar with regard to age, gender, and patient-caller relationship to the overall population of callers in 1999. The top-ten algorithms used to triage symptomatic callers in the sample included: upper respiratory illness, abdominal pain, trauma to an extremity, insect bite, vomiting, diarrhea, skin-wound problems, skin rash, sore throat, and cough.
Overall satisfaction with the nurse triage service was high. More than 90 percent of callers reported being "satisfied" or "very satisfied" with the care received. Nearly three-fourths of all respondents reported being "very satisfied." (See Table 1.)
Table 1. Caller satisfaction with the nurse triage service | |||||
Survey Item | Sample (n) | Frequency | Percent | ||
Q1. | Overall satisfaction with care received from nurse (responses 4 and 5) | 35,374 | 31,962 | 90.4 | |
By actual response | |||||
5 = "very satisfied" | 25,616 | 72.5 | |||
4 = "satisfied" | 6,346 | 18.0 | |||
3 = "indifferent" | 2,134 | 6.0 | |||
2 = "dissatisfied" | 670 | 1.9 | |||
1 = "very dissatisfied" | 581 | 1.6 | |||
Q2. | Satisfaction with nurse's medical knowledge | 35,374 | 32,268 | 91.3 | |
Q3. | Satisfaction with nurse's understanding of condition | 35,116 | 32,276 | 91.9 | |
Q4. | Comfort level speaking to nurse | 35,165 | 32,897 | 93.6 | |
Overall satisfaction (Q1) stratified by patient characteristics | |||||
Patient Age (n=32,130) | |||||
0–4 | 5,512 | 5,003 | 90.8x | ||
5–17 | 4,558 | 4,163 | 91.3x | ||
18–44 | 12,417 | 11,126 | 89.6 | ||
45–64 | 6,244 | 5,622 | 90.4 | ||
65 + | 3,399 | 3,161 | 93.0 | ||
Patient Gender (n=31,625)x | |||||
Male | 10,777 | 9,669 | 89.7x | ||
Female | 20,848 | 18,907 | 90.4 | ||
Caller Ethnicity (n=7,976) | |||||
Caucasian | 6,005 | 5,449 | 90.7 | ||
African American | 1,321 | 1,198 | 90.7 | ||
Hispanic | 268 | 244 | 91.0 | ||
Asian | 122 | 104 | 85.3 | ||
Other | 260 | 243 | 93.5 | ||
Caller Educational Attainment (n=8,085) | |||||
Less than high school, high school graduate, or GED | 3,008 | 2,774 | 92.2 | ||
Some college | 2,284 | 2,074 | 90.8 | ||
College graduate | 2,793 | 2,479 | 88.8 | ||
Caller relationship to patient (n=28,987) | |||||
Self | 21,651 | 19,552 | 90.3 | ||
Parent | 5,714 | 5,160 | 90.3 | ||
Spouse | 1,003 | 903 | 90.0 | ||
Child | 193 | 176 | 91.2x | ||
Other | 426 | 385 | 90.4 | ||
Type of health insurance coverage (n=17,409) | |||||
Point of Service | 1,521 | 1,386 | 91.1 | ||
Preferred Provider Organization | 1,861 | 1,705 | 91.6 | ||
Health Maintenance Organization | 10,761 | 9,724 | 90.4 | ||
Medicare | 739 | 680 | 92.0 | ||
Medicaid | 1,216 | 1,115 | 91.7y | ||
Other | 1,311 | 1,183 | 90.2 | ||
Algorithm group (n=6,732) | |||||
Adult cardiovascular | 990 | 912 | 92.1 | ||
Adult musculoskeletal | 1,693 | 1,508 | 89.1 | ||
Adult gastrointestinal | 1,836 | 1,662 | 90.5 | ||
Pediatric upper-respiratory illness | 1,988 | 1,783 | 89.7 | ||
Seniors upper-respiratory illness | 225 | 208 | 92.5 | ||
Triage recommendation (n=35,270) | |||||
Go to the hospital emergency room | 654 | 600 | 91.7 | ||
Use urgent care services | 4,895 | 4,430 | 90.5y | ||
Make an appointment to see your medical provider | 5,091 | 4,535 | 89.1y | ||
Call your medical provider | 11,472 | 10,273 | 89.6 | ||
Use self-care recommendations at home | 13,158 | 12,055 | 91.6x | ||
Caller redirection (n=27,810) | |||||
Directed to a less acute level of care | 14,322 | 12,904 | 90.1x | ||
Directed to the same level of care | 7,815 | 7,143 | 91.4 | ||
Directed to a more acute level of care | 5,673 | 5,162 | 91.0 | ||
y,xStatistically significant difference at the 0.05 and 0.01 levels, respectively. The reference group for age was 18-44 years; gender, males; caller relationship to patient, self; triage recommendation, call your provider; redirection, same level of care; race, Caucasian; education, some college and plan type, HMO. The statistical findings must be interpreted with caution, as some differences in satisfaction levels are statistically significant due in part to the large sample size for some characteristics; larger differences were not significant due in part to smaller sample sizes. The significance of algorithm type was not tested since most algorithms could not be grouped into meaningful categories. |
When satisfaction levels were stratified by age, gender, caller relationship to patient, and race/ethnicity, satisfaction generally remained at or above 90 percent. Satisfaction for Asian callers was somewhat lower, however, at 85.3 percent. Although there were variations in satisfaction by caller educational level and by type of insurance coverage, satisfaction levels were 90 percent or above for all groups. (The statistical significance of these differences is presented in Table 1.)
Only minor differences in satisfaction were observed when satisfaction was stratified by type of medical complaint as assessed by the type of algorithm used during the triage call. At least 90 percent of callers triaged using the upper respiratory infection and abdominal pain algorithms were satisfied with the service. Similarly, callers triaged by the chest pain (92.1 percent) and musculoskeletal pain (89.1 percent) algorithms were satisfied with the nurse triage service. There was little variation in satisfaction by type of triage recommendation or by caller redirection. Approximately 90 percent of callers reported satisfaction with the service despite being redirected to a less-acute setting than they would have otherwise used.
Three indicators of triage quality were assessed. When callers were asked whether they followed the care-algorithm recommendation, 90 percent of callers (29,685 of 32,995 respondents) reported complying with the nurses' recommendations. Second, caller agreement with the triage recommendation was evaluated. Callers who reported they followed the recommendation were asked to review their triage call experience and rate (on the 1–5 scale) the appropriateness of the algorithm recommendation. Nearly all these respondents (95.2 percent) reported that the care-algorithm recommendation was appropriate.
The third indicator of triage quality related to use of medical services following a triage call. The investigators examined the follow-up care obtained by callers who reported following triage recommendations for less-acute types of medical care. Of the 3,754 persons provided the recommendation to make an appointment with their providers, only 41 people (1.0 percent) reported use of the ER, and three (0.07 percent) reported use of urgent care services. Six percent scheduled follow-up office visits with a physician.
Of the 12,037 persons who were provided with self-care recommendations, 11.5 percent (n=1,391) went on to schedule a visit with their provider, 1.5 percent (n=182) used the ER, and 0.2 percent (n=19) used urgent care services.
Roughly 10 percent of callers reported that they did not follow the algorithm recommendation. Reasons given for noncompliance are provided in Table 2. Twenty-eight percent of those who did not comply reported that they felt the patient was not as sick as the nurse had believed, while 16.2 percent felt the patient was sicker than the nurse had believed. Another 31.7 percent did not want to call their provider, could not contact their physician, or did not have time to follow the recommendation.
Table 2. Reasons for noncompliance with algorithm recommendation | ||
Number | Percent | |
Felt patient was not as sick as nurse believed | 938 | 28.3 |
Felt patient was sicker than nurse believed | 535 | 16.2 |
Did not want to call provider | 528 | 16.0 |
Wanted second opinion | 274 | 8.3 |
Did not have time to follow recommendation | 275 | 8.3 |
Could not contact physician | 244 | 7.4 |
Did not want to go to the ER | 205 | 6.2 |
Felt nurse did not have enough information to make a decision | 128 | 3.9 |
Financial reasons | 95 | 2.9 |
Does not have a regular provider to see/call | 88 | 2.7 |
Total | 3,310 | 100.0 |
Callers who did not comply were asked how they resolved their medical conditions. Their responses closely matched their reasons for noncompliance, with the majority seeking care at a less-acute level than that recommended. Of those who were given the recommendation to see their provider, call their provider, or take care of their condition at home, 14.9 percent reported they sought services at an ER or urgent care center.
Only one previous study of satisfaction with nurse triage systems in the United States had been conducted, and this had a relatively small sample size of 422 pediatric patients.11 In this paper, we have described the satisfaction of 35,374 callers of all ages who used a nurse service during 1999. The results of this study confirm previous findings concerning high levels of satisfaction with such services in the United States as well as other countries.8-11
Due to the large sample size, the investigators were able to examine satisfaction by demographic variables such as patient age and gender, caller educational attainment, ethnicity, patient-caller relationship, type of insurance plan, triage recommendation, and type of medical complaint. Although there was some minor variation, satisfaction rates remained generally at or above 90 percent when stratified by caller characteristics. Findings indicate that callers were satisfied even when directed to a lower level of medical care than they would have otherwise used.
The investigators assessed three indicators of patient-reported quality of care in this study: caller adherence to the triage recommendation, caller agreement that the recommendation was appropriate, and the use of medical services following the call.
Ninety percent of callers reported following the triage-recommended course of care and 95 percent still perceived the algorithm recommendation to have been appropriate when asked two to four weeks after the triage call. An analysis of the use of medical services after the call indicated that only an extremely limited number of callers sought additional medical care at a later date. Nevertheless, to continue to improve the quality of the triage service, there is a need to further understand the reasons callers/patients do not follow triage recommendations.
One limitation of this study is the response rate. Although a response rate of nearly 60 percent is reasonable for a telephone-based survey, respondents could have viewed the service more favorably than nonrespondents.
In addition, the self-reported compliance data could include an upward bias. The compliance question was worded: "I understand the triage nurse recommended you [triage recommendation]. Did you decide to [triage recommendation]?" Even given this wording, it is likely that reported compliance with the nurses' recommendation might be biased upwards.
Medical claims and encounter data were used to assess compliance rates for recommendations to use an ER, physician office services, and self-care advice for the same triage service.12 According to these data, which have a downward bias, approximately 66 percent of patients adhered to the recommendation. It may be that actual compliance lies between the two levels, given the biases of the two different types of data.
This study addresses satisfaction and self-reported outcomes for one nurse triage service. The quality of these services varies due to the clinical rigor of the decision-support tools that range from loosely structured, paper-based guidelines to peer-reviewed, computerized algorithms, as well as nursing training, triage quality monitoring activities, and the frequency of algorithm updates.2,13-15
The results indicate that telephone-based triage services may be a useful method of providing health care information and advice, especially during evenings and weekends. Additional research is needed, however, to further assess patient compliance with telephone-based nurse advice and to clinically evaluate triage quality.
- Emerging Market Trends. Strategic Briefings in Telemedicine. Jacksonsonville, Ore: Feedback Research Services; 1999;2(6): 7–10
- Lattimer V, George S, Thompson F, Thomas E, Mullee M, Turnbull J, et al. Safety and effectiveness of nurse telephone consultation in out of hours primary care: randomised controlled trial. BMJ. 1999;317:1054–1059.
- McCarthy R. It takes more than a phone call to manage demand. Business and Health. 1997;5:36–41.
- Sher C, Mimouni M, Weitzen T, Waisman Y. Pediatric telephone advice: a new medical service in Israel. Isr J Med Sci. 1994;30:651–666.
- Marklund B, Bengtsson C. Medical advice by telephone at Swedish health centres: who calls and what are the problems? Fam Practice. 1989;6(1):42–46.
- Christensen M, Olesen F. Out of hours service in Denmark: evaluation five years after reform. BMJ. 1998;613:1502–1504.
- Evans RJ, McCabe M, Allen H, Rainer T, and Richmond PW. Telephone advice in the accident and emergency department: a survey of current practice. Arch Emer Med. 1993;10:216–219.
- Gallagher M, Huddart T, Henderson B. Telephone triage of acute illness by a practice nurse in general practice: outcomes of care. Br J Gen Pract. 1999;48(429):1141–1145.
- Jones K, Gilbert P, Little J, Wilkinson K. Nurse triage for house call requests in Tyneside general practice: patients' views and effect on doctor workload. Br J Gen Pract. 1999;48:1303–1306.
- Dale J, Crouch R, Patel S, Williams S. Patients telephoning A&E for advice: a comparison of expectations and outcomes. J Accid Emerg Med. 1997;14(1):21–23.
- Poole SR, Schmitt BD, Carruth T, Person-Smith A, Slusarski M. After-hours telephone coverage: The application of an area-wide telephone triage and advice system for pediatric practices. Pediatrics. 1993;92(5): 670–679.
- O'Connell JM, Towles W, Yin M, Malakar CL. Patient adherence to telephone-based nurse triage recommendations. Unpublished manuscript, 2001.
- Salk ED, Schriger DL, Hubbell KA, Schwartz BL. Effect of visual cues, vital signs, and protocols on triage: a prospective randomized crossover trial. Ann Emerg Med. 1999;32(2):655–664.
- Sullivan G. Advice or diagnosis? A legal perspective. Business and Health. 1997;5:40–42.
- Wolcott B. Putting clinical pathways to work: using algorithms. In: Howe R, editors. Clinical Pathways for Ambulatory Care Management. Gaithersburg, MD: Aspen Publishers, Inc.; 1996: p. 1–7.
Author correspondence:
Joan M. O'Connell, Ph.D., M.H.S.
Director, Health Information
Anthem Blue Cross Blue Shield
700 Broadway
Denver, CO 80273
Phone: (303) 831-3254
E-mail: email@example.com


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Below are the instructions for creating the Lenovo Microsoft Windows 8 preload Recovery Media for Lenovo Think branded systems. A minimum 16GB USB flash drive is required to make a complete backup.
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NOTE: From this point forward in the recovery process, the choices for actual operating system recovery depend on the existing state of the computer hard drive.
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Showing 1-24 of 54 items found in Outdoors & Play
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Coyote Creek Golf Club
Championship course with a country club atmosphere. A challenging 18-hole course designed by the late Bruce Borland, senior designer for Jack Nicklaus.
Camp Komfort
The campground is very clean and quiet. There are many features, such as an in-ground pool, a large pavilion, a play area for children, a small store and a dog walk area. There is plenty of shade in this campground. They provide 30 and 50 AMP service.
Three Sisters Park
Three sisters, Sadie, Lillian, and Goldie Cohen, expressed a wish that the 400-acres of farmland located adjacent to the city of Chillicothe, IL be dedicated as park land and a model farm for educational, recreational, and conservational purposes. While the Cohen sisters lived just off Moss Avenue in Peoria, they loved their family farm. Their vision was for the property to remain agriculturally related. The master plan envisions the creation of a living history farm, a central activity building, large festival areas, a welcome center, restaurant, agricultural equipment museum activity area, and outdoor natural amphitheater. The open fields and forested areas offer unique space for special events, concerts and festivals.
Carriage Classics, Ltd.
This horse-drawn carriage service is available for scenic tours, weddings and other occasions. Equipped for all seasons. Evening rides in downtown Peoria Fridays and Saturdays during April through mid-October. Thursday through Saturday rides during June through August. Pick-up points at Hotel Pere Marquette and The Landing. $20 for two adults and $5 for each additional person. Children under 10 ride free. Carriage rides available 7 p.m. through midnight. May be hired any time of the year for service in the Peoria and surrounding area. We also have a horse-drawn trolley available for special groups outings. Call for details!!!
Green View Nursery, Inc.
Enjoy the ever-changing beauty of nature and discover Green View Nursery. Green View is a family-owned business that offers a full service garden center and a gift show. Expert horticulturists and extensive irrigation and fertilization practices allow Green View to produce what we feel is some of Illinois' finest nursery stock: the Green View Grown® Brand. "Today's Garden Center" recognized Green View Companies as one of the Top 100 Revolutionary Garden Centers in the United States for 2009. We join the ranks of the horticulture industry's top independent garden centers for the second consecutive year. Green View was also featured on ABC-TV's "Extreme Home Makeover: Home Edition" for their work on the Grys' home in Pekin, IL.
Splashdown Water Park
Central Illinois' premier family water park is located at the Eastside Centre Sports Complex. Play in Splash Tower Island, ride the lazy river, or spend time in the splash and play area designed for little ones.
CITY:East Peoria
Fon du Lac Park District
Experience what 1600+ acres of parks, natural areas, riverfront and trails have to offer. Enjoy 2 golf courses, a picturesque marina and campground, Splashdown Water Park, and a variety of recreational programs and activities for all ages.
CITY:East Peoria
Fon du Lac Golf Course
This nine-hole course is challenging for the experienced golfer, but also beginner-friendly for the novice. Great for a quick round and easy on your pocketbook.
CITY:East Peoria
Carl Spindler Marina
Part of the Riverfront Greenway, Spindler Marina is a public gateway to the Illinois River, offering reasonable rates, parking and storage. Make Spindler Marina your launch today. Available for public boat launch, slip rental and dry dock storage. Pick up your ice, boating or camping supplies at the Marina office. With a picnic and shelter area, rest rooms available seasonally, and the beautiful views from the River Trail Boardwalk, make Spindler Marina your next Illinois adventure.
CITY:East Peoria
EastPort Marina
One of the area's premier marinas, EastPort Marina is located along Illinois Route 116, at mile marker 164.5 on the Illinois River. Rated Four Anchors in the Quimby Cruising Guide, this East Peoria marina is presently lined with 280 slips ranging from 25 to 50 feet in length. Boaters are welcome to stop and spend a few days enjoying the marina and its many amenities, as well as the entertainment opportunities in East Peoria and the the Peoria area.
CITY:East Peoria
River Trail of Illinois
This 10-foot wide asphalt trail winds 4.8 miles along the former Illinois Terminal Railroad Co. path. Build in 1991, the River Trail provides a safe scenic route for outdoor recreation year round, winter weather permitting. The trail affords patrons the opportunity to experience the natural preservation of wildflowers, grasses, trees and wildlife. With direct access at the Park Administration Center, Bunnell field, and Taylor Street ball diamonds, and in close proximity to Veterans Park, Central Jr. High, West Park, and local restaurants, the River Trail offers something for everyone!
CITY:East Peoria
Splashdown at EastSide
The wettest and wildest family water park in Central Illinois. Play in Splashtower Island or ride the lazy river. There's even a splash and play area for the young ones in your family. www.fondulacpark.com
CITY:East Peoria
Wildlife Prairie Park
A unique, 2,000-acre zoological park which is home to wolves, bison, waterfowl, black bear, elk, cougar, otter, and others. You will enjoy the park's spectacular natural settings, butterfly garden, wildflowers, lakes and restored prairies.
CITY:Hanna City
Comlara Park Visitor's Center
This enviromental education facility houses permanent audio/visual wildlife displays, artifacts originating from the site and a rotating summer exhibit.
Woodford State Fish and Wildlife Area
Picturesque bottomland setting with an abundance of silver maple, cottonwood, ash and willow trees. Picnicking, camping, boating, fishing, and hunting add to the visitor's enjoyment.
Mackinaw River State Fish and Wildlife Area
This site offers a diversity of landscape covering 1,448 acres over timbered hills, open meadows, and river bottoms. Canoe access enables visitors to float the scenic Mackinaw River. Other activities include fishing, hunting, hiking, and picnicking.
Lavender Creek Farm
Lavender Creek Farm grows fields of organic lavender plants. Walk the lavender fields, pick bouquets and browse the plants for sale. Lavender soaps, oils, lotions, candles and more are made at the farmhouse - the old fashioned way!
Mackinaw Valley Vineyard
Experience a bit of Napa Valley in Central Illinois. Visit the winery, tasting room and gift shop. Enjoy the panoramic view available for weddings, receptions and meetings.
Powerton Lake State Fish and Wildlife Area
The lake was built on the floodplain of the Illinois River in 1971 by Commonwealth Edison Company as a cooling reservoir for the fossil-fuel power plant. Today, the completely diked, 1,426-acre lake is leased for visitor hunting and fishing.
Spring Lake State Fish and Wildlife Area
Contains a large bluff overlooking a long, narrow lake. Camping, picnicking, fishing, boating, hiking, and hunting opportunities provide a vast recreational experience. Concession and boat rentals are also available.
Metamora Fields Golf Club
An 18-hole D. A. Weibring/Wolfard designed championship golf course with a 25,000 sq-ft clubhouse that offers banquet seating up to 400 people in one room. Introducing a brand new "classic" golf course to the Tri-County area focusing on offering "playable" golf for every skill level. Stunning panoramic views overlooking this links course make for an amazing backdrop for any special event. Our tag line "Where You're Always Welcome" says it all. Hang out for a while in the clubhouse - even if you don't play golf very much but like to watch. We have the very best view of golf in all of Central Illinois from our two level outdoor deck that peers out to the 9th and 18th greens tucked on opposite sides of our beautiful clubhouse chain of lakes. We intentionally brought these two greens as close to the clubhouse as possible so that everyone can enjoy watching golf while relaxing on the decks or inside the clubhouse.
Ackerman Farms
Ackerman Farms, celebrating over 100 years as a working family farm, invites everyone to join us from the 3rd week in August through the 3rd week in December. We feature over 150 different varieties of pumpkins and squash in all shapes and sizes, over 25 varieties of beautiful hardy mums, and over 15 varieties of apples from our orchard - everything you need for your fall decorations and for your table. Plan to spend the afternoon with us in our family friendly corn maze, ride a hay rack, browse the gift shop and visit our friendly farm animals. At Christmas, join us for hot cider by a cozy fire and leisurely shop our wonderful Christmas selection of gifts and decor. Don't forget to call us to schedule birthday parties or class field trips.
Peoria Palace Roller Skating Rink
Heart of Illinois' premier roller rink with family entertainment. We feature great food, a party area, live music, big screen TVs, wireless internet access and more. Peoria Palace Skating Rink offers the best in family oriented entertainment that will appeal to all ages! Peoria Palace has a large arcade area with the newest games, and some "Old Skool" classics that offer arcade tickets which can be traded for prizes at the Redemption Center. Choosing healthier lifestyles has become more important and Peoria Palace definitely fits the bill! Research has shown that roller skating burns up to 660 calories an hour! You see not only is skating fun but it's good for your health!!
Pekin Park District
Facilities include a 4-mile trail, indoor ice-skating rink, horse riding stables, fishing, bocce ball, canoes, bike boats, Frisbee golf course, mini-golf and a lot more.


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Well, I received my 3rd Crosshair II Formula today. When I was taking it out of the package, I noticed a motherboard standoff screw in the container which the motherboard was sitting on (not a good sign to see random stuff in your box) Also, the blue heatsink covering the south bridge was missing a screw so it was no where firmly pressed against the chip it needed to cool. Therefore, I can not even test the board without risking frying that chip, (although that chip would rather be in IC heaven than on the a piece of crap motherboard). Strangely enough, that standoff screw was not the screw missing from the heatsink assembly, it was some proprietary screw with a spring about it.
I just emailed newegg to let them know about this crap. Lets see what they say.


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Great Expectations (p. 216). Scanned image and text by Philip V. Allingham from material reproduced courtesy of The Charles Dickens Museum, 48 Doughty Street, London WC1N 2LF.
by F. A. Fraser. c. 1877. 3.8 x 4.9 inches. An illustration for the Household Edition of Dickens'sReferences
Dickens, Charles. Great Expectations. Volume 6 of the Household Edition. London: Chapman and Hall, 1871-1880 [this volume c. 1877].


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This is the first time anyone has ever asked me to say more. LOL! Never happens. But I digress...
Loved the semi hollow. Loved the pickups. Loved the fingerboard and headstock materials (though hand signed would be weird on ebony IMHO, it should be inlaid but wouldn't be a deal breaker). Loved the option to not have piezo. Dig the body style. Don't care about the neck material either way. Don't care about the direction the birds fly.
But big love for the semi hollow idea, and I think the Starla pickups would be awesome, too. Loved the scale length.
In fact, this is the kind of guitar I would love to own. This is different enough to warrant putting another guitar in the studio. PRS does a GREAT job with the semi-hollow models.
I was reluctantly on board before. But this was a great idea.


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U.S. sues Lance Armstrong
Lance Armstrong was stripped of his seven Tour de France titles and banned for life after the International Cycling Union (UCI) ratified the United States Anti-Doping Agency's (USADA) sanctions against him. The Justice Department formally filed its case against Lance Armstrong and his company Tailwind Sports for millions of dollars that the U.S. Postal Service spent to sponsor the cycling team.
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Hotel D'Angleterre is a boutique hotel in the fashionable heart of Geneva.
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Enjoy breathtaking views with cuisine and wines to match at Windows Restaurant. For a relaxing spot to sit and enjoy a drink, try the Leopard Bar.
Located on Mont-Blanc overlooking Lake Geneva, the hotel is perfecty positioned for enjoying the city's best shopping, culture and chic lakeside lifestyle.
The hotel's intimate atmosphere, discreet charm and splendid luxury are complemented by truly exceptional personal service.
Exclusive Lake King Bed. Sumptuously furnished and spacious. 37SQM
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Carouge is like a little town in the city, with galleries, antiques stores and trendy shops in atmospheric houses; Yvoire is a wonderful medieval village on the lakeshore, not far from town; Mont Salève, reachable by cable car, has a good hiking trail and a great view of the city.
This gorgeous medieval town is known for its well-preserved castle, and of course for its cheese, which you can taste at one of many traditional restaurants and see made at the local factory. Combine your trip with a visit to the atmospheric and fascinating chocolate-making factory Cailler.
Geneva's fountain where the lake meets the Rhone River is one of the city's most famous landmarks—but few visitors know that you can walk right up to the fountain's nozzle and take photographs of the plume just a few meters from its source.
This lovely wine bar spans three floors and has an excellent selection of wines as well as small-plate Swiss dishes. www.tourdumolard.ch.
Reopened following a renovation last year, this museum in a gorgeous 19th-century Neoclassical building is known for its superlative biannual special exhibitions. Next up is one devoted to Jean-Jacques Rousseau. Place de Neuve 1; (41-22) 418-33-40.
This simple French restaurant serves superb takes on classic French dishes, including fresh fish—perch meunière, trout au bleu—on a beautiful terrace in the summer, or in a cozy bistro with fireplace in the winter. www.creuxdegenthod.com.
The famous Swiss manufacturer has a flagship store on Rue de Marché, stocking a wide assortment of clothing, luggage and, of course, those pocket knives. Make an appointment in advance to create your own personalized knife. Rue de Marché 2; (41-22) 318-63-40.
In the Grottes district, a few meters behind the main train station, you'll find this special spot—ignored by most visitors—that features buildings, doors, windows and balconies done in a fantastical style reminiscent of Gaudí.
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Wine Cooler Video Buying Guide
Learn More Wine Refrigerator Buying Guide
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Wine Refrigerators / Beverage CentersWine refrigerators and beverage centers are a great addition to any kitchen, providing dedicated wine storage, or freeing up space in your main refrigerator by holding all of your chilled beverages. Whether your wine collection contains a dozen bottles or a hundred, Abt has a wine cooler refrigerator to meet your needs. Need to keep some drinks cooled in the Man Cave? An under-counter beverage center refrigerator is a perfect solution that doesn't need a lot of space, and uses much less energy than a full-sized fridge. Abt carries a wide array of wine coolers from top manufacturers like GE, Sub-Zero, and Jenn-Air.
Wine Cooler/Wine RefrigeratorAbt is proud to stock a wide selection of the industry's best items. You can find the right wine refrigerator, beverage center or wine cooler, no matter the size or style. beverage centers, from over a dozen different brands. If you are looking for the perfect wine fridge or beverage fridge, Abt has a variety of items that will fit perfectly in your home. Whether you are looking for simple storage, or a professional wine collection, we have the one for you. |


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Giant Snake-Tailed Chameleon
this wiki
editGiant Snake-Tailed Chameleon | |
Debut | |
Manga | Chapter #374 |
Anime | Naruto Shippūden Episode #130 |
Game | Naruto Shippūden: Ultimate Ninja Storm 2 |
Appears in | Anime, Manga, Game |
Personal | |
Species | Chameleon |
Classification |
This summon is a large chimera-like chameleon with snake for a tail. Like all of Nagato's summons, it has a number of body piercings and Rinnegan, implying that it is being controlled.
Much like a real-life chameleon, this creature can also blend with its surroundings for camouflage, so perfectly that it renders itself completely invisible to other viewers around. This ability has been used by the Animal Path of Pain to step inside the chameleon's mouth and attack his opponents by surprise. As perfect as it may be, however, this camouflage can be detected by barrier-related techniques, as when Jiraiya tried to use his Barrier: Canopy Method Formation to locate it, Pain had the chameleon distance itself from him, and attacked him with an offensive summon. Another reptilian trait that the chameleon shows is the ability to crawl on vertical and inclined surfaces, such as walls. Also, it has exhibited great destruction capabilities, as it could fend off attacks from Konoha ninja and wreck houses and buildings during the invasion of Pain. The snake-tail can be used as a prehensile limb, to be able to grab and capture intended targets for Pain with its tongue, as shown during the Fourth Shinobi World War.[1]
Part II
Itachi Pursuit Arc
It is first summoned during Pain's battle with Jiraiya in Amegakure, swallowing Pain's Animal path and turning invisible via camouflage, to conceal the latter and give it stealth-based advantages. After failing to detect it via a barrier technique, Jiraiya summons Shima and Fukasaku to use Sage Mode. Analysing the situation, Shima is easily able deduce the creature's location and restrain it with her Fighting Tongue Bind technique, before excreting a corrosive liquid along her tongue's length to disable it's camouflage. Fukasaku then slices the creature in half, with the Fighting Tongue Slash.
Invasion of Pain Arc
In the anime, the chameleon is summoned again by the second Animal Path during the invasion of Konoha. After causing a rampage along with Pain's other summons, it is de-summoned (along with other animal summons) when Pain decides to concentrate his power solely to the Deva Path for a large-scale Shinra Tensei on Konoha.
Shinobi World War Arc
During the Fourth Shinobi World War, the chameleon is summoned by Nagato, who has been reincarnated by Kabuto Yakushi. Nagato, being controlled by Kabuto, uses it to hide within it's mouth, while the creature is invisible, and then unleash a massive Shinra Tensei on his surroundings to obliterate a portion of the forest while battling Naruto Uzumaki and Killer B. After Nagato revitalises to his youthful appearance by absorbing B's chakra, he has the chameleon use his snake-tail to hold Naruto while he removes his soul. However, both it and the King of Hell get blinded when Itachi throws several kunai into their eyes, allowing him to save both Naruto and B from Nagato.
- In the manga, when the chameleon is seen in chapter 374, the snake had regular eyes. This was corrected in subsequent chapters and the snake was seen with Rinnegan eyes.
- ↑ Naruto chapter 550, page 17


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Last Activity: 4 Days Ago
About Me
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Ohio's Covered Bridges (Main)
Submitted by site_admin on Mon, 01/14/2013 - 4:10pm
Tuesday,January 29th, 2013 at 6:00 p.m.
Join Springfield local Keith Whitehead as he shares photos and history of Ohio's covered bridges.
This program will take place in the Gaier Room of the Main Library, 201 S. Fountain Ave., Springfield, OH. Call (937) 328-6903 for more information.
Tuesday, January 29, 2013 - 6:00pm - 7:30pm


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Hey Tim,
Just inquiring to see if you were going to try to do the Sub races this year at Carmel. I know last year it did not seem to work out. But this year I am building a little high-speed number to try and (Blow The Doors) off all the competition. . I already have a grudge race against Kielbasa if he gets his (SLED) Delphin ready. So bring those fast subs boys. BD.


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Researchers Evaluate Riding School Horse Health
Lack of pasture time and advancing age were the prime culprits behind lesson horse health problems.
Photo by Anne M. Eberhardt/The Horse
Top Equine Medicine Studies of 2013
Carol Clark, DVM, Dipl. ACVIM, shares her picks for the top equine medicine studies of 2013.
Photo by Photos.com
Using Cryotherapy to Prevent Colitis-Associated Laminitis
Horses with colitis were 10 times less likely to develop laminitis when treated with cryotherapy.
Photo by Rood & Riddle Equine Hospital
Studying Emerging Diseases in the Equine Industry
January 30, 2015
Dr. Scott Weese studies microbial populations in the horses' digestive tracts, infection sources and carriers, and more.... Read More
Researchers Evaluate Riding School Horse Health
November 17, 2014
Lack of pasture time and advancing age were the prime culprits behind lesson horse health problems.... Read More
Knottenbelt: Fecal Blood Test Opening Diagnostic Doors
June 05, 2014
Learn how one vet believes the test can help improve diagnostics for a number of horse health conditions.... Read More
Top Equine Medicine Studies of 2013
January 31, 2014
Carol Clark, DVM, Dipl. ACVIM, shares her picks for the top equine medicine studies of 2013.... Read More
Using Cryotherapy to Prevent Colitis-Associated Laminitis
November 29, 2013
Horses with colitis were 10 times less likely to develop laminitis when treated with cryotherapy.... Read More
Feeding the Sick Horse
October 31, 2013
Dr. Ginger Rich of Rich Equine Nutritional Consulting shares practices for feeding sick horses.... Read More
Racehorse Paynter to Stand at WinStar
October 31, 2013
Paynter recovered from a life-threatening illness a year ago before successfully returning to the racetrack. ... Read More
Researchers Explore Microbes to Benefit Animal, Human Health
October 26, 2013
Researchers are exploring animal microbiome to benefit both animals--including horses--and humans.... Read More
Maintaining Ideal Body Condition in Athletic Horses
October 19, 2013
Here's what to consider if your athletic horse isn't maintaining ideal body weight and condition.... Read More
Racehorse who Overcame Laminitis Returns to Racing
June 14, 2013
Paynter, who overcame a serious illness, will return to the races later today in California. ... Read More
Racehorse Paynter to Resume Training, Wins Vox Populi
December 27, 2012
It's hoped that the colt, who battled a series of medical issues in 2012, will return to the track in 2013.... Read More
Commentary: Racehorse Paynter Continues Road to Recovery
November 13, 2012
Steve Haskin provides an update on Paynter's recovery at Fair Hill Equine Therapy Center.... Read More
Racehorse Paynter to Rehab at Fair Hill Equine Therapy
October 15, 2012
Zayat, commenting Oct. 12, said the intent is to eventually return Paynter to training.
Read More
Commentary: Paynter--A Profile in Courage
October 07, 2012
Steve Haskin shares his thoughts on racehorse Paynter's multiple medical battles and his recovery.... Read More
Racehorse Paynter Undergoes Surgery
October 03, 2012
Veterinarians removed a 15-inch external growth from the colt's intestines this morning.... Read More
Racehorse Paynter Recovers from Laminitis, Fighting Colitis
September 21, 2012
Paynter has "beaten laminitis" and will be able to race again if he beats colitis, his owner said Sept. 21.... Read More
Zayat Family: Paynter Continues Improvement
September 07, 2012
Zayat Stables reports that its 3-year-old colt Paynter continues to improve after a rough couple of days.... Read More
Next 24 Hours 'Critical' in Case of Racehorse Paynter
September 04, 2012
Ailing Haskell Invitational winner fights infected catheter after receiving treatment for fever... Read More
Salmonella and Colitis in Horses
September 10, 2011
Salmonellosis and colitis often occur in tandem in horses, but can be detected independently as well.... Read More
Enteric Bacteria: Can Healthy Horses be Carriers?
July 11, 2011
Could a healthy horse in one's own backyard be a disease risk for other horses?... Read More
Combining 'Best' of Two Surgical Techniques for Right Dorsal Colitis
October 10, 2010
A gelding with right dorsal colitis has two surgical techniques to remove a diseased part of his bowel.... Read More
Colic in Horses
May 01, 2010
Colic is a catch-all phrase in horses that means they have mild or severe discomfort in their abdomens.... Read More
Scientists Consider Irritable Bowel Syndrome in Horses
April 30, 2010
Horses could suffer from irritable bowel syndrome (IBS) like humans do, hypothesized human gastroenterologist John Hunter, MD, from the Gastoenterology Research Unit at Addenbrooke's Hospital in Cambridge, United Kingdom.
In humans, IBS is ext... Read More
Necropsy Shows Racehorse Died of Colitis Complications
June 22, 2009
The initial necropsy report on Team Valor's Sailor's Cap, who died suddenly in his stall three days after winning the June 14 Poker Stakes, showed that he died of probable cardiac arrest caused by colitis-X.
The Merck Veterinary Manual... Read More
Human Strain of Clostridium Difficile Reported in Quarter Horse
May 13, 2009
The same strain of Clostridium difficile that causes illness and death in human hospitals was reported in a 14-year-old Quarter Horse, according to a paper published in May issue of the Journal of Veterinary Diagnostic Investigation.... Read More


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Software developer at yWorks GmbH.
Usually I'll answer questions here about Java, C#, PowerShell, batch files, random numbers, regular expressions and Unicode. At work I primarily deal with C++, C#, PHP and a few other things.
My interests are mostly HCI, Interaction Design and UX. Recently I18n joined that list as well. That does not mean I have profound knowledge in either of those fields, just that I am interested in them.
Note: People contacting me outside SO/SE is fine, but for discussing their own questions or answers SO already provides a mechanism, namely edits and comments. So please use those things first.
I do hang around on Freenode as Hypftier, though.
people reached
- Tübingen, Germany
- ygra
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- Member for 4 years
- 6 profile views
- Last seen Apr 24 at 8:16


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Why Not?
As a Reformed pastor, I am regularly confronted with questions about Reformed theology. Sometimes I am asked to explain a particular point of Reformed theology, and sometimes I am asked simply to explain what Reformed theology is. Depending upon who …Read More
The Fine Points of Calvinism
The late theologian Cornelius Van Til once made the observation that Calvinism is not to be identified with the so-called five points of Calvinism. Rather, Van Til concluded that the five points function as a pathway, or a bridge, to …Read More
Truly Reformed
Reformed theology has an image problem among the ranks of evangelical Christianity. And anyone who has had the unfortunate problem of being either misunderstood or misrepresented knows that it is not an easy task to repair one's image. Other articles …Read More
God in the Hands
It was a strange time for me. I was attending a high school that was so nominal in its commitment to the Christian faith that the high school English teacher was an atheist. Still, his was among my favorite classes, …Read More
Reforming Our Mission
Looking across the landscape of evangelicalism, the most common misperception and criticism of Reformed theology is that it is incompatible with a high commitment to evangelism and missions. Even the slightest theological understanding and historical perspective should prevent such confusion, …Read More
Long December
This month is a time for decisions. A year is ending, another is about to begin. We remember Christ's decision to come to earth and take on flesh. The gatherings of families remind us of those nearest and dearest. Many …Read More
Perseverance of the Saints
What are we to make of the stunning words of Hebrews 6:4–6 with their fearful warning against apostasy, a falling away from the faith and from the Lord? They have often been a source of puzzlement and dread to Christian …Read More
Truly Reformed Theology
It probably won't surprise you to learn that no one has taught me more about the Bible and its theology than R.C. Sproul. And it shouldn't surprise you to learn that no one has taught me more about mercy ministry …Read More
In the Hope of His Glory
One of the most beautiful passages of Scripture found itself eloquently translated in the seventeenth century: "There is a river, the streams whereof shall make glad the city of God, the holy place of the tabernacles of the most High. …Read More
Privileges Bring Responsibilities
The letter to the Hebrews, as our studies throughout the year have shown, is full of Old Testament language and ritual. Running throughout it is an ongoing sense that as believers we are on the move, on a pilgrimage through …Read More
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Jeter's Leaders' Participation in Summer Discovery
Through the Summer Discovery program, junior Jeter's Leaders attend multiple-week programs at prestigious colleges and universities. Participating colleges are located in close proximity to world-class cultural, entertainment and recreation attractions. During their stay, students take college-level courses and are awarded early credit upon completion. Outside the classroom, students participate in various extracurricular activities, excursions and trips. The Summer Discovery program is a tremendous learning experience for students as they gain a valuable jump-start on the college experience. The Summer Discovery partnership continues to benefit the selected Jeter's Leaders as it prepares them for the upcoming experiences of college academics and college life. In 2011, Summer Discovery increased participation for Jeter's Leaders from two per program to three, totaling six scholarships per year. Summer Discovery 2011
Nadine, New York Jeter's Leaders Rafael, New York Jeter's Leaders Music performance and architecture University of Michigan Tracy, Kalamazoo Jeter's Leaders Introduction to medicine, University of Michigan Summer Discovery 2010
Divina, New York Jeter's Leaders Jeremiah, Kalamazoo Jeter's Leaders Sports management and communications, University of Michigan Sonille, New York Jeter's Leaders Business and economics, Northeastern University Terryn, Kalamazoo Jeter's Leaders Crime Scene Investigation and video production, University of Michigan Summer Discovery 2009
Aaron, New York Jeter's Leader Jean, New York Jeter's Leaders Business and economics, Northeastern University Katelyn, Kalamazoo Jeter's Leaders Introduction to business and psychology, University of Michigan Krity, Kalamazoo Jeter's Leaders Health and economics, University of Michigan |
Since its launch in 1996, the Turn 2 Foundation has awarded more than $20 million to create and support signature programs that motivate young people to turn away from drugs and alcohol and "Turn 2" healthy lifestyles. Learn more »
Social Change Project
The Project is an event created to share one of the Foundation's principles with communities. Learn more »
Turn 2 Foundation Dinner
The 19th Annual Turn 2 Foundation Dinner will take place Wednesday, Oct. 14, 2015. Purchase sponsorship »


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Update: Oops, left one out.
If you come across pictures I may have missed feel free to send them in for future consideration.
Images via NFL, Seattle Seahawks, and Yahoo!
I want more like this!
Follow Kissing Suzy Kolber on Facebook and get the latest NFL news & humor before everyone else.


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The Women's Center of Greater Danbury
We are a non-profit organization with a vision to end the violence against women, men and children to foster equality and empowerment for all. We serve the needs of individuals, families and the community in the Northern Fairfield and Southern Litchfield areas with prevention, crisis intervention and support services with regard to domestic violence, sexual assault and other major life transitions.
Support Groups
Several sessions are offered on a recurring basis including:
- Breaking the Silence - for female survivors of sexual assault
- Voices of Courage - for male adult survivors of sexual assault
- SOAR - Survivors Overcoming Abusive Relationships
- Endings - ending a marriage or relationship
- I AM OK! - reclaiming your self esteem
- Thriving Women - sustaining healthy relationships
- Don't Worry, Be Happy - coping with stress and anxiety
- Child/Parent Divorce Support
- Project Be Program - empowerment series for Middle & High School aged girls (Information about our spring 2015 Project Be groups can be found here.) (Information on our spring 2015 Project Be groups for Spanish speaking girls can be found here.)
Please contact the Center for information on additional groups and workshops or to register.


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Main Content
Tennessee game days wouldn't be the same without you going crazy in the stands for your Volunteers. You're a precious commodity to your school's celebrations and things just wouldn't be the same if you couldn't make it. Ensure you're in attendance for every Vols event when you don the Sideline Transition jacket from adidas. This spiffy jacket features a school wordmark and name embroidered on the left chest, contrast stripes around the collar, cuffs, and waist, and two front zippered pockets to store any game day essentials. This classy jacket and you were meant to be together – you're both irreplaceable!
- 95% Polyester/5% Spandex
- Full zip jacket
- Imported
- Officially licensed Volunteers jacket
- Olympic collar
- Player ID tag
- Quality embroidery
- Rib-knit collar, cuffs & waist with striped detail
- Tagless collar
- Two front zippered pockets
Other 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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The standard therapy for limited small cell lung cancer is chemotherapy with cisplatin and etoposide every three weeks, plus radiation therapy twice a day for three weeks. In this study, researchers want to study two other chemoradiation regimens with the standard therapy to compare their effectiveness and their side effects.
Patients will be randomly assigned to receive the standard treatment regimen or one of two investigational regimens. In one investigational regimen, radiation therapy is given once a day for seven weeks. In the second investigational regimen, patients receive radiation once a day for 16 days of treatment (about three weeks), followed by radiation twice a day for the remaining 9 days of treatment (about two weeks), for a total of five weeks. Patients in all three study groups will receive cisplatin and etoposide every three weeks.
To be eligible for this study, patients must meet several criteria, including but not limited to the following:
For more information about this study and to inquire about eligibility, please contact Dr. Andreas Rimner at 212-639-6025.


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Showing 1-24 of 1,907 items found in Places to Stay
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Hampton Inn & Suites Addison
DuPage County, Chicago's Western Suburbs - This comfortable Hampton Inn & Suites is conveniently situated near the Marcus 16 Cinema IMAX, Dave & Busters, Famous Dave's and Home Run Inn pizza. We are 18 miles west of downtown Chicago and 10 miles from O'Hare, located off I-355 at Lake Street.
Hilton Garden Inn Addison
The Hilton Garden Inn Addison is located only 11 miles from O'Hare and 22 miles from Midway Airport. Certain to please executive travelers are the hotel's wide array of amenities including complimentary high-speed internet, in-room hospitality center, Herman Miler chairs and much more!
Howard Johnson
Howard Johnson Hotel in Addison has two meeting room. The largest is 500 sq.ft., Smoking rooms available; continental breakfast included in rate; free shuttle to/from O'Hare airport; free Wi-Fi, pet-friendly.
Victorian Rose Garden Bed & Breakfast
Welcome to Victorian Rose Garden B&B for Romantic Getaways, recreation or the Business Traveler. Only 45 miles from downtown Chicago, our quiet location in Algonquins 1835 historic district lends itself to many nearby leisure activities. Take a stroll in Towne Park or on the Fox River/Prairie Bicycle Trail, walk to several excellent restaurants, or just relax on the porch swing.
Victorian Rose Garden Bed and Breakfast
Home is listed by the McHenry County Historical Society. Located in downtown Algonquin, it has a quiet, romantic flavor. We specialize in personal attention for our guests.
Budget Lodge - Alsip
Nice, clean, newly decorated rooms. Cable TV and very low rates. Easy access to highway and restaurants nearby.
Presidential Inn & Suites Motel - Alsip
This inn offers spacious standard, double, queen and king guestrooms. Non-smoking rooms available.
Key Motel
This property has 20 guest rooms that include free parking, Wi-Fi access as well as microwave and refrigerator availability.
DoubleTree by Hilton Chicago-Alsip
193 Rooms. Full service hotel located near Midway Airport in the Chicago Southland area.
Grand Geneva
100 rooms. Seven suites. Valet. Business center. Exercise facilities. Complimentary breakfast. Special amenities incluse microwave and refrigerator in all rooms, 33cable stations. Located eight miles south of Midway Airport.
Baymont Inn & Suites - Alsip
The Baymont Inn is pleased to provide our guests with exceptional service. We are an incorridor property with 3 floors. Whether you are here for business or leisure, we have many amenities at an affordable price.
Days Inn - Alsip
Limited-service hotel - entertainment and shopping nearby - continental breakfast - Free local phone calls - 30 minutes from airports and downtown Chicago. Many discounts offered.
The Stable House
Western-themed, fully-furnished living quarters that sleep seven, attached barn and stables on the 50 acre Herold Ranch, adjacent to J&M Quarter Horses. Full kitchen, patio and BBQ. Hunters welcome. Corral and horse stall rental available.
CITY:Alto Pass
Alto Wine Trail Loft
Located on Main Street in historic downtown Alto Pass, the Alto Wine Trail Loft provides 2 new units, both with 2 bedrooms offering unique accommodations for experiencing the wineries and wilderness of Southern Illinois. An alternative to cabins in Southern Illinois, the Wine Loft is a vacation loft rental in Southern Illinois. A unique getaway in the heart of the Shawnee National Forest, the Loft is a private vacation rental, close to Giant City, Southern Illinois University, and the Shawnee Hills Wine Trail. The historic building that is home to the Wine Loft was constructed in 1912 as a general store. The Loft renovations used environmentally friendly material and preserved as much of the original brick work and exterior as possible.
CITY:Alto Pass
Big Sky Cabins
Big Sky Cabins is a private 4 bedroom vacation cabin available for nightly rental in Southern Illinois. Currently 2 cabins are available for a getaway to peace and nature. Located in the middle of the Shawnee National Forest and the Shawnee Hills Wine Trail, the cabins are perfect for large groups, weddings parties, honeymoons, or just a nice getaway. Big Sky Cabins provides the most private getaway on the Southern Illinois Wine Trail. At night, build a big fire and look up at all the stars in the sky.
CITY:Alto Pass
RiverView Suites
Located in a historic downtown Alton building, these suites are private, secure and first class in a quiet, relaxing atmosphere. Fully furnished one and two bedroom units. Kitchen, VCR, digital cable, washer and dryer, free local calls. Located within walking distance to local restaurants, clubs and shopping.
Haagen Haus
Comfort, convenience and beautiful surroundings await you in this 1870's guest house located in the historic Christian Hill District. Enjoy private one or two bedroom units with secluded brick courtyards and cozy gas fireplaces. Located on State Street, the Haagen Haus is within walking distance to downtown shops, restaurants, the scenic byway, biking and walking trails, and the Argosy Casino.
Tiffany Inn
Ideally placed in the historic Downtown Alton antique district, the Tiffany Inn is walking distance from shops, restaurants and the casino, with beautiful views of the Mississippi River and Clark Bridge. Located above the Alton Stained Glass Works shop, the inn has three elegant rooms decorated with lovely stained glass and antiques. Amenities include: private baths, air conditioning, mini refrigerators and coffeemakers.


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To grind up on some preferably strange (acceptably familiar) ass until you have ground all of strange's loose pocket change onto the dance floor, at which point you stop grinding, collect all of the loose change immediately, and run out of the club proclaiming "WE RICH!".
Yo dawg, let's grind 'till we rich.
viết bởi djhotbawlz
19 Tháng một, 2009


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Treasure Coast International Film Festival The fifth annual Treasure Coast International Film Festival will be held April 19-22. For information on the festival and its events, or to purchase tickets, visit http://www.tcifilmfest.com. Previous Next The Port St. Lucie Civic Center will host a VIP Kickoff Wine and Cheese Party on Thursday at 6 p.m. in the Civic Center Art Gallery. Tickets cost $25 and include admission to the Opening Night Gala comments and the screening of the movie USS Seaviper. Proceeds benefit the IRSC film scholarship program. The Opening Night Gala Comments will be at 7 p.m., followed by a screening of USS Seaviper at 7:30 p.m. in the Civic Center Emerald Ballroom. WWII veterans will receive a free ticket. Tickets are $5 each for other attendees. The Civic Center is located at 9221 SE Civic Center Place. Opening night events will be followed by an After Party from 10 p.m.-1 a.m. at Good Times West, located at 2096 NW Courtyard Circle in Port St. Lucie. "USS Seaviper" will be screened at 7:30 p.m. Thursday in the Port St. Lucie Civic Center Emerald Ballroom. The World War II drama is directed by local veteran filmmaker Ralph Villani. The Treasure Coast International Film Festival will hold a Family Fun Day from noon to 9 p.m. at Martin Health System's Village Square at the Port St. Lucie Civic Center with free music, entertainment and activities for the entire family. The film "City of Dreams" will also be shown at 7:30 p.m. The Director's After Party will be held at the Marriott Residence Inn at 9 p.m. Saturday. Tickets are $30 per person and include light fare, open bar and a celebrity look-a-like contest. Filmmaking professionals representing the different parts of the production process, from conception to distribution, will take part in a round table forum at the hotel at 10 a.m. Sunday to discuss how to make and distribute independent films. The Marriott Residence Inn is located at 1920 SW Fountainview Blvd. in Port St. Lucie. The festival's Awards Gala will take place at 5 p.m. Sunday at the Port St. Lucie Botanical Gardens, located at 2410 SE Westmoreland Blvd. Stuart News Nova Sabal Palm Cinemas in Fort Pierce will be showing the film festival entries on Friday and Saturday. The theater will also host a special effects workshop, screenplay seminar and screen actors workshop on Saturday. Nova Sabal Palm Cinemas is located at 2539 S. Federal Hwy in Fort Pierce. Tiny Pupil (Japan), directed by Komaki Teng Statue (USA), directed by Andrew Bryan Underground (USA), directed by Akil DuPont Last Ride on the Midwest Pacific (USA), directed by Daniel Killman The Wedding Ring (USA), directed by James Babanikos The Hit (USA), directed by Gary Lester True Bromance (USA), directed by Sebastian Doggart Bigfoot's Spring Break (USA), directed by Ray and Migdalia Etheridge Fancypants (USA), directed by Joshua Russle sun Don't Shine for Us (USA), directed by Pete Stamatelatos and Scott Ackerlund The Handshake (USA), directed by Danny Hankins The Weatherwax Legacy (USA), directed by Gary Lester The Last Fall (USA), directed by Matthew A. Cherry When You Find Me, directed by Bryce Dallas Howard Waking Eloise (USA), directed by Bobby Marinelli The Fourth World (USA), directed by Mark Volkers My License (USA), directed by Elizabeth Herrick A Love Supreme (USA), directed by Evan Houston Barbarian Days (USA), directed by Damian Horan Tuesday (USA), directed by David Shark According to Plan A (USA), directed by Anuj Nijhawan Luz (USA), directed by David Liz Croquembouche (USA), directed by Matthew Chevlen First Hand (Pakistan), directed by Naqi Khawer Moments Like These (USA), directed by Jeremy Hicks Stalker (USA), directed by Damien Patrik Cheese! (USA), directed by Damien Patrik Steve Phoenix: The Untold Story (USA), directed by Bill Haley The Gold and the Beautiful (USA), directed by Jack Serino Masque (USA), directed by Robert Hatch Lo Estipulado - The Norm (Spain), directed by javier Gonzalez Prada Hollywood Struggles (USA), directed by Gloria Kisel Present Tense (USA), directed by John Aniu The Things My Father Never Taught Me (Australia), directed by Burleigh Smith Children of the Air (USA), directed by Damian Horan Life! Camera Action... (USA), directed by Rohit Gupta Show Caption Hide Caption


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Chris Doyle's travel essentials
X Games BMX Dirt and Park rider Chris Doyle travels often, and he prefers to keep it simple. "If you ask me, my travel gear is comprised of pretty basic stuff. However, to me, while traveling it's important to be comfortable and practical. These are the things that help get me by while on the road. Big thanks to Rockstar for the great bag that is good for traveling and holding my pads and tools!"


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The point is that if one produces a product, he will only know its value through the marketplace, through what others are willing to pay for it.
Now what did your father discover in the marketplace as to the worth of his provided services?
Were the parents delighted with the education received by their children? Were there alternatives for those parents not so satisfied with the education received for the amounts charged? Would the state fund those alternatives? Did your father fear losing allotted funds to successful competition?
I think you need to reflect on the subject with a little less passion and a little more reason.
You see. The state is free to take your money, as much as it desires, without having to justify that taking. No private corporation can commandeer its funds that way, unless the government abets it.
Get the point!
And of those appearing in your list, how many could just wave their little pen and extract large sums of money for supplying some mediocre or unnecessary service, as government does repeatedly?


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Psittacosis is an infection caused by Chlamydia psittaci, a type of bacteria found in the droppings of birds. Birds spread the infection to humans.
Ornithosis; Chlamydia psittaci
Psittacosis is a rare disease: 100 - 200 cases are reported each year in the United States.
Bird owners, pet shop employees, persons who work in poultry processing plants, and veterinarians are at increased risk for this infection. Typical birds involved are parrots, parakeets, and budgerigars, although other birds have also caused the disease.
The health care provider will hear abnormal lung sounds such as crackles and decreased breath sounds when listening to the chest with a stethoscope.
Tests include:
The infection is treated with antibiotics. Doxycycline is the first line treatment. Other antibiotics that may be prescribed include:
Note: Tetracycline and doxycycline by mouth is usually not prescribed for children until after all their permanent teeth have started to grow in or to pregnant women. The medicine can permanently discolor teeth that are still forming.
Full recovery is expected.
Antibiotics are needed to treat this infection. If you develop symptoms of psittacosis, call your health care provider.
Avoid exposure to birds that may carry this bacteria, such as imported parakeets. Medical problems that lead to a weak immune system increase your risk for this disease and should be treated appropriately.
Torres A. Pyogenic Bacterial Pneumonia and Lung Abscess. In: Mason RJ, Broaddus CV, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 32.
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Acne chocolate brown alpaca "Cassidy" coat. |
Blazer –
Blonde & Blonde, scarf – Lola Rose,
white shirt – Acne, coat - Acne, cross-body bag – Serapian,
jeans – Levi's, tote – Tumi,
brown loafers – Lanvin
Acne chocolate brown alpaca "Cassidy" coat. |
Blazer –
Blonde & Blonde, scarf – Lola Rose,
white shirt – Acne, coat - Acne, cross-body bag – Serapian,
jeans – Levi's, tote – Tumi,
brown loafers – Lanvin
Thanks, once again, for these wonderful packing-for-style ideas! I'm learning a LOT from these posts and am bookmarking every one.
Love that coat, and I've always worn a lot of brown.
I have had the opportunity to see and examine Acne clothing in person, and my verdict is - junk.
Mixing brown and camel beige is not to my liking either.
iHowever, brown is ok, if it is the " right " brown, and in small dozes ( one piece of clothing ).
My favourite colour,live in it most of the year,my answer to the little black dress!
Mix mine with creams/mustard/kakhi/taupes.Ida
LOOOOVE brown in all its many shades and have a wardrobe to prove it:) I am bookmarking this..too many great ideas!
Janice, lovely as always. But METTE, please, have you never heard the expression, "If you can't say something nice, then (please) don't say anything at all"? Thanks! Ellen
That coat is gorgeous - in fact it's a bit like The Bear, a vintage 50s number that I found at Brixton market last year and have been wearing a lot this week.
Love this post and the coat. Black has become trickier for me to wear as I get older. I'm very pale and I find browns to be softer. Thanks for such lovely combinations for travel. These posts are very helpful!
It's beautiful -- milk-chocolate brown with that pale blue. I wrote browns off, pretty much, in favor of black, because it's easier. This makes me rethink.
I so agree with sisty-the brown with pops of blue are lovely. Since following Janice's advice, packing is a breeze. I've been to Ireland and Boston this fall and have packed less with plenty of options from what I have brought. Bravo Janice!
I always enjoy Mette's comments!
okay, that's it! I'm finished with this black/gray travel wardrobe that I'm always carting around. I'm reworking after this post. Beaautiful. Thanks for the great ideas.
Isn't Janice amazing?!! Oh my gosh, you had me at that coat. It's so perfect. What a beautiful capsule. Never, ever, EVER tire of La Vivienne.
I like the brown coat and everything Janice had put together in this color. I wear brown quite often, and this post is wonderful for me.
thanks for reminding me. This could apply to you too!
Acne clothing is overpriced, produced in whatever country, and actually meant for younger women.


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