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Prenatal Congenital Heart Disease a new beginning
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Transcript of "Prenatal Congenital Heart Disease a new beginning "
1. Prenatal Congenital Heart Disease a new beginning Tiny Tickers Summary of issues and recommendations for improving the prenatal detection, diagnosis and care of Congenital Heart Disease in the UK
Prenatal Congenital Heart Disease: a new beginning FURTHER INFORMATION ABOUT THIS DOCUMENT This document proposes an integrated strategy for the prenatal (or antenatal) screening of babies for congenital heart disease (CoHD), and subsequent referral, diagnosis and management of the affected pregnancy. We highlight current issues and recommend a care pathway (Map 1) and professional process (Map 2) to address gaps in training and provision of service. If you have comments about this document, please contact us: email: firstname.lastname@example.com FULL REPORT This summary is based on the full report of the outcome of the Tiny Tickers RCOG Workshop, July 2008, on improving antenatal congenital heart disease, with 30 invited professionals. The full report, "Antenatal CoHD Pathway TTv1.pdf", including current practices, issues and recommendations, is available on the Tiny Tickers website: www.tinytickers.org/infoprof_links.html (Link: "Antenatal CoHD Pathway TTv1.pdf") ABOUT TINY TICKERS Tiny Tickers is a national charity, established in 1999, working locally and nationally to improve the prenatal detection, diagnosis and care of congenital heart disease. www.tinytickers.org ANTENATAL DATA ONLINE The Central Cardiac Audit database (CCAD) have begun to publish antenatal data derived from infants with major antenatal CoHD, by Strategic Health Authority: www.ccad.org.uk/002/congenital.nsf/vwContent/Antenatal%20Diagnosis (accessed Feb. '10) BINOCAR (British Isles Network of Congenital Anomaly Registers), collect data on congenital anomalies from various regional registers, where they exist: www.binocar.org ANTENATAL CARDIAC TRAINING/CERTIFICATION RESOURCES There are a number of online resources and CDs from organisations such as International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG), Fetal Medicine Foundation (FMF) and Tiny Tickers. If you have information or comments about any of these resources, please contact us by email: email@example.com Tiny Tickers, Feb. 2010 DRAFT v2.1 2
Prenatal Congenital Heart Disease: a new beginning INTRODUCTION Congenital Heart Disease is common The heart is fully formed in the first 50 days of life. Congenital heart disease (CoHD) is the most common congenital condition and accounts for 10% of all infant deaths in the developed world. Just under 1% of all pregnancies are affected by CoHD and usually there is no identifiable cause. In the UK, with 800,000 births per annum (www.statistics.gov.uk), about 5,500 babies will be born with CoHD. Half of these "heart babies" will have major CoHD, requiring surgery or intervention in the first year of life. One third of babies with major CoHD will also have duct‐dependent heart disease and, if not recognised in the first few days after birth, this is life‐threatening. 50% minor CoHD 35% major CoHD 15% major and life-threatening CoHD Figure 1. How "heart babies" are affected by CoHD (percentages) Prospects for babies with Congenital Heart Disease are good The majority of babies have isolated CoHD, with no genetic associations and their outcome is good. Surgical improvements mean that 80‐85% of children born with CoHD now survive to adulthood (BCS Report, Heart, 2002) and in 2003 there were at least 150,000 adults living with CoHD in the UK (BHF report, 2003). Tiny Tickers, Feb. 2010 DRAFT v2.1 3
Prenatal Congenital Heart Disease: a new beginning Prenatal detection is important Studies show that if CoHD is detected before birth, there are significant benefits for babies, their families and for medical services around the time of birth and in the first year of life (1). Prenatal diagnosis and appropriate treatment may prevent the devastating consequences of early circulatory collapse, such as brain damage. Prenatal detection – a postcode lottery? Routine ultrasound screening has been offered to pregnant women for over twenty years. In 1995, prenatal detection of CoHD for the UK was estimated at 23% (2). The latest available data derived from children with major CoHD indicates that approximately 30% receive a prenatal diagnosis across the UK (3). This figure of 30% should be viewed with caution – being derived after birth and with caveats about data availability on the CCAD website. Nevertheless, we welcome this initiative in bringing prenatal detection and diagnosis into the spotlight. There continues to be wide variation in detection rates throughout the UK, although only average data for each Strategic Health Authority is available at present and there is likely to be wide variation within each Strategic Health Authority region. Figure 2. CCAD antenatal diagnosis derived from major CoHD in childhood by Strategic Health Authority, latest available data (3) REFERENCES (1) "Delayed diagnosis of congenital heart disease worsens pre‐operative condition and outcome of surgery in neonates", Brown K et al., Heart, 2006;92:1298‐1302 (2) "Current and potential impact of fetal diagnosis on prevalence and spectrum of serious congenital heart disease at term in the UK", Bull C, Lancet, 1999 Oct 9;354(9186):1242‐7 (3) Central Cardiac Audit database (CCAD), www.ccad.org.uk/002/congenital.nsf/vwContent/Antenatal%20Diagnosis (accessed Feb. '10) Tiny Tickers, Feb. 2010 DRAFT v2.1 4
Prenatal Congenital Heart Disease: a new beginning EXECUTIVE SUMMARY 1. Integrated Care Pathway Prenatal diagnosis and appropriate treatment will improve outcomes for most babies with congenital heart disease (CoHD). It may also prevent the devastating consequences of early circulatory collapse, such as brain damage. To achieve this, it is vital that there is a national approach to improve the detection, referral, diagnosis, management and audit of "heart babies" in pregnancy. We recommend an integrated prenatal cardiac care pathway with recognised fetal cardiology expertise, similar to that published by the Department of Health, together with the Grown Up Congenital Heart Patients Association, GUCHPA, for Specialist GUCH Consultants. This should be supported by an integrated approach to congenital cardiac audit, including prenatal data. This should be nationally funded and independent of political change. 2. Improving detection, referral and audit The detection and subsequent referral of CoHD involves sonographers and midwives, in obstetric ultrasound departments, supported by obstetricians and radiologists. We recommend an integrated approach to training, accreditation and ongoing education and minimum national standards of ultrasound screening for CoHD at the fetal anomaly scan. We recommend that every maternity hospital has a health professional with expertise in fetal cardiology, who can provide input in local decision making about screening and referral. We further recommend investigation into ways to improve overall screening, referral and audit pathways (e.g. through specialist training, telemedicine, feedback from cardiac centres). 3. Adopting standards: The 5 Transverse Views We recommend a systematic way of screening the whole fetal heart that is proven, practical and comprehensive. The 5 Transverse View protocol provides an overview of the fetal heart and circulation with a minimum of sweeps and changes in orientation. With suitable training and support, it has been shown to improve detection of CoHD at screening, without adding significantly to the time required. For details refer to: http://www.tinytickers.org/sonog5vprotocol.html. 4. Specialist training: expertise in fetal cardiology Prenatal CoHD should be recognised as requiring expertise that differs from postnatal (paediatric) cardiology, general fetal medicine or obstetrics. In this document we refer to health professionals with this expertise as fetal cardiology specialists. These specialists should be an integral part of the care pathway, with recognised training and accreditation – for example, see the guidelines published by the European Association of Paediatric Cardiologists (AEPC) and International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG). Reference our full document: www.tinytickers.org/infoprof_links.html. Tiny Tickers, Feb. 2010 DRAFT v2.1 5
Prenatal Congenital Heart Disease: a new beginning SUMMARY OF RECOMMENDATIONS Map 1: Recommended care pathway for prenatal congenital heart disease Tiny Tickers, Feb. 2010 DRAFT v2.1 6
Prenatal Congenital Heart Disease: a new beginning FETAL ANOMALY SCREENING The fetal anomaly scan is offered to most pregnant women at 18 to 20+6 weeks' gestation. This includes an examination of the fetal heart for signs of congenital heart disease (CoHD). In the UK it is not common to screen for heart disease before 18 weeks. However, some centres do offer this and if a major cardiac anomaly is detected and a woman continues with her pregnancy, she will usually be offered specialist care – either in a Fetal Medicine Unit, or by specialists who provide a fetal medicine service locally. In Map 1, we show a "Recommended care pathway for prenatal congenital heart disease" and this begins with detection at the fetal anomaly scan or before. 1) Standardised cardiac training for routine fetal anomaly screening Less than 30% of babies born in the UK with serious heart malformations have a prenatal diagnosis (serious CoHD is defined as requiring surgery or intervention in the first year of life). Early detection has many benefits for babies, their families and for medical services because it allows appropriate prenatal monitoring, a planned delivery, and avoids emergency situations where babies with CoHD can become ill. We recommend standardised training and practical assessments in the workplace to improve detection rates for CoHD at the fetal anomaly scan. We also recommend screening the whole heart ‐ see the 5 Transverse Views, in the Executive Summary. 2) Sufficient time for screening Many screening departments do not allow sufficient time for scanning, associated paper work and audit, which impacts on the quality of screening. We recommend that the standard appointment time for the fetal anomaly scan should be no less than thirty minutes. If trainee staff are present this time should be increased further. 3) Adequate electronic systems and audit Departments that do not have electronic systems usually have less effective audit. We support the use of electronic audit and ideally digital clip storage of all screened hearts, to improve quality of audit, training and feedback, but this is still not practised in many units. 4) Conducive environment A calm environment in which to perform a complete examination will aid communication between the health professional and the pregnant woman. It should be explained to pregnant women that the fetal anomaly scan is a medical screening examination and not a social viewing of the baby by family and friends. We recommend that where possible child care arrangements should be implemented. Tiny Tickers, Feb. 2010 DRAFT v2.1 7
Prenatal Congenital Heart Disease: a new beginning REFERRAL 5) Reducing automatic referral of "high‐risk cases" "High risk cases" are often automatically referred for a cardiac consultation. These include maternal diabetes, certain drugs, "identical" twins, a family history of CoHD and increased Nuchal translucency. Numbers of specialists are likely to remain the same, and as prenatal detection increases, demands on specialists will also increase, so automatic referral is not helpful. We acknowledge that the risk of CoHD in these groups is slightly higher, c. 3%, than the general population. However, with appropriate improvements in screening, we recommend that all pregnant women be scanned for congenital heart disease within the existing fetal anomaly scan. If CoHD is not found, an automatic referral is not necessary. 6) Timely referral When cardiac views cannot be obtained women are often reviewed upto 2 weeks later. When cardiac views cannot be obtained we recommend review within 48 hours by an experienced colleague and referral to an appropriately trained specialist if a "normal" heart cannot be seen, as this often indicates an anomaly. 7) Referral via Telemedicine Access to specialists for triage of cases or second opinion can be facilitated by a Telemedicine link and this can reduce delays and transport costs. We recommend investment in Telemedicine – especially for remote areas. Appropriate on‐going training of local sonographers and obstetricians, and dedicated specialist resources is essential. Cost savings should be recognised and used to maintain the service. Tiny Tickers, Feb. 2010 DRAFT v2.1 8
Prenatal Congenital Heart Disease: a new beginning DIAGNOSIS, COMMUNICATIONS AND AUDIT 8) Specialist diagnosis and communications with parents Detailed diagnosis of CoHD is required for accurate counselling. Detailed diagnosis of CoHD and subsequent counselling should come from a specialist working in cardiology (i.e. a fetal cardiology specialist, see 9) and supported by an experienced, multi‐disciplinary team. Parents should be made aware of the value of knowing the chromosomes (karyotype) to assist in the planning of mode of delivery, monitoring in labour and decision making in the case of fetal distress as well as postnatal management. 9) Effective communication between health professionals Congenital heart disease is a complex disease requiring a team approach. Effective communication between team members, who often operate across multiple sites, is vital to deliver a high standard of care. Prenatal CoHD should be recognised as requiring expertise that differs from postnatal (paediatric) cardiology, general fetal medicine or obstetrics. Such "fetal cardiology specialists" should be an integral part of the care pathway, with recognised training and accreditation (see guidelines from the European Association of Paediatric Cardiologists, AEPC, and International Society of Ultrasound in Obstetrics and Gynaecology, ISUOG). Cardiac liaison nurses have an important role in collecting information, discussing this with parents, and providing feedback to the team. 10) Investment in audit and good IT support Without good audit it is virtually impossible to manage an integrated care pathway. Initiatives such as the CCAD database show how audit can improve the quality of service. Good quality audit, supported by appropriate IT systems, is vital to improve the integrated care pathway and should include prenatal records (see 11). 11) Access to prenatal records Currently copies of prenatal letters, reports and delivery and management plans are sent to a variety of locations: mother's hand‐held notes, a mother's file in the local maternity hospital, the tertiary neonatal unit and paediatric cardiac intensive care unit at the cardiac centre. This paper trail does not appear to be an effective means of communication. We recommend a record of all prenatal correspondence and ultrasound scan reports, be held online (e.g. on a secure web‐based system, supported by suitable IT resources), for access by the major cardiac centres and maternity units where the baby may be treated in the case of a planned or unexpected delivery. Tiny Tickers, Feb. 2010 DRAFT v2.1 9
Prenatal Congenital Heart Disease: a new beginning ON‐GOING MONITORING AND MANAGEMENT 12) Ongoing monitoring and management The benefits of prenatal detection of CoHD include: better care for mothers, appropriate monitoring during pregnancy and planning for a safer delivery in the right place at the right time. Although it is not always possible, we recommend a woman has a fetal cardiology and fetal medicine obstetric assessment in the same place, as this minimises visits to hospital and improves communication between specialists, including referring obstetricians and sonographers. At each consultation, sufficient time should be given to discuss management plans and new findings with the family. 13) Preparation for delivery The cardiac centre is often separate from the maternity hospital. Parents should be offered a visit to the cardiac unit and neonatal intensive care unit (NICU) before delivery providing the chance to talk to the surgeon, neonatal and cardiac teams, co‐ ordinated by the cardiac liaison nurse. This will also give the parents a chance to view the parental facilities and plan for their stay in hospital with the new baby if early surgery is required. 14) Specialist post mortem & counselling If there is an intrauterine death or termination of pregnancy, a detailed post mortem (PM) of the baby including the heart is vital for counselling before future pregnancies. We recommend the heart is assessed by an appropriately trained professional with special interest in cardiac pathology (or access to highly specialised professionals if there is no local expertise). If consent for PM is declined, we recommend seeking alternatives, such as consent for medical photographs (for geneticists) and a total body MRI. Counselling following the end of a pregnancy should be offered to all. The timing is usually about 6 weeks later, once PM results are available and coinciding with a postnatal check by the obstetrician. The purpose is to discuss what happened in this pregnancy, possible reasons and recurrence risks in future pregnancies. An early fetal cardiac scan may be offered for future pregnancies. Tiny Tickers, Feb. 2010 DRAFT v2.1 10
Prenatal Congenital Heart Disease: a new beginning PROFESSIONAL PROCESS This section deals with professional education, audit and feedback, with further recommendations to improve second trimester screening, referral and diagnosis. Map 2: Recommended professional process for education, audit and feedback 15) Cardiac screening standards: Whilst we support the minimum standards for screening the 4‐chambers and Outflow Tracts (NICE Antenatal Screening Update 2008), we recommend a practical, comprehensive and systematic protocol such as the 5 Transverse Views that incorporates the major views of the heart. The protocol includes establishing fetal lie, sweeping up the fetal chest to identify structures and trace cardiac connections More details: http://www.tinytickers.org/sonog5vprotocol.html Tiny Tickers, Feb. 2010 DRAFT v2.1 11
Prenatal Congenital Heart Disease: a new beginning The inclusion of the important 3 Vessel and Tracheal View (View 5) allows detection of important, usually life‐threatening lesions involving the aortic and ductal arches (duct‐ dependent lesions) which comprise 15% of major CoHD (Fig 1). 16) Workplace assessment: To improve CoHD detection rates and maintain that improvement, we recommend practical workplace assessment and continued professional education for all health professionals involved in fetal cardiac scanning, including training, screening, referral, diagnosis and management. 17) Improving audit: Local audit is a vital part of improvement and there should be adequate investment in coding and storing data, including clips, which can then be reviewed to further improve screening or identify training needs. 18) Local second opinion: We support local, expert second opinion ‐ available on the same day as screening ‐ whereby individuals, with specialist training, examine suspected cases before referral to improve education and quality locally. 19) Creating ownership: We recommend focus on developing good leadership and a sense of responsibility and ownership, supported by a learning culture and by good communication, audit and feedback. 20) Increasing resources: Skills for Health proposed that other health personnel be re‐trained in obstetric ultrasound screening to address recruitment and resource issues. Having more resources has other benefits ‐ for example, sonographer sessions can be varied to improve performance and morale. In a sub‐speciality such as fetal cardiology where there are few specialists, limited resources must be used efficiently. One model is the development of fetal medicine obstetricians specially trained in fetal cardiology that triage referrals from local obstetric hospitals and are supported by the congenital heart disease unit/service. NATIONAL CONGENITAL CARDIAC AUDIT A national audit of prenatal and postnatal congenital cardiac data will inform the development of the care pathway, enable assessment of screening, identify needs and highlight systemic problems (e.g. low detection rates, delays in referral). 21) Improving patchy CMR coverage: Congenital Malformation Registers (CMRs), seem to be the best source of prenatal congenital cardiac data, but their existence is reliant on local funding, which is unreliable. A recent example is the demise of NW Thames CMR, which covered c. 47,000 births (or about 8% of UK births). CMRs gather local pregnancy data on fetal malformations and submit it to national bodies such as Office of National Statistics (ONS) and EUROCAT. They are aggregated via BINOCAR (British Isles Network of Congenital Anomaly Registers, www.binocar.org). National coverage by CMRs is currently about 45%. Ascertainment of prenatal data is poor where there is no CMR. Tiny Tickers, Feb. 2010 DRAFT v2.1 12
Prenatal Congenital Heart Disease: a new beginning To address these issues, we recommend a suitable approach to funding to achieve national CMR coverage and provide a high quality, accurate comprehensive audit. 22) Standardised data collection is desirable to permit amalgamation of data across different registers (e.g. using definitions published by the coding committee) and bridging prenatal and postnatal data. A specialist group should consider the likely areas within the dataset where this may be problematic and formulate recommendations that will be useful for anyone setting up or modifying an anomaly register. 23) Collection of congenital cardiac data should begin before birth, so integration between BINOCAR (local CMRs) and Central Cardiac Audit Database (CCAD) is essential. We recommend an investigation of how local CMR data and national (cardiac centre and CCAD) data can be made available to improve the service. 24) Enabling National Tracking: Recording prenatal diagnoses (confirmed by fetal cardiology specialists) and postnatal maternal demographics can assist in tracking missed cases and can provide feedback to prenatal screening services in local hospitals, to improve detection rates. It is essential to make better use of the National Tracking Service which allows one to track via an NHS number. If the cost for this, from one government department to another, creates an artificial barrier to greater use, this should be resolved through a national, integrated approach. Tiny Tickers, Feb. 2010 DRAFT v2.1 13


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"This exceeded our expectations. The photos don't do this justice. The kitchen has been renovated and is nice. The living room is larger than shown and has plenty of seating. The views are fantastic! It has a warm comfortable feel. Yes it's an older established Floridian house on a quiet beach. It could use a few minor updates like new fixtures in the bathrooms and a new mattress in the master bedroom but all in all we still loved it! It was clean and fully stocked. Our vacation here was a wonderful experience."Guest: Maralyn W. Date of Stay: May 2015 Review Submitted: June 8, 2015View listing
Featured Destinations: Dauphin Island, Isle of Palms, Bald Head Island, Destin Condo Rentals


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Human Machine Interfaces Software
- Status: 4 - Beta ×
Linux driver for Owon digital scopes
A userspace USB peripheral driver for the Owon range of digital storage oscilloscopes. Based on the libUSB library it is aimed at Linux but also portable across platforms.3 weekly downloads
LogiDist offer a solution of "Computer Aided Logistic" with mostly informative purposes on executed pickups/delivery of merchandise. Is able to manage the whole process of purchase, order management, merchandise delivery to reduce distribution costs.3 weekly downloads
M68331 Voice Recognition System
This project will show how to implement the Hidden Markov Model approximations of Voice Recognition into embedded and low power systems.3 weekly downloads
This project is for a virtual keyboard on the silkscreen area of a PalmOS device. It supports multiple key layouts editable on the handheld itself; previewing on the screen; and macros to start programs or input keys. 10x4 Qwerty layout included.3 weekly downloads
Online Large Integer Calculator
Large Integer Calculator. Includes most arithmetic functions plus named memory values.3 weekly downloads
Velleman k8061 USB Interface under Linux
This software contains a port of the Velleman K8061 USB Interface library (k8061.dll) and a command line interface for using the card on a linux system.3 weekly downloads
Xylo is a simulation software that emulates a vibraphone, a musical instrument that belongs to the xylophone's percussion family. It uses a WiiMote to track the 2D positioning of two ir-emitting sticks.3 weekly downloads
Zodiac is a Molecular Modelling suite for drug design. Its features include support for haptic devices and nintendo wiimote fully undoable command list, MMFF94 implementation, POVRAY output.3 weekly downloads
Kinect based controller.1 weekly downloads
Programming plateform for the Méta-Instrument2 weekly downloads
ACT-CV provides an easy to use interface between visual objects on the computer screen (or another video source) and a cognitive modeling tool.2 weekly downloads
AMELiA is a collection of libraries developed at the Arts, Media and Engineering Program at Arizona State University. It includes the AME Patterns library, a generic C++ library for modeling, recognition and synthesis of sequential patterns.2 weekly downloads
BioPro project has been moved to http://www.bioera.net/2 weekly downloads
A Controlled Language Programming (CLP) compiler, runtime engine, and development IDE for writing software in a natural (but somewhat restricted) language that clearly represents the real world concerns and maps to a 3GL (Java/Groovy) for execution.2 weekly downloads
Generic Adaptivity Model Engine
The generic adaptivity model engine is a system that allows for easy addition of user modeling functionality to existing systems.2 weekly downloads
HephaisTK multimodal toolkit
HephaisTK is a toolkit for rapid prototyping of multimodal interfaces. HephaisTK uses SMUIML, a simple markup language for describing human machine multimodal interaction scenarios and integration mechanisms.2 weekly downloads
A framework and set of initial applications of network-aware software for wearable-computers.2 weekly downloads
JRobot - Tool for Mitsubishi RVM1 robot
JRobot is a Java utility intended for the manipulation of the Mitsubishi RVM1. It provides the possibility to connect locally and remotely to RVM1 robots, manipulate with joysticks and has a virtual 3D view intended for simulation.2 weekly downloads
Java Context-Awareness Framework
Context-awareness is a key concept in ubiquitous computing. The Java Context-Awareness Framework (JCAF) is a Java-based context-awareness infrastructure and programming API for creating context-aware applications.2 weekly downloads
OmniHelp tripane on-line help viewer
OpenCV User Contribution Library
A collection of user contributed applications which use the Open Computer Vision Library2 weekly downloads
Document Structuring schema for Natural Language Generation2 weekly downloads
ParallelPort Control for Linux
A free software made to control the parallel port on linux systems. Programmed in C em GTK the software allows to control, monitore em automatize the old printer port, and made it useful again.2 weekly downloads
QAdvancedItemViews (QAIV) extends the capabilities of QTableView2 weekly downloads
Simulo Driving Assessment Project
Open and extensible driving simulation software intended for (1) developing measures of cognitive distraction resulting from performing secondary tasks while driving, and (2) quantifying the distractive influence of specific secondary tasks.2 weekly downloads


text: Closed Captioning ON OFF apply | reset x Text Display Background Enhancements font Times New Roman Arial Comic Sans size T T T T color share link May 19th, 2013 3: David talks with Donald Rumsfeld The former defense secretary visits Meet the Press to discuss recent developments in the Defense Department and his new book. More video Sponsored Content Now Playing Bernie Sanders Responds To #BlackLivesMatter Criticism Sponsored Content Now Playing 'We're Not Running for Class President' Sponsored Content Now Playing Nerdscreen: Trump is Up in Iowa and New Hampshire Polls Sponsored Content Now Playing New Poll: Trump in the Lead in New Hampshire NBC News Drupal Now Playing 8 kids, 5 sisters, 3 dogs, 1 home: 'It Takes a Sister' Now Playing There are otters loose in the studio (and in a city near you) Now Playing Backyard BBQ etiquette: 'Can't we suck the bones?' Now Playing Hooray! It's National 'Going to Poughkeepsie' Day TRENDING Now Playing Artist creates amazing balloon animals Now Playing New 'mommy friend' apps help lonely moms find friends Now Playing How hot is this? Jimmy Fallon jokes about Donald Trump and Al Now Playing Jon Stewart announces his final 3 guests, including Louis C.K. Most Watched Now Playing Sponsored Content MH370: Is debris near Madagascar from the missing plane? Now Playing Sponsored Content Jane Birkin to Hermes: Take my name off crocodile bag Now Playing Sponsored Content Dentist who killed Cecil the lion faces growing backlash, protests Now Playing Sponsored Content Rossen Reports: What are your rights during a traffic stop? Now Playing Sponsored Content Milwaukee plane crash kills 2 after failed landing attempts Now Playing Sponsored Content J.C. Penney worker sent home for wearing shorts bought... at J.C. Penney Now Playing Sponsored Content What charges could Walter Palmer face for killing Cecil the lion?


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Does Putin Know When to Fold 'Em?
The Gist explores whether the Russian leader might change course on a losing strategy.
Listen to Episode 52 of Slate's The Gist:
Today on The Gist, Slate's Anne Applebaum shares insights into Vladimir Putin's next move. How might the downing of Malaysia Airlines Flight 17 affect what Applebaum believes is Putin's failing strategy in Ukraine? Then, count penguin poo with researcher Michelle LaRue from the University of Minnesota's Polar Geospatial Center. She's using satellite imagery to get a better count on penguin populations. In today's Spiel, the MH17 story is all about the telling detail.
Email: email@example.com
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The XX Factor
Planned Parenthood Defunding Vote Shows How Much the Right-Wing Fringe Owns Republicans
Donald Trump Said It's "Disgusting" to Pump Milk in Front of Colleagues. So We Found A Lady Who Did.
Behind the Year of Outrage Here's how Slate tracked down everything we were angry about in 2014.
What Happens When We Get It Wrong? Slate's Corrections Czar Talks About Our Policy on Errors and Typos.
It Took 22 Years for the Women's 1,500-Meters Record to Fall. What's the Fastest Humans Can Possibly Run?


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We desperately try to adhere to the less-is-more philosophy, and Dr. Jart's Water Fuse Beauty Balm helps us minimize our routine. A moisturizer, sunscreen, and treatment serum all-in-one, this tinted BB cream even helps hide imperfections—so there's no need for foundation or cover-up. Made with 50 percent water, the brand's Advanced Water Bead Technology helps hydrate and maintain healthy moisture for a dewy, fresh look, with additonal help from hyaluronic acid and aloe vera. Sebum-regulating ingredients keep your complexion from becoming greasy, and the broad-spectrum SPF 25+ blocks harmful UVA and UVB rays. Free of sulfates and phthalates.
Since BB and CC creams have come out, I have tried the majority of them. Some don't blend well, leaving the chin lines, others start off white and adjust to your skin tone...when I first put Dr. Jart on, I was a little nervous. it was a bit darker than my skin and it was already a "flesh" color, so I didn't think it would adjust....But it did! You can wear it alone or as a great makeup primer. I put some on, use a bit of concealer, and am good to go. Also, major plus, it doesn't rub off easily! So no face stained pillows, shirts, or boyfriend :)5


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Bodies and Lives in Ancient America offers a broad overview of what it was like to live and die throughout North America before European contact. Using a unique life history approach, the book moves from pregnancy and birth through to senescence. Drawing on biological data gathered from human…
Paperback – 2015-11-08
The Dark Side of Emotional Labour explores the work that the rest of society would rather not think about, the often unseen work that is emotionally disturbing, exhausting, upsetting, and stigmatising. This is work that is simultaneously undesirable and rewarding, work whose tasks are eschewed and…
Hardback – 2015-10-19
Routledge Studies in Management, Organizations and Society
Gendered Violence, Abuse and Mental Health in Everyday Lives: Beyond Trauma offers new insights into the social dimensions of emotional distress in abuse-related mental health problems, and explores the many interconnections between gendered violence, different forms of abuse and poor mental health…
Hardback – 2015-10-11
Routledge Studies in the Sociology of Health and Illness
Ignorance is mostly framed as a void, a gap to be filled with appropriate knowledge. In nursing and health care, concerns about ignorance fuel searches for knowledge expected to bring certainty to care provision, preventing risk, accidents, or mistakes. This unique volume turns the focus on…
Hardback – 2015-08-24
Routledge Key Themes in Health and Society
Population ageing and the globalisation of international migration are challenging the research agendas of social scientists around the world, and posing numerous challenges for policy makers and practitioners whose goal is to formulate and design high-quality and user-friendly policies and…
Hardback – 2015-08-18
Routledge Advances in Sociology
Originally published in 1990. Many post-World War I autobiographies focus on episodes of crisis. In a century torn by global strife and breakdown of cultural institutions, autobiography provides a way of recovering from crisis and restructuring reality–a healing act that involves the writer in a "…
Hardback – 2015-08-12
Routledge Library Editions: Autobiography
The criminal justice system now serves as the chief provider of health care services to a significant portion of society. This includes the provision of physical and mental health care for offender populations who require substantial health care resources. To date, little is known or understood…
Hardback – 2015-07-23
Giving Blood represents a new agenda for blood donation research. It explores the diverse historical and contemporary undercurrents that influence how blood donation takes place, and the social meanings that people attribute to the act of giving blood. Drawing from empirical studies conducted in…
Hardback – 2015-07-21
Routledge Studies in the Sociology of Health and Illness
Doping has become one of the most important and high-profile issues in contemporary sport. Shocking cases such as that of Lance Armstrong and the US Postal cycling team have exposed the complicated relationships between athletes, teams, physicians, sports governing bodies, drugs providers, and…
Hardback – 2015-06-22
Routledge International Handbooks
First published in 1998. Routledge is an imprint of Taylor & Francis, an informa company.…
Paperback – 2015-05-21
Whilst the body has recently assumed greater sociological significance, there has been less engagement in social work and social care on the bodily experience of health, illness and disease. This innovative volume redresses the balance by exploring chronic illness and social work, through the…
Hardback – 2015-05-07
Routledge Advances in Social Work
The last twenty years have seen a growth in multi-disciplinary work in the area of sexuality, culture and health. What was once a set of specialist concerns has been steadily mainstreamed. Alongside this, a broader interest has developed in 'social' and 'cultural' factors relating to sexuality…
Paperback – 2015-04-20
Sexuality, Culture and Health


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Search by BreedSearch Breeders by North Carolina
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MH & HRHC Sired Fox Red Pups $500 Commonwealth Retrievers in Payneville, Kentucky
AKC German Shorthaired Pointer "Col... Old Orchard Farm in Elberta, Alabama
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Crown Point Shorthairs - North Carolina German Shorthaired Pointer Breeders
Want to list your puppies for sale? Post a classified today!
About Crown Point Shorthairs
Crown Point Shorthairs strives to provide a quality, well socialized, healthy German Shorthaired Pointer. Our Shorthairs are great hunters, loyal companions, and a excellent addition to any family. We provide puppies, started dogs, finished dogs and stud service.
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Toby Trivett
494 Stonebridge Lane
Todd, North Carolina 28684
Breeding quality gun dogs for over 12 years.
336-620-2644Send Email to Crown Point Shorthairs
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Testimonials (4)
Submitted by: Linda on Jul 10, 2015Love these precious puppies! You wont find anyone else who will loves these pups as much as they do!
Submitted by: Tess on Jul 09, 2015Great folks and great dogs!
Submitted by: Cleo on Jul 10, 2013We have two German Shorthaired Pointers from Crown Point Shorthairs. We could not be happier! Both of our Shorthairs have natural hunting ability, very smart and so sweet. These folks really care about their pups and their new owners. Toby is great guy and super to work with. We would definitely would purchase another pup from Crown Point Shorthairs and we highly recommend them!
Submitted by: Nic on Jul 07, 2013I got my first shorthair several years ago and was blown away by the breed. Very intelligent and loyal dogs that love to love and be loved. Cant say enough about the loads of information and resources provided by Crown Point Shorthairs. Raising dogs is a way of life and a passion for these folks. There dogs eat better than they do.


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Foursquare © 2015 Lovingly made in NYC & SF
Blue Water Seafood
Seafood · $$$
1126 State Route 18
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683 State Route 18
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text:
Roccaporena, Perugia (province)
- Free parking
Main amenities
- 70 guestrooms
- Restaurant and bar/lounge
- WiFi in the lobby
- Spa tub
- Fitness center
- 24-hour front desk
- Garden
- Library
- Front desk safe
- Conference space
What's around
- Basilica di Santa Rita (3.5 mi / 5.6 km)
- Saint Benedict Square (14.1 mi / 22.7 km)
Enter dates to check prices
Hotel Info: 866-539-8117from $92
- Single Room
- Double Room
Recommended hotels
At a glance
Key facts
Hotel size
- This hotel has 70 rooms
- Check-in time 10 AM-9 PM
- Check-out time is 10 AM
Required at check in
- Credit card or cash deposit required
- Government-issued photo ID required
Travelling with others
- Children (3 years old and younger) stay free when occupying the parent or guardian's room, using existing bedding
- Pets allowed *
Extra people
- Roll-away beds available, charges may apply*
- WiFi in public areas *
- Free self parking
In the hotel
- Restaurant
- Bar/lounge
- Room service
- Fitness facilities
- Spa tub
- Bicycle rentals nearby
- Mountain biking nearby
- Conference space
- Meeting rooms
- 24-hour front desk
- Elevator/lift
- Safe-deposit box at front desk
- Garden
- Library
In the room
- Climate control
- Hair dryer
- Cable TV channels
- Desk
- Phone
- Refrigerator
Top Perugia (province) hotels
Recently reviewed hotels in Perugia (province)
- Hotel Dei DuchiFrom
"The Hotel dei Duchi in Spoleto is well located for tourism and has free parking. The hotel is basic modern and is well suited for tour groups. The location is its great advantage.…"Apr 26, 2015
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"The hotel is a little difficult to find but in a beautiful and unspoilt setting. I thought the hotel was excellent value for money, the staff could not have been more helpful and…"Nov 3, 2014
- Palazzo SenecaFrom
"This was an amazing historic property in the center of town. Every time I took a turn, there was another sitting room that was to be discovered. We loved sitting in front of the…"Oct 27, 2014
- Hotel San LucaFrom
"Big, open, comfortable room. Clean and spacious. Classic hotel, charming and genuine. The staff was friendly and informative - sent us on a good path right up and thru town.…"Oct 24, 2014
Nearby hotels
Roccaporena, Perugia (province)'s small print
Also known as
- Roccaporena
- Roccaporena Cascia
- Roccaporena Hotel
- Roccaporena Hotel Cascia
- Alberghi Roccaporena
- B&B Roccaporena
- Alberghi A Roccaporena
- Roccaporena Perugia
Cash transactions at this property cannot exceed EUR 999.99, due to national regulations. For further details, please contact the property using information in the booking confirmation.
Optional extras
Rollaway beds are available for EUR 15.00 per day
Pets are allowed for an extra charge of EUR 7.00 per day
We have included all charges provided to us by this hotel. However, charges can vary, for example, based on length of stay or the room you book.


text:
High school boys basketball: No. 1 Wasatch Academy tops No. 2 Liahona
MOUNT PLEASANT — No. 1 Wasatch Academy jumped out to a 17-point first-quarter lead and then fought off repeated runs by second-ranked Liahona Academy to post a 76-59 victory and move into first place in Region 18.
Wasatch Academy's 6-foot-7-inch center Insa Kaba wasted little time taking control of the paint. His Tigers jumped out to a 10-2 lead with 4:23 left in the quarter after he scored his eighth point. He finished the night with 14 points.
"It's just my job," said Kaba about his quick start. "It is what I do."
"This was a great confidence game for him," said Wasatch coach Geno Morgan. "He works as hard as any big man I have coached."
The extra hours in the gym paid huge dividends for Kaba, who averages less than six points per game.
Ross Belliston scored the Warriors' second basket of the quarter to pull Liahona to within six points midway through the period.
Enter Jarryn Skeete, Wasatch Academy's 6-3 shooting guard. He scored six unanswered points, and 50 seconds later the score ballooned to 19-4.
"Jarryn is special," Morgan said. "He is a coach's dream and capable of taking the game to a different level — not quite a Jimmer level, but still a different level."
Skeete, who entered the game averaging just under 20 points per game, finished with 28 points, six steals and five assists.
The teams traded baskets to finish the quarter and the Tigers (10-2, 3-0) led 26-9. At the end of the half, the Tigers led 43-29.
Brandon Nichols led Liahona (11-3, 3-1) with 16 points, while Matt Comer added 11 and Ross Belliston and Brayden Facemyer added 10 each.
Facemyer, who entered the game averaging 20.7 points a game, did not start, but played most the game with his left hand in an orthopedic brace. He fractured his wrist in two places Wednesday night against Wendover.
Behind Skeete and Kaba, Mitko Kurtev added 10 points for Wasatch Academy.
"These are two very good Region 18 teams playing at a high level right now," Morgan said.
The league has two automatic bids to the state tournament this year, and it is expected that these two teams will fill those slots.
Liahona will host Region 19 contender Whitehorse on Wednesday, while Wasatch Academy will travel to Piute, a perennial contender in Region 20, next Saturday.
Liahona and Wasatch Academy will meet in the regular-season finale in Pleasant Grove on Feb. 22.
Kevin spent 7 years early in his career as a community newspaper editor. He is an avid 1A basketball fan and the father of Liahona coach Jeremy Long. He can be reached at firstname.lastname@example.com
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Jonathan Haidt, who believes we are hard-wired to be selfish, mistakes conformity and obedience to authority for the moral life in his new book, "The Righteous Mind: Why Good People Are Divided by Politics and Religion."
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When Bootsy Collins defected from James Brown's band for George Clinton's, RJ Smith, in his new biography of Brown, gives us the desertion from Brown's point of view: "You could not copyright a beat, a smell, the One. You made it and then a younger man in an ass-length blond wig marked it up and made it new."
The central theme of "When I Was a Child I Read Books," the powerful new collection of essays by Marilynne Robinson, is the examination of the soul and of its central attributes—generosity, caritas, understanding—and of the miraculous presence of these things in the world.
In "Republic of Noise: The Loss of Solitude in Schools and Culture," Diana Senechal argues that the omnipresence of computers, tablets and smartphones hampers our ability to commune not just with one another, but with ourselves.
In Jack Gilbert's poetry, the mythic anguish of Orpheus in the underworld suddenly seems fused with something very much like the room in which you sit.
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Cozi Family Organizer
От Cozi
Откройте iTunes, чтобы купить и загрузить приложения.
Manage everyday life and keep the whole family in the loop with Cozi, Appy Award Winner for Best Family App, BMA Gold Winner for Best Mobile Calendar and named a "must-have app for a better life" by The TODAY Show.
There's nothing stationary about your life, so why depend on a family calendar that hangs on a fridge or wall? Cozi is the leading choice for families and includes a color-coded calendar, shopping lists, to do lists, family journal and more. Cozi also offers a premium ad-free version with additional features called Cozi Gold (available as an in-app purchase).
Cozi Family Organizer is shared, so you only need one account for the whole family. Cozi's free features include:
• Easy to use color-coded calendar, view an individual's schedule or the whole family at once
• Add or edit appointments that everyone in the family can see
• Set reminders so no one misses practice or an important event
• Send an automated agenda for the upcoming week to any family member
• Shared grocery lists the whole family can access anytime and on-the-go
• See items added by other family members in real-time, no more coming home with everything but the one thing you really needed
• View and check-off items from your Apple Watch, finally a hands-free shopping list!
• Create a shared to do list, a honey do list or chore checklists for the kids
• Have your tasks right there in your pocket to remind yourself or send them to a family member to remind them
• Create as many lists as you want - emergency supplies lists, packing checklists, camp supplies list and more
• Keep all your recipes in one place
• Search and view recipes from anywhere - in your kitchen or at the store
• Add ingredients to the shopping list with one click
• Jot down a special moment and add a photo all while you are on the move
• Cozi's journal is designed especially for busy moms and dads, so it's quick and easy to keep favorite memories you don't want to forget
• Add any photograph from your iOS 8 device right to the Family Journal quickly and easily with Cozi Journal share extension
• Your Cozi calendar, shopping lists, to do's and family journal are accessible from any mobile device as well as from any computer by visiting cozi.com. (The free online version of Cozi has additional features like a meal planner and recipe box.)
• No matter where or how your family signs in to Cozi, you'll always be looking at the same information.
• The whole family shares one account that everyone can access using their own email address (as specified in Settings) and the shared family password.
• Cozi supports iOS 8 handoffs, so you can easily switch between your iOS 8-enabled devices and pick up where you left off.
• "Cozi is, in short, ridiculously handy. My only regret is that I waited this long to start using it." –PC World
• "Cozi just works." –The Wall Street Journal
• "Too good to be true." –Family Fun Magazine
• "Incredibly helpful." –Better Homes and Gardens
• "The only FlyLady approved application." –The FlyLady
• "An online calendar we love." –Parents Magazine
Cozi is free to download and use. An optional subscription to Cozi Gold gives your family an ad-free experience plus additional features, like Contacts, Birthday Tracker, mobile app themes, more reminders, mobile month view, change notifications and more. It is available for $2.50 /month (billed as $29.99 /year) and applies to the whole family.
Cozi Gold's price may vary by location and subscriptions are charged to your credit card through iTunes at time of purchase. It will automatically renew unless cancelled at least 24 hours before the end of the current period. You can manage your subscription in iTunes or visit Account Settings in Cozi after purchase.
Cozi's terms of use: www.cozi.com/terms-of-use.htm
Что нового в версии 8.2.5503
- Improvements to the Cozi Journal, including improved privacy for public journals, and design fixes for longer journal entries
- Improvements and bug fixes to Cozi Today cards
- Addressed issue with orientation of family photos
- Minor bug fixes and additional improvements
Apple Watch
Наши покупатели также приобрели:
- Бесплатно
- Категория: Производительность
- Обновлено: 21.07.2015
- Версия: 8.2.5503
- Размер: 55.7 МБ
- Apple Watch: Да
- Язык: английский
- Разработчик: Cozi
- © 2015 Cozi Inc.
Совместимость: Требуется iOS 7.0 или более поздняя версия. Совместимо с iPhone, iPad и iPod touch. Это приложение оптимизировано для iPhone 5, iPhone 6 и iPhone 6 Plus.
Топ встроенных покупок
- Cozi Gold1 790 р.
- 1-year subscription to Cozi Gold1 790 р.


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View Singles in Vermillion
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Search for singles in the Land of 10,000 Lakes. We have thousands of online personal ads in Minnesota. Match.com makes it easy to find Minnesota singles through this free personals site. Whether you are looking for marriage, a long term relationship, or just a friend, you will find what you're looking for at Match.com. A picture is worth a thousand clicks — Upload your personal photo to your free Vermillion personals ad today!
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text:
OSI-Approved Open Source (140)
- GNU General Public License version 2.0 (23)
- GNU Library or Lesser General Public License version 2.0 (10)
- BSD License (9)
- Apache License V2.0 (8)
- GNU General Public License version 3.0 (5)
- MIT License (5)
- Common Public License 1.0 (4)
- Mozilla Public License 1.1 (3)
- Apple Public Source License (2)
- GNU Library or Lesser General Public License version 3.0 (2)
- Python Software Foundation License (2)
- zlib/libpng License (2)
- Adaptive Public License (1)
- Affero GNU Public License (1)
- Artistic License (1)
- Other License (7)
- Public Domain (2)
- Linux (126)
Grouping and Descriptive Categories (109)
- All POSIX (60)
- All 32-bit MS Windows (25)
- OS Independent (21)
- Project is OS Distribution-Specific (19)
- 32-bit MS Windows (12)
- All BSD Platforms (11)
- 32-bit MS Windows (5)
- OS Portable (5)
- 64-bit MS Windows (2)
- Classic 8-bit Operating Systems (1)
- Project is an Operating System Distribution (1)
- Project is an Operating System Kernel (1)
- Windows (91)
- Mac (78)
- Modern (51)
- Other Operating Systems (12)
Top Apps
- Audio & Video
- Business & Enterprise
- Communications
- Development
- Home & Education
- Games
- Graphics
- Science & Engineering
- Security & Utilities
- System Administration
JSPowerLin - Linux with a Java edge
JSPowerLin - Linux with a Java edge, a lightweight platform for developing and deploying J2EE applications and Java Server Pages on a server or servercluster.3 weekly downloads
SNMP Apache Module
SNMP Apache Module allows you to monitor different configuration and status values of Apache Web Server using SNMP (simple network management protocol)3 weekly downloads
RIDE Project
A framework in which IHE's XDS, ATNA, CT and PIX profiles work together. ATNA, CT and PIX Profiles are implemented and the open source implementation of IHE XDS Registry and Repository http://sourceforge.net/projects/iheos is customized.2 weekly downloads
mod_athena load balancer
We needed an efficient, easy to configure, affordable, reliable, and flexible HTTP(S) load balancer for our three-tier (n*proxy / n*app / n*db) web software. So we wrote it! Configuration managed in apache, with mirroring and monitoring capabilities.2 weekly downloads
The mod_auth project provides authn and authz modules for the apache httpd 2.1 authentication framework.2 weekly downloads
mod_epp for Apache 2
This module adds support for the Extensible Provisioning Protocol "EPP" to an Apache 2 server. An full EPP server can thus be implemented as CGI scripts with the Apache 2 request framework.2 weekly downloads
mod_mysql_access is an Apache module to authorize access based on ip addresses through a MySQL database. The module will work on both Apache 1.x and Apache 2.x.2 weekly downloads
This Apache module makes it possible authentication/authorization to be done by an external program. The external program can be provided as a CGI, PHP or any other schemes which allow dynamic content to Apache.1 weekly downloads
A simple apache module for providing high performance and easy maintain URL forwarding1 weekly downloads
APR Virtual File System
APR based virtual file system library and modules for read/write access to gzip, bzip, tar, cpio, iso and zip archives.1 weekly downloads
Accelerating Apache Project
The Accelerating Apache Project was SGI's effort to increase the performance of the Apache HTTP server. It has a new home now on SourceForge, courtesy of SGI. Now it seeks a new owner and a fresh start. Want to help make Apache MORE than 10x faster?1 weekly downloads
Apache Auth Module for IBM DB2
mod_auth_ibmdb2 is an Apache module written in C. It provides authentication and group authorization using data stored in an IBM DB2 database.1 weekly downloads
Apache RADIUS AAA module
Radius client implementation for Apache to allow basic authentication and authorization through radius.1 weekly downloads
C Tasks
C Tasks consists of Ant tasks that invoke C/C++ development tools. The tasks are based on the very general CC task from Ant Contrib project on SourceForge. A framework for applying XSL transforms to buildfiles to target different systems is provided.1 weekly downloads
CUBOT Apache HTTPD Module
CUBOT mod_rx.c is httpd module to handle web requests. /* mod_rx is service handler to process client requests on web extension .rx. * This code uses Unix Message Queue to write web server request in form of message. * Application want to process mes1 weekly downloads
A project to develop a tool converts Intel IHEX format or other to machine-depend format. Basically it intends to help cross compiling environment for old-time 8-bit computers.1 weekly downloads
Hotlist is a Controller program, developped for the purpose to be a powerfull, customizeable GUI for Winamp AVS. Hotlist has been written in Delphi, whereas it's additional APE's have been written in C++. Hotlist is primary aimed at the needs of VJ's.1 weekly downloads
Application for Alcatel 50x and 70x phones1 weekly downloads
Micro-80: Z80 Homebrew Computer Emulator
Micro-80 aims to simulate a Z80 homebrew computer down to the bare metal: 64K RAM, ADM-3A terminal, parallel port, serial port and...3.5" 1.44MB floppy drive?!1 weekly downloads
Open Source GlassFish Software Appliance
Open Source Application Server Appliance based on Open Source GlassFish1 weekly downloads
PROSE is a system that performs controlled, systematic, and efficient modification of the code of running Java applications without requiring them to be shut down. PROSE is an infrastructure that supports software adaptation by extending apps at runtime.1 weekly downloads
SSLider is a web server benchmarking and testing tool supporting HTTP/HTTPS, cookies, data submission via POST, and scripted site tests suitable for CGI application and servlet testing.1 weekly downloads
Satellite WebApp
A framework allowing java servlet-based webapps to be easily deployed as cross-platform desktop applications. Uses GTK, Mozilla, and GCJ.1 weekly downloads
Stalk: an OO language
Stalk is a new prototyping, message-passing OO language similar to Self. The interpreter compiles source text to bytecode for the Stalk Virtual Machine (SVM) and caches it. Compilable on most systems with sane C++ compilers, stalk has optional gtk binding1 weekly downloads
User Design-able Operative System
I Was Making A User Designable/Data Protection Operative System, I Am Tired Of Making It And I Do Not Even Know If It Is A Good Idea, So I Decided To Associate To Know If It Is A Good Idea And Finish It. Join To Discuss The Main Ideas For Project.1 weekly downloads


text:
Current offers
Referral Prize
Calling all members! We have an excellent referral challenge running through out July! The person who recommends the most new members can make huge savings on their membership fees and win our prize for the month a Laguna 2 burner gas BBQ! Read more
Shape up this Summer with our fantastic membership offer!
Pay £20.15 and pay nothing more until 1st September 20.15. Save over £45.00 on a standard gym membership if you join today! Read more
Latest news
Additional changes to pool timetable 27th July - 31st July 2015
Please note there will only be 2 lanes in the pool during certain times this week as we have a lifeguard course on Read more
Summer Holiday Programme
The summer programme is now here for you to download. Read more
Swimtag Montly Prizes
Whichever swimmer swims the most in July 2015 will win a Mystery Prize Read more
Take out a 6 week swimming & aqua classes pass for only £25 Read more
Important Changes to Group Swimming Lessons
From the 1st June class movements will be undertaken by parents via our online web portal on our website. Read more
"If you would like to make a comment or need more information please use the links to the left to get in touch. We look forward to welcoming you at our centre soon."
Stacey Wild, General Manager
Other leisure centres managed by Places for People Leisure on behalf of High Peak Borough Council
St John's Road,
Tel: 01298 766142
High Street East,
Tel: 01457 842272
Dinting Road,
Tel: 01457 842262


text:
'Texas Chainsaw Massacre' Heading Back to Screen ... in 3D (Cannes)
John Luessenhop is in talks to direct the Lionsgate project, with production slated to begin in June.
Texas Chainsaw Massacre is heading back to the big screen, this time in 3D.
John Luessenhop is in talks to direct the Lionsgate project, which is being produced by Carl Mazzocone.
Production is slated to begin in June.
The movie will be a joint Lionsgate and Nu Image production, with Lionsgate distributing the movie in the U.S. and Nu Image selling international rights at Cannes.
Carl Mazzocone is producing the movie, which hopes to launch a new franchise featuring Leatherface and his family of cannibals. Mazzocone was production president of horror house Twisted Pictures before becoming an independent producer; he pursued the rights to the property and came away with a deal to make up to six movies.
The original Chainsaw is considered a landmark horror movie. Directed by Tobe Hooper, the 1974 pic introduced the chainsaw wielding cannibal known as Leatherface to audiences.
This isn't the first time the movie is getting remade. New Line and Platinum Dunes remade the movie in 2003 (it grossed $80 million domestically) and made a prequel in 2006.
Never miss a story. Stay up-to-date with THR's Daily Headlines.
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Lena Dunham, Amy Schumer and Comedy Actress A-List in Raunchy, R-Rated Roundtable


text:
County Championship: Green track gives big-hitting Brown chance to dig in
Nottinghamshire 328 Warwickshire 13-0
Tuesday 17 August 2010
Nottinghamshire felt they were robbed by a conspiracy of circumstances when Somerset denied them a place in the Twenty20 Cup final on Saturday. In the Championship, they have no intention of letting fate control their destiny.
Three home matches in their five remaining games gives them a better than even chance in that respect. Pitches primed to produce results leave something to luck but Nottinghamshire have lost only two four-day games here in two years and they have gambled on getting the best of a typical Trent Bridge strip in this game.
Early indications are that the strategy will pay off as they try to stretch their slender lead over Somerset and Yorkshire, the rivals still in genuine contention for the prize.
Winning the toss, they chose to bat on the green pitch. There was something in it for the bowlers – bounce and lateral movement – as they surely knew there would be, but Nottinghamshire have the batsmen to force the pace and the innings rattled along at four an over.
Warwickshire's hard-working attack were rewarded with acceptable frequency but the home side scored heavily in between, claiming three bonus points by the 77th over. Their bottom-of-the-table visitors, whose batting is fragile at best, knew they would have their work cut out, and dropping four catches has made their task all the tougher.
Ali Brown, the veteran plunderer who lies in wait for unsuspecting opponents in Nottinghamshire's dangerous lower order, emerged as their steady fulcrum in his 76 yesterday, although he reached his fifty off 94 balls, not exactly a dawdle.
Mark Wagh's 54 was the earlier highlight. The stylish strokemaker, who will be a loss to cricket when he retires to become a commercial lawyer next year, has a good record against his former county. In five first-class innings against them since his move here he has scored 378 runs, including two centuries.
Nottinghamshire's batting would be stronger still if only they could find a consistently productive combination at the top. Alex Hales and Matt Wood yesterday became the county's fifth opening partnership this season. No pair has managed more than 43 and that record was not improved yesterday as Hales, looking to force off the back foot, nicked a catch to Tim Ambrose.
Wood was similarly caught behind, hanging out his bat somewhat. Samit Patel, right on message, scored his first 28 runs in boundaries but edged Darren Maddy's first ball to second slip before David Hussey, who briskly picked up half a dozen fours, chopped on to Chris Woakes.
The ever-dependable Chris Read kept up the momentum with 45 off 52 balls, including two sixes – one streaky, the other less so – off Boyd Rankin, before Maddy produced a ball that slipped through low.
Warwickshire will rue their four dropped catches. The costliest were those that let off Hussey on nought, perpetrated by Rikki Clarke at first slip off Maddy, and Read on 11 by Maddy at mid-on off Imran Tahir.
Sport blogs
Gareth Bale to Manchester United: Louis van Gaal has made 'two £100m bids this summer'
Jose Mourinho-Arsene Wenger feud is not sporting, but keeps alive raw spirit of competition - Sam Wallace
Pedro to Manchester United: Transfer news live - Angel Di Maria to PSG, John Stones to Chelsea, £100m Gareth Bale bid
Premier League 2015/16 preview: Club-by-club guide to the new season
Manchester United transfer news: Victor Valdes moved to U21 dressing room as exit looms
- 1 Edward Heath 'raped 12 year-old boy at Mayfair flat'
- 2 Sabrina Corgatelli: US hunting tourist posts picture of herself with dead giraffe after Cecil the lion outrage
- 3 Porn block in India: hundreds of sexual websites banned, internet outraged
- 4 Gwen Stefani and Gavin Rossdale divorce: One of music industry's most enduring couples announce split after 12 years of marriage
- 5 A-level results 2015: UK exam board OCR admits it 'estimates' hundreds of pupils' grades after papers 'go missing'
Is Britain really full up? Are migrants taking our jobs? Leading academic answers the most common anti-immigration claims
Calais Migrant Crisis: Deputy Mayor of Calais labels Cameron's use of 'swarm' as 'racist' and 'ignorant'
Chris Leslie: Jeremy Corbyn's anti-austerity agenda will harm the poor, says Labour shadow Chancellor
Landlords renting properties to illegal immigrants to face up to five years in prison
While we fixate on Calais, the Home Office is quietly deporting dozens of migrants on 'ghost flights'
Calais crisis: The seven claims made about the migrants - and the reality


text:
Feb 21 - Homily: Close to God
Version 8 and above required to view videos
Uploaded by AirMaria on Feb 21, 2012
God does not want us to live in fear anymore - fear of offending God but not fear of approaching Him. God became man and dwelt amoung us. He wants us to be close to Him. We need to talk to Him often. Our Lady too helps us to come close to God. Let us nourish our closeness and our nearness to God with constant prayer. Ave Maria! Mass: Ordinary From -ĀSt. Peter Damian - Optional Memorial Readings: 1st Reading: James 4:1-10 Responsorial Psalm: 55:7-8, 9-10, 10-11, 23 Gospel: Mark 9:30-37 To Download Audio go to http://airmaria.com?p=27074
Closeness to God Fear of God Prayer
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So you went on a date last night. Should you text them today?
This 17-year-old is standing up against unfair dress code policies
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