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Outreach Visits to Optimize Chronic Care Management in General Practice: A Cluster Randomized Trial (Output)
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The aim of this project is to motivate and support general practice clinics in implementing the visions and recommendations presented in two of the disease specific programmes for chronic care management (for chronic obstructive lung disease and Type 2 diabetes). These programmes describe evidence based treatment and division of tasks between the municipalities, the hospitals and general practice.
The Facilitator Project is funded by The Danish Ministry of Interior and Health.
Chronic Disease
Behavioral: Outreach visits
|Study Type:
|Study Design:
|Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:
|Outreach Visits to Optimize Chronic Care Management in General Practice: A Cluster Randomized Trial
- Change from baseline at 12 month in Annual systematic chronic disease follow up consultations [ Time Frame: Month 4, 3, 2 before baseline and month 13,14,15 after baseline (after intervention) ] [ Designated as safety issue: No ]Change in annual systematic chronic disease controls per person affiliated with a primary care at a period at baseline and at 12 month.
- ICPC diagnosis coding [ Time Frame: 12 months ] [ Designated as safety issue: No ]Self reports regarding the use of ICPC diagnosis coding for Type 2 Diabetes and Chronic Obstructive Pulmonary Disease.
- Sentinel Data Capture [ Time Frame: 12 months ] [ Designated as safety issue: No ]Application for the electronic Sentinel Data Capture module for overview of patients with chronic diseases.
- Stratification [ Time Frame: 12 months ] [ Designated as safety issue: No ]The self reported use of stratification as part of primary care management of patients with chronic diseases
- Change from baseline and at 12 month in practices with low performance on annual systematic chronic disease follow up consultations. [ Time Frame: Month 4, 3, 2 before baseline and month 13,14,15 after baseline (after intervention) ] [ Designated as safety issue: No ]Reduction in the number of practices with less than 1% annual systematic chronic disease follow up consultations.
|Study Start Date:
|March 2011
|Study Completion Date:
|April 2012
|Primary Completion Date:
|February 2012 (Final data collection date for primary outcome measure)
|Assigned Interventions
Experimental: Outreach visits
Practices allocated to outreach visits may receive up to three outreach visits in order to motivate and support general practice clinics in implementing two chronic care programmes for chronic obstructive Pulmonary disease and Type 2 diabetes.
Behavioral: Outreach visits
The 16 facilitators in the project attend an educational programme designed to provide them with the necessary skills and tools for the task. The facilitators visit general practice clinics from March 2011 until the end of 2012. Each clinic is offered three visits. The facilitator is to act as a change agent who motivates and helps the clinic team in the process of defining common goals, and choosing the appropriate means for achieving them.
No Intervention: Control (late intervention)
These practices are allocated to outreach visits after the initial evaluation stops at 12 months.
Detailed Description:
In a cluster randomized trial the investigators will explore the efficacy of up to three outreach visits by specially trained GPs. Efficacy data are obtained by means of questionnaires at regional databases.
|Ages Eligible for Study:
|30 Years to 70 Years
|Genders Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
General Practices working in the capital region in Denmark
Exclusion Criteria:
General Practices where the facilitator works.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01297075
|Frans Boch Waldorff
|Copenhagen, Capital Area, Denmark, 1014
|Research Unit of General Practice
|Copenhagen, Capital, Denmark, 1014
|Principal Investigator:
|Frans B Waldorff, PhD
|Research Unit of General Practice
No publications provided by Research Unit Of General Practice, Copenhagen
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
|Responsible Party:
|Frans Boch Waldorff, Research Associate professor, Research Unit Of General Practice, Copenhagen
|ClinicalTrials.gov Identifier:
|NCT01297075 History of Changes
|Other Study ID Numbers:
|Study First Received:
|February 15, 2011
|Last Updated:
|May 22, 2014
|Health Authority:
|Denmark: Danish Dataprotection Agency
Keywords provided by Research Unit Of General Practice, Copenhagen:
Health Services Research
Chronic Care
Outreach Visits
Primary care
chronic disease management
Additional relevant MeSH terms:
Chronic Disease
Disease Attributes
Pathologic Processes
ClinicalTrials.gov processed this record on October 13, 2015


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Items where Author is "Lokošek, Vedran"
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Jurić-Lekić, Gordana and Radujković, Vedran and Kancijan, Valentina and Bulić-Jakuš, Floriana and Lokošek, Vedran and Katušić, Ana and Vlahović, Maja and Šerman, Ljiljana (2008) Differentiation of epiglottal epithelia during prenatal and postnatal human development. Collegium antropologicum, 32 (4). pp. 1115-1120. ISSN 0350-6134 (Print)

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- Northern New York Newspapers
- Watertown
- Ogdensburg
- Massena-Potsdam
- Lowville
- Carthage
- Malone
- NNY Business
- NNY Living
- NNY Ads
GOUVERNEUR E.J. Noble Hospital has a management agreement with Canton-Potsdam Hospital, Potsdam, a new board, a new administrator, an infusion of money and the start of a new vision of how to provide health care in Gouverneur.
People want clarity. Were not there yet, Canton-Potsdam Administrator David B. Acker said. Hospitals are big, complicated ships and it takes a while to turn them around. From my perspective, the number one issue relative to the hospital is its financial stabilization and to make certain the Department of Healths concerns about quality are resolved. It will be more clear in the next several weeks how we define services in the future.
Canton-Potsdam and E.J. Noble were advised Tuesday that their management agreement was approved by the E.J. Noble bondholder, the National Automatic Sprinkler Pension Fund, which paved the way for Marlinda L. LaValley, vice president for administrative services at Canton-Potsdam, to be named full-time administrator at the Gouverneur hospital.
An application for E.J. Noble to change its designation from acute care to critical access was filed Monday, Mr. Acker said. That would allow the hospital to gain increased Medicare reimbursements.
A recently named E.J. Noble board of trustees, consisting of President Michael J. Burgess, a vice president at Kinney Drugs; Mark L. Brackett, Kinney Foundation Board president; Nicholas F. Gardner, a Gouverneur dentist; Stephen E. Knight, United Helpers chief executive officer; and Dr. Andrew Williams, a physician at Cerebral Palsy Association of the North Country and Canton-Potsdam, is continuing to review the hospitals fiscal situation and its operations, including what services should be kept, and to oversee the eventual opening of a primary-care clinic in the hospital.
For the foreseeable future, were in place, Mr. Burgess said. Theres a lot of work ahead of us.
The size of the board could grow.
We may need to seek out some other community members that have the same passion that we do, Mr. Burgess said.
The role of the new board will be much the same as the old board, which resigned, as did former Administrator Charles P. Conole.
There was a sense that this really needed to be a rebirth, to start afresh, Mr. Acker said.
The state Department of Health shut down E.J. Nobles laboratory for deficiencies Sept. 28, then later allowed a partial reopening of services. Already in dire financial straits, the hospital has struggled to stay open as its revenues dropped.
On top of a $2 million loan for the short-term relief of E.J. Noble arranged through the Dormitory Authority by the state Department of Health, Canton-Potsdam Hospital will provide a $300,000 loan, which it will forgive. Canton-Potsdam also will waive its management fee for six months and use that money at E.J. Noble, Mr. Acker said.
The $2 million loan is to be repaid by the end of the year, but Mr. Acker said he hopes to work out terms that are not a burden on E.J. Noble.
We are working with the state on an ongoing basis to see that there is adequate funding to sustain ongoing operations, he said.
E.J. Noble is meeting payroll, but has a lot of catch-up in order to make good with all of its vendors, Mr. Burgess said.
Kinney Nursing Home, which is affiliated with E.J. Noble, will remain open under the supervision of United Helpers, and the hospitals laboratory will be supervised for now by Samaritan Medical Center, Watertown.
About 70 of E.J. Nobles 245 employees were told not to report to work after the lab closed and acute-care services shut down, and not all have returned to work. The future of the rest of the jobs and the hospitals satellite clinics remains unknown until the review of operations is complete.
Canton-Potsdam also will furnish an on-site nursing manager, part-time educator Nan Rutledge, to provide oversight. Her role will not be to supplant existing management at E.J. Noble, but to improve processes, Mr. Acker said.
There will be a deployment of Canton-Potsdam Hospital resources on a steady and ongoing basis, he said.
Canton-Potsdams goal, along with that of United Helpers and Cerebral Palsy, is to provide the community with sustainable high-quality care, Mr. Acker said.
A key part of stabilizing E.J. Noble will be to have a strong primary-care clinic within the hospital, and an architect is looking at the building to determine its best location, Mr. Acker said. Another goal is to keep the physicians that remain.
Gaining critical-access status could benefit E.J. Noble through increased Medicare reimbursements, Mr. Acker said. The status would require the hospital to have no more than 25 beds and have most patients stay no longer than four days, but the hospitals occupancy of its 37 beds is rarely even at 25, he said.
The only other critical-access hospital in St. Lawrence County is Clifton-Fine Hospital, Star Lake; others do not qualify because of their size.
Mr. Acker said he was at E.J. Noble the night the Department of Health ordered it shut down, sending its patients to neighboring hospitals.
The panic that people felt that night really struck hard, he said. I think our goal is we cant let that happen again.
Thousands of readers like you have made Northern New York Newspapers the number one ranked website* for local news and sports coverage in the north country.
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AP Legal Affairs Writer
COLUMBUS, Ohio (AP) - Attorneys for two Ohio high school football players charged with raping a 16-year-old girl say the alleged victim and two other witnesses from West Virginia are now expected to testify because a judge reversed his earlier ruling.
A judge in West Virginia had rejected requests that the three juveniles be called to testify at the trial set to begin Wednesday in Steubenville in eastern Ohio. Defense attorneys say the judge reversed that ruling late Tuesday.
It wasn't clear why, and a copy of the ruling wasn't immediately available.
The juveniles' testimony was expected to bolster the players' defense against the charges.
One of two Ohio high school football players charged with raping a 16-year-old girl after an alcohol-fueled party says a photo of the defendants apparently carrying the girl by her arms and legs was a joke.
Sixteen-year-old Ma'Lik Richmond talks about the photo in an excerpt of a videotaped interview with ABC's "20/20." The program says Richmond contends the girl was awake and was a willing participant.
Richmond says the boys weren't carrying the girl away. Online circulation of the photo drew increased attention to the case.
The players' attorneys had filed to have the case dismissed, arguing the defendants' rights were compromised or violated by the inability to compel the three juveniles to testify.


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BUFFALO, NY-- A hot oil spill lead to a fire at a nearby packaging company.
Buffalo Firefighters were called to TRS Packaging Company on Dingens Street around 8 o'clock Tuesday morning after a fire broke out inside the compressor room.
According to fire officials, a hose broke off one of the hot oil compressors, allowing oil to spew out and ignite a fire.
Luckily, the companies sprinkler system was working and kept the fire contained to just the one room. However, it did cause quite a mess.
A professional cleaning company was called in to take care of the oil and water. Some of the firefighter's uniforms got pretty messy, too. They'll be sent to the department's supply center and cleaned up.


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Martin Regional Library will be closed Oct 19-Nov 1 for library improvements.
Did you know that you can take free non-credit courses through Universal Class with your TCCL library card number? You can enroll in up to five courses, and you have six months to complete each course. You can take courses that focus on developing specific knowledge and skills, like accounting, history, medical coding, language arts, office skills, etc. You can also take courses to prepare for the GED!
Tutors, basic literacy learners, and English language learners can all find something interesting and useful to improve their abilities and knowledge base. Click here to try it.
Stephanie Griggs (not verified)
Mon, 03/09/2015 - 12:34pm
Can you provide proof of enrollment?
ctudyk (not verified)
Wed, 11/07/2012 - 12:43pm
Hi Savana,
The first step to getting started with Universal Class is to register as a member. Follow the link http://tulsacitycountyok.universalclass.com/register.htm to register for free. Registration only takes a few minutes. Once you have registered, you will be ready to enroll in any class of your choice.
If you would like to speak to a librarian, or if you have more questions about this service, please call us at 918-549-READ (7323).
Good luck!
savana west (not verified)
Wed, 11/07/2012 - 12:23pm
i would like to be a medical receptionist. how can i start taking the business and medical terminology classes?


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Tonight, I'd like to continue our study of Dogen Zenji's waka poetry, and I will once again use Steven Heine's excellent translation and interpretation as the basis for my talk. There's a traditional saying about Zen, ascribed to Bodhidharma, that says that Zen is a "special transmission outside the teachings, with no reliance on words and letters". This idea conforms to what may have been our initial idea about Zen, that enlightenment, whatever that is, lies completely outside of our words and ideas and that some sort of breakthrough into nonconceptual understanding is required. This is the idea behind a lot of our clichés about Zen (and Zen-related themes) – David Carradine in Kung Fu, or Luke Skywalker being told to let go of the conscious mind and rely on instinct.
A unique part of the heritage of Soto Zen is Dogen's radically different understanding of language. For Dogen, all forms of communication, written or oral, and even discursive thought are part of our inherently awakened mind. For Dogen, awakening must be expressed symbolically through language. It's not that language is some sort of a tool that is used for the higher purpose of teaching the dharma, it's that language itself is the dharma. Dharma is somehow embedded in language. In his fascicle Bendowa, Dogen writes: "Let it go and it fills your hand – it is unbound by singularity or multiplicity. Speak and it has already filled your mouth – it is not restricted by lesser or greater." If we can accept the notion of nonduality, then of course language is not something separate from awakening. It's simply the symbolic way that awakening expresses itself.
In Japanese aesthetics, the term yugen refers to the mysterious profundity of things that are only vaguely suggested in a poem. The Japanese poet Chomei, who lived around the same time as Dogen, said that yugen conveys a profundity of mystery and tranquility "only when many meanings are compressed into a single word, when the depths of feeling are exhausted yet not expressed, when an unseen atmosphere hovers over the poem". This is related to another concept in Japanese aesthetics, yojo, which refers to the abundance of overtones of feeling in a poem. Dogen plays around with many of these ideas in the following waka poem:
The dharma, like an oyster
Washed atop a high cliff:
Even waves crashing against
The reefy coast, like words,
May reach, but cannot wash it away
Now the conventional interpretation of this poem is in line with our simple ideas about Zen and language, that the dharma resides on a lofty peak, above the crashing waves of discourse. The dharma is thus somehow above or outside of language and really isn't accessible by words, even those of the sutras. But, as is often the case, the meaning of this poem requires digging a little deeper into the translation and into the subtlety of the Japanese language.
What is translated here as 'the reefy coast, like words' is, in Japanese kaki mo tsukubeki, which has many layers of meaning. First, the word kaki can mean 'oyster' so there's this feeling that the reason why the oyster is on the cliff to begin with is because the waves put it there. In other words, the Dharma finds its place beyond words because of language itself. There's a traditional Mahayana image of water representing the absolute and waves representing the relative. So in this image, the oyster has been cast out of the absolute background into the relative by a particular wave, but it totally depends on the water for its location.
Kaki can also mean writing, or more generally, language and communication. Here it's modified by the word tsukubeki, which means 'must exhaust' or 'must reach'. So this line also means something like 'language must reach/must exhast' the dharma. Not only can the dharma be expressed in language, it actually must express the dharma, or (the other way around), dharma must be expressed. The dharma cannot escape the necessity of communication. This idea is extended in the next line (nori naraba koso). Nori means 'seaweed' and (apparently) it can also mean dharma. Seaweed is also cast out of the ocean like an oyster and thus underscores the connection between conceptual discourse and realization.
Here's another poem from Dogen that uses different imagery to get at a similar point:
To what shall
I liken the world?
Moonlight, reflected
In dewdrops,
Shaken from a crane's bill
Dogen often uses images of reflections in water to describe how totality is expressed in the individual. The dewdrop is also used as an image of impermanence, and the moon is used as an image of Buddha-nature, so here this means that the dharma is completely embodied in the evanescent. And there's a sense that Buddha-nature is not standing apart from the finite and particular since it fully merges with each thing. In the same way, each word or phrase expresses Buddha-nature as well. In fact, all expressions completely realize the authentic mind of awakening, which is identical with transient reality. In this sense, this poem is not pointing to some idea of awakening, but is itself the complete embodiment of the awakened mind.


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Mets may not acquire OF before Spring Training
This morning on MLB Network Radio, Sandy Alderson said it's possible the Mets might not make a significant acquisition in the outfield this off-season.
"There's not a lot left on the shelf," Alderson explained. "At some point, we have to realize the outfield is not the strength of our team. But, at least going into Spring Training, we may be looking at what we have and not being able to make an addition."
In regards to losing Scott Hairston to the Cubs, Alderson said Hairston wanted a full-time role and the Mets were considering other full-time options instead.
Last week, Terry Collins told Adam Rubin of ESPN New York he would consider both Justin Turner and minor leaguers Zach Lutz in the outfield. In addition, the Mets invited Matt Den Dekker to Spring Training.
Michael Baron, Contributor
Right now, the outfield isn't just a weakness, it's an absolute joke… and putting more players out there who are out of position makes the mess messier. Frankly, if they can't sign Michael Bourn, I'd rather they look at both Den Dekker and Jordany Valdespin as opposed to Turner and Lutz. Den Dekker is already an outstanding defensive center fielder, and Valdespin proved last season he is at least capable of playing there as well.


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16 U.S. Code § 2004 - Continuing appraisal of soil, water, and related resources
(a) Data
In recognition of the importance of and need for obtaining and maintaining information on the current status of soil, water, and related resources, the Secretary is authorized and directed to carry out a continuing appraisal of the soil, water, and related resources of the Nation. The appraisal shall include, but not be limited to—
(1) data on the quality and quantity of soil, water, and related resources, including fish and wildlife habitats;
(2) data on the capability and limitations of those resources for meeting current and projected demands on the resource base;
(3) data on the changes that have occurred in the status and condition of those resources resulting from various past uses, including the impact of farming technologies, techniques, and practices;
(4) data on current Federal, State, and tribal laws, policies, programs, rights, regulations, ownerships, and their trends and other considerations relating to the use, development, and conservation of soil, water, and related resources;
(6) data on alternative irrigation techniques regarding their costs, benefits, and impact on soil and water conservation, crop production, and environmental factors; and
(b) Collection of data
The appraisal shall utilize data collected under this chapter and pertinent data and information collected by the Department of Agriculture and other Federal, State, tribal, and local agencies and organizations. The Secretary shall establish an integrated system capable of using combinations of resource data to determine the quality and capabilities for alternative uses of the resource base and to identify areas of local, State, tribal, and National concerns and related roles pertaining to soil and water conservation, resource use and development, and environmental improvement.
(c) Public participation
The appraisal shall be made in cooperation with conservation districts, State and tribal soil and water conservation agencies, and other appropriate citizen groups, and local, tribal, and State agencies under such procedures as the Secretary may prescribe to insure public participation.
(d) Evaluation of appraisal
In conducting the appraisal described in subsection (a), the Secretary shall concurrently solicit and evaluate recommendations for improving the appraisal, including the content, scope, process, participation in, and other elements of the appraisal, as determined by the Secretary.
Source(Pub. L. 95–192, § 5,Nov. 18, 1977, 91 Stat. 1408; Pub. L. 99–198, title XII, § 1252(a),Dec. 23, 1985, 99 Stat. 1516; Pub. L. 110–234, title II, § 2804(b),May 22, 2008, 122 Stat. 1086; Pub. L. 110–246, § 4(a), title II, § 2804(b),June 18, 2008, 122 Stat. 1664, 1814; Pub. L. 113–79, title II, § 2508(b),Feb. 7, 2014, 128 Stat. 756.)
Pub. L. 110–234and Pub. L. 110–246made identical amendments to this section. The amendments by Pub. L. 110–234were repealed by section 4(a) ofPub. L. 110–246.
2014—Subsec. (a)(4). Pub. L. 113–79, § 2508(b)(1), substituted ", State, and tribal" for "and State".
Subsec. (b). Pub. L. 113–79, § 2508(b)(2), inserted ", tribal" after "State" in two places.
Subsec. (c). Pub. L. 113–79, § 2508(b)(3), substituted "State and tribal soil" for "State soil" and "local, tribal," for "local".
2008—Subsec. (a)(7). Pub. L. 110–246, § 2804(b)(1), added par. (7).
Subsecs. (d), (e). Pub. L. 110–246, § 2804(b)(2)–(4), added subsec. (d), redesignated former subsec. (d) as (e), and substituted "The Secretary shall conduct comprehensive appraisals under this section, to be completed by December 31, 2010, and December 31, 2015." for "The Secretary shall conduct four comprehensive appraisals under this section, to be completed by December 31, 1979, December 31, 1986, December 31, 1995, and December 31, 2005, respectively."
1985—Subsec. (d). Pub. L. 99–198amended subsec. (d) generally. Prior to amendment, subsec. (d) read as follows: "The appraisal shall be completed by December 31, 1979, and at each five-year interval thereafter during the period this chapter is in effect."
Effective Date of 2008 Amendment
Amendment of this section and repeal of Pub. L. 110–234by Pub. L. 110–246effective May 22, 2008, the date of enactment of Pub. L. 110–234, see section 4 ofPub. L. 110–246, set out as an Effective Date note under section 8701 of Title 7, Agriculture.
Transfer of Functions
For transfer of certain enforcement functions of Secretary or other official in Department of Agriculture under this chapter to Federal Inspector, Office of Federal Inspector for Alaska Natural Gas Transportation System, and subsequent transfer to Secretary of Energy, then to Federal Coordinator for Alaska Natural Gas Transportation Projects, see note set out under section 2002 of this title.
LII has no control over and does not endorse any external Internet site that contains links to or references LII.


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tekenaars Artist: Adrien Floch
Artist Adrien Floch
Beschikbare series in de webshop categorie "Stripboeken"
Adrien Floch in the
"Adrien Floch was born in Paris, but settled in Aix-en-Provence and eventually in Brussels, Belgium. He took part in several comic contests. During one of these contests, he met Jean-Blaise Dijan, with whom he created the series 'Fatal Jack', of which three volumes were published by..." [ Lees meer ]


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Peach Bottom to offer prizes for kids and $2 discount ride coupons on Thursday.
Delta, Pennsylvania –On Thursday, July 15, Exelon will sponsor Family Fun Night at the 12th Annual Mason-Dixon Fair. Employees from Exelon Nuclear's Peach Bottom Atomic Power Station in Delta will be on hand from 5-8 p.m. handing out prizes and $2 discount coupons to all fair attendees. The coupons are good for $2 off all-night ride bracelets on Thursday night only.
Peach Bottom has supported the Mason-Dixon Fair and its predecessor, the Delta Carnival in numerous ways throughout the years but this is the first time the station has sponsored a Family Fun Night. Proceeds from Family Fun Night will support the Mason-Dixon Fair and the Delta-Cardiff Volunteer Fire Company. Peach Bottom employees and their children will also be participating in the 2010 Fireman's Parade on Saturday July 17, tossing candy and prizes to families along the parade route.
"We look forward to supporting and participating in the Mason-Dixon Fair and Fireman's Parade each year," said Peach Bottom Site Vice-President, Tom Dougherty. "Peach Bottom will always be an integral part of this community and we are committed to supporting our local organizations and community events through annual outreach and education programs."
"Peach Bottom has supported the Mason-Dixon Fair and Delta-Cardiff Volunteer Fire Company for many years," said President, Doug Farrington. "That support continues this year with Exelon Family Fun Night, which will help us raise funds while lowering fair costs for local families."
While Peach Bottom Atomic Power Station has a business mission to generate safe and reliable power to more than two million homes in the area, the station and its employees are very active in the community. Peach Bottom employees volunteer, host tours, visit area schools, mentor students, appear at community events and financially support dozens of civic organizations each year.
Exelon Corporation is one of the nation's largest electric utilities with more than $17 billion in annual revenues. The company has one of the industry's largest portfolios of electricity generation capacity, with a nationwide reach and strong positions in the Midwest and Mid-Atlantic. Exelon distributes electricity to approximately 5.4 million customers in northern Illinois and southeastern Pennsylvania and natural gas to approximately 486,000 customers in the Philadelphia area. Exelon is headquartered in Chicago and trades on the NYSE under the ticker EXC.


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|Print Page
black diamond
A competitor struggles to stay aboard a bucking bull during the Black Diamond Rodeo over the weekend. Thousands of fans saw the bull riding and other events Friday and Saturday nights at the county fairgrounds. C.J. McManus and the Sun Advocate want to thank the anonymous fan who turned C.J.'s missing camera bag over to the fairgrounds lost and found.
|Print Page


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By TERRY WILLISSun Advocate sports reporter
The CEU mens and womens basketball teams just completed a road trip that took them north to Salt Lake and then south to Ephraim to take on Snow. The men fell just short of beating SLCC with a 75-73 loss. They did squeak by Snow 66-65 for an important conference win.
The Lady Eagles did not fair as well. They dropped a close game to the Bruins with a 89-81 loss on Friday night. Then they lost another close game to the Badgers by the score of 69-66 on Saturday.
The Eagles are sitting in third place in the SWAC just one game under Salt Lake. The Bruins are at 9-4, CEU is sitting at 8-4 and CSI is currently at 7-5. Northern Idaho is on top at 10-2.
For the Lady Eagles, it looks like they will finish in fifth place in the conference. They sit at 3-10 in SWAC action and are 7-16 overall.
This weekend CEU will play host to CSI on Friday night with the women's game starting at 5 p.m. and the men at 7:30 p.m. in the B-DAC. On Saturday, NIC will roll into town with game times at 3:30 p.m. and 5 p.m.


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LEROY, NY - A doctor working to determine what is causing more than a dozen teenage girls to experience uncontrollable tics announced all the girls he has seen have tested positive for infections that could mean they are suffering from Pediatric Acute Neuropsychiatric Syndrome (PANS, formerly known as PANDAS.)
Dr. Rosario Trifiletti made his annoucement on the Dr. Drew Show on the cable network HLN.
"I can tell you that they are testing positive for, each one is testing positive either for streptococcas or mycoplasma, which are known triggers of the PANDAS/ PANS Syndrome," said Trifiletti.
Trifeletti was called for a second opinion by parents in LeRoy who aren't satisfied with the initial diagnosis, conversion disorder, given by the doctors at DENT Neurological in Amherst.
There are some parents who are satisfied with that diagnosis.
Dr. David Lichter, a Clinical Professor of Neurology at the University at Buffalo has examined one of the affected girls, and says it appears the girls are suffering from conversion disorder.
In fact, Dr. Lichter is warning that social media outlets like YouTube and Facebook might actually aid the spread of disorder.
"When you're being exposed also through videos and uploaded images to the same kind of phenomena, if you are a person who is vulnerable in some way, because of your own stresses and anxieties, and particularly if you identify with that individual, through some kind of an emotional bond through the kind of behaviors or in this case, movements that they're exhibiting," said Dr. Lichter, "Then I think there is a potential to create a further potential spread beyond that area that was initially involved."
Lichter says social media can be a double-edged sword in this case, and sometime people can seek support online as well.
Related Stories:


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Best of Sport
Beitar Jerusalem players and Bnei Sakhnin players congratulate each... News PhotoCongratulating,Football,Jerusalem,Match - Sport,Playing,Qualification Round,Sport,Sports Team,VerticalPhotographer -Collection: AFP 2013 AFP==ISRAEL OUT== Beitar Jerusalem players and Bnei Sakhnin players congratulate each other after their match at the Teddy Kollek Stadium in Jerusalem on February 10, 2013 during the teams State match qualification football game. The Beitar Jerusalem soccer club hosted the Israeli Arab team Bnei Sakhnin in a highly charged atmosphere, only three days after indictments were filed against four Beitar fans over charges relating to racism. AFP PHOTO / STR (Photo credit should read -/AFP/Getty Images)


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Product Details
Decorate and personalize any child's room with this sweet "C is for Chick" wall decal featuring Minnie and Daisy.
This custom wall decal can be modified with the text, colors, and art of your choice. Simply click "customize it" to enter our studio and change the design any way you please. Like all RoomMates, this personalized decal is removable, repositionable, and reusable, making it great for temporary decorating in bedrooms, playrooms, and more.
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text: While Price Main Street is torn up, the traffic lights are still functioning and the green appears to signal that the project is go. The project moved a step last week when construction entered the 200 East block in front of the county courthouse. Merchants along Main Street affected by the closure are having 'back door' promotions. The merchants remind Carbon County residents that the stores are not closed, but open for business as usual.


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9/11 Reconstruction
News about 9/11 Reconstruction, including commentary and archival articles published in The New York Times.
Ground Zero Arts Center to Shrink Further
Officials insisted that the proposed arts center should cost no more than $200 million — about half its original estimated cost.
July 24, 2015, Friday
MORE ON RECONSTRUCTION AND: Culture (Arts) , Lower Manhattan Development Corp , World Trade Center (Manhattan, NY) , Art
'World Trade Center Ship' to Travel to Permanent Berth in Albany
The remnants of an 18th-century ship, excavated five years ago in Lower Manhattan, will find a home at the New York State Museum for a proper display.
April 2, 2015, Thursday
MORE ON RECONSTRUCTION AND: Ships and Shipping , New York State Museum , World Trade Center (Manhattan, NY) , Lower Manhattan Development Corp , AKRF Inc , Emil, David , New York State , Hudson River
In Politics of Rebuilding Ground Zero, a Lone Critical Voice
John C. Whitehead, who was the chairman of the Lower Manhattan Development Corporation, criticized Gov. George E. Pataki for stopping plans for a cultural building at the World Trade Center site.
February 12, 2015, Thursday
MORE ON RECONSTRUCTION AND: Whitehead, John C (1922-2015) , Lower Manhattan Development Corp , World Trade Center (Manhattan, NY) , Pataki, George E
John C. Whitehead, Who Led Effort to Rebuild After 9/11, Dies at 92
A Navy veteran, Mr. Whitehead became a chairman of Goldman Sachs, deputy secretary of state and head of the corporation charged with rebuilding the World Trade Center site.
February 9, 2015, Monday
Out of Dust and Debris, a New Jewel Rises
The dazzling Fulton Center, opening Monday, is seen by some as Lower Manhattan's answer to Grand Central Terminal.
November 10, 2014, Monday
MORE ON RECONSTRUCTION AND: Stations and Terminals (Passenger) , Subways , Fulton Center (Manhattan, NY) , Manhattan (NYC) , September 11 (2001) , Metropolitan Transportation Authority , Restoration and Renovation
Plans for Ground Zero Arts Hub Shift Again
Instead of having one anchor, a performing arts center in Lower Manhattan is to be a multidisciplinary space.
March 27, 2013, Wednesday
MORE ON RECONSTRUCTION AND: Culture (Arts) , Joyce Theater , 1 World Trade Center (NYC) , Lower Manhattan Development Corp , World Trade Center (NYC)
Arts Center at Trade Center Gets $1 Million in Seed Money
The Lower Manhattan Development Corp. has authorized $1million for the Performing Arts Center at the World Trade Center site, a sum that is designed to allow the center to begin hiring staff members.
January 31, 2013, Thursday
MORE ON RECONSTRUCTION AND: Lower Manhattan Development Corp , World Trade Center (NYC)
Seeing Big Promise in Manhattan Corporate Apartments
Silverstein Properties, the developer of the World Trade Center complex, is converting the Beekman Tower Hotel into luxury corporate dwellings.
January 30, 2013, Wednesday
At Museum on 9/11, Talking Through an Identity Crisis
Exquisite sensitivities surround every detail in the creation of the National September 11 Memorial Museum, which is being built on land that many revere as hallowed ground.
June 3, 2012, Sunday
MORE ON RECONSTRUCTION AND: National September 11 Memorial and Museum , September 11 (2001) , Museums , Lower Manhattan Development Corp , Manhattan (NYC)
Board Named for World Trade Center Site's Planned Arts Center
The naming of a board of directors was necessary to gain access to funds from the Lower Manhattan Development Corporation.
December 30, 2011, Friday
MORE ON RECONSTRUCTION AND: National September 11 Memorial and Museum , Ferer, Christy , Lower Manhattan Development Corp , Cuomo, Andrew M , Bloomberg, Michael R , Gehry, Frank , News , Harris, Patricia E , Menin, Julie , Walt Disney Company|DIS|NYSE , Silverstein, Larry A , World Trade Center (NYC) , Walt Disney Company
Reviving Ground Zero
The Times's David W. Dunlap describes how the new World Trade Center complex is taking shape.
Tangible Progress at the World Trade Center
Photographs from the Times's Fred R. Conrad provide an intimate view of construction at the site of the World Trade Center.
The New World Trade Center
Panoramic views of 1 World Trade Center show the progress of building.
The Freedom Tower Rises
Steel at 1 World Trade Center is more than 100 feet -- the first time a structure has stood so high at ground zero since 9/11.
The $250 Million East Bathtub at Ground Zero
An incessant din resounds for some 20 hours a day as hundreds of workers and mammoth mining machines excavate the foundations for two future office towers at Church Street between Liberty and Vesey Streets in Lower Manhattan. The pit is framed by 85-foot-tall concrete walls that hold the Hudson River at bay. Because a site preparation deadline was missed, every day of delay costs the Port Authority of New York and New Jersey $300,000 in penalties.
Slide Show: Changes to the Freedom Tower Design
The Lower Manhattan Development Corporation released new designs for the Freedom Tower.
More On 9-11 and Its Aftermath
Rss Feeds On 9/11 Reconstruction
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|Jobs, Grant Money Coming to Area
|Written by Steve Frank
|Thursday, 25 October 2012 06:27
Gov. Bev Perdue had good economic news for the area yesterday in two announcements. The Governor announced that Woodgrain Millwork Inc, a leading producer of wood millwork, will locate a new facility in Caldwell County. The company plans to create 170 jobs and invest more than $8 million
over the next five years in Lenoir. The project was made possible in part by a $635,000 grant from the One North Carolina Fund. Woodgrain Millwork is a family-owned company headquartered in Fruitland, Idaho, according to the state release, with Woodgrain's millwork product lines including moulding, doors, and windows. The company currently employs more than 180 people at its facilities in Richmond and Union counties. Salaries will vary by job function, but the average annual wage for the new jobs will be $29,981, plus benefits, just above the Caldwell County average annual wage. "The decision to open a facility in Caldwell County was based on the access to a workforce with wood manufacturing experience from the furniture industry as well as the strategic location within our southeast distribution coverage area," said Kelly Dame, CEO of Woodgrain Millwork, Inc. "The expansion of Woodgrain Millwork with this state of the art facility is a direct result of our partnership with the various North Carolina State Agencies.
The Governor also announced yesterday that the North Carolina Commission on Volunteerism and Community Service has awarded more than $3.3 million in grants to 11 AmeriCorps programs across the state for the 2012-2013 program year. "North Carolina AmeriCorps programs help make a positive difference in our communities," said Gov. Perdue. "I am proud of AmeriCorps members for the services they provide by mentoring our youth, assisting the elderly, increasing literacy rates and helping to end homelessness. With these grants, North Carolina can continue its efforts in giving back to its citizens while investing in the future." AmeriCorps members serving with these organizations will assist in community outreach and education efforts, provide conservation services, participate in mentoring programs and work in other service activities. Carolina Mountain Land Conservancy, a 425,600 grant to fund Project Conserve: Members address critical conservation needs in Western N.C. by conducting environmental education and outreach activities, recruiting and coordinating volunteers for local conservation projects, and providing direct service to support key conservation initiatives. The program offers services in Alexander, Alleghany, Ashe, Avery, Buncombe, Burke, Caldwell, Cherokee, Cleveland, Graham, Haywood, Henderson, Jackson, Lincoln, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Watauga, Wilkes and Yancey counties.
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Oak Circle Plaintoe
Item # K59353
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DetailsIt really is all in the details. The Oak Circle Collection showcases our attention to traditional craftsmanship with detailed designs in full grain leather while continuing to reflect changing needs of the modern man. Equipped with adiPRENE technology, padding at the collar and tongue, and odor-stopping antimicrobial lining. Long live your new look.
Highly shock-absorbent cushioning protects the heel at impact
Oak Circle Plaintoe is rated out of 5 by 1.
Rated 3 out of 5 by Wyorattler from Ok but got it for a great price. Had I paid what appears to be what is the current price I would have been upset. I bought them on sale for $50. If you are planning on using these for a business work shoes they will not be kind to your feet. The look nice and are light weight. However if you plan to wear them for eight hours or longer you might want to look for something else.
Date published: 2014-05-29


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#TBT Style Spotlight: Audrey Hepburn
- 1 of 6
If you fancy a stylish throwback, then be sure to tune in every week for our most recent style retrospect, and how to shop the look!
- 2 of 6
Who: Audrey Hepburn
When: 1954
Where: Filming Sabrina
Why: Who better to take style lessons from than an original style icon?
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Topshop Mensy Throw On Jacket ($120)
This jacket is a simple and polished way to add a menswear-inspired element to your look.
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Michael Kors Pleated Linen Shorts ($595)
Paired with chic sandals, these would be perfect for a weekend getaway.
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CF Concept Suede Hoops ($93)
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Mensy Throw On JacketTopshop, $120
Plaid Button-Down ShirtLily Aldridge for Velvet, $114
Pleated Linen ShortsMichael Kors, $595
Suede HoopsCF Concept, $93


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LINCOLN — Before a brutal, four-game stretch of crossover games, Lincoln High was sitting nicely atop the Division I-North standings with an unbeaten 8-0 mark.
It's a little different now.
Facing some of the upper-echelon of squads from I-South and I-Central over the last week, the Lions suffered their third setback in the last four games Tuesday afternoon with a 5-1 loss to Bishop Hendricken at Chet Nichols Field. The Hawks belted out 11 hits and had a quality start from lefty Tim Pannone to improve to 9-2 for the spring.
Lincoln dropped to 8-3 and is tied with Moses Brown (a 4-3 winner over Chariho on Tuesday) for first in the division. The Lions defeated Portsmouth (2-7 in I-South) this past Saturday, but lost their other two games last week to North Kingstown (9-2 in I-South) and Cranston West (7-3 in I-Central).
"In the crossovers, I think Cumberland and us have the most difficult schedule," assessed Lincoln coach Ed Hunt. "But like I said to our kids we are going to go back to our division rivals and we have to make those games count again. If we beat those team twice in our division we can win the division. That's the goal. Hopefully, we'll improve as time goes on."
Lincoln's biggest problem early in the game was dealing with Pannone. Before leaving after the fourth inning with an 85-pitch count, the junior southpaw stymied the Lions bats, striking out eight and yielding just three hits.
"He threw hard," Hunt said. "He kind of picked up in the first inning and started striking guys out. His out-pitch was a high fastball. It worked originally and then we kind of laid off. He had a hard curveball and we got three lefties in the lineup. We are not accustomed to seeing real quality, left-handed pitchers. He had three pitches going for him today. He had a good, giddy-up on his fastball, he had a good curveball and a changeup…He was very challenging."
"He did a great job," Hendricken coach Ed Holloway added. "This was his first start. He threw the ball really well for us and did a great job.
The Hawks' offense made it easy for Holloway to make the decision to take Pannone out as it held a 3-1 lead at that point. Hendricken went to work right away on Lion starter Zach Perry with three hits in the top of the first, including an RBI double by Pannone and a run-scoring sacrifice fly from Bobby Indeglia. The Hawks tacked another run in the second with Baron driving home Conte (single) with a base hit.
Lincoln was able to chop into the deficit in the bottom of the third with speedy Matt Sorkin (2-for-3) leading off the frame with a double to shallow left field. Tyler Santaniello plated Sorkin with a two-out, RBI single.
Hendricken caught a break in the fifth to break the game open. With two outs and Chase Sullivan on second after a fielder's choice and a stolen base, P.J. Murray hit a high fly ball to left field that hit the top of the glove of outfielder Dan Cameron. The error allowed Sullivan to score and then designated hitter Mike Flood put the Hawks up by its eventual 5-1 score with a run-scoring double to center.
"My starting leftfielder (Max Blais) sprained a finger in a game Saturday night against Portsmouth sliding into third base," Hunt said. "He's a sophomore out there. It looked like he had a good beat on it. He just misjudged it a little bit and it went off the top of his glove. That kind of put it away for us.
Hendricken was able to maintain its cushion with quality relief pitching from Nick Panarello and Cody Perras, who retried the final nine batters. The Hawks, who went into the contest after dropping a 9-0 loss to North Kingstown this past Saturday, had an error-less defense.
"We play a good game all-around," Holloway said. "Coming off a tough loss to NK, I was concerned because Lincoln is an excellent team. I was concerned coming into the game, but pitching is the name of the game. Tommy did a tremendous job for us. Nick Panarello and Cody Perras did a nice job. I am really happy with the overall effort."
Despite absorbing the loss on the mound, Hunt was pleased with the performance of Perry, who limited the Hawks to three earned runs.
"I think Perry pitched a great game," he said. "He's a competitor. He didn't fold. That's a very potent lineup. I was pleased with the fire in his belly. We just didn't hit today."
Lincoln will try to get back to its winning ways when it returns back to its I-North slate. The Lions face a strong Cumberland squad on Thursday night at Chet Nichols Field. The Clippers, owners of a 7-4 mark, have won four of their last five games, including victories over North Kingstown and Cranston West.
"Cumberland is a very good team," Hunt said. "They have beaten more of the better teams than we have. I have a lot of respect for them. They hit well. If their pitching is on, we are going to have our hands full."
[1] http://www.pawtuckettimes.com/sites/default/files/aaaaaalincbase.jpg
[2] mailto:email@example.com


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phone: view phone857-404-0170
website: http://www.bostonreadwrite.com
Your child is doing well in school. We think your child can do better. Call CHUNGDAHM ReadWrite after school and summer learning center for a free trial class.
phone: view phone617-244-9540
website: kumon.com
We are the teachers/owners of the Newton and Belmont. Kumon Centers. We offer free testing/orientations which guide us in our individualized programs in Math and Reading serving grades Pre-K through 12th. Jane Chiong, Ed.D. &Winston Chiong, Ph.D.
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website: http://www.facebook.com/schenabacus
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phone: view phone(781) 444-5193
website: http://commlearn.com/home
Commonwealth Learning Center is a non-profit educational center established in 1988 by the Stratford Foundation. We offer 1 to 1 tutoring to children and adults to help them increase academic skills and reach their full potential.


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Seven other US Senate Democrats joined Frank R. Lautenberg (NJ) in expressing concern over Atlantic offshore seismic tests planned as part of the Obama administration's 2012-17 Outer Continental Shelf management program.
"While we support your administration's decision not to allow lease sales for offshore oil and gas drilling in the Atlantic Ocean, the proposed seismic testing poses a serious threat to our coastal economy, environment, and marine life," they said in a Jan. 30 letter to US President Barack Obama.
Seismic testing off the US Atlantic coast from Delaware to the middle of Florida "could injure or kill thousands of marine mammals and fish, including endangered species…in addition to moving the region closer to risky offshore oil drilling," the letter noted.
In addition to Lautenberg, Sens. Sheldon Whitehouse (RI), Patrick J. Leahy (Vt.), Robert Menendez (NJ), Benjamin L. Cardin (Md.), Barbara A. Mikulski (Md.), Barbara Boxer (Calif.), and Maria E. Cantwell (Wash.) signed the letter.
Contact Nick Snow at firstname.lastname@example.com.


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|Print Page
Divided we stand, united we fall, or sometimes
Have you ever sat in a room with a group of people you kind of know while a political television show or a presidential debate was going on via a television set in the room?
Letter to the Editor: Once again....
Once again we approach election time. We will be selecting a president and persons to represent our state in congress.
A prediction
It's time to throw my hat in the ring predicting the 2012 election results. So here it is: Barack Obama will be defeated. Seriously and convincingly defeated. Not due to racism, not due to the forces of reaction, spending, rejecting God, economy, no...
|Print Page


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I need to drop Yahoo! since they will be charging for email services. I need a new provider.
I need:
- Pop access
- that it be free
I would like:
- no spam (filtering provider)
- no ads from the provider.
- Runs on a non-Microsoft OS.
I don't think that will do, since he doesn't want advertisements and that is what hotpop provides. Who knows, maybe he can just filter the ads out?hotpop.com
what advertisements?
Well, according to this it is supposed to email you advertisements:what advertisements?
It is at http://www.hotpop.com/details. *And It's Free!
How much does this account cost? Nothing, ever. This is not a trial period agreement, and there are no charges for any of our services, in addition to what you pay your current ISP. You will never have to send HotPOP any money. We generate the revenues necessary to pay for this service through OPT-IN Email Advertising. This means that we allow advertisers to send messages to you. These messages will not contain pornographic or adult material, and they will also not include MLM (Multi Level Marketing, Pyramid) schemes. These are legitimate companies offering you valuable products, services, and discounts. The information you provide on the signup form will allow us to only send messages that interest you. You are even able to block certain types of ads. Since the acceptance of these advertisements is part of your service agreement, these messages are not Spam. If you have a problem with a particular message, you must mail email@example.com. Do not send cancel-requests or remove-requests to the advertisers. The messages will contain information to identify it as a solicited message. For your privacy and security, we do not disclose your address to the advertisers, but rather an alias. We strictly regulate these messages and would appreciate any comments you have on them. If you do not want advertisements, you may participate in our premium Opt-Out Program which will give you access to all of HotPOP's features without any advertisements. We recommend that you sign up for the free account, and if you change your mind you can Opt-Out at any time.
BTW...I just signed up for their service, so don't think that I am putting them down.
Yahoo will start charging now?I need to drop Yahoo! since they will be charging for email services. I need a new provider.
ok, I guess I just havent paid attention to them [advertisements], since i recv like 40 something emails a day
Yeah >
Yahoo will start charging now?
hmm .. im at http://www.gmx.com
they have pop access and no spam, the only problem would be their website is in german ....


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Mehndi Designs | May 07, 2010 | Comments 0
Mehandi Design Photos
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Latest & Stylish Bridal Mehndi Designs 2013 For Girls
Place for Mehndi Designs | Mehndi Design | Mehndi Designs Hands | Arabic Mehndi Designs | Mehndi Designs Arabic | Bridal Mehndi Design
Almost many mehndi designs are created by us in our own Beauty Parlor ( Bridal Henna Choice Lahore ), and many webmasters are using those images on there web sites. We are working and requesting to remove those images from there web sites.
All the images are the property of their respective owners. Some images found on this site have been collected from the web and are believed to be in the "public domain". So If you are the rightful owner of any design or other stuff posted here, and want to remove etc..., please contact us and it will be removed promptly. shamusasif ( at ) gmail.com


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Mountain Hardwear
Canyon Sun Hiker Cap (out-of-stock)
Out of Stock Product Number: 25602
Made from a nylon plainweave with a UPF of 50, this lightweight and breathable sun cap with a Coolmax sweatband provides full face coverage for long days on the trail. Mesh sides provide ventilation while wrinkle resistant, quick-drying, and durable fabric stands up to rough wear.
* This product does not qualify for shipping to all countries.
Gender: Unisex
Season: S13
Vendor ProductId: OM3991
Review ProductId: 25602


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The federal Bureau of Alcohol, Tobacco, Firearms and Explosives (still known as ATF) has come under fire for promoting three supervisors of a sting operation that led to the illegal sales of firearms to drug cartels in Mexico. At least 2,000 guns were reported lost in Operation Fast and Furious, many of them later found at crime scenes in Mexico.
Two were recovered at the site where U.S. Border Patrol agent Brian Terry was killed in Arizona last year.
The Los Angeles Times reported Tuesday that the three supervisors of the operation — William McMahon, William Newell, and David Roth — have been promoted to management positions at ATF headquarters in Washington. McMahon was the agency's Deputy Director of Operations in the West when the sting operation was carried out. Newell and Roth were field supervisors out of the ATF's Phoenix office. The news brought a quick response from Sen. John Cornyn (R-Texas), who last week sent a letter to U.S. Attorney General Eric Holder demanding to know about other alleged ATF operations similar to Fast and Furious.
Click here to read the entire article.


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Ripon, WI – Megan McCabe, a first-year player from Victoria, Minnesota (Holy Family Catholic) is the Beloit College Women's Soccer team's lone representative on the 2012 All-Midwest Conference Women's Soccer Team, released today by the Conference office. The team is selected by a vote of league coaches.
McCabe, a midfielder, was named to the Second Team. She finished the season with two assists but was more recognized for her ability to control the middle of the field and distribute the ball, as well as her help on the defensive end.
The Bucs finished the season with a 7-9-1 overall record, the most wins they've posted since the 2009 season.


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|Jeep Flips Twice, Zionville Man Hurt
|Written by Steve Frank
|Friday, 12 July 2013 05:23
Just before 2:30 Friday morning, a vehicle crashed into a utility pole in Foscoe, causing injuries to Nicholas Lee Strader, who was taken to Watauga Medical Center. Medics had hoped for an Air Ambulance for Strader, but weather conditions would not permit, although trooper Alexander
says they are working to transfer the 34-year old Will Isaacs Road man. Alexander said that Strader told him he was lighting a cigarette, took his eyes off the road, ran off of the road to the right, slammed into the utility pole, his 2004 Jeep overturning twice. It wasn't clear whether Strader was ejected—he didn't seem sure—but the impact damaged the utility pole so that BREMCO had to come to replace the pole. Nicholas Lee Strader is charged with Failure to Maintain Lane Control and Exceeding a Safe Speed for the Curve.
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Sample storage facility: Eckerd College, St. Petersburg, Florida ; Sediment sample source: collected during USGS Field Activity; Sample location: Florida, Inner West Central FL Shelf
|1 : [material from this subsample is not available]
|Additional data and information available for this sample: description (online); grain size analysis; other analyses: calcium carbonate content and total organic content. For select samples, mineralogy by XRD analysis and age dating by carbon 14 or Sr-isotope ratio.; USGS publication (online): Brooks, Gregg R., Doyle, Larry J., Suthard, Beau C., and DeWitt, Nancy T., 1999, Inner West-Central Florida continental shelf: sedimentary facies and facies associations: USGS Open File Report 98-796.


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- Musician's Friend Best Selection, Price & Service. Guaranteed.
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at: 800-449-9128
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The MB 200 wall/ceiling mount "U" bracket kit is designed to accommodate the System 200 installation in a...
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Insanely cool midnight blue leather platforms featuring a chunky box-shaped separated platform lined with gold detailing and a gold zip closure at back. Genuine leather lining. Looks killer paired with a sheer tank and a midi skirt! By Kat Maconie.
*Genuine Leather
*Height: 7.75"
*Heel Height: 5"
*Platform Height: 1.5"
If you're not utterly obsessed with your recent purchase, it's now so easy to send it back! All US returns can be completed online using our fast, hassle-free system. Check out the links below for more details.
Hair accessories, opened makeup, earrings, ear cuffs, panties and bodysuits cannot be returned.


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Jimmy Martinez was born on Aug. 2 1966. He went home to be with his father, mother, brother and sister in Oct. 2010.
He leaves behind five brothers, four sisters and a son he loved very much.
He leaves a void that can never be filled. He will be missed dearly by all.
Forever fishing!


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The Efavirenz (EFV) Central Nervous System Exposure Sub-study of Encore1 (ENCORE1-CNS)
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Persistent HIV infection in the central nervous system (CNS) compartment may put subjects at risk of developing HIV-related brain disease. Important factors associated with the development of HIV-related brain disease include therapeutic concentrations of antiretroviral drugs in the CNS. Conflicting evidence regarding the CNS exposure of the antiretroviral drug used for the encore1 study, efavirenz (EFV) have been described in related studies. There were recent study of two small series assessment of EFV exposure in the cerebral spinal fluid (CSF); one group reported small detectable EFV concentrations, while another observed undetectable EFV exposure in the CSF. Also, in a larger reported series comprising of 80 subjects on EFV-containing antiretroviral therapy, a CSF to plasma concentration suggested that there is limited movement of EFV out of the CSF. In HIV-1 infected subjects at steady state, EFV plasma level parameters are dose proportional following 200mg, 400mg, and 600mg daily doses. The CNS exposure of EFV at different daily dosing has not been described.
HIV Infection
Drug: Efavirenz
Phase 3
|Study Type:
|Study Design:
|Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
|Official Title:
|The EFV Central Nervous System Exposure Sub-study of Encore1: A Randomised, Double-blind, Placebo-controlled, Clinical Trial to Compare the Safety and Efficacy of Reduced Dose Efavirenz (EFV) With Standard Dose EFV Plus Two Nucleotide Reverse Transcriptase Inhibitors (N(t)RTI) in Antiretroviral-naïve HIV-infected Individuals Over 96 Weeks
- comparison of mean CSF concentration of EFV from both doses after week 24. [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]measure the CSF exposure of EFV when dosed at 400mg and 600mg daily. Efavirenz plasma and CSF concentrations will be analysed and CSF:plasma ratios will be compared. Associations between plasma and CSF concentrations and relationship to study clinical parameters will be assessed.
- CSF EFV exposure and plasma exposure (CSF:plasma ratio) using statistical analysis [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]The relationship between CSF EFV exposure and plasma exposure (CSF:plasma ratio), both for protein bound and free plasma EFV exposure.
- The relationship between CSF EFV exposure and neuropsychiatric side effects using questionnaires and medical assessments [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]
- The relationship between CSF EFV exposure and other study parameters such as race and sex. [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]
- The number of subjects with EFV CSF exposure greater than the postulated CSF IC50 for wild type virus (0.51ng/mL) [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]
- CSF HIV RNA measurement after 12 - 24 weeks of study therapy [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]
- Relationship between plasma HIV RNA and CSF HIV RNA [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]
- CSF biomarker analysis after 12 - 24 weeks of study therapy [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]
- comparison between magnetic resonance (MR) spectroscopy findings and CSF HIV RNA and EFV concentration [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]
|Study Start Date:
|September 2011
|Study Completion Date:
|February 2013
|Primary Completion Date:
|October 2012 (Final data collection date for primary outcome measure)
|Assigned Interventions
Experimental: Reduced dose Efavirenz arm
Patient's on main study that was randomised to receive TDF (300mg qd)/FTC (200mg qd) + EFV (400mg qd; 2 x 200mg + 1 x 200mg placebo qd).
Drug: Efavirenz
400mg qd; 2 x 200mg
Active Comparator: Normal Efavirenz dose arm
Patient's on main study randomised to receive tenofovir (TDF) (300mg qd)/emtricitabine (FTC) (200mg qd) + EFV (600mg qd; 3 x 200mg qd)
Drug: Efavirenz
600mg qd; 3 x 200mg qd
|Ages Eligible for Study:
|16 Years and older
|Genders Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- All subjects entering into the main study protocol at participating centres will be eligible to enter this sub-study.
Exclusion Criteria:
- Existing neurological disease which in the opinion of the investigator would be a contra-indication to lumbar puncture examination
- CNS opportunistic infections in the past 12 weeks of randomisation
- Bacterial or viral meningitis in the past 12 weeks of randomisation
- Head injury requiring medical assessment in the past 12 weeks of randomisation
Please refer to this study by its ClinicalTrials.gov identifier: NCT01451333
|Medical Group Practice
|Berlin, Germany, 10777
|HIVNAT Research Collaboration
|Patumwan, Bangkok, Thailand, 10330
|Khon Kaen University
|Khon Kaen, Thailand, 40002
|United Kingdom
|Imperial College, St. Mary's Hospital
|Clinical Trials Centre, Winston Churchil Wing, London, United Kingdom, W2 1NY
|Chelsea and Westminster Hospital
|HIV/GUM laboratory 5th floor St. Stephen Centre, London, United Kingdom, SW10 9NH
|Principal Investigator:
|Alan Winston, Dr.
|Imperial College London
No publications provided
|Responsible Party:
|Kirby Institute
|ClinicalTrials.gov Identifier:
|NCT01451333 History of Changes
|Other Study ID Numbers:
|Study First Received:
|January 5, 2011
|Last Updated:
|May 10, 2013
|Health Authority:
|Australia: Therapeutic Goods Administration
United Kingdom: Medicines and Healthcare Products Regulatory Agency
Keywords provided by Kirby Institute:
Central Nervous System (CNS)
Lumbar puncture
Dose reduction
Additional relevant MeSH terms:
Reverse Transcriptase Inhibitors
Anti-Infective Agents
Anti-Retroviral Agents
Antiviral Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Nucleic Acid Synthesis Inhibitors
Pharmacologic Actions
Therapeutic Uses
ClinicalTrials.gov processed this record on October 13, 2015


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Jordan Tuwiner wrote:I'd consider it. He's not the big bat the O's need, but I see him more as a solid hitter.
He'd be a nice addition, but he's not worth more than one of our #10-12 prospects IMO.
ofahn wrote:
I was just starting to compose a reply saying the same thing. Morales was still recovering from a serious leg injury last year, but it doesn't explain why his OBA went down. I think his real upside is that he will be playing in his "contract" year so he should be very motivated to put up good numbers. I like the switch hitter component, too.
IMO something like two of Clayton Schrader, Michael Belfiore, or Oliver Drake would be a fair price. All of those guys are about a year away from the ML and the Angels need bullpen arms. We have a surplus there.
ofahn wrote:I think his real upside is that he will be playing in his "contract" year so he should be very motivated to put up good numbers.
Matt P wrote:
ofahn wrote:
UM, yes; or I wouldn't have typed it.
At the time he signed he was one of the second generation, big money Cuban free agents. His agent is now Scott Boras. Boras counsels players in Morales' position about the importance of their contract year so he can get them big money on the market. Regardless of whom he plays for I would expect Morales to have a big year in 2013.
birdwatcher55 wrote:Not with Hamilton under contract. Morales will likely be batting sixth or seventh in that lineup .. not a spot to put up the big numbers Boras craves
osforlife wrote:I don't see the Angels trading him. The only player I see them trading is one of Vernon Wells and Peter Bourjos. Iannetta, Pujols, Kendrick, Callaspo, Aybar, Hamilton, Trout, Trumbo, Morales.
ofahn wrote:
I could see them trading him if:
1) they believe they can't find a market for Wells
2) they believe they need to add some ML ready (or almost ready) bull pen pieces
3) Boras advises him to become a squeaky wheel so he can get out of LA and be assured of playing time in his contract year
I can easily see any of those things happening.
osforlife wrote:1.) If they can't find a market for Wells, they'll trade Bourjos.
osforlife wrote:2.) They'll likely ask for bullpen pieces from Bourjos/Wells.
osforlife wrote:3.) I seriously doubt Mike Scioscia will play Vernon Wells over Kendry Morales. Morales is likely to DH almost everyday in LA just like last year.
osforlife wrote:Morales is gonna DH everyday.
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No prob Jessica :)
Raw food eggnog recipe
Prep Time
Total Time
Shelf LifeConsume immediately
Rating5/5 (from 7 ratings)5
- 1/2 cup cashews
- 1/4 cup dates
- 1 tablespoon coconut oil
- 1/2 teaspoon pure vanilla extract
- 1 teaspoon cinnamon
- 1 cup water
Recipe Directions
- 1. Blend until smooth.
- 2. Consume immediately.
The Rawtarian's ThoughtsBy The Rawtarian
This is my first fifth raw Christmas. One of the most important Christmas food traditions in my household is eggnog, so I knew I had to find a suitable SAD eggnog substitute.
There are no eggs in this recipe, but the coconut oil is the secret ingredient that adds the richness that we all know and love re: holiday eggnog. (If you don't have coconut oil, don't use any other oils as substitutes. Simply omit it.)
Think of this as an instant raw eggnog recipe. It's very rich and festive. Enjoy!
Nutrition Facts
- This recipe is very low in Carbohydrates, and Sodium.
- This recipe is low in Calories.
- This recipe is a good source of Protein, and Iron.
- This recipe is a noteworthy source of Dietary Fiber, Vitamin B6, and Vitamin K.
Amounts per 180 g (6 oz) suggested serving
|% Daily
|12 %
|7 g
|12 %
|22 g
|27 %
|25 g
|7 %
|Dietary Fiber
|3 g
|10 %
|14 g
|36 mg
|4 %
|2.6 mg
|20 %
|8 mg
Print This Recipe (PDF)
Related To This Recipe
Comments and Reviews
Top voted
So glad you enjoyed, Farah! I love cinnamon - it's one of my fave flavors : )
May 19, 2013
Lovely! Added some cacao to make it chocolatey, once again, another delicious recipe. Loving the oomph from the allspice, cloves cinnamon!
Dec 14, 2014
Teresa's Review
Raw food eggnog recipe
I love you!!!!!! This is delicious!!!!!! I added do two more ingredients ice and 1/2 bannna (got the idea from your post of first receipe). I drank both serving ( greedy me)
This is my second attempt trying to live a Raw Life... Nothing about being in a kitchen hold my interest.. (I'm trying to get out of that). With your recipes I'm going to attempt the Raw life again.
I don't know how I found you but I'm so grateful that I did!
Thank You,
Aw, Teresa, thank YOU for your compliments! You can do it - go easy on yourself and try not to 'do it all' at once! :)
Hey I am going to try this recipe too but do you still have the one from last year (with the bananas)? It was delicious!
Aw, I love that you remembered! This wasn't a fave version so I overwrote it. Sorry! *kiss!*
Sep 01, 2014
Delicious! I was very skeptical but when I tasted it, WOW! Followed recipe exactly and it was perfect for me.
Thanks for sharing. I'm so glad you liked the eggnog!
Kathy Everett
Jul 05, 2014
Kathy Everett's Review
Raw food eggnog recipe
Love this! I have been missing eggnog SO much! I tried it just as written but wasn't quite getting the "eggnog flavor" - though the texture was heavenly. I added a dash of nutmeg and a small amount (maybe 1/4 tsp.) rum extract along with some ice cubes and it tastes just like the eggnog I remember. Can't wait to have it this Christmas - does anyone know if you can make a batch and keep it in the refrigerator, or would it separate?
Nice tweaks Kathy! It will separate in the fridge, so best to make right before eating :)
Mar 30, 2014
I add a little maca in my eggnog. It gives it a little more nog flavor.
Nice Rawbin
Feb 11, 2014
Heaven in my mouth!! Thank you so much!!
Now there's a great description. Thanks, Celine!
Jan 12, 2014
This sounds so good. When you say 1/4 cup dates, do you cut them up to measure them? I get medjool dates and they are big! Thanks!
Hi Barbara,
I just pit my Medjool dates, and smoosh them down into the cup (rather than chopping them) to save time. :-)
Dec 26, 2013
Woah! It changed. I'm going to try this version too- but in case I want to go back to the bananas- it's 4 bananas in place of the cashews right?
Hi Jessica!
Yes, sorry, I made the banana one again this year and didn't care for it, so I replaced the old recipe with this new one :)
The old recipe:
5 ripe bananas
1 cup cold water
1 tablespoon agave nectar
1 tablespoon coconut oil or coconut butter
2 teaspoons vanilla extract
1/2 teaspoon cinnamon
1/8 teaspoon cloves
1/8 teaspoon allspice
1 pinch of sea salt
1. Blend until smooth.
2. Taste. Add more cinnamon, cloves or allspice to taste.
3. Consume immediately. If refrigerated, the texture will change and become more of a pudding, so consume this raw food eggnog recipe immediately.
Hope this helps!
Dec 22, 2013
Im new to the app but would like to ask if you got nut free recipe discovered for us? ;-)
Hi Gizmuf, Yes! In the app, when you're looking at the categories (click "recipes" in bottom bar) then you will see a list of categories, starting with "raw cakes, cookies and bars". If you scroll down to the BOTTOM of this list, you will see these categories: "raw nut-free savory recipes" and "raw nut-free sweet recipes"
Dec 22, 2013
keyla's Review
Raw food eggnog recipe
This is absolutely delicious!! I did not have dates so I added coconut sugar instead. It was perfection! Thanks for sharing this recipe.
So glad you loved it, Keyla :)
Dec 21, 2013
What a great recipe! Eggnog isn't really big here in Australia but I'm planning on introducing it to my family this year :) Just a quick question about the coconut oil - should it be a liquid or is it alright to add it in when it is a solid since it gets blended?
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Posted by Kevin Arnovitz on Wed, 06/28/06, 05:06pm:
Category: General
Posted by: Kevin Arnovitz
- Charlotte ranked 28th of 30 teams in offensive efficency. They've got a nice defensive stopper at the wing with Gerald Wallace -- a guy who can hide Adam Morrison if need be. I don't think that Morrison is the defensive liability that most think he is. And let's face it -- the Bobcats need some guys who can move off the ball.
- I like Aldridge in Portland -- particularly with the imminent departure of Przybilla. I'm perplexed with the poo-pooing by the ESPN experts. Let's wait and see with Thomas. I'm not sold on Athletes. Darius Miles? Stromile Swift, no?
- Atlanta did well. I know they need a point, but at least they didn't choose yet another wing player. He should be a solid 13-8 guy, top 5 in blocks, 3rd team All-Defense by his qualifying year.


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Are you a galactic superstar? In this BrainPOP movie, Tim and Moby will teach you how to be one by learning about the wonders of galaxies, those massive clusters of stars, gas, and dust. Learn just how many zillions of objects a galaxy can have (okay, a zillion isn't a real number...) in addition to what exactly is lurking inside each galaxy. You'll find out about our own spiral Milky Way galaxy, as well as other galaxies that have different shapes. And you can discover the way galaxies behave — how they're speeding away from each other and what happens to a galaxy at the end of its life. It's a galaxy of fun!
Learn More:Can you tell me about galaxies? Are we able to observe the nearest galaxy to ours?Are other galaxies bigger than ours or smaller?
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Results 1 to 14 of 14
- 11-04-2012, 07:05 PM Thread Author #1
4G LTE or 32 GIG
IMHO Apple makes it difficult to choose an iPad. I have pretty much decided on the Retina 4...
Now I have to decide on 4G or using the extra 100 bux for a 32 GB model.
Most people don't end up with the 4G. Interested in hearing your feedback.
4G LTE or 32 GIG
Really depends in your scenarios for using it. Are you mostly on wifi? When you're not, do you have access to another device such as a phone that can get online? If yes, then you have to decide if 1) you are willing to use just the phone when you are out, 2) you can tether the phone to get online with the iPad, or 3) you don't have another device or are not able or willing to tether.
I've had both versions and didn't use the cellular capability nearly enough to be worth the $130 cost premium.
One other thing to consider is that with the 3G and/or LTE iPads you also get GPS even if the cellular plan is not active. You will not have GPS on the wifi only iPads.
- 11-04-2012, 07:38 PM Thread Author #3
Re: 4G LTE or 32 GIG
Hi - Are you saying if I get the LTE iPad and don't activate the cellular, I can still use the GPS (does that include the GPS apps?)
in the car? That would seal it...
- 11-04-2012, 08:44 PM Thread Author #5
Re: 4G LTE or 32 GIG
thank you, that seals it.
- 11-04-2012, 08:54 PM Thread Author #6
Re: 4G LTE or 32 GIG
you sure, you don't need an internet connection?
4G LTE or 32 GIG
Yes I'm sure but hopefully someone else on the forums will chime in to confirm.
- 11-05-2012, 06:23 AM #8iMore Genius
- Posts
- 6,070 Posts
- Global Posts
- 6,451 Global Posts
- iOS Version
- iOS 8
4G LTE or 32 GIG
It would have to be a 3rd party GPS mapping app that preloads maps. I'm sure someone with experience with those apps will chime in on which ones work best.
4G LTE or 32 GIG
True. GPS would work without cellular service but you would need to have the maps downloaded while using wifi. Apple Maps would probably work as well as long as you looked up the directions beforehand. Several blogs tested the Apple Maps offline and said that the amount of data cached was perfectly adequate for most navigation.
4G LTE or 32 GIG
Hers some articles about the caching and using Apple Maps while offline:
- 11-06-2012, 12:51 PM #11iPhone Beginner
- Posts
- 83 Posts
- Global Posts
- 121 Global Posts
- iOS Version
- iOS 6.0.1
4G LTE or 32 GIG
Dude don't get the cellular unless u absolutely have to. I'm in the same boat as you, I need 32GB but I kinda wanted the LTE, but then I realized I always have my phone with me so I can just tether my iPad from my iPhone. And besides, there's WiFi everywhere nowadays , AND it's an iPad 4 so I'm guessing your like me and its gonna mostly be at home or at family/girlfriend/friends houses and not always with you so with WiFi only you are set. Don't spend the extra $130 on cellular that u will have to pay extra for as well, spend the extra $100 and get more memory
Sent from my iPhone 5 using Tapatalk
- 11-10-2012, 11:13 PM #12iPhone Newbie
- Posts
- 11 Posts
- iOS Version
- 6, 5.1
Re: 4G LTE or 32 GIG
Let me start of by saying, it entirely depends on what you plan on doing with it (and where you are for 3G/4G service). 4G iPad is amazing, and I say it's definitely worth it. Something incredibly convenient about having an always-on 4G LTE connection (assuming your area is covered well - mine is).
If you don't think you'll use the 4G when you're not on WiFi, then don't worry about it. Go with the additional memory.
- 11-16-2012, 08:50 PM #13iMore Genius
- Posts
- 5,384 Posts
- Global Posts
- 5,434 Global Posts
- iOS Version
- Newest
4G LTE or 32 GIG
I made this same decision today I got the iPad 4 .. 4g ... Too many times I needed Internet and didn't have it so this time I went 4g life problem solved lolMaverick: Started up on a 6, when he pulled from the clouds, and then I moved in above him.
Charlie: Well, if you were directly above him, how could you see him?
Maverick: Because I was inverted.
- 11-17-2012, 09:47 AM #14iPhone Beginner
- C.G - iPad Mini - 32 GB iPhone 5 - 32GB Retina MacBook Pro. 15'' - 2,3 Ghz. Quad-Core i7 - 8 GB RAM - 256 GB SSD - Mid 2012
- Posts
- 52 Posts
- iOS Version
- iOs 6.0.1
Similar Threads
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LOUISVILLE The St. Lawrence River Valley Redevelopment agency is looking to create new jobs in Potsdam.
The River Agency, in partnership with St. Lawrence County Industrial Development Agency and the Local Development Corp., has granted a $51,500 loan to First Class Aire LLC, which offers heating, ventilation, air-conditioning, recycling and waste treatment services, with the expectation that it will create new jobs.
The company will help to reduce the waste stream by expanding the salvage and recycling capacity, according to the resolution, which was adopted by the board at its meeting Tuesday night.
River Agency Chairman Robert O. McNeil and Louisville representative Thomas J. Carroll Jr. were absent.
Since First Class Aire moved to 495 W. Parishville Road, Potsdam, in February, it has been seeking funds in order to expand its services into commercial electronic waste, said Thomas A. Plastino, St. Lawrence County Industrial Development Agency deputy CEO and CFO.
The money will help the company buy new equipment and machinery such as roll-off containers and scales, leaving them more room to expand and hire more help, Mr. Plastino said.
The company plans to hire three full-time and two part-time seasonal workers.
The loan also will help retain four new jobs already created by the company, Mr. Plastino said.
Thousands of readers like you have made Northern New York Newspapers the number one ranked website* for local news and sports coverage in the north country.
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Every two hours, every night, an alarm goes off in Taylor and Joy Buckminster's bedroom.
And every two hours, every night, Taylor or Joy gets up and checks their daughter's blood sugar.
Every two hours, every night, an alarm goes off in Taylor and Joy Buckminster's bedroom.
And every two hours, every night, Taylor or Joy gets up and checks their daughter's blood sugar.
This is a routine the parents have had for the past two years. And there have been times when someone didn't wake up for an alarm.
"There are times that you're so exhausted, you may sleep through one alarm, and all of a sudden, you just have this gut-wrenching feeling that you just fly out of bed," Taylor Buckminster said.
In about two months, the Buckminsters, of Enid, will receive an $18,000 diabetic alert system that will better enable them to predict their daughter's blood sugar.
The system is about 40 pounds, about 8 months old, and goes by the name Memphis.
Kaleigh will be the first to tell you that she cannot wait for her diabetic alert dog to show up.
"I love him," she said.
Many people are familiar with other types of service dogs, those that help the blind, or help police officers detect drugs.
The Buckminsters will get Memphis from the National Institute for Diabetic Alert Dogs, one of the first companies in the nation to train dogs for this specific purpose.
Committed partner
The family has held at least nine fundraisers to raise money to buy Memphis, who will cost $18,000. So far, they have about $15,800. It's recommended that Memphis eat special food, which costs $50 per bag. Add veterinary bills, and the family is looking at taking on a significant commitment.
But the family understands the cost of Memphis, and more than that, they appreciate what he can bring to their family.
Kaleigh was diagnosed with Type 1 diabetes when she was 13 months old. Type 1 diabetes is a lifelong disease in which there are high levels of sugar in the blood, according to the National Institutes of Health.
Kaleigh was diagnosed after being sick for three weeks. After several doctor's appointments, her parents took Kaleigh to the emergency room.
When hospital staff took Kaleigh's blood sugar, it was 868. A normal range for Kaleigh would have been 80 to 180. Her blood sugar was so high, the hospital staff thought its machine was broken.
"They've told us several times that it's a miracle she's still with us," Joy Buckminster said.
Continue reading this story on the...


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Historical Route 66 Increasingly Threatened By Development
Route 66 carries little traffic on June 16, 2007 east of Daggett,... NachrichtenfotoAuto,Bedrohte Tierart,Eingemacht,Geschichtlich,Kalifornien,Klein,Nachrichtenereignis,National Trust,Richtung,Tragen,USA,Verkehr,VermischtesPhotographer David McNewCollection: Getty Images News 2007 Getty ImagesDAGGETT, CA - JUNE 16: Route 66 carries little traffic on June 16, 2007 east of Daggett, California. Route 66 opened in 1926 stretching from Chicago to Los Angeles and became a western migration route for people looking for work during the great depression of the 1930's or to escape the Dust Bowl disaster. Later it offered vacation getaways and driving adventures until 1985 when it was decommissioned as a federal highway. Due to neglect and commercial development Route 66, the first highway to connect the Midwest with the West Coast, has recently been added to the biennially compiled list of the world's most endangered landmarks by the World Monuments Fund and the National Trust for Historic Preservation's yearly list of the 11 most endangered historic places in America. (Photo by David McNew/Getty Images)


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What Is Diphtheria?
Diphtheria is a highly contagious infection. It can be life-threatening. It is caused by specific bacteria. The germ produces a toxin that can spread from the site of infection to other tissues in the body. Diphtheria usually affects the throat and nose. In serious cases, it may affect the nervous system and heart.
Diphtheria spreads easily from person to person by coughing or sneezing. People nearby breathe in the infected droplets. In rare cases, they come into direct contact with elements from an infected person's mouth, nose, throat, or skin.
Because of a widespread immunization program, diphtheria is now rare in the United States.
What Is the Diphtheria Vaccine?
The diphtheria vaccine is an inactivated toxin called a toxoid. There are different types of the vaccines to prevent diphtheria, including:
- DTaP—given to children to protect against diphtheria, tetanus , and pertussis
- DT—given to children who cannot receive the pertussis part of the DTaP vaccine
- Tdap—given to children, adolescents, and adults to protect against tetanus, diphtheria, and pertussis
- Td—given to adolescents and adults to protect against tetanus and diphtheria
The vaccine is injected into the muscle.
Who Should Be Vaccinated and When?
The DTaP vaccine is generally required before starting school. The regular immunization schedule is to give the vaccine at:
- 2 months
- 4 months
- 6 months
- 15-18 months
- 4-6 years
Tdap is routinely recommended for children aged 11-12 years who have completed the DTaP series. Tdap can also be given to:
- Children aged 7-10 years who have not been fully vaccinated
- Children and teens aged 13-18 years who did not get the Tdap when they were 11-12 years old
- Adults who have never received Tdap
- Pregnant women during each pregnancy, optimal timing is between the 27th and 36th week of pregnancy.
- Adults who have not been previously vaccinated and who have contact with babies aged 12 months or younger
- Healthcare providers who have not received Tdap
Td is given as a booster shot every 10 years.
Catch-Up Schedule
Talk to a doctor if you or your child has not been fully vaccinated against tetanus.
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As with any vaccine, there is a small risk of severe reaction, such as a severe allergic reaction. Most people get the vaccine without any problems. The most common reactions are mild.
Mild reactions may include:
- Fever
- Soreness, redness, or swelling at the injection site.
- Fussiness in infants
- Fatigue
- Vomiting
More serious reactions include seizure, nonstop crying, fever over 105 degrees Fahrenheit (40.6 degrees Celsius), allergic reaction.
Very rare reactions may include long-term seizures, brain damage, and coma.
Mild reactions may include:
- Pain, redness, or swelling at the injection site.
- Low-grade fever
- Headache
- Nausea, vomiting, or diarrhea
- Fatigue
More serious reactions include fever over 102 degrees Fahrenheit (38.9 degrees Celsius), extensive swelling, severe pain, bleeding, and redness in the arm where the shot was given.
Mild reactions may include:
- Pain, redness, or swelling at the injection site.
- Low-grade fever
- Headache
- Fatigue
More serious reactions include fever over 102°F (38.9°C), extensive swelling, severe pain, bleeding, and redness in the arm where the shot was given.
Acetaminophen is sometimes given to help prevent pain and fever that may occur after getting a vaccine. In infants, the medication may make the vaccine weak. Talk with your doctor about the risks and benefits of taking acetaminophen. For children who have had a seizure in the past, controlling any fever may be important.
Acetaminophen is sometimes given to help prevent pain and fever that may occur after getting a vaccine. In infants, the medication may make the vaccine weak. Talk with your doctor about the risks and benefits of taking acetaminophen. For children who have had a seizure in the past, controlling any fever may be important.
Who Should Not Be Vaccinated?
You should not get the vaccine if you:
- Have had a life-threatening allergic reaction to a previous dose of the vaccine
- Suffer from a brain or nervous system disease within 7 days after a previous dose of the vaccine
- Have had certain conditions after a previous dose of the vaccine, such as coma or a seizure
- Are moderately or severely ill
Talk to your doctor if the person getting the vaccine has any nervous system problems or has had Guillain-Barre syndrome. Also talk to your doctor if your child has previously had a very high fever or nonstop crying after a previous dose of the vaccine.
What Other Ways Can Diphtheria Be Prevented Besides Vaccination?
Prevention depends on getting the vaccine and responding quickly to outbreaks.
What Happens in the Event of an Outbreak?
Suspected cases of diphtheria need to be reported right away to public health authorities.
In the event of a suspected or confirmed outbreak, close contacts are at risk. For close contacts, treatment includes:
- Getting a vaccine dose right away if one is needed
- Having samples taken for lab tests, taking antibiotics, and being followed closely
Revision Information
- Reviewer: David L. Horn, MD, FACP
- Review Date: 12/2014 -
- Update Date: 12/20/2014 -