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Treatment with selective vitamin D receptor activators such as paricalcitol have been shown to exert an anti-inflammatory effect in patients on hemodialysis, in addition to their action on mineral metabolism and independently of parathyroid hormone (PTH) levels. The objective of this study was to evaluate the additional antioxidant capacity of paricalcitol in a clinical setting.
The study included 19 patients with renal disease on hemodialysis, of whom peripheral blood was obtained for analysis at baseline and three months after starting intravenous paricalcitol treatment. The following oxidizing and inflammatory markers were quantified: malondialdehyde (MDA), nitrites and carbonyl groups, indoleamine 2,3-dioxygenase (IDO), tumor necrosis factor alfa (TNF-α), interleukin-6 (IL-6), interleukin-18 (IL-18) and C-reactive protein (CRP). Of the antioxidants and anti-inflammatory markers, superoxide dismutase (SOD), catalase, reduced glutathione (GSH), thioredoxin, and interleukin-10 (IL-10) levels were obtained.
Baseline levels of oxidation markers MDA, nitric oxide and protein carbonyl groups significantly decreased after three months on paricalcitol treatment, while levels of GSH, thioredoxin, catalase and SOD activity significantly increased. After paricalcitol treatment, levels of the inflammatory markers CRP, TNF-α, IL-6 and IL-18 were significantly reduced in serum and the level of anti-inflammatory cytokine IL-10 was increased.
In renal patients undergoing hemodialysis, paricalcitol treatment significantly reduces oxidative stress and inflammation, two well known factors leading to cardiovascular damage.
Keywords:Oxidative Stress; Immunomodulation; Receptors, Calcitriol; Paricalcitol; 19-nor-1alpha,25-dihydroxyvitamin D2
Oxidative stress is defined as the loss of balance between the generation of oxidants and the system's antioxidant activity, in favor of the former. The production of superoxide anion, a by-product of the respiratory chain from which most free radicals derive, increases with the activity of NADPH oxidase in response to certain stimuli, including proinflammatory mediators such as complement component C5a, interleukins, tumor necrosis factor, bacterial molecules, endotoxins, etc. [1]. Maintenance of this balance is crucial in biological systems, and cells are endowed with a molecular defense system, including antioxidant enzymes such as superoxide dismutase (SOD), glutathione peroxidase and catalase, as well as vitamins (A, C, and E) and reduced glutathione (GSH). Nevertheless, some conditions or disease treatments may have an effect on this finely controlled balance, causing oxidative stress that exacerbates the patient's condition. Such is the case of renal patients on dialysis; exposed to increased levels of oxidants due to their uremia [2,3], they have an additional load on the oxidative-inflammatory arm of this balance, caused by bioincompatible systems, adjunctive treatments (erythropoiesis-stimulating agents, intravenous iron therapy) and the antioxidant depletion caused by hemodialysis per se[4]. Oxidative stress in these patients leads to a state of malnutrition and accelerated cardiovascular disease [5,6].
The oxidant-antioxidant balance in renal failure has been previously studied, and dialysis treatment has been shown to increase lipid peroxidation in cell membranes and oxidation markers in the blood of treated patients [7], leading to cardiovascular dysfunction. Likewise, the characteristic apoptosis of peripheral blood leukocytes in renal patients has been associated with oxidative stress by depletion of intracellular thiol groups [8,9]. Given the body of evidence linking pathophysiological dialysis treatment with oxidative stress, which causes progressive worsening of renal patients, including cardiovascular morbidity and mortality [5,6], some authors have indicated that antioxidant therapy should be a central pillar of the preventive and curative treatment of renal disease [10,11]. Increasing evidence shows the prevalent role of vitamin D signaling pathways in redox homeostasis and cardiovascular disease prevention [12-15]. Vitamin D receptor (VDR) is present in many organs and displays pleiotropic effects; moreover, a recent clinical report indicated that intravenous calcitriol, as a VDR agonist (VDRA), reduces oxidative stress in hemodialysis patients [13].
The purpose of this study was to assess the effects of intravenous paricalcitol, a selective VDR agonist, on redox homeostasis and antioxidant systems in hemodialysis patients with secondary hyperparathyroidism (SHPT), as a possible added benefit of its use in these patients.
This study was approved by the Clinical Research Ethics Committee of Hospital General Yagüe (Burgos, Spain). All the patients included were fully informed and gave their written consent to participate. Eligible patients were naïve to vitamin-D analogues or derivatives, had undergone regular hemodialysis three times per week for at least 12 months before the study started, and needed treatment for SHPT, presenting PTH levels ≥ 300 pg/ml, serum calcium ≥ 8 mg/dl and serum phosphorus ≤ 5.5 mg/dl. Paricalcitol dosing depended upon the levels of calcium, phosphorus and PTH. Patients presenting with PTH levels ≥ 300 pg/ml, serum calcium ≤ 9.5 mg/dl and serum phosphorus ≤ 4.5 mg/dl received 15 μg/week, distributed in three hemodialysis sessions. Those with PTH levels ≥ 300 pg/ml, serum calcium > 9.5 mg/dl and serum phosphorus > 4.5 mg/dl received 7.5 μg/week, distributed in three hemodialysis sessions. Those participants who suffered infectious or inflammatory episodes during the active phase of the study period, or who had neoplasia, were excluded from data analysis, as were those who needed transfusions or replacement of their vascular access during the study. Other reasons for exclusion were adverse effects leading to a reduction in the paricalcitol dose or treatment suspension. In the case of hyperphosphatemia, patients were treated with non-calcium binders and a controlled diet. Any concomitant treatment the patients were receiving prior to this study was maintained without variations.
Blood samples for baseline determinations were collected from each patient after inclusion and just prior to initiating paricalcitol treatment. A second sample was taken at a follow-up visit after three months of receiving paricalcitol. Extractions were performed on the day between dialysis treatments. The paricalcitol dosage for each patient was calculated according to baseline calcium, phosphorus and PTH levels. Paricalcitol doses were maintained throughout the treatment period, and were reduced only in the case of hypercalcemia or hyperphosphatemia; however they could be increased if SHPT persisted and electrolyte levels were adequate. Whole blood was used for some measurements, using heparin as anticoagulant; serum was separated following a standard protocol.
Determination of inflammation markers in serum
The serum IL-6, IL-10, IL-18 and TNF-α levels were quantified using ELISA kits (R&D Systems, Minneapolis, USA). Serum CRP was measured using a high sensitivity turbidimetric immunoassay (hs-CRP), calcium using the calcium-o-cresolphthalein complexone method and phosphorus using the phosphomolybdate method. All were analyzed on a Roche/Hitachi Modular P analyzer ACN 210 (Roche Diagnostics, Basel, Switzerland). IDO activity was evaluated by measuring kynurenine in plasma according to Alegre et al.[16]. Serum PTH was quantified by electrochemiuminescence immunoassay, using a Roche Elecsys 1010/2010 analyzer (Roche Diagnostics, Basel, Switzerland). Each sample was analyzed in triplicate.
Analysis of oxidative stress-related parameters
SOD activity was quantified with the method developed by McCord and Fridovich [17], based on the production of superoxide radicals during the conversion of xanthine to uric acid by xanthine oxidase, and the inhibition of cytochrome c reduction. One unit of SOD activity was defined as the amount of SOD that produces 50% inhibition of cytochrome c reduction. Catalase activities were assayed using the method described by Claibone [18].
Reduced GSH levels were measured in blood using the protocol of Brigelius et al.[19] for glutathione-S-transferase. Plasma thioredoxin was determined with an ELISA kit (TRX ELISA Kit, Redox Bioscience Inc., Japan), and malondialdehyde (MDA) was measured by HPLC [20].
Protein oxidation was assessed with an estimation of carbonyl groups formed using the protocol described by Levine et al. [21]. Total protein concentration was determined by the Lowry method [22], using bovine albumin as a standard. The Griess reaction [23], frequently used to indirectly measure nitric oxide content, was performed for nitrite quantification.
Statistical analysis
All data are reported as mean ± SD. Comparison between parameter values obtained before treatment and three months after treatment initiation was performed using the paired Wilcoxon test for comparisons, since the sample size was too small for parametric tests. All statistical analyses were performed using software environment R, version 2.14.0 (Developed by international R project: http://www.r-project.org webcite).
The study included 19 renal patients on dialysis (15 male and 4 female), between 42 and 78 years of age (mean 68 ± 13.5), with two types of vascular access: arteriovenous fistula (n= 14) or permanent internal jugular catheter (n= 5). Etiology of kidney disease in our sample was diabetes mellitus (n= 2), nephrosclerosis (n= 12), polycystic kidney disease (n= 1), and vasculitis (n= 4). All patients received treatment with EPO alfa (mean dose 5842 ± 3610 U/week, SC) as an erythropoiesis-stimulating agent; 52.6% of patients were already receiving intravenous iron (5 mg/week) two months before initiating paricalcitol treatment and iron therapy was maintained at the same dose throughout the study; 63.2% of patients were taking statins to treat dyslipidemia, and 15.8% were on angiotensin-converting enzyme (ACE) inhibitors II or angiotensin receptor blockers (ARB). The dialysis vintage had a median of 43.1 months (max. 120 - min. 12 months). Dialysis was performed for all patients using a high-flux dialyzer with a polyethersulphone membrane filter (Elisio 210H), with effective surface area 2.1 m² and dialysis solution containing 1.25-1.5 mmol/l of calcium. This dialysis protocol was maintained throughout the study. All patients had received previous treatment for SHPT: six had received calcium-chelating agents, twelve other chelating agents and one calcimimetics. Baseline oxidation and inflammation parameters were similar in all patients.
Secondary hyperparathyroidism
The mean paricalcitol dose was 13.46 ± 3.98 μg/week and all patients included in the final analysis received paricalcitol for 12 weeks with no variations. All the patients responded to treatment, and endpoint values were compared to their baseline parameters. The dose and treatment schedule were based on the patient's calculated requirements, as indicated in the Methods section.
Baseline PTH, calcium and phosphorus levels are shown for all the participants (Table 1). High baseline PTH levels were significantly decreased after 12 weeks of treatment with paricalcitol, while both blood calcium and phosphorus levels were increased.
Table 1. Effects of paricalcitol on SHPT and electrolyte levels in our sample
Inflammation biomarkers
Interleukins in serum were measured in 13 patients. Paricalcitol significantly increased serum IL-10 levels. On the other hand, inflammatory cytokine levels, including IL-18, IL-6, and TNF-α were reduced after twelve weeks of treatment (Table 2). The reduction rate in serum was approximately 74%, 66%, and 53% for IL-18, IL-6, and TNF-α, respectively. However, no differences were seen in IDO activity as a result of the treatment.
Table 2. Inflammation markers in serum of patients before treatment initiation with paricalcitol and after 12 weeks of treatment
Oxidative stress biomarkers
Compared to baseline values, increased antioxidant concentrations were observed (Table 3), including the enzymatic participants (SOD and catalase), and non-enzymatic scavengers (GSH and thioredoxin). SOD, catalase, GSH and thioredoxin levels in blood were significantly higher: 3.74, 1.35, 1.77 and 1.65-fold the baseline values. We determined the carbonyl groups and MDA levels in plasma as parameters indicative of protein and lipid oxidative damage and nitrites. As shown in Table 3, all were found to be significantly reduced after paricalcitol therapy.
Table 3. Enzymatic antioxidant activity and oxidation markers in the blood of dialysis patients before and after treatment with paricalcitol
Our results suggest that treatment with paricalcitol, a VDR selective activator, has antioxidant and anti-inflammatory effects in patients on hemodialysis. This potential effect could be very beneficial for these patients, since they suffer redox imbalance due to the uremia caused by their renal condition [2]. Many treatments also induce oxidation and inflammation in hemodialysis patients, including intravenous iron therapy, erythropoiesis-stimulating agents, failed vascular access and intercurrent infectious processes [24]. Renal patients on dialysis are at risk of cardiovascular disease, due to the link of oxidative stress and inflammation with endothelial damage and immune system dysfunction and subsequent infections, perpetuating an oxidation-inflammation-infection cycle. Furthermore, the effects of the low activation of vitamin-D receptors are enhanced by the significantly reduced expression of these molecules in patients with chronic kidney disease (CKD), further contributing to endothelial dysfunction [14,15,25]. These circumstances lead inexorably to cardiovascular disease, which is a major cause of mortality in renal patients.
Therapy with vitamin D for hemodialysis patients was primarily designed to treat SHPT, regulating calcium and phosphorus absorption in the intestine and bone remodeling. This approach showed parallel benefits, as preclinical in vitro and observational studies found that treatment with a nonselective vitamin D activator (calcitriol) also decreased inflammatory markers [26,27] and had immunomodulatory effects [28], thus showing the potential to reduce cardiovascular damage and mortality, beyond the primarily intended control of SHPT [29]. Despite presenting excellent control of SHPT, and adding this anti-inflammatory effect, calcitriol treatment has the drawback of producing elevated serum phosphorus and calcium levels. This effect is caused by increased intestinal absorption of both electrolytes [30,31], and limits the usefulness of calcitriol in patients with severe renal disease, since the calcium and phosphorus overload cannot be adequately excreted by a failing kidney. However, the good clinical results obtained for VDRA agonists against SHTP and the need to reduce adverse effects has prompted further research for improved VDRAs. Therefore, the present study focuses on a second generation direct selective VDR agonist, 19-nor-1,25-dihydroxyvitamin D2, or paricalcitol. This selective VDRA has already shown improved effects on calcium homeostasis and SHPT treatment [31-33], controlling SHPT without increasing serum electrolyte concentrations to the levels induced by calcitriol [34,35]. In our sample, the beneficial effects on SHPT are clear, and although our patients did experience a significant increase in calcium and phosphate, the focus of our study was on other pleiotropic effects that have been reported.
The central findings of this study are the antioxidant effects of paricalcitol in a clinical setting. Redox homeostasis is a clinical concern in dialysis patients and, although hemodialysis with on-line regeneration of the ultrafiltrate has shown some improvement over conventional polysulphone dialysis in some parameters [36,37], the treatment is still related to oxidative stress, and patients undergoing hemodialysis with any of these techniques may benefit from concomitant treatments that could contribute to redox homeostasis. The anti-inflammatory/antioxidant effect of a VDRA was recently reported by Wu et al.[26], who carried out a study in hemodialysis patients with SHPT receiving calcitriol for 16 weeks. Paricalcitol had shown some promise regarding redox homeostasis in preclinical studies. Husain et al. designed an antioxidant strategy including enalapril and paricalcitol for ApoE-deficient atherosclerotic mice, since ACE inhibitors, such as enalapril, prevent formation of angiotensin II, which is known to induce free-radical generation. This combination demonstrated protective efficacy in aortic inflammatory and oxidative injury in this animal model [38]. Moreover, paricalcitol has also shown protective effects against oxidative stress in the cardiac tissue of uremic rats, through inhibition of NADPH oxidase activity [39], but there was still no clinical evidence of the anti-inflammatory/antioxidant effect of this selective VDR.
The increased levels of SOD and GSH with paricalcitol treatment found in our study follow preclinical findings with this selective VDR agonist. Since both GSH and SOD are the main contributors to cellular redox homeostasis, it is rather relevant that paricalcitol treatment seemed to increase the levels of these ROS scavengers, but we also found increased thioredoxin levels. A recent study on the effects of VDRAs on the thioredoxin pathway in endothelial cells in vitro indicated that paricalcitol did not modify thioredoxin expression or activity, although expression of its inhibitor, thioredoxin-interacting protein, was significantly reduced [40]. However, in vitro environments are rather limited and the higher levels of thioredoxin after paricalcitol treatment found in our study are consistent with the increase in other components of the antioxidant arm. The induction pathway of most of these antioxidant molecules by paricalcitol remains unknown, and further exploration of their signaling pathways could provide more information on the different mechanisms of paricalcitol and calcitriol, as suggested by their different effects.
Regarding the oxidation markers, the reduction in MDA levels by paricalcitol was also reported in an animal model, and it was postulated that the reason could be downregulation of RAS by vitamin D analogues [38]. The antioxidant effect of paricalcitol is further observed with the reduction of carbonyl groups and nitrites. The latter may be due to a previously described downregulation of eNOS and iNOS activity, which would respond both to an antioxidant and anti-inflammatory effect of VDR activation [38,41]. On the other hand, the reduced production of nitrites, MDA and carbonyl groups could also be a consequence of the increased antioxidant elements, i.e. GSH, thioredoxin and SOD, scavenging excess ROS before excessive oxidation can take place.
Modulatory effects on inflammatory and immune signaling pathways in vitro have been previously described, with significant reduction of proinflammatory cytokines IL-8, CRP and TNF-α and increased anti-inflammatory markers [12,42]. As previous studies have suggested, our results showed significant reduction of several inflammatory markers (CRP, TNF-α, and ILs 6 and 18) in CKD patients treated with paricalcitol, while IL-10, an anti-inflammatory cytokine, was significantly increased in the serum of our patients. No significant changes were found in IDO activity; these results have not been included in this study because IDO activity and kyneurine are increased in CKD patients and have been linked to atherosclerosis [43-45]. Permanent hemodialysis catheters are a well-known source of inflammation, and our patients had two different types of venous access, so we checked for differences in inflammatory markers between the patients with catheters and those with arteriovenous fistula, finding similar baseline and final results (data not shown), which finally allowed for a pooled analysis. Our findings are similar to those of Alborzi et al.[46], who observed a 20% reduction in CRP with paricalcitol. Navarro et al.[47] also found a significant reduction in CRP and TNF-α, while detecting higher levels of TNF-α/IL-10 and IL-6/IL-10 indices, showing an immunomodulatory effect as suggested by our own results. Our findings in this group are consistent with previous reports on clinical data and experimental studies in rats [12,42,48].
The results of this clinical study, conducted on 19 patients with hemodialysis, suggest another important effect of paricalcitol, regarding renal disease complications. This is the first report on the antioxidant effects of a VDR agonist, namely the selective agonist paricalcitol, in a clinical study involving renal patients. One limitation of this study is the absence of a placebo arm, as our study was performed in the setting of routine clinical practice and comparison with a control group was not possible. However, comparison of final values, with baseline analyses of the same patients acting as control, showed significant changes after paricalcitrol treatment; these very significant changes in so many different parameters are unlikely to be observed in an untreated control group as a result of spontaneous evolution. Moreover, these improvements in redox homeostasis could be observed after a short treatment period of three months indicating that, although the study period was very short, three months was also enough to observe significant changes. Since this study was conducted in a clinical setting and the patients were receiving concomitant medication, an association between oxidative stress/inflammation and other medications commonly adopted in dialysis patients, such as ACE inhibitors, ARBs or chelating agents could be suspected [49-51]. However, the participants' concomitant medication was started before the study and maintained without modifications during the study, so the possible effects of these drugs were constant. Although the laboratory results of the three patients who were receiving ACE inhibitors were well within the range of values obtained for the rest of the patients, we performed a sensitivity analysis excluding these patients to determine any influence that this medication might have in our results, but the level of statistical significance did not change substantially (data not shown). The main limitations are the small sample size and the lack of a control group or randomization, with possible selection bias, since the setting and circumstances in which it was performed did not allow improvements in this aspect.
Hemodialysis patients receiving this selective VDR agonist could benefit not only from SHPT control but also from anti-inflammatory and antioxidant effects that could improve their situation in terms of cardiovascular protection. We consider the results of this study promising, as improvements were seen in a very short follow-up period, although a larger trial comparing treatment with paricalcitol, other VDR agonists and placebo could provide conclusive data on the topic.
Competing interests
Dr de Francisco is consultant to Amgen Fresenius and has received speaker′s honoraria from Abbott, Roche, Rubió, Shire, and Genzyme on occasion. Dr. Izquierdo has received speaker's honoraria form Abbott on occasion. The other authors have no conflicts of interests regarding the contents of this manuscript, and the study has not received any funds from Industry.
Authors' contributions
MJI participated in the design of the study, performed patient selection, managed the data and drafted the manuscript. MC and PM carried out the biochemical analyses. AF and MA conceived the study, participated in its design and collaborated in the manuscript. JA participated in patient selection and PA in the design and coordination. All authors read and approved the final manuscript.
Medical writing assistance by Dr. Blanca Piedrafita from Medical Statistics Consulting S.L., Valencia (Spain) is acknowledged.
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Tan X, Wen X, Liu Y: Paricalcitol inhibits renal inflammation by promoting vitamin D receptor-mediated sequestration of NF-kappaB signaling.
J Am Soc Nephrol 2008, 19(9):1741-1752. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Gamboa JL, Pretorius M, Todd-Tzanetos DR, Luther JM, Yu C, Ikizler TA, Brown NJ: Comparative effects of angiotensin-converting enzyme inhibition and angiotensin-receptor blockade on inflammation during hemodialysis.
J Am Soc Nephrol 2012, 23(2):334-342. PubMed Abstract | Publisher Full Text
Antoniades C, Bakogiannis C, Leeson P, Guzik TJ, Zhang MH, Tousoulis D, Antonopoulos AS, Demosthenous M, Marinou K, Hale A, Paschalis A, Psarros C, Triantafyllou C, Bendall J, Casadei B, Stefanadis C, Channon KM: Rapid, direct effects of statin treatment on arterial redox state and nitric oxide bioavailability in human atherosclerosis via tetrahydrobiopterin-mediated endothelial nitric oxide synthase coupling.
Circulation 2011, 124(3):335-345. PubMed Abstract | Publisher Full Text
Peres AT, Dalboni MA, Canziani ME, Manfredi SR, Carvalho JT, Batista MC, Cuppari L, Carvalho AB, Moyses RM, Guimarães N, Jorgetti V, Andreoli MC, Draibe SA, Cendoroglo M: Effect of phosphate binders on oxidative stress and inflammation markers in hemodialysis patients.
Hemodial Int 2009, 13(3):271-277. PubMed Abstract | Publisher Full Text
Pre-publication history
The pre-publication history for this paper can be accessed here:


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Blue Ridge minister to preach on relationships Feb. 24 at UUFVB
VERO BEACH - Rev. Russ Savage, minister of the Blue Ridge UU congregation in Sperryville, Va., will conduct the 10 a.m. worship service on Sunday, February 24, at the Unitarian Universalist Fellowship of Vero Beach. His sermon title is "Getting Along With One Another," examining the mechanics of personal relationships in the light of ancient teachings and modern psychology.
Rev. Savage holds degrees from the University of Maryland and the Harvard Divinity School. He has served churches in Massachusetts, New York, Maryland and Virginia, and was an associate minister at the River Road UU congregation when the senior minister was Rev. Scott Alexander, now UUFVB senior minister. Before entering the ministry, Rev. Savage was an executive with AT&T for 24 years, retiring from Bell Laboratories.
Children's religious education and child care are available at 10 a.m. on Sundays..
The UU Fellowship, a liberal religion on the Treasure Coast, is located on the southeast corner of 27th Avenue and 16th Street. For further information, please call 772-778-5880.
This story is contributed by a member of the community and is neither endorsed nor affiliated with TCPalm.
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subset: commoncrawl


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The Center for Industrial Ecology (CIE) at the University of Coimbra was established to provide an organizational focus for research and teaching in industrial ecology. CIE brings together faculty, researchers and doctoral/master students from the University of Coimbra and elsewhere to develop new knowledge at the forefront of the field. Research is carried out in collaboration with other institutions and with international partners mainly in Europe, USA and Latin America.
Current research activities include:
CIE has strong involvement in the Energy for Sustainability initiative at the University of Coimbra (www.uc.pt/en/efs), and is also part of the research group Energy, Environment and Comfort (at ADAI - Associação para o Desenvolvimento da Aerodinâmica Industrial) of the Associated Laboratory for Energy, Transports and Aeronautics (LAETA).
O Centro para a Ecologia Industrial (CIE) da Universidade de Coimbra foi criado para estabelecer uma estrutura organizacional para promover a investigação e o ensino em Ecologia Industrial. O Centro para a Ecologia Industrial reúne Professores, Investigadores e Estudantes de Doutoramento/Mestrado da Universidade de Coimbra, para desenvolver novos conhecimentos na vanguarda desta área científica. A investigação é levada a cabo em colaboração com outras instituições e parceiros internacionais, principalmente na Europa, EUA e América Latina.
Investigação actual inclui:
O CIE tem um forte envolvimento na iniciativa Energia para a Sustentabilidade (http://www.uc.pt/efs) e faz parte do grupo de investigação "Energia, Ambiente e Conforto" (da ADAI – Associação para o desenvolvimento da Aerodinâmica Industrial) do Laboratório Associado em Energia, Transportes e Aeronáutica (LAETA).
Érica Castanheira, post-doctoral researcher at the Center for Industrial Ecology of the University of Coimbra, was awarded with the best presentation award during the VI International Conference on Life Cycle Assessment in Latin America conference (CILCA 2015), for the presentation of the paper "Environmental Life-Cycle Assessment of soybean biodiesel in Portugal: import grain, oil or biodiesel from Brazil?", coauthored by Erica Castanheira and Fausto Freire (University of Coimbra, Portugal) as well as Renata Grisoli, Suani Coelho and Gil Anderi da Silva (University of São Paulo, Brazil).
2nd DISCUSSION FORUM ON INDUSTRIAL ECOLOGY AND LIFE-CYCLE MANAGEMENT
March 5-6 2015
The 2nd Discussion Forum on Industrial Ecology took place at the Department of Mechanical Engineering of the University of Coimbra on 5-6 March 2015, with more than 40 participants from six different countries (Portugal, Brazil, France, Spain, UK, and USA). There were two plenary sessions by Prof. Roland Clift on "Life cycle sustainability assessment: extending the scope of LCA" and Prof. Paulo Ferrão on "Urban Metabolism", and 20 presentations on topics such as bioenergy, urban systems, forest and agro-industrial systems, and methodological advances. The Forum was organized by the Center for Industrial Ecology at the University of Coimbra.
Amir Safaei, SES PhD student at University of Coimbra, under the MIT Portugal Program, successfully discussed his thesis entitled "Life-cycle optimization model for distributed generation in buildings" on November, 10th, at Sala dos Capelos, Universidade de Coimbra.
29 October | 14h | Auditorium of the Department of Mechanical Engineering, University of Coimbra
Invited lecture:
"Robust decision making in life-cycle assessment of vehicles: the need for uncertainty propagation", by Maarten Messagie
Carlos Ferreira participated in the NATO AVT-243 Specialists Meeting on "Next Generation Greener Energetics and their Management", 16-17 October, Brussels, Belgium. He presented the communication: "Evaluation of alternatives substances to those banned by REACH supported with Life-Cycle Assessment".
Researchers from CIE-UC participated in the expert workshop "LCA Aspects of Electricity Production, Distribution and Charging Infrastructure for Electric Vehicles", organized by the IEA HEV Task 19 "LCA of EVs", 15-16 October, Barcelona. Prof. Fausto Freire presented the communication: "LCA of electricity generation, distribution and charging of electric vehicles: Addressing recent changes in the Portuguese electricity technology portfolio and alternative charging systems".
Rita Garcia presented the communication:
Garcia, R., Gregory, J., Freire, F. (2014). "Dynamic fleet-based LCA of the Portuguese light-duty fleet: the introduction of electric vehicles", in the LCA XIV Conference, 6-8 October 2014, San Francisco, CA, US.
EfS Opening lecture:
"Sustainability of Biofuels in Brazil", by Prof. Suani Coelho (Professor of bioenergy in the University of São Paulo, Brazil), September 17, 15:00, auditorium C21 of the Chemical Engineering Department, University of Coimbra.
Prof. Fausto Freire was invited to give the lecture "Avaliação de Ciclo de Vida: Metodologia e Aplicação em Sistemas Sustentáveis de Energia" at Seminário APEB - "Gestão Eficiente da Energia nas Organizações Industriais", Auditório da Ordem dos Engenheiros, Lisbon, November 6.
Workshop: "Eco-efficiency in the Portuguese wine and olive oil production sector", Anfiteatro do Centro Cultural de Mirandela, 9:00 am, July 11. Co-organized by CIE.
Érica Geraldes Castanheira, SES PhD student at University of Coimbra, under the MIT Portugal Program, will discuss her thesis on June, 26th (2:15 pm). The discussion of the thesis "Environmental Sustainability Assessment of Soybean and Palm Biodiesel Systems: A Life-Cycle Approach" will take place at University of Coimbra (Sala dos Capelos).
April 7- 8 2014
Auditorium of the Department of Mechanical Engineering, University of Coimbra (UC), Pólo II
Keynote Speaker: Prof. Roland Clift, Emeritus Professor, University of Surrey, UK
Organization: Center for Industrial Ecology, UC
Last updated on October 14 2014.


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More New and Used
from Private Sellers
Social Studies Today : Research and Practiceby Parker; Walter
Nonspecific Binding
Questions About This Book?
Why should I rent this book?
Renting is easy, fast, and cheap! Renting from eCampus.com can save you hundreds of dollars compared to the cost of new or used books each semester. At the end of the semester, simply ship the book back to us with a free UPS shipping label! No need to worry about selling it back.
How do rental returns work?
Returning books is as easy as possible. As your rental due date approaches, we will email you several courtesy reminders. When you are ready to return, you can print a free UPS shipping label from our website at any time. Then, just return the book to your UPS driver or any staffed UPS location. You can even use the same box we shipped it in!
What version or edition is this?
This is the 1st edition with a publication date of 7/29/2009.
What is included with this book?
- The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any CDs, lab manuals, study guides, etc.
- The Rental copy of this book is not guaranteed to include any supplemental materials. You may receive a brand new copy, but typically, only the book itself.
- The eBook copy of this book is not guaranteed to include any supplemental materials. Typically only the book itself is included.
Social Studies Today provokes readers to consider the equal importance of research and practice as they think through some of the most interesting challenges that animate social studies education today.
Author Biography
Walter C. Parker is Professor and Chair of Social Studies Education and (by courtesy) Professor of Political Science at the University of Washington, Seattle.
Table of Contents
|p. ix
|Social Studies Education eC21
|p. 3
|Purpose Matters
|Social Studies and the Social Order: Transmission or Transformation?
|p. 17
|The Social Studies Wars, Now and Then
|p. 25
|Why Don't More History Teachers Engage Students in Interpretation?
|p. 35
|High-Stakes Testing: How are Social Studies Teachers Responding?
|p. 43
|Authentic Intellectual Work: Common Standards for Teaching Social Studies
|p. 53
|Perspective Matters
|Education and Diversity
|p. 67
|Isn't Culturally Responsive Instruction Just Good Teaching?
|p. 77
|Silence on Gays and Lesbians in Social Studies Curriculum
|p. 87
|Race, Gender, and the Teaching and Learning of National History
|p. 95
|Subject Matters
|What Can Forrest Gump Tell Us about Students' Historical Understanding?
|p. 105
|What Does It Mean to think Historically . . . and How Do you Teach It?
|p. 113
|Maps and Map Learning in Social Studies
|p. 121
|What Do Children Know about Cultural Universals?
|p. 133
|High Quality Civic Education: What Is It and Who Gets It?
|p. 141
|Holocaust Fatigue in Teaching Today
|p. 151
|Global Matters
|How Are Teachers Responding to Globalization?
|p. 165
|Using Literature to Teach about Others: The Case of Shabanu
|p. 175
|The Two World Histories
|p. 183
|Teaching Civic Engagement in Five Societies
|p. 197
|Discussion in Social Studies: Is it Worth the Trouble?
|p. 205
|What Constrains Meaningful Social Studies Teaching?
|p. 215
|What is the Connection between Curriculum and Instruction?
|p. 225
|Can Tolerance be Taught?
|p. 235
|Idiocy, Puberty, and Citizenship: The Road Ahead
|p. 247
|p. 261
|p. 263
|Table of Contents provided by Ingram. All Rights Reserved.


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Fred and I were determined that his work would continue after he was gone, and it is through the generosity of people like you that we can keep working towards a world where no one is needlessly blind.
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My dogs do not know that there is a difference between canines and humans. Sami Jo is too young to drink beer but can hold it for mommy.
My boy. Spoiled? Loved!
By: sassyinspfldSubscribe Channel: Pets & Wildlife
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text:
Do Love OPI Couture De Minnie Runway Minnies
Seriously, how can I not love this adorable OPI Couture De Minnie Runway Minnies ($12.95) Set. Right?
Minnie Mouse has never been this stylish! This four piece set includes bursts of red and pink polish for tips and toes inspired by thee famous and ultra cute Miss Minnie Mouse!
- A Definite Moust-Have
- Magazine Cover Mouse
- Chic from Ears to Tail
- Innie Minnie Mightie Bow
Cutes right?
Available now at Ulta and Ulta.com
101 Reasons Why It's Great Game of Thrones is Back….
The utter joy I felt when the Kingslayer got his hand sliced off. I didn't shed a tear, I didn't feel a little bit bad for him, no remorse, none….Jamie Lannister is a grown up bitchy Joffrey. Gag me. On that note I will say I LOVE how closely they are following the book this season. Well done!
5/6/13 12:48 Shelby:
oh my gosh this is SO cute!
5/6/13 13:12 Cj:
Reason 16-100: Olyvar's butt.
5/6/13 13:19 Cj:
You're so welcome my dear. *hands you a fan for afterwards*
5/6/13 13:20 Cj:
Oh FFS
There click that one lol
5/6/13 13:18 Cj:
Reasons* 16-101* sorry got preoccupied thinking of his butt…
5/6/13 13:22 Tammie:
Just finished the first book (and started the second) so I am going to start watching the show now! Does the first season follow the first book, second the next etc.?
5/6/13 15:19 Tammie:
That's good :). So I'll read a book, watch a season, read a book, watch a season etc. lol. I want to read the book first because I like reading but if I know what's going to happen I might not feel like slogging through such a long book, if it's exciting I have something to keep me reading lol
5/6/13 15:59 Tammie:
Yeah, that's why I like reading the books before I see it, then I know what happened in the parts we don't see.
I'm mostly concerned with not watching ahead of what I read, if they change stuff or take a lot out I can deal with that. I just want to keep my momentum up with reading.
5/6/13 18:07 Tammie:
Nah, too impatient lol.
5/6/13 14:10 AnniLau:
Wow, really? I feel like they put book three in a blender and then threw in some random crap just for the hell of it. This is my least favorite season so far.
I do feel kind of sorry for Jaime though. Most of his bad behavior has been a result of trying to live up to other people's expectations and the one really good thing he's done (killing the Mad King) has gotten him nothing but contempt. I can never quite like him because of what he did to Bran, but I have some sympathy for his circumstances.
5/6/13 16:35 deana:
I felt bad for Jaime, too. I think what he did for Brienne got me. And he's a handsome devil…guess I'm a sucker..
5/6/13 17:54 kimkats:
I used to hate on Jamie but he's shown he's a complex character, not just a one dimensional villan. His bathtub speech about what really happened with the Mad King did a lot to make him sympathetic, I think. That, and his friendship with Brienne makes him a lot more human than he had been. He's still a self centered creep – his strangling the Karstark boy was almost as cold as shoving Bran out the window, but I like how they are developing the characters into real people with good and bad qualities.
that said, I can't wait for someone to off Melisandre – I don't know why but I *loathe* that woman! There is nothing redeeming about her!
5/7/13 8:03 Suzanne Peters:
I must disagree. Jaime may not be the most likeable person, but he has a sense of honor. Joffrey is simply psychotic.
5/7/13 10:27 Shadia:
Muse, have you read the fifth book yet? OMG.


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Ringmaster of every Freaks' show, he also takes care of the burial ceremonies for the late night fights. Charming and generous with his day-time audience, he becomes the man to take down when night falls. Until now, no clan has ever managed to properly finish him off, even though they all know what his Achilles' heel is: he goes crazy if you throw tomatoes at him!
At level 1: min 20 216 Clintz
At level 2: min 16 793 Clintz
At level 3: min 19 245 Clintz


text: [ Skillz Sums Up 2009 With Annual 'Rap Up' By Theo Bark December 30, 2009 Virginia rapper Skillz' annual 'Rap Up' reports have become an institution. Every year, we wait to hear Skillz' take on the year in rhyme, and this year we had a lot to laugh/shake our heads at... Read More Category: Hip-Hop Tags: Rap-Up, RapUp, skillz Send to a friend! Share on Facebook Share on Twitter Pin it! Reddit This! Share on Tumblr!


text: James Bardin | IBDB: The official source for Broadway Information IBDB: The official source for Broadway Information Official Broadway League sites: - sites - broadway.org broadwayleague.com broadwayfanclub.com kidsnightonbroadway.com stagespecs.org tonyawards.com Quick Search For: In This Category: All Show People/Org. Theatre Season James Bardin Performer Male Productions ProductionsDate of ProductionsBlossom Time[Musical, Comedy, Operetta, Revival] Performer: James Bardin [Vogel]Mar 08, 1926 - Mar 20, 1926 Find out where James Bardin and are credited together © 2001-2015, The Broadway League, All Rights Reserved. (Copyright and Disclaimer)


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Item Of The Day
Back in August I did a scary, uncomfortable, ridiculous thing. I went cage diving with Great White sharks for four days straight, with a bunch of strangers. I raised the money for the trip, took a deep breath and tried my best not to have a heart attack before setting foot on the boat.
A few weeks before the trip the hardcore divers start friend requesting the wimpy newbies like me on Facebook which is kinda nice, since you at least get a peek at these people you'll be risking your life with. That's how I discovered the awesomeness that is a hand-knitted shark hat.
One of my new Facebook shark friends (let's call her Shark Mama) was especially comforting and helpful (her #1 tip: "seasickness meds – A MUST." That tip was more helpful than comforting) and she sent us all photos of these silly yet beautiful shark hats to buy before the trip. I fell for a hat called "Cousteau" because the shark hat had its own red beret. I mean – a hat that's wearing a hat? Too cute. When you buy a hat the money also goes towards the non-profit Halos of Hope, which provides handmade hats and caps to cancer patients in need. Not a bad idea for a holiday gift! And if plunking down cash for a Cousteau of your own ain't in the cards right now, but you have mad knitting/crocheting skills, you can make your own shark hats for Halos of Hope to sell. Check out their Facebook page for more pics and info!


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About The Institute
The Global Food Protection Institute, established in 2009 in Battle Creek, Mich., is dedicated to protecting the world's food supply by providing FDA-aligned training, advancing new food technologies and convening forums for the transformative exchange of ideas about food protection. For more information, visit gfpi.org.
Read the full story at http://www.prweb.com/releases/2013/9/prweb11108212.htm.
|Source: PRWeb
Copyright©2012 Vocus, Inc.
All rights reserved


text:
Welcome to Prudential Florida Realty
Prudential Florida Realty has over 40 locations and more than 1,700 real estate sales associates serving 18 counties throughout Florida. We are a full-service residential and commercial real estate company that offers consumers professional assistance with purchases, sales, seasonal rentals, property management, corporate relocations, referral services, mortgage, title and insurance services. The company ranked #22 in number of transactions and to # 30 in sales volume in 2010, according to the 2011 RISMedia's 23rd Annual Power Broker Report. We are the #1 Prudential affiliate in Florida and #5 in North America. Prudential Real estate boasts the highest average sales price of any nationwide real estate firm.
Prudential Florida Realty has more than 40 Florida real estate locations and more than 2,000 Florida real estate sales associates serving 17 counties! Prudential Florida Realty is a full-service residential and commercial real estate company. We offer consumers professional assistance with:
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National Relocation Director of the Year
National Performance Award for 3 years in a row
Regional Performance Award
National Referral Coordinator of the Year


text:
MANHATTAN, Kan., Nov. 30, 2012 /PRNewswire-iReach/ -- Briggs Buick GMC, a Manhattan Buick dealer, couldn't be happier to have recently learned that the 2013 Buick Verano received a 5-star Over Vehicle Score, for safety, thanks to the National Highway Traffic Safety Administration...
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The Psychology Behind Cannibalism
By Guest Blogger Allison Gamble
Cannibal. The word alone evokes images of victims being roasted on a spit or boiled in a giant cauldron. The thought of humans consuming the flesh of other humans strike us on a visceral level, inducing disgust, revulsion, and horror. Yet underneath these primal and negative emotional responses there exists an underlying fascination that can't be denied. Indeed, forensic psychology is often brought to bear to explain how something deep within the mind is fascinated by the notion of consuming human flesh. The idea turns our stomachs, yet like gawkers passing an auto accident on the highway we peek through our fingers at the carnage, our eyes and attention drawn to the dark allure of the scene of horror.
"Allison Gamble has been a curious student of psychology since high school. She brings her understanding of the criminal mind "
Cannibalism Throughout History
The word "cannibal" is derived from the Spanish canibales, itself is a corruption of the name for the Carib Indians encountered by early Spanish expeditions to the West Indies. The first known historical account of cannibalism in the modern age came from Columbus' expeditions in the late 15th century, and tells of the Carib Indians consuming the flesh of their enemies in a ritualistic and gruesome manner.
This historical account of the Caribs has become the nexus of a long-running debate concerning the role allegations of cannibalism may have had in European colonialism. From the ideological perspective of some scholars whose imperative is always to find ways to criticize and denigrate western civilization, the European powers used these stories of cannibalism to justify enslaving and exploiting hapless indigenes. Some even go so far as to deny cannibalism ever existed as a culturally-accepted practice, and claim stories of cannibalism by native peoples were mythologized by Europeans as a means of justifying oppression.
However, historical evidence is clear that cannibalism has indeed been practiced since Paleolithic times. Archeologists have uncovered numerous human remains that show clear evidence of having been butchered and eaten, and the mythology, folklore, and early historical records of virtually all cultures are rife with allusions to humans eating the flesh of other humans. From the Greek myths to the Bible to the Vedas, it seems humans have always harbored this fascination with eating human meat.
The Darkest Taboo
The very idea of cannibalism in modern society remains shrouded in fear and sinister symbolism. Throughout history and across almost all cultures, eating human flesh has always been one of the ultimate unspeakable taboos. There is some deep psychological hook of mingled horror and fascination about cannibalism that seems innate, pre-cultural, and almost instinctual.
Cannibalism is associated in the popular view not only with primitive and savage cultures, but also with unspeakable and heinous crimes committed by the most depraved criminals imaginable. People like Jeffrey Dahmer of America, Armin Meiwes of Germany, Andrei Chiktilo of Ukraine, and the Mauerovas of the Czech Republic are more than just deranged criminals: their infamy has been magnified infinitely into an immortal cultural status because they all ate the flesh of their murdered victims.
Distinctions of Cannibalism
Anthropologists make several distinctions to describe different categories of cannibalism:
Spiritual and ritualistic cannibalism describes the ritualized consumption of human flesh in the context of cultural expression, and is further sub-categorized as exocannibalism (eating people from other groups) and endocannibalism (eating members of one's own group). The classic conception of primitive tribes engaging in head-hunting expeditions falls into the exocannibalism category, wherein one group consumes members of an outside group as a show of power and aggression.
Most often, endocannibalism manifests as a form of mortuary cannibalism, where people consume small portions of the corpse of a loved one in the belief that the spirit of the departed can then be absorbed. The idea that the powers and spirits of the dead are imparted through eating their flesh appears to be the universal psychological basis for manifestations of spiritual and ritualistic cannibalism.
Criminal and sexual cannibalism covers the gamut of instances of criminal anthropophagy perpetrated usually as a form of sexual sadism, and is considered by clinical psychiatry to be a behavioral symptom of psycho-sexual disorder. There have been many high profile criminal cases involving cannibalism, several of which have already been mentioned.
Others include the case of Albert Fish, who, in the 1920s, kidnapped, raped, murdered, and consumed the bodies of an unknown number of children, and Ed Gein, a Wisconsin farmer who is believed to have killed at least 3 people and inspired the character in the movie Silence of the Lambs who flayed his victims and made a suit from their skins. Criminal cannibals often claim to feel a rush of power when consuming the flesh of their victims, and express the belief in a kind of metaphysical fortification, not unlike the beliefs of primitive ritualistic cannibals. The psychological underpinning of the belief that consuming human flesh imparts metaphysical benefits is identical.
Survival cannibalism is the only form of anthropophagy ever considered justifiable. In these cases, people find themselves in extremely desperate and adverse situations where resorting to cannibalism is their only means of survival. The most famous case of survival cannibalism occurred in the 1840s, when heavy snows in the Sierra Nevada Mountains stranded a group of settlers known as the Donner Party. Some members of the group survived the cruel winter by consuming the bodies of those who perished from starvation and exposure. Similarly, in 1972, a plane crashed high in the Andes Mountains of South America and 16 people survived for seventy days only by feeding on the corpses of those killed in the crash.
That so many distinctions exist to categorize cannibalism makes it clear some deep connection in the human psyche drives our desire to learn about it, and some to actually try it. The psychological basis of this fascination is so complex; it's unlikely that any consensus will ever be achieved concerning the underlying motivations and causes of cannibalistic behavior. Nevertheless, somewhere in the convoluted swirls of human thought there is a distinct connection between the motivations of a tribesman in New Guinea, who consumes the flesh of a departed loved one with solemnity and deep respect, and those of a deranged criminal who seeks some bizarre rush through the unspeakable crime of murdering and cannibalizing an innocent person.
Thanks to Allison Gamble for contacting Crime Case Files and writing this article, I also have a great fascination about the psychology behind Cannibalism, so I was interested to see another point of view.we now have a few articles with-in this blog related to Cannibalism.


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The AAII Charlotte Chapter
» Upcoming Chapter Meetings:Thursday, October 8, 2015 »
Charles Rotblut, CFA, Vice President and Senior Financial Analyst, AAII; Editor, AAII Journal "Smart Investing: Seeking Reward While Reducing Risk"
George Dagnino, Ph.D., Editor, The Peter Dag Portfolio "Easy Ways to Beat the Market With ETFs"
» Past Chapter Meetings:
Saturday, September 12, 2015
"A Case for Index Fund Portfolios"
Richard Ferri, Managing Partner, Portfolio Solutions
Saturday, August 8, 2015
"Mission Critical Portfolios: Remove Risk and Increase Returns With Diversification "
David Johnson, Chief Investment Officer, Global Capital Group
Saturday, July 11, 2015
"Medicare Made Clear"
Donna Green, Licensed Agent, United Healthcare Medicare Solutions
Saturday, June 13, 2015
"A Trader and Math Finance Program Size Each Other Up"
Rajah Chacko, Senior Java Developer, Wells Fargo
Saturday, May 9, 2015
"Fidelity's Asset Allocation Team Market Update"
Dirk Hofschire, Senior Vice President of Asset Allocation Research, Fidelity Investments
Saturday, April 11, 2015
"Covered Call Writing to Generate Monthly Cash Flow"
Dr. Alan Ellman, President, The Blue Collar Investor Corp.
Saturday, March 14, 2015
"True Sector Rotation: Breaking Through the Efficient Frontier"
Scott Juds, Founder and President, SumGrowth Strategies
Saturday, February 14, 2015
"2015 Economic Scenarios: Boom or Gloom?"
Dennis Stearns, President, Stearns Financial Group
Saturday, January 10, 2015
"Creating High-Quality, Risk-Adjusted Return Portfolios"
Daniel Charbonnet, COO, FastTrack Capital Management LLC
Saturday, November 8, 2014
"An Analysis of Bear Markets"
Bryan Johnson, Moon Run Report
Saturday, October 11, 2014
"It's What You Learn After You Know It All That Counts"
Paul Townsend, Associate Vice President and Investment Officer, Wells Fargo Advisors LLC
Saturday, September 13, 2014
"Investment Fraud: Guarding Your Assets in a Scary World"
John Maron, Director of the Investor Education Program, North Carolina Secretary of State
Saturday, August 9, 2014
"Seven Common Characteristics of Winning Stocks"
Harold Morris, National Education Speaker, Investor's Business Daily
Saturday, July 12, 2014
"Top Tax Strategies for Today's Changing Times"
Ken Martin, CPA, Senior Tax Partner, Stancil & Company
Saturday, June 14, 2014
"America Gets its Mojo Back"
Bill Hackney, CFA, Senior Partner, Atlanta Capital Management
Saturday, May 10, 2014
"King Risk is Dead. Long Live the King!"
John Simms, Chief Investment Officer, Piedmont Trust Company
Saturday, April 12, 2014
"How to Prevent and Detect Fraud"
Glenn L. Helms, Ph.D.,
Saturday, March 8, 2014
"How to Choose Your Strategy"
Nicole Wachs, Director of Education, TradeKing
Saturday, February 8, 2014
"Stock Valuation and Stock Market Cycles"
Steve Chappell, Director of Educational Services, VectorVest, Inc
Saturday, November 9, 2013
"The Three Things Every Successful Investor Must Know"
Bill Staton, CFA, "America's Money Coach"
Saturday, October 12, 2013
"Advanced Technical Analysis"
Justin Krebs, Personal Trading Plan Instructor, Online Trading Academy


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01738 580457
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The name of this Wetherspoon pub recalls the building's original purpose as a savings bank and Perth's status in medieval times as the capital of Scotland.
Spread along the west bank of the River Tay, modern Perth has its roots deep in the past. In 1210, William, the Lion King of Scots, founded a royal burgh here, which was the early capital of Scotland until c1452. It was also the meeting place for the parliament, with Scottish kings being crowned at the nearby Palace of Scone.
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Each week we host 3 support groups for our child victims. The groups are designed to teach skills like safety, coping, prosocial interaction, anger management, etc, but do so while the kids are playing games, making crafts, and having a great time!
We also have a monthly parent/caregiver group that meets on the last Thursday of each month. If you are interested in attending the parent/caregiver group please call Macee at 229-435-0074.
Who We Are
Lily Pad is regionally recognized for its exceptional delivery of comprehensive services to victims and families impacted by crimes of sexual assault and child sexual/physical abuse. Services provided are developmentally appropriate and specialized to meet the distinctive needs of each individual. Programs and services provided include:
Who We Help
Since opening its doors in 2008, the Lily Pad has helped over 3,500 primary and secondary victims, offering a safe haven for abused children and adult victims, providing long-term advocacy for victims and their families, and assisting in the investigation of abuse cases.
Since 2006, the Lily Pad:
How We Are Funded
There is no charge to victims that receive direct services from the Lily Pad.
The Lily Pad is a 501(c)3 charitable organization. Approximately 70% of the agency budget comes from state and federal grant sources, and in 2009, state funding for sexual assault centers decreased by 47%.
Since 2008, Lily Pad has touched the lives of thousands of children and adults, who are victims of sexual assault or child abuse, and their families.
As the number of people living with the aftermath of sexual assault and child abuse grows, the demand for our services has dramatically increased. To meet the challenge in 2014 – and reach more families in Southwest Georgia than ever before – we need YOUR support.
Please help us reach our goal and help more victims find help and hope.


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The cost of opening a fast food franchise in the U.S. is no small investment. We break down the costs for some of the top chains.» Read More
With fast-casual restaurants growing at a sprint while fast-food counterparts moving at a slow jog, the latter group is entering the race to open more premium concepts.
Sentiment on the Street suggests restaurant stocks should be avoided. Cramer doesn't think that's right.
Hooters girls drafted to man the sidelines during spring training are throwing the game a curveball. Over the last two weeks, there have been several errors, as some Hooters girls attempted to "wing" it playing America's pastime.
Hoping to attract female customers, the chain is hoping to lure mothers by offering free entrees for mothers. Would you take your mom to Hooters for Mother's Day?
A former Hooters waitress contends in a lawsuit that the restaurant discriminated against her, when she didn't wear a wig after brain surgery.
More entrepreneurs are forecast to buy U.S. franchises. See which sectors are likely to grow more quickly and generate jobs growth.
Actor slash entrepreneur Wendell Pierce is opening Sterling Farms, grocery stores with fresh produce in Katrina-struck New Orleans.
Extended jobless benefits derail employers' ability to hire, the head of Landry's restaurant chain told CNBC on Wednesday. See what other trends could halt Main Street job growth.
Sales at the restaurant chain are declining, as more women are driving family eating choices and the franchise's core customers, young men, have been hit by the recession.
Small merchants and those in the e-commerce space are feeling let down by the initial hype of Groupon. Is the daily coupon model dead?
The Subway Restaurants founder says regulations are hurting small companies and entrepreneurs. "If I started Subway today, Subway would not exist," Deluca told CNBC Wednesday.
The number of franchise establishments grew in 2012, the first time since 2008, according to a report compiled by IHS Global Insight. But while more growth is forecast for 2013, cautious optimism is the dominant mood.
Some small companies including franchises are managing to grow. But the overall Main Street mood is anxiety-filled.
Pizzeria owner Mark Tramontana offers a cautionary tale for franchisees about the potential benefits and pitfalls of digital discount platforms. Is Groupon the new piggy bank for cash-starved entrepreneurs?
As haggling over a debt deal continues, small businesses have much at stake. If people pay higher taxes, they will likely spend less. Could a hobbled Main Street derail the economic recovery?
Much is at stake for small businesses amid the deficit talks. A look at why Main Street is worried and why job creation isn't happening.
Brewer Tom Seefurth made a beer brewed with basil, oregano, tomato and garlic that tastes like pizza. The combination not only worked as a beer, it helped him save his home.
How retailers can turn holiday shoppers into loyal year-round customers.
Despite lingering economic worries, Small Business Saturday sales data is slightly better than expected. A look at the numbers.
Serial entrepreneur Richard Branson offers three tips for being mindful of competitors, while forging ahead with your own ideas.


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Aetna health plans have your well-being in mind.
From a large network of doctors and hospitals to the latest fitness apps, your Aetna medical benefits and insurance plans offer much more than just "coverage." They feature many ways to keep you on a path to a healthier life.
Dental care should be easy and affordable. We offer a range of dental benefits and insurance plans and programs. With every option you'll enjoy access to one of the largest networks of dentists in the country.
Go to dental plans
Anyone with Aetna health benefits has access to our vision discount program. Or your employer may offer a separate vision insurance plan.
See more about vision plans and discount programs
If your employer-based plan offers our pharmacy benefits and services, we can help you make the best choices for your health and budget.
Your employer's medical plan may include behavioral and mental health benefits. These kinds of benefits come in handy when dealing with problems like substance abuse, depression and anxiety disorders.
Sometimes you need more coverage than your employer provides. We can help. Aetna offers extra plans that can give you added peace of mind.
Most employer plans have disability insurance benefits built in. If you become unable to work, these benefits can help protect you financially.
Explore disability insurance
Your employer may offer Aetna life insurance. This is called group term insurance or group coverage. These plans provide coverage for you, your spouse or partner and your dependent children. Aetna's life insurance benefits also include access to expert financial advice, legal services and discounts on products and services for you and your family.
Our tools, resources and experience can help you handle any health-related issue. Dealing with depression? We can help. Need immediate advice from a nurse? Give us a call. Interested in lifestyle coaching to be your best? Talk to one of our coaches.


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For more than 50 years, African Wildlife Foundation has been committed to focusing on Africa's unique conservation needs. Your gifts make our work possible, and we hope you will help us plan for an even brighter future. A planned gift is a unique way for you to support the future work of AWF during your lifetime and beyond. These gifts require a little bit of planning but provide an opportunity to make a real difference for Africa's wildlife.
Bequests are the easiest, most popular way to support the future of AWF.
Thinking about making a gift to AWF? Get our official bequest language to share with your attorney.
Each of our donors has a unique connection to AWF. Find their stories here.


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During the Tangshan Earthquake of 1976, a mother is forced to choose which of her children is saved from the rubble, since rescue teams fear that rescuing one will kill the other. She chooses her son - but her daughter survives and grows up apart from her family, until they meet again 30 years later...
An epic and heartbreaking take on the Sophie's Choice dilemma.
Reviewed by Simon Crook
Read The Full Empire Review »
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Peoples National Bank appoints three
GREENVILLE - Peoples National Bank recently appointed Beverly Pressley as vice president/Greenville branch administrator for the Antrim Drive office in Greenville, Lisa Sfiris McGehee as banking officer and branch manager for the Mills Avenue office in Greenville, and Michael Tollison as investment adviser representative.
Ms. Pressley will be responsible for managing the office staff at the soon-to-be-opened 45 East Antrim Drive office as well overseeing retail banking for both Greenville locations. Ms. Pressley was most recently employed by SunTrust Bank. She has been a lender and managed offices in Pickens, Anderson and Greenville counties.
Ms. McGehee is a University of South Carolina graduate who received a degree in finance and real estate. She joined Peoples in September 2006. Ms. McGehee was previously employed by Carolina First, serving as branch manager at the Cleveland Street office in Greenville.
Mr. Tollison will serve as investment adviser representative for Antrim Drive and Mills Avenue locations of Peoples Investment Services.
He is a graduate of Washington & Lee University and has more than 14 years experience as a financial advisor in the Upstate. Most recently, Mr. Tollison served as private financial advisor for SunTrust Bank.
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Oh. My. God. Becky. Look at this haircut.
This week, Nicki Minaj finally released the much-anticipated video for her song "Anaconda." And people watched it. People watched it so much it overtook the awful Miley Cyrus/Terry Richardson collaboration that is "Wrecking Ball" as the video with the most views in a 24 hour period.
But while most of the world was watching Minaj's celebration of life on repeat, being mesmerized by 'donk and wondering why Drake was so sad, one man was giving Minaj the thanks she deserves—with this amazing, bootylicious tribute haircut.
Forget Lena Dunham's bowl cut. Forget Karlie Kloss's bob. Forget "the Rachel." This is the haircut we need. Though Cosmopolitan.com points out it might also be a tattoo, it doesn't matter. This man is a hero.
h/t Cosmo


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PRIMARY - These dancers spend under 6 hours per week in a dance studio, including all training, rehearsals, and coaching. Primary singers have less than one year formal vocal training.
ADVANCED - These dancers spend 6+ hours per week in a dance studio, including all training, rehearsals, and coaching. Advanced singers have more than one year formal vocal training.
At least 50% of all participants in each entry must be a part of the designated competition level, otherwise the entry must 'move up' in level.
If a duo/trio contains performers of both levels, it must compete in the advanced competition division.
If a division is not selected it will automatically be placed in the advanced level.
All ages are as of January 1, 2015 for the entire 2015 season, including Nationals.
To reach the average age of an entry, add all the ages together and divide by the number of performers in the entry. After averaging age, DROP THE DECIMAL to come up with the competition age for the entry. For example: An entry whose average age is 10.7 will compete as age 10. Names, ages and birthdates of all performers must appear on the entry form or it will not be accepted. All competing performers must be prepared to present proof of age should a question arise.


text: From ABC News Washington, Illionis Hard Hit By Tornadoes By Jim Phillips November 18, 2013 The mayor of Washington, Ill., estimates that up to 500 homes in his town were either damaged or destroyed by a wave of fierce storms that brought damaging winds and tornadoes to 12 states yesterday. ... Read More|Comment Category: Articles, News Tags: Illionis, Illionis Disaster, Mayor Gary Manier, washington Send to a friend! Share on Facebook Share on Twitter Pin it! Reddit This! Share on Tumblr!


text: Gini Turner | IBDB: The official source for Broadway Information IBDB: The official source for Broadway Information Official Broadway League sites: - sites - broadway.org broadwayleague.com broadwayfanclub.com kidsnightonbroadway.com stagespecs.org tonyawards.com Quick Search For: In This Category: All Show People/Org. Theatre Season Gini Turner Performer Female Productions ProductionsDate of ProductionsZiegfeld Follies of 1957[Musical, Revue, Original] Performer: Gini Turner [Dancer]Mar 01, 1957 - Jun 15, 1957Carousel[Musical, Drama, Revival] Performer: Gini Turner [Dancer]Jun 02, 1954 - Aug 08, 1954 Find out where Gini Turner and are credited together © 2001-2015, The Broadway League, All Rights Reserved. (Copyright and Disclaimer)


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Patients cross border for non-FDA approved weight loss procedure
PHOENIX - A new capsule could help people lose 20 to 30 pounds in a few months without surgery. But, Americans have to leave the country to get it.
Obalon, which has been described as one of the biggest advancements in obesity treatment, is the world's first gastric balloon that you can swallow. It's targeted at individuals who are overweight, but do not qualify for traditional weight loss surgery.
During a five-minute procedure that does not require anesthesia or medication, the patient swallows a vitamin-sized capsule attached to a thin tube, according to the company's website.
Then, the balloon deploys to about the size of an apple inside the stomach, creating a sensation of fullness. The expanded balloon restricts the amount of food a patient can eat and suppresses the appetite.
After about a month, the company says the patient's body starts to adapt to the balloon, and its appetite-suppressing effects start to diminish. Then, the patient swallows another capsule to maintain the effects of treatment. A patient can use two-to-three balloons over the course of 12-week treatment.
At the end of treatment, an endoscopic procedure is performed to deflate and remove the balloon through the patient's mouth. During that process, patients have to be sedated while the balloon is punctured and removed.
The total treatment time is approximately three months. In that time, the company says patients can lose more than 50 percent of their excess weight.
Even though Obalon is manufactured in San Diego, patients have to either go to Mexico or Europe to get it.
In the U.S., the drug received Investigational Device Exemption from the Food and Drug Administration (FDA), according to the manufacturer. That means it's likely on the road to get premarket approval (PMA) by the FDA.
The FDA would not confirm that Obalon is in the approval process, saying "We cannot confirm the existence of or comment on any current/pending product applications."
Ora Verduzco found Obalon when she was searching YouTube, she said.
"It's almost like having a nutritionist in your pocket every single day," Verduzco said. She said she had dieted unsuccessfully for the last couple of years and always gained the weight back.
Verduzco, from San Diego, decided to go south of the border to get the procedure. She found Dr. Ariel Ortiz at the Obesity Control Center in Tijuana. It costs between $3,000 and $4,000 for the procedure there. He said he receives hundreds of requests for the device each week.
"What we are looking at is very similar weight loss to gastric surgery, but, instead of a year and a half, we are obtaining results in three to four months," Ortiz said.
After they get the balloons implanted inside of them, Ortiz's patients work with a nutritionist on their eating and exercise plan. It's all monitored by a smart phone app.
But, there's a catch: If a patient still chooses to overeat, they will get sick.
Critics say the device could rupture or cause blockage. In the company's safety information, there are warnings about injury to the stomach lining and "spontaneous balloon deflation and resulting passing through the intestines." That, they say, could result in bowel obstruction, which can be deadly.
The ABC15 Investigators talked to Dr. David Podkameni, a bariatric surgeon at Banner Gateway Medical Center.
He says the balloon rupturing and causing a blockage are the same kinds of complications that happened when balloons like this were first on the market in the 1980s.
"So, essentially, it was pulled off the market," Podkameni said.
But Dr. Ortiz claims the "worst case scenario" for patients who use Obalon isn't all that bad.
"What we would most fear is that the balloon deflates in the stomach, then it would pass through and into the toilet," he said.
Podkameni said the balloons that are being manufactured today are better, but the root problem is the same.
"It's similar to yo-yo dieting," he said. "Probably you're going to lose a little more weight and you can prolong that effect of the weight loss, but it's probably bound to happen again that you're going to end up regaining the weight."
He said balloons could help as a bridge for an obese patient who wanted to get a metabolic surgery like gastric bypass or a sleeve gastrectomy.
But, for patients looking to lose weight long term using just a balloon device, he doesn't think it's the healthiest option.
"You are not addressing the root issue, which his changing behavior, changing metabolism," Podkameni said.
The ABC15 Investigators found three clinical trials on Obalon. Two were conducted at Dr. Ortiz's Obesity Control Center in Tijuana and another took place in France.
Podkameni said there are clinical trials going on in South America, Brazil, Europe and Asia and he expects balloons like these will have a role in the United States in the future – keeping in mind, he said, "it needs to be followed up by a program."
Verduzco said the balloon is just one part of her fight to get fit.
"The rest is really you and the commitment you make to following the correct diet," she said.
The San Diego-based company that makes the capsule did not respond to requests for comment.
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Selected Femme features two lines, a more casual "everyday wear" line and a more feminine party fashion line. In Selected Femme's range you will find silk, cashmere and well-made leather garments as well as cool T-shirts. Selected Femme's goal is to deliver high quality products with fine detailing, and their motto is "value for money". Shop Selected Femme at Nelly.com.
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Born out of the copper mining industry, which thrived here in the last century before finally closing in 1982, this attractive village on the Avoca River is now more famous for the hand weaving looms and the craft shop of the Avoca handweavers. Avoca has also in recent years been recognised as the location for the well known series "Ballykissangle".
On this page you can see a map of Avoca, see what's on in Avoca, find out how to get to Avoca, find things to see and do in Avoca, visit local websites for Avoca, find Bed and Breakfasts (B&Bs) in Avoca, browse restaurants in Avoca.
Tell us about any upcoming major events in Avoca and we can add to our website!
Avoca, Kilmacanogue, Co Wicklow, Ireland
The oldest working woollen mill in Ireland located in beautiful surroundings of Avoca, which is also known today as Ballykissangel
Avoca, Co Wicklow, Ireland
Commenced only in 1995, this 3.5 acre garden was a prize winner for Design in the All Ireland Gardens Competition in 1999. Specimen trees, old roses, woodland, parterre, Japanese meditation area, Chinese bridge to island and brook. Only open to...
See all Places to Visit in Avoca > >
Ashdene, Knockanree Lower, Avoca, Co. Wicklow
Set within its own private grounds, Ashdene Country Home B&B is situated in rural countryside, 15 minutesâ walk from the Avoca village. It offers free Wi-Fi and is just 10 km from the coast.
Meetings of the Waters, Vale of Avoca, Co. Wicklow
Ashton House is luxury guest house in the Vale of Avoca, location for the TV series Ballykissangel, beside the Meeting of The Waters, where the Avonmore and Avonbeg river meet.
Beech Road, Avoca, Co. Wicklow
Koliba Country Home is a 4-star B&B situated in 2 acres of landscaped gardens. It is 2 miles from Arklow town and Avoca village, featured in the Ballykissangel TV series.
Avoca, Arklow, Co. Wicklow
With scenic views of the Vale of Avoca and the surrounding countryside, Rockfield B&B also offers a peaceful garden and tea/coffee on arrival.
Avoca, Co. Wicklow
Overlooking the joining of the Avonmore and Avonbeg Rivers, The Meetings offers free onsite parking and free WiFi. Situated in Avoca, this bed and breakfast boasts a bar and a shop.
Meeting Of The Waters, Avoca, Co. Wicklow
The Old Coach House is a 4-star guest house dating from 1780 next to the famous Meeting of the Waters, offering historic period décor and tea/coffee and cakes on arrival.
Avoca, Co. Wicklow
Main Street, Avoca, Co. Wicklow
The Best Western Hotel, Vale of Avoca, Avoca, Co. Wicklow
Kilcashel, Avoca, Co. Wicklow
Kilcashel, Avoca, Co. Wicklow
Kilcashel, Avoca, Co. Wicklow
Vale Of Avoca, Avoca, Co. Wicklow
See all Restaurants in Avoca > >


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02/29/2012 07:01:52
The church structure is gorgeous. You don't see that kind of stonework anymore. Looks like it's well kept.
Rev. Peter D'Alesandre, Vicar Alan McNeely, Organist
Sunday Service 9:30 AM
Sunday School 9:30AM
(860) 887-2082
Across from the Yantic post officeWith the guidance of the Holy Spirit and God's almighty love, we proclaim Jesus Christ as "Lord and Savior." In Him, we strive to honor the past, celebrate the present, and welcome the future.