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Edythe & Lloyd Katz Elementary School
Las Vegas, NV 89128
About This School
In 2011, Edythe & Lloyd Katz Elementary School had 19 students for every full-time equivalent teacher. The Nevada average is 20 students per full-time equivalent teacher.
Student Ethnicity (2011)
Students (2011)
Students Per Teacher (2011)
Female/Male (2011)
Subsidized Lunch (2011)
District Spending (2010)
Grade 3 Math Performance
Edythe & Lloyd Katz Elementary School Reviews
I absolutely LOVED this elementary school. I can't believe how long it has been since I actually attended. The staff and faculty are amazing! Man I miss 4th and 5th grade:)
I am so grateful for this school because my 3 children are going to this school. The teachers are so helpful and great and my children love this school. It is a very good school and I see since my children have moved to that school I have really seen a great improvement with my child's work, so I think this is a great school.
I went to this school from K-4 it was so fun. I'm in 10th grade now and I'm in Illinois. So many things change.
I went to this school when I was younger, and this is the best school I have ever been to. I have so many good memories, starting in first grade with the ugly duckling show. I love this school!


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Get PDFFull Article
Indian Materials Congress® (IMC)
Ashutosh Tiwari, Editor-in-Chief
Volume 4, Issue 12, Page 875-875, Year 2013 | DOI: 10.5185/amlett.2013.12001
Indian Materials Congress, IMC
We are pleased to announce Indian Materials Congress® (IMC). It will be an annual event organised by Vinoba Bhave Research Institute, India during 08-11 December each year from 2014. The goal of congress is to provide a global platform for Indian researchers and engineers coming from academia and industry to present their research results and activities in the field of fundamental and interdisciplinary research of materials science.Copyright © 2013 VBRI press.
Get PDFFull Article

subset: commoncrawl


text:
Banking Support Rep Sr. (Branch Banking Experience)
FIS Global - Township of Cranberry, PA
This job posting is no longer available on FIS. Find similar jobs:Banking Support Representative Senior jobs - FIS Global jobs
About this company
FIS™ is the world's largest global provider dedicated to banking and payments technologies. With a long history deeply rooted in...


text:
Organic Design for Napa Valley Remodel
From Margaret Everton on July 16, 2010 in San Francisco
After studying architecture on the East Coast and spending two years applying what he learned in St. Remy de Provence, France, Daniel Hale was ready to piece together his own Napa Valley home. Using the naturally beautiful setting to guide his vision, he created a design rich in organic material and unlike any other upscale California home in the area. In using mostly recycled materials, Hale was able to add a unique texture and subdued earth tones to each room. And whered that interesting sofa come from? It was actually built from the wooden crates used to transport his Travertine flooring tiles into the house. While the kitchen backsplash and stainless steel touches suggest more of a traditional design, the cabinets were made from salvaged window panesvery cool. The bathtub shown below might be the most luxurious part of the home. Other elements, like the light fixture, cupboard and sliding window panels were all made by Hale himself. Simplicity reigns in the bedroom, with the focal point being the four poster bed equipped with candle holders. Off the side of the house are breathtaking views of neighboring vineyards that make the property seem absolutely priceless. In the back is a pool with built-in seating. With a unique combination of old and new materials, Hale brought together a design that seems to have sprouted from the land itself. Organic looks like the way to go.


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Guido: Freeport celebrates 50th anniversary of title team
TribLIVE Sports Videos
Freeport has always been a good place to live, work, worship — and play football.
The Yellowjackets, by far, have won more football games than any other local school — 524. That's 141 more wins than any other area program.
Despite many great teams since Freeport inaugurated football in 1922, no team ever made the WPIAL's championship game until 1963, when the team posted a 9-0 regular season.
As the 50th anniversary of that great Yellowjackets season takes place, many still have fond memories of that outstanding season.
The 1963 Freeport team finished the previous campaign with an 7-1-1 record in coach Bob King's first season.
While expectations were high, no one was taking the potential of an undefeated season for granted.
"The competition up and down the Valley was so good," halfback Chip Young said. "Everybody knew everybody else, and there were lots of good athletes."
As opening night approached, rival Ford City was the first team on the schedule.
Freeport won that one on the road, 13-7.
"For me, this was the toughest game, since they had Ron Dilliard," Yellowjackets quarterback Ron Canterna said. "The was probably the only game I felt unsure of. Once we beat them, I felt confident that no other team would beat us."
A 27-13 Week 2 victory at Tarentum set the stage for a big, early season showdown against Arnold in Freeport's home opener.
Young ran for touchdowns of 8 and 41 yards and hauled in a 38-yard pass from Canterna as the Yellowjackets prevailed, 20-13.
"Arnold was definitely the toughest team we played, but we knew that going in," Young said.
A 21-12 victory at Plum was followed by a 34-0 romp over Kittanning.
Freeport went to 6-0 with a 28-12 win at Springdale before returning home to defeat West Deer, 39-19.
In the only Saturday afternoon encounter of the season, Freeport won in Week 8 at Richland, 41-7.
In that era, the two undefeated and untied teams with the most Gardner Points played for the WPIAL title. Freeport was accumulating a considerable number of Gardner Points.
All that stood between the Yellowjackets and the WPIAL title game was a date with rival Leechburg.
"Leechburg was our biggest rival, it was so intense," Young said.
"I remember vividly the week of practice before the game," Canterna said. "It was tense, unnerving and quite stressful."
Before an overflow crowd of 6,000 at Freeport, two Chip Young touchdowns propelled the Yellowjackets to a 21-7 victory and a berth in the WPIAL title game against Montour at Jeannette's McKee Stadium.
Freeport finished a regular season undefeated for the first time since 1931. The halfback on that team was Charles W. Young, father of Chip.
As 8,630 packed 7,000-seat McKee Stadium, things were looking good for the Yellowjackets. Leading 6-0 with time running out just before the half, Young burst into the end zone and had the ball dislodged.
Montour recovered the loose ball, preventing Freeport from taking a two-touchdown advantage.
"It would have been a touchdown nowadays," Canterna said. "I wanted to protest the call, but Bob King wouldn't hear of it. He was too much of a sportsman and gentleman to argue with the refs."
Montour seized the momentum after that and rolled to a 29-12 victory.
Future NFL hall of famer Ted Kwalick caught two extra-point conversions for the Spartans.
"Bob King was an awesome coach," Young said. "He was very demanding, and we had a lot of respect for him."
King, now 82, lives with his wife near Saxonburg.
His son, Mike, has been the Knoch coach for the past 16 seasons. His grandson, Kraig King, is a Knoch senior lineman and indicates he'd like to get into coaching some day.
That would make it three generations of Kings prowling the sidelines.
Young, who led the A-K Valley in touchdowns with 20, and lineman Al Yates both attended William & Mary and both are members of the Armstrong County Sports Hall of Fame. Young lives in Mt. Lebanon and has been in the insurance business for a number of years.
Yates lives in the North Hills area and is a Pittsburgh-based attorney.
Canterna is now retired and living with his wife in Italy.
Another key 1963 team member, Lou Pukal, is in the Armstrong hall.
George Guido is a Valley News Dispatch scholastic sports correspondent. His column appears Wednesdays.
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|I Saw The Light-lyr
|TABS text only
|Difficulty: undetermined
|return to normal Subject: Fw: I SAW THE LIGHT ...HANK WILLIAMS Submitted by...Jessie Harvey Written By ...Hank Williams Sr. I SAW THE LIGHT . I wandered so aimless , life filled with sin. I wouldn't let my dear Saviour in. Then Jesus came like a stranger i (roughstock.com)


text:
LAME VBR Settings
LAME VBR Settings
Sep 18 2012, 22:40
Post #1
Group: Members
Posts: 14
Joined: 18-September 12
Member No.: 103243
Hello guys. I'm newbie in audio ripping, and I have a issue here:
I use Easy CD-DA Extractor, as software for ripping and converting my MP3s, because it uses latest LAME 0.99.5. But when I set my MP3 settings at VBR, I have only preset option (Quality Level 0, Quality Level 1, ......Quality Level 9). Until now I had used Switch Sound Converter (with LAME 0.82) and with it i was able to put a custom range at VBR (192kbps - 320kbps), and what I want now is to put the same custom setting on Easy CD-DA Extractor.
So my question is: It is LAME related (in this case version 0.99.5) or strictly to the software that uses LAME encoder.
And one more thing: with Easy CD-DA Extractor CBR encoding it's much slower than VBR encoding? It it normal? I thought that VBR uses more resources.
Thank you in advance,
This post has been edited by daniel.ok: Sep 18 2012, 22:42
Sep 20 2012, 18:43
Post #2
Group: Developer
Posts: 3829
Joined: 2-December 07
Member No.: 49183
Intel Core2 (2.5GHz) and LAME 3.99.5 -V4 --noreplaygain, encoding time:
32bit: 93.4 seconds
64bit: 81.2 seconds
=> 15% speed increase.
This post has been edited by lvqcl: Sep 20 2012, 19:00
|Lo-Fi Version
|Time is now: 1st December 2015 - 17:28


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Thanksgiving Sale - Save 10% -- Use Coupon thanksgiving at checkout Offer expires TODAY.
Boston Museum of Fine Arts Paintings Oil Painting Reproductions
Every Boston Museum of Fine Arts painting is hand painted by an Ocean's Bridge talented artist to your exact specifications and comes with a Money-Back Guarantee and FREE Shipping.
Lifespan: unspecified
Collection: 1492 paintings


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Where should I park? A grave???
Submitted by Roni
Share More
Laura Grosvenor:
March 24, 2014 at 9:20 pm
Hmmmm...don't want to see you when you are leaving though.
"Best of" Lists
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Copyright © 2008- Defy Media. All rights reserved.
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Mobil Delvac™ Synthetic ATF is a synthetic fluid recommended by Allison Transmission, Inc. approved against the Allison TES-295 Specification. The fluid is designed to meet the demanding requirements of modern heavy duty automatic transmissions. The synthetic base oil composition enables excellent performance even in some of the harshest of operating conditions. It offers outstanding gear shifting and power transfer performance versus conventional ATF fluids. The inherently high viscosity index and stability of Mobil Delvac Synthetic ATF protects against thermal breakdown at high operating temperatures, while still providing outstanding performance at sub-zero temperatures.
Mobil Delvac Synthetic ATF advanced technology has demonstrated extended drain, long-term friction retention, and low-temperature capability. Further, it improves overall transmission durability and cleanliness. Key features and benefits include


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Technical Assistance Grants for Preserving and Interpreting Black History In Pennsylvania
The State Historic Preservation Office/Bureau for Historic Preservation at the Pennsylvania Historical & Museum Commission (PHMC) is the recipient of a Preserve America Grant from the National Park Service, U.S. Department of the Interior. Preserve America is a federal initiative that encourages and supports community efforts to preserve and enjoy our priceless cultural and natural heritage. The goals of the program include a greater shared knowledge about the nation's past, strengthened regional identities and local pride, increased local participation in preserving the country's cultural and natural heritage, and support for the economic vitality of communities.
Using a portion of this federal grant award, the PHMC is making technical assistance grants available to encourage the documentation, preservation, and interpretation of Pennsylvania's African American history. Because the federal government is the source of these funds, special terms and conditions apply. PHMC staff will assist applicants with the special requirements.
Total amount of funding available for these grants: $36,400. The maximum grant award from PHMC to an organization is $3,000. Grants do not require a match. Generally, $2,000 will be available to pay a consultant to provide direction and training to the applicant organization and $1,000 for implementation of the project. The PHMC anticipates awarding approximately 12 grants.
Availability of Funds
Funding through this Preserve America Grant is limited to a single-award period as described below.
Who May Apply Eligible applicants must be a non-profit 501c3 organization or a unit of local government. While any eligible not for profit organization may apply for these grants, the primary audience is African-American community organizations. Community-initiated projects will receive funding preference. Organizations that do not have not for profit status may partner with an organization that is an IRS tax-exempt 501c3 organization. The tax-exempt organization must be the applicant and fiscal agent.
The following are the types of organizations that are eligible to apply:
Who May Not Apply
Organizations and others that are not eligible to apply include:
State Eligibility Requirements
To apply for Preserve America grants for Preserving and Interpreting African-American Heritage in Pennsylvania, an organization must meet the following requirements:
Federal Eligibility Requirements In order to be eligible to receive a Preserve America-funded grant, the Department of the Interior requires that each applicant:
Special Requirements
General Conditions There are a number of general conditions for these Preserve America Grants.
Ineligible Activities Preserve America Grants may not be used to fund the following:
Categories of Support
Grant Assistance is available to support the following institutional capacity building and African American heritage preservation activities:
Archives, Local and Regional History, Historic Preservation, Museum Projects
Following are some examples of projects that are eligible for grant funding:
Criteria for Evaluation
The following criteria will be used to evaluate the grant proposals.
Defines the project activity and projected work products
If artifacts, records, buildings and sites, or other historical
resources are involved, the project application describes
them and their importance to the project
Relates project to goals and previous/ongoing
work of organization
Relates project to African American context
Public/Community Benefit, Support, Merit and Promotion 30 pts total
Identifies intended audience for project and describes steps
to make them aware and supportive of the project
Describes how project benefits the community and includes at
least two letters of support
Demonstrates how it will increase understanding of African
American Heritage in Pennsylvania
Work Plan/Timetable 12 pts total
Provides chronology and explanation of steps required
Project can be accomplished at the rate and within
the schedule provided
Personnel/Consultants 12 pts total
Identifies project personnel by name and provides resumes which show
they are qualified to carry out and complete the project
If personnel are not yet identified, provides job descriptions
that will be used to solicit personnel
Outlines responsibilities of personnel/consultant
Project Budget 16 pts total
Application describes how each budget line item is determined
Each expense shown on budget page is explained in project narrative
and vendor quotes are included for products and services, as appropriate
Budget is detailed and allocates funds and any matching funds, if available,
into correct categories
Budget is realistic and appropriate for the project
Application is complete, accurate, and all requirements have been met
Grant Period and Implementation TimetableApplication Submission Deadline is September 30, 2011.
The following timetable for processing grant applications and implementing projects is provided for your information and as a planning guide.
E-grant system opens August 1, 2011
Grant Application deadline September 30, 2011
Grant Evaluation Review Panel early October 2011
PHMC Approvals November 16, 2011
Award/Rejection Letters Mailed Late November 2011
Grant Agreements Mailed Late November 2011
Signed Grant Agreement Returned
To PHMC No later than December 31, 2011
Fully-executed Contracts Mailed
To grantee March 2012
Interim Grant Report due August 2012
Project Completed December 31, 2012
Final Grant Report Due to PHMC January 31, 2013
Maximum Number of Awards Eligible applicants may submit only one application.


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|Low-level cadmium exposure in Toyama City and its surroundings in Toyama prefecture, Japan, with references to possible contribution of shellfish intake to increase urinary cadmium levels.
MedLine Citation:
|PMID: 16169058 Owner: NLM Status: MEDLINE
|OBJECTIVES: This study was initiated to examine if exposure to cadmium (Cd) was high also outside of the previously identified Itai-itai disease endemic region in the Jinzu River basin in Toyama prefecture in Japan. METHODS: Morning spot urine samples were collected in June-August 2004 from 651 adult women (including 535 never-smokers) in various regions in Toyama prefecture, and subjected to urinalyses for cadmium (Cd), alpha1-microglobulin (alpha1-MG), beta2-microglobulin (beta2-MG), N-acetyl-beta-D-glucosaminidase (NAG), specific gravity (SG or sg) and creatinine (CR or cr). Three months later, the second urine samples were collected from those with elevated Cd in urine (e.g., > or =4 microg/g cr), together with answers to questionnaires on shellfish consumption. RESULTS: The geometric mean (GM) Cd, alpha1-MG, beta2-MG and NAG (after correction for CR) for the total participants were 2.0 microg/g cr, 2.4 mg/g cr, 104 microg/g cr and 2.8 units/g cr, respectively; further analysis with never-smoking cases only did not induce significant changes in these parameters. Analyses of the second urine samples from the high Cd subjects showed that there was substantial decrease (to about a half) in Cd in the 3-month period, and that the decrease was accompanied by reduction in alpha1-MG and NAG (beta2-MG did not show elevation even in the first samples). The urinalysis results in combination with the results of the questionnaire survey suggest that the high urinary Cd was temporary and might be induced by intake of shellfish that is edible whole. CONCLUSIONS: The overall findings appear to suggest that Cd exposure in Toyama populations (outside of the Itai-itai disease endemic region) was at the levels commonly observed on the coast of the Sea of Japan, and that the Cd level in urine might be modified by the intake of some types of seafood. Further studies are necessary to elucidate the relation of urinary Cd with seafood intake.
|T Yamagami; T Ezaki; J Moriguchi; Y Fukui; S Okamoto; H Ukai; H Sakurai; K Aoshima; M Ikeda
Related Documents :
|9602918 - Oral cadmium exposure of adults in germany. 2: market basket calculations.
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23562868 - Sensory-specific appetition: postingestive detection of glucose rapidly promotes contin...
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Publication Detail:
|Type: Comparative Study; Journal Article Date: 2005-09-16
Journal Detail:
|Title: The Science of the total environment Volume: 362 ISSN: 0048-9697 ISO Abbreviation: Sci. Total Environ. Publication Date: 2006 Jun
Date Detail:
|Created Date: 2006-05-23 Completed Date: 2006-07-28 Revised Date: 2007-11-15
Medline Journal Info:
|Nlm Unique ID: 0330500 Medline TA: Sci Total Environ Country: Netherlands
Other Details:
|Languages: eng Pagination: 56-67 Citation Subset: IM
|Hokuriku Health Service Association, Toyama 930-0177, Japan.
Export Citation:
|APA/MLA Format Download EndNote Download BibTex
|MeSH Terms
Alpha-Globulins / urine
Biological Markers / urine
Cadmium / urine*
Environmental Monitoring
Environmental Pollutants / urine*
Food Contamination*
Kidney Tubules / metabolism
Middle Aged
beta 2-Microglobulin / urine
Reg. No./Substance:
|0/Alpha-Globulins; 0/Biological Markers; 0/Environmental Pollutants; 0/alpha-1-microglobulin; 0/beta 2-Microglobulin; 7440-43-9/Cadmium; EC 22.214.171.124/Acetylglucosaminidase
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Mercury methylation and bacterial activity associated to tropical phytoplankton.
Next Document: A history of total mercury in edible muscle of fish from lakes in northern Canada.


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@ GoDani.... You baffoon, over the last half a dozen rain drenched motogp races in recent times there has been a fist ful of riders mention the exact same thing regarding visor problems yet simply because it's Rossi this time who mentioned it, it has to be an excuse!
Get a life and grow up ffs!


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WASHINGTON, D.C.--If Vice President Dick Cheney and other Bush Administration officials interfered in a high-stakes battle over endangered species in 2002, Democrats can't find any tracks. Although a former National Oceanic and Atmospheric Administration scientist testified about his recommendations being overturned, a hearing today by the House Natural Resources Committee did not uncover any evidence to support allegations of meddling made in a recent article in The Washington Post.
The battle concerns the Klamath River Basin, which spans southern Oregon and northern California (Science, 4 April 2003, p. 36). In 2001, a severe drought forced the Bureau of Reclamation, which runs dams and canals along the river, to deliver less water than normal from the river to farms and pastures. The decision was based on a 2001 "biological opinion" from the Fish and Wildlife Service (FWS) and the National Marine Fisheries Service (NMFS), which had determined that three species of endangered fish, including the coho salmon, needed the water to survive. Dependent on this irrigation, some 70,000 hectares of farmland dried up. Oregon farmers raised a stink.
That's when Cheney allegedly got involved. A 27 June article in the Washington Post reported that, at Cheney's request, the Department of Interior (DOI) asked the National Research Council (NRC) to review the biological opinions underpinning the decision to keep the water in the river. Its preliminary report concluded that removing water was unlikely to harm the fishes. A subsequent opinion in 2002 by NMFS concurred with NRC. "Because of Cheney's intervention, the government reversed itself and let the water flow in time to save the 2002 growing season," the Post concluded.
At today's hearing, former NMFS biologist Michael Kelly--author of the 2002 opinion--told panel chair Representative Nick Rahall (D-WV) that he believed more water needed to be left in the river in 2002 than what NRC had recommended. But Kelly says his draft opinion was reviewed by the Department of Justice and found to be "indefensible."
Subsequently, Kelly said, James Lecky, assistant administrator of the Southwest region for NMFS, arrived at the field office and produced a "defensible" opinion that was consistent with the NRC report. "It was obvious to me that someone up the chain of command was applying a tremendous amount of pressure on Mr. Lecky," Kelly said. Not so, says NMFS Assistant Administrator William Hogarth. "There was no pressure," he told ScienceNOW after testifying. "The only pressure was that we were behind schedule."
The House committee also reviewed a second allegation of political influence in the Klamath. In 2003, the Wall Street Journal reported that Karl Rove, then White House chief of staff, had visited 50 DOI managers and noted that the Bush Administration favors farmers over fish. In subsequent investigations, however, the DOI Inspector General's office found "no evidence of political influence affecting the decisions pertaining to the water in the Klamath Project."
Although the DOI investigations did not look at any possible involvement by the vice president, Representative Greg Walden (R-OR) said he doubted that the earlier investigations would have ignored tampering by Cheney. Mary Kendall, deputy inspector general of DOI, said she couldn't be sure without taking another look. "There is room to interpret that perhaps information was not provided," she told the committee. But don't expect an answer soon: Kendall says her office has no plans to investigate.
Related sites


text:
Research Topics
Abel N Kho
Affiliation: Northwestern University
Country: USA
Detail Information
- Electronic medical records for genetic research: results of the eMERGE consortiumAbel N Kho
Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
Sci Transl Med 3:79re1. 2011..Efforts and incentives to increase the implementation of interoperable EMRs will markedly improve the availability of clinical data for genomics research...
- An evaluation of the NQF Quality Data Model for representing Electronic Health Record driven phenotyping algorithmsWilliam K Thompson
Northwestern University, Chicago, IL, USA
AMIA Annu Symp Proc 2012:911-20. 2012..However, we also found areas in which the QDM could be usefully extended, such as representing information extracted from clinical text, and the ability to handle algorithms that do not consist of Boolean combinations of criteria...
- Practical challenges in integrating genomic data into the electronic health recordAbel N Kho
Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
Genet Med 15:772-8. 2013..Successful integration of genomic data may require significant redesign of existing electronic health record systems...
- High density GWAS for LDL cholesterol in African Americans using electronic medical records reveals a strong protective variant in APOELaura J Rasmussen-Torvik
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Clin Transl Sci 5:394-9. 2012..Use of median LDL-C extracted from EMR after exclusions for medications and comorbidities increased the percentage of trait variance explained by genetic variation...
- Use of diverse electronic medical record systems to identify genetic risk for type 2 diabetes within a genome-wide association studyAbel N Kho
Northwestern University, Chicago, Illinois, USA
J Am Med Inform Assoc 19:212-8. 2012..The aim of this study was to identify type 2 diabetes (T2D) cases and controls for a GWAS, using data captured through routine clinical care across five institutions using different electronic medical record (EMR) systems...


text:
Magazine article National Association of School Psychologists. Communique
Coming Soon: The 2009 NASP Public Policy Institute
Article excerpt
The NASP Public Policy Institute (PPI) will be held July 13-15 in Bethesda, MD and is an essential training experience for any state interested in pursuing public policy initiatives that impact school psychology. Many states are currently working to achieve NCSP parity, protect the title "school psychologist," or expand the availability of school mental health services. Many school districts are facing budget cuts and school psychologists are working to prioritize and position their services to protect them from being impacted by difficult financial times. A terrific way for individuals and state associations to build their capacity to engage in effective advocacy is to involve individuals or teams from their state in the 2009 NASP PPI. Through this experience, participants and state association leaders will gain critical knowledge and a realistic perspective about how to make policy and legislative goals a reality.
Nationally recognized experts, NASP leaders, and NASP staff will provide training on the fundamentals of both professional and legislative advocacy. The 2009 NASP PPI will be held concurrently with the NASP Summer Conference and all participants will attend the four general session presentations together. These four general sessions will include presentations by Dr. George Sugai examining how PBIS can be advanced through policy and practice; Dr. Karen Reivich sharing howher partnership with the Pepperidge Farm "Fishful Thinking" project has promoted positive psychology in schools; former NASP president Kevin Dwyer addressing how school psychologists can add value to their roles in school; and past-president of the National Association of Elementary School Principals, Rich Barbacane, who will address how school psychologists can become integral to school improvement initiatives.
All other PPI sessions will be led by local experts in the area of education, public policy, or government affairs; NASP leaders; and NASP staff. The primary objective of the PPI is to build capacity, knowledge, and skills related to public policy and grassroots advocacy. Topics reviewed will be key education statutes like NCLB and IDEA, and how states can create local advocacy networks that are effective at influencing public policy. Communication strategies, NASP initiatives, and specific tools for involving profession- als in the advocacy process will be addressed. …


text:
Prognosis in patients suffering out-of-hospital cardiac arrest is poor. Higher survival rates have been observed only in patients with ventricular fibrillation who were fortunate enough to have basic and advanced life support initiated soon after cardiac arrest. An ability to predict cardiac arrest outcomes would be useful for resuscitation. Changes in expired end-tidal carbon dioxide levels during cardiopulmonary resuscitation (CPR) may be a useful, noninvasive predictor of successful resuscitation and survival from cardiac arrest, and could help in determining when to cease CPR efforts.
This is a prospective, observational study of 737 cases of out-of-hospital cardiac arrest. The patients were intubated and measurements of end-tidal carbon dioxide taken. Data according to the Utstein criteria, demographic information, medical data, and partial pressure of end-tidal carbon dioxide (PetCO2) values were collected for each patient in cardiac arrest by the emergency physician. We hypothesized that an end-tidal carbon dioxide level of 1.9 kPa (14.3 mmHg) or more after 20 minutes of standard advanced cardiac life support would predict restoration of spontaneous circulation (ROSC).
PetCO2 after 20 minutes of advanced life support averaged 0.92 ± 0.29 kPa (6.9 ± 2.2 mmHg) in patients who did not have ROSC and 4.36 ± 1.11 kPa (32.8 ± 9.1 mmHg) in those who did (P < 0.001). End-tidal carbon dioxide values of 1.9 kPa (14.3 mmHg) or less discriminated between the 402 patients with ROSC and 335 patients without. When a 20-minute end-tidal carbon dioxide value of 1.9 kPa (14.3 mmHg) or less was used as a screening test to predict ROSC, the sensitivity, specificity, positive predictive value, and negative predictive value were all 100%.
End-tidal carbon dioxide levels of more than 1.9 kPa (14.3 mmHg) after 20 minutes may be used to predict ROSC with accuracy. End-tidal carbon dioxide levels should be monitored during CPR and considered a useful prognostic value for determining the outcome of resuscitative efforts and when to cease CPR in the field.
Despite all of the progress that has been made in reanimating patients in cardiac arrest over the past half century, resuscitation attempts often fail to restore spontaneous circulation. Consistent and discouraging low survival rates mandate a reassessment of current resuscitative strategies and techniques [1-5]. Overall survival after out-of-hospital cardiac arrest is frequently under 3% [6-8], and so the most common of all decisions after initiation of cardiopulmonary resuscitation (CPR) remains the decision of when to stop. An library of research and guidelines for terminating resuscitative efforts has been developed during the past two decades, and various clinical indicators have been used to determine when CPR efforts should be terminated [8-12]. Capnography (capnometry) potentially represents a useful clinical indicator of death that could guide decisions to terminate resuscitative efforts [8,13]. We sought to evaluate the hypothesis that partial pressure of end-tidal carbon dioxide (PetCO2) can predict nonsurvival in an independent cohort of patients suffering out-of-hospital cardiac arrest.
Materials and methods
A total of 737 patients who suffered a sudden cardiac arrest in the field and were treated by a mobile emergency team were included in the present prospective study. The data were obtained fin the field in Maribor (approximately 200,000 inhabitants). The study was approved by the Ethics Board of the Ministry of Health of the Republic of Slovenia (59/05/00), which granted a waiver of the need for informed consent. Whenever possible, patients who regained consciousness or their relatives were informed of the study after enrollment.
Consistent with the European Union recommendations, we have a single emergency number: 112. In the Centre for Emergency Medicine Maribor there are two prehospital emergency teams and two basic life support teams equipped with defibrillators. In addition, from April till October during the daytime, in Maribor there is a motorcycle rescuer with defibrillation capability; he and the prehospital emergency team are simultaneously dispatched and they rendezvous in the field.
The prehospital emergency team is an advanced life support unit including three members with an adequately equipped road vehicle. The team includes an emergency physician and two registered nurses or medical technicians.
The basic life support team includes two medical technicians or nurses and driver (paramedic). The motorcycle rescuer is a registered nurse or nurse. The prehospital emergency team is routinely dispatched to the field in emergency situations (in case of presumed cardiac arrest, heart attacks, respiratory distress, cerebrovascular incident, trauma, delivery, poisoning and so on). Basic life support and advanced life support are provided using a regional protocol that incorporates European Resuscitation Council standards and guidelines, and clinical algorithms for cardiac resuscitation. After resuscitation, the patient is transferred to the intensive care unit (ICU) of the University Clinical Center, Maribor. Data in accordance with the Utstein criteria, demographic information, medical data and PetCO2 values were collected for each patient in cardiac arrest by the emergency physician. Hospital records were used for outcome analysis, which also included assessment of cerebral performance category (CPC) by the intensive care unit specialist. A CPC score of 1 reflects good cerebral performance, CPC scores of 2 and 3 indicate moderate and severe cerebral disability, a CPC score of 4 indicates a comatose, vegetative stage, and CPC score 5 indicates brain death.
All nontraumatic out-of-hospital cardiac arrests in adults older than 18 years in the years from January 1998 to December 2006 were included in the study. Exclusion criteria were documented terminal illness and severe hypothermia (<30°C). We defined return of spontaneous circulation (ROSC) in accordance with the Utstein style ('any ROSC' – palpabile pulse on carotid artery, regardless of duration, and ROSC with admission to hospital). In our analysis and comparison, we consider only those patients with ROSC on admission to hospital (defined as having a stable blood pressure when the prehospital resuscitation team was dismissed by the ICU team).
An endotracheal tube was immediately connected to the capnometer. We measured PetCO2 continuously and recorded it during resuscitation, beginning with intial postintubation PetCO2 (first PetCO2 value obtained) and ending with the final PetCO2 value at admission to the hospital or termination of resuscitation attempts. Measurements of PetCO2 were taken using the sidestream method with the infrared capnometer integrated into the LIFEPACK 12 defibrillator monitor (Physio Control, Medtronic Inc., Redmond, WA, USA) or with BCI Capnocheck Model 20600A1 (BCi International, Waukesha, WI, USA).
Continuous data are expressed as median (range) and other data are expressed as mean ± standard deviation. Proportions were reported with 95% confidence interval. Analysis for caterogical variables were performed using χ2 test (with Yates correction, if appropriate) and exact Fisher test. Comparisons between groups were performed using t-test (normal distribution) and Mann-Whitney test (normality test failed). Sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were calaculated using standard formulae. For each value, receiver operating characteristic (ROC) curves were obtained. The ROC curve depicts the relation between true positive results (number of predicted deaths among those who actually died) and false positive results (number of predicted deaths among those who actually survived) for each score. The greater the area under the ROC curve (AUROC), the better the predictive value of PetCO2.
Analyses of independent predictors for ROSC and survival from univariate analysis were performed using multivariate logistic regression.
The null hypothesis was considered to be rejected at P values less than 0.05 in all tests. For statistical analysis we used SPSS12.01 software (SPSS Inc., Chicago, IL, USA).
During the period of evaluation, our centre was involved in 1,086 emergency interventions in which there was absence of signs of circulation at the start of intervention. Ultimately, 737 patients were resuscitated. ROSC was achieved in 438 patients (59.4%), overall survival to hospital admission occurred in 55% (402 patients) and 170 (23%) patients were discharged alive (Figure 1).
Figure 1. Utstein reporting template for out-of-hospital cardiac arrest obtained over an 8-year period. CPC, cerebral performance category; CPR indicates cardiopulmonary resuscitation; EMS, emergency medicine services; PEA, pulseless electrical activity; ROSC, restoration of spontaneous circulation; VF, ventricular fibrillation; VT, ventricular tachycardia.
The univariate analysis for ROSC on admission (Table 1) showed that initial PetCO2, ventricular fibrillation or pulseless ventricular tachycardia as the initial rhythm, witnessed arrest, bystander-performed CPR, female sex and response time were associated with ROSC. Using the same method, we found that bystander CPR, witnessed arrest, final PetCO2, initial PetCO2 and resposne time were associated with survival. The initial PetCO2 was higher in patients who survived and in those who achieved ROSC (values expressed as kPa [mmHg]; surviving patients: 3.17 [23.8] ± 1.42 [10.7] versus 2.34 [17.6] ± 1.95 [14.7]; ROSC patients 3.13 [23.5] ± 1.65 [12.4] versus 2.54 [19.1] ± 2.43 [18.3]; P < 0.001). The final PetCO2 (kPa [mmHg]; surviving patients: 3.89 [29.3] ± 1.12 [8.4] versus 1.99 [15.0 mmHg] ± 1.33 [10.0]; ROSC patients: 3.64 [27.4] ± 0.94 [7.1] versus 0.97 [7.3] ± 0.33 [2.5]; P < 0.001) was also considerably higher in the surviving and ROSC patients (Table 2).
Table 1. Clinical and demographic characteristics for 737 of cardiac arrest patients, according to immediate outcome (ROSC with hospital admission)
Table 2. Clinical and demographic characteristics for the 737 cardiac arrest patients, according to survival (discharge from hospital)
The PetCO2 value after 20 minutes of advanced life support averaged 0.91 kPa (6.8 mmHg) ± 0.29 kPa (2.2 mmHg) in patients without ROSC and 4.36 kPa (32.8 mmHg) ± 1.11 kPa (8.4 mmHg) in those who achieved ROSC (P < 0.001). An end-tidal carbon dioxide value above 1.9 kPa (14.3 mmHg) discriminated between the 402 patients with ROSC and 335 patients without ROSC. When an end-tidal carbon dioxide value of 1.9 kPa (14.3 mmHg) or less was used to predict death, the sensitivity, specificity, PPV and NPV were all 100% (Table 3).
Table 3. Performance of various values of PetCO2 and duration of CPR for predicting ROSC in all patients with cardiac arrest
A 15-minute PetCO2 value of 1.8 kPa (13.5 mmHg) had a sensitivity and NPV of 100%, with high specificity and positive predictive value (98%).
In the patients with nonshockable initial rhythm (pulseless electrical activity), we observed significantly higher initial PetCO2 values in comparison with the patients with shockable initial rhythm. On the contrary, in the group of patients who presented with ventricular fibrillation/pulseless tachycardia arrest, there were significantly higher values of PetCO2 from the first minute of CPR to the final value (admission to hospital or termination of CPR; Table 4).
Table 4. Comparison of characteristics and values of PetCO2 between shockable and nonshockable initial rhythm for patients with cardiac arrest
The values of PetCO2 in both groups (the group of shockable and the group of nonshockable initial rhythm) were significantly higher in patients with ROSC than in the patients without ROSC (except the PetCO2 after 1 minute of CPR in patients with asystole or pulseless electrical activity as initial rhythm). No patients with an initial, average, final, or maximum PetCO2 value of less than 1.33 kPa (10 mmHg) was resuscitated (Tables 5 and 6).
Table 5. Comparison of characteristics and values of PetCO2 between patients with ROSC and without ROSC in shockable initial rhythm in cardiac arrest
Table 6. Comparison of characteristics and values of PetCO2 between patients with ROSC and without ROSC in nonshockable initial rhythm in cardiac arrest
After 20 minutes of CPR, PetCO2 (regardless of initial rhythm) clearly discriminated between survivors and nonsurvivors in the field (admission to hospital; Tables 7 and 8). In the shockable group PetCO2 values above 1.5 kPa (11.3 mmHg; for a positive outcome), and in the nonshockable group values above 1.90 kPa (14.3 mmHg) had a sensitivity, specificity, PPV and NPV values of 100%, and the AUROC was 1.
Table 7. Performance of various values of PetCO2 and duration of CPR for prediction of ROSC in patients with shockable initial rhythm in cardiac arrest
Table 8. Performance of various values of PetCO2 and duration of CPR for prediction of ROSC in patients with nonshockable initial rhythm in cardiac arrest
After 15 minutes of CPR, PetCO2 values above 1.8 kPa (13.5 mmHg), in both shockable and nonshockable groups, had sensitivity and NPV of 100%, with acceptable specificity and PPV, and an AUROC of 1 (Tables 7 and 8).
At 20 minutes of CPR, a cut-off point for PetCO2 values of 1.5 kPa (13.5 mmHg) yielded sensitivity and NPV of 100% in terms of predicting discharge from hospital in patients with shockable intial rhythm. With a 20-minute PetCO2 cut-off of 2.1 kPa (15.8 mmHg), the sensitivity and NPV were 100% in terms of predicting discharge from hospital in patients with nonshockable initial rhythm (Table 9, Table 10).
Table 9. Performance of various values of PetCO2 and duration of CPR for prediction of survival in patients with shockable initial rhythm in cardiac arrest
Table 10. Performance of various values of PetCO2 and duration of CPR for prediction of survival in patients with nonshockable initial rhythm in cardiac arrest
In multivariate analysis (Table 11), initial, average, 10-minute, 15-minute, 20-minute, maximum and final values of PetCO2, shockable initial rhythm (ventricular fibrillation or tachycardia), witnessed arrest, bystander-performed CPR, female sex and arrival time were associated with improved ROSC. Using the same method we found that bystander CPR, witnessed arrest, shockable initial rhythm, initial, average, 10-minute, 15-minute, 20-minute, maximum and final PetCO2 values, and arrival time were associated with improved survival (Table 12).
Presenting the European perspective, Scogvoll and coworkers [14] reported that the annual incidence of attempted CPR ranged from 33 to 71 per 100,000 inhabitants. Sudden cardiac death accounts for approximately 1000 lives per day in the USA [5]. In the majority of cases, CPR and other treatment efforts are unsuccessful, and the patient was eventually pronounced dead. A number of clinical indicators can be used to determine when those efforts should be terminated [15-18]. Morrison and colleagues [12] described a clinical decision rule for termination of resuscitation (TOR), which was designed to help emergency medical services to determine whether to terminate resuscitative efforts in the setting of out-of-hospital cardiac arrest. In that Canadian study, the investigators sought to validate their previously proposed prediction rule, namely that TOR should be considered if spontaneous circulation does not return before transport is initiated, if no automatic external defibrillator (AED) shocks are given before transport is initiated, and if arrest was not witnessed by emergency personnel. This simple prediction rule has 99.5% PPV and a specificity of 90.2%, and may be useful for providing supplementary guidance in the field [17]. However, a rule cannot determine, for example, how long to continue resuscitation efforts before declaring 'no ROSC'. Decisions about TOR continue to cause difficulties for health care professionals. Current guidelines provide some information on underlying principles, but they do not include a objective, clear and numerical decision rule regarding TOR.
Several animal and clinical studies suggest that the PetCO2 can be used to determine when resuscitation should be ceased. Investigators have suggested that there is a close correlation between PetCO2 and cardiac output, stroke volume, and coronary and cerebral perfusion pressure during CPR. Kalenda [19] first reported a decrease in PetCO2 in patients who could not be resuscitated, and a significant rise in PetCO2 in those patients in whom ROSC could be achieved.
Falk and coworkers [20] found that PetCO2 decreased from mean of 1.4% before arrest to 0.4% after the onset of cardiac arrest. It then increased with CPR and ROSC. Sanders and colleagues [21] found that the end-tidal carbon dioxide level predicted successful resuscitation after in hospital and out-of-hospital cardiac arrest. The average, initial, final, maximum and minimum values of PetCO2 were all higher in resuscitated patients. No patient with an average PetCO2 value of less than 1.33 kPa (10 mmHg) was resuscitated.
Callaham and Barton [22] found that the four patients who had initial and later PetCO2 values of less than 1.33 kPa (10 mmHg) were all resuscitated. These data and similar reports of ROSC after prolonged resuscitative attempts [23] with low PetCO2 values may account for the reluctance of the scientific community to incorporate PetCO2 in Utstein-style reports and resuscitation algorithms. In a landmark prospective study, Levine and colleagues [8] observed 150 patients suffering cardiac arrest and measured PetCO2 using a mainstream capnometer. They compared 20-minute PetCO2 and initial values and concluded that initial values are unreliable in predicting mortality. The 20-minute values of PetCO2 were promising and more reliable in predicting mortality. Values less then 1.33 kPa (10 mmHg) after 20 minutes of CPR were incompatible with survival, and the authors are of the opinion that this could be helpful in deciding when to stop resuscitation efforts. We established the relationship between PetCO2 and prognosis in prehospital CPR in our previous studies [5,24]. In the second study [24], we confirmed that PetCO2 and mean arterial pressure values are prognostic for the outcome of out-of-hospital cardiac arrest. During a cardiac arrest, PetCO2 can be considered an indirect parameter for the evaluation of cardiac output in the prehospital setting, together with mean arterial pressure, when spontaneous circulation is restored.
Our study is the largest prospective study of the predictive value of PetCO2 measurement for ROSC and survival, and includes 737 victims of out-of-hospital sudden cardiac arrest. We confirmed that bystander CPR, witnessed arrest, shockable initial rhythm, initial, average, 10-minute, 15-minute, 20-minute, maximum and final values of PetCO2 and arrival time were all associated with improved ROSC and survival.
We found that PetCO2 values above 1.9 kPa (14.3 mmHg) measured after 20 minutes of resuscitation identified patients with ROSC with 100% sensitivity, specificity, PPV and NPV. No patients with initial, average, final and maximum PetCO2 values of less than 1.33 kPa (10 mmHg) was resuscitated. With a cut-off point of 20-minute PetCO2 value at 1.5 kPa (13.5 mmHg) in patients with shockable initial rhythm and a cut-off point at 2.1 kPa (15.8 mmHg) in patients with nonshockable initial rhythm, sensitivity and NPV were 100% in predicting discharge from hospital.
In nonshockable rhythm we found higher initial values and lower values after 1 minute of CPR. In our previous study [25] we confirmed PetCO2 to be markedly elevated during the first minute of CPR in asphyxial cardiac arrest. This study therefore confirmed the findings of studies that used animal models in which cardiopulmonary arrest was induced by asphyxia. In this study the PetCO2 values during CPR were initially high, then decreasing to subnormal levels and then increasing again to near-normal levels in patients with ROSC. This pattern of PetCO2 change is different from the pattern observed in cardiac arrest caused by venticular fibrillation, because cardiac arrest from venticular fibrillation results in an abrupt cessation of cardiac output and pulmonary blood flow. We concluded that, during the period of asphyxia, continued cardiac output before cardiac arrest permits continued delivery of carbon dioxide to the lungs, which (in the absence of exhalation) results in higher alveolar carbon dioxide levels. This is reflected in increased PetCO2 when ventilation is resumed.
Our findings in patients with shockable initial rhythm confirmed the view of Levine and coworkers [8] that the data from their study (PetCO2 in patients with pulseless electrical activity) can be extended to all types of cardiac arrest. Sehra and coworkers [26], in a human model of ventricular fibrillation, confirmed that PetCO2 can predict severity of ventricular fibrillation cardiac arrest and efficacy of CPR in this type of cardiac arrest. Our findings in shockable group possible indirectly confirm the three-phase, time-dependent concept of cardiac arrest due to ventricular fibrillation [26]. PetCO2 values under 1.5 kPa (11.3 mmHg) after 20 minutes of CPR (or less that 1.8 kPa [13.5 mmHg] after 15 minutes of CPR) are incompatible with ROSC. This is time of the end of haemodynamic phase of CPR. Possibly, these values represent irreversible hemodynamic collapse, with inadequate coronary or myocardial perfusion pressure, or they may represent perfusion pressures supplied too late (after the haemodynamic phase), with consequent irreversible tissue damage [27,28].
Our prehospital data, combined with the findings of other investigators, provide strong support for a resuscitation thresholds of PetCO2 1.33 kPa (10 mmHg) initially and 1.9 kPa (14.3 mmHg) after 20 minutes of CPR in the field. The initial values of PetCO2 are not influenced by medications used during CPR, and values at 20 minutes reflect the patient's 'response' to resuscitation efforts. We recommend initial and 20-minute (final PetCO2) to be ranked in Utstein-style reports. The objectives of this approach are to assess the initial condition of the patient in the setting of nontraumatic normothermic cardiac arrest, and to optimize the reliability of PetCO2 in predicting survival in such patients.
Our finding are potentially important, especially in emergency medical system that do not include physicians. The results of the study confirm that PetCO2 can play a pivotal role in the multifactorial decision-making process of whether to discontinue resuscitative efforts. Application of our findings could improve clinical prediction rules for TOR in the field and reduce the number of patients with cardiac arrest who undergo prolonged, futile resuscitation efforts; furthermore, they may reduce transportation of patients with refractory cardiac arrest to the hospital. For the health care system, there is less cost involved in TOR in the field than in the transfer of the patient to the hospital [12,29,30].
Measurements of PetCO2 should be used to predict nonsurvival of patients with cardiopulmonary arrest. End-tidal carbon dioxide levels should be monitored during CPR and should be regarded as having prognostic value for determining the outcome of resuscitative efforts. The results can inform decisions regarding when advanced cardiac life support can be discontinued, thus decreasing costs and dilemmas to resuscitation teams. Based on our findings, we believe that end-tidal carbon dioxide monitoring should be incorporated into advanced cardiac life support algorithms and ranked in Utstein-style reports to provide insight into the condition of patients suffering cardiac arrest.
Key messages
• A PetCO2 level of 1.9 kPa (14.3 mmHg) or less measured 20 minutes after the initiation of advanced cardiac life support accurately predicts death in patients with nonshockable initial rhythm who are suffering cardiac arrest.
• When a 20-minute PetCO2 value of 1.5 kPa (11.3 mmHg) or less was used as a screening test to predict death in patients with shockable rhythm, the sensitivity, specificity, PPV and NPV were all 100%.
• Values of PetCO2 less than 1.5 kPa (11.3 mmHg) after 20 minutes of CPR (or <1.8 kPa [<13.5 mmHg] after 15 minutes of CPR) are incompatible with ROSC.
• End-tidal carbon dioxide levels should be monitored during CPR, and should be regarded as having prognostic value in predicting the outcome of resuscitative efforts and informing decisions regarding TOR.
AUROC: area under the ROC curve; CPC: cerebral performance category; CPR: cardiopulmonary resuscitation; ICU: intensive care unit; NPV: negative predictive value; PetCO2: partial pressure of end-tidal carbon dioxide; PPV: positive predictive value; ROC: receiver operating characteristic; ROSC: return of spontaneous circulation; TOR: termination of resuscitation.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
MK participated in designing the study, collection and analysis of data, and helped to draft the manuscript. MK participated in designing the study, and collection and statistical analysis of data. PK participated in designing the study and helped to draft the manuscript. ŠG participated in designing the study, collection and analysis of data, revised the manuscript for important intellectual content and helped to draft the manuscript. All authors read and approved the final version of the manuscript.
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Not a trailer queen...
Several years ago, while living in Belgium on an expatriate assignment, I was looking for a classic car. I was looking for a 4-seater convertible with iconic styling that was not going to be difficult (read expensive) to maintain. Reading a Classic Car magazine that made me realize what I was looking for. When Classic and Sport Cars featured the Mustang convertible on the cover celebrating 100 year of Ford, my choice was made. The fact that I had owned a '95 GT convertible when living in South Carolina helped the connection with mustang.
After searching the web, visiting specialists, looking through magazines for over a year, I finally found one in 2004 after contacting the chairman of the Belgian Mustang & Cougar Club. He had one of his 5 ponies for sale, and within 2 days the car was mine. I had a 1969 royal maroon Mustang Convertible. Life was good. To make the car more useable I had power breaks installed in the 1st month at a Mustang specialist, along with a modern radio/cd player. I made my first trip up to the Netherlands to show off the new purchase to some friends and upon my return disaster struck in the form of a 1987 sibling, a frontal encounter with an old Escort.
The accident required a new fender, grill, headlamps, bumper, many associated parts and a partial re-spray. I was now thankful that I had chosen a car with most parts still available and good specialist support. The silver lining of the accident was that my insurance company put in a contact with probably the best Mustang specialist outside the USA: Alpha Cars, which happens to be located in Antwerpen where I was living at that moment.
Since the car was going to be in the shop for repairs we decided to use the opportunity to improve the car: revision of the steering, revision of the water pump, new wooden grant steering wheel, replacing seals to solve all little oil leaks (people claim that oil leaks are part of owning a Mustang, but this does not need to be the case) new tires, Petronix ignition upgrade, Koni adjustable shocks, Global West subframe connectors, and taking care of a rattling window. The objective was to ensure that the car would easily drive back and forth from Antwerpen Belgium to St. Tropez in the south of France.
In the spring we made some trips to Maastricht, Brussels, and Bruges and fully enjoyed the car. I feel strongly that classic cars need to be used, not driven from show to show on a trailer. Many of my happiest moments are behind the wheel of my Mustang with the top down and the radio on.
So we set off in June with our two dogs to drive pony via stops in Paris, Beaune, Lyon, to St. Tropez. We alternated small roads through the wine country with stretches of Motorway to ensure that we made it to our destination in reasonable time. The car drove like a charm, easily keeping up with modern traffic at 80 miles per hour. The temperature gauge easily stayed below half even with the 90 degree whether in Southern France. The great weather also meant that we could keep the top down. My wife commented that I could not stop smiling, when driving the car.
(An American in Paris, on the Mediterranean coast, and in Reims)
The wonderful trip made clear that we are not finished with the car, since I added air conditioning, reupholstered the interior and installed bigger speakers needed at full speed with the top down. Oh, and by the way, the only damage we sustained in our 2500 mile trip was a burnt out light bulb. Not bad for a 36 year old.
The car in now back in Atlanta, GA. Home in the US where it belongs. It has come out of retirement and now serves as my daily driver. Why not smile every day on the way to work!
In 1973, my father was the Coach of a YMCA Basketball team filled with neighborhood kids - "The Red Rockets."
We practiced at the Decatur First United Methodist Church gymnasium. My father would pick up most of the team and drive 5-6 kids in his 1965 Chevrolet Corvair. Most of the time, people who were not familiar with the Corvair's rear engine/front trunk layout, were shocked to see the "Coach" unload the entire team, then reach into the front (where the engine was supposed to be) and pull out a bag of basketballs, clip boards, cones, and even a couple of water coolers.
His Corvair was a darker shade of blue, and I remember every aspect of that car to this day.
I always said "When I grow up, I am going to have a Corvair like my dad's." Well, I got older, procured my own 1966 Chevrolet Corvair, but I still haven't grown up. I am still the little kid riding up with my dad to basketball practice.
The first car my father bought brand new when he got out of the Army was a '69 Oldsmobile Cutlass S. Dad passed that car onto my brother who drove it all through high school and wrecked it twice. Each time we rebuilt it and it kept going. When my brother would leave the car at home overnight I would take advantage of the extra key dad kept and take the car cruising with my friends. To this day my brother still doesn't know why the car always had more gas in the tank when he came to pick it up. Eventually dad sold the car and I missed my chance to have it.
Years later I found this '69 Delta 88 in the exact color combination that my dad's car had been! Even stranger my dad's car was originally gold with a cream interior and later painted metallic red with a black vinyl top and black dyed interior, just like this Delta 88. A close inspection of the Delta 88 revealed the exact same color change history. Upon seeing it dad commented that if he had the money back then he would have bought a Delta 88 instead, but the Army didn't pay that well. It was wrecked and a mess but I rebuilt it in my parent's basement. Dad helped me chase down all the parts I needed to get the car back into shape.
I had planned to use the car in my wedding but a drunk driver put my wrenching abilities on hold. Dad knew I had hoped to have the car finished so he called in a favor with an old hot rod friend and got the car painted. I was thrilled and worked harder than ever to recuperate enough to drive the car on my wedding day. My brother chauffeured my bride and me from the church to the reception but I drove the car away for my honeymoon. My wife jokes with her friends that she married me for my car.
Recently dad and I went to a classic British car show. His first car was a '57 MGA that he bought after convincing my grandmother to co-sign for the loan. I haven't found a suitable MGA yet but I'm still looking. I hope to some day put my dad behind the wheel of the car he had to sell because Uncle Sam sent him off to war. My father isn't an emotional man but he speaks fondly of owning that MGA.
When I was in high school back in the 60's I saved up my paper route money and bought a 1959 Austin-Healey Bug-Eye Sprite. It was bright red and just the car for a young buck like me. One catch, all I had was $500 and the Sprite didn't run. So my Dad pulled me home on the end of a rope. Well, during the summer we got the Sprite running, but the rope pulling routine went on quite regularly. In fact we got so good at it we could cross town without a jerk or snap.
One time when Dad was towing me I saw something very strange. A wheel and tire exactly like the Sprite's rolled passed me on the right. Turns out it was my wheel and the car balanced just fine on the remaining three.
Of course I sold the Sprite after college. But six years ago I found another red Bug-Eye Sprite and me and my grandson enjoy many hours cruisin' and listening to the driving tunes of the 60's.
If Wikipedia would have been around back in 1985, we might have known what jewel we had on our hands. We might have realized that our 1958 Chrysler 300D was one of only 191 convertibles ever produced. And with this knowledge maybe we'd still have the car today instead of trading it for a fun, but infinitely less valuable car.
Our white 300D had been in our family as long as I can remember. My grandparents were big Chrysler/Dodge fans and had many over the years. I distinctly riding out to surveying jobs with my grandpa in the orange and brown Dodge Power Wagon, and coming back to a driveway stuffed with the aforementioned 300D and a 300K. I'm pretty sure there were some more in the mix.
Some time around 1984-85 grandpa, or Papa as we called him, decided the 300D had spent enough time suffering through Plattsburgh, NY winters and that a convertible like that needed to retire down in Orlando, FL where we were living at the time. So he drove it down. Now I can't say I remember a lot of stories about his drive down, but I do know that if you put a 65-70 year old guy in a 27 year old car and put him on the road for at least 24 hours, things will happen. What I do know is that somehow he made it! By himself! I hope he took a plane home.
Having that big ole convertible in Orlando was a teenaged boys dream. That big FirePower Hemi put out 390hp and was more than enough to push you back in your seat. My dad as the proud new owner of it was hesitant to let 15 year old me drive it, but while Papa was still there HE let me get behind the wheel. The power that car had is something I've been unable to find. Yet.
After about a year or so my dad decided it was time to tackle that NY rust. That was basically the beginning of the end. In order to save money, he hooked up with a rather shady restorer. As the pictures show, the car went from looking good, to looking like a wreck. The plus side is that we did win the "Unrestored" Division at a Chrysler Car Show in Daytona. I think they might have made that up out of pity.
The car turned into a money pit. Every week it needed a new part, a new body panel and had been under construction for almost a year. At some point, not knowing the intrinsic value of the car, my dad decided to get out of the pit and traded "up" to a 1967 Firebird. I hated to see the old car go...but boy, was I ready to take that Firebird for a spin!


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Warm hospitality, awesome food, spectacular views, great service! What more does one want?
Alchemy Waschbank River Restaurant is the most spectacular spot on the breathtaking banks of the Orange River. One is instantly captivated by the sweet angelic melody of the ever-flowing waters.
We pride ourselves on offering scrumptious, traditional and mouth-watering food without hurting one's wallet. Currently the restaurant can accommodate 35 guests inside and 35 guests outside on the deck, but we also do cater for larger groups or functions.
We invite you to come and unwind at the most enchanted spot the Orange River has to offer - our delightful little deck. Here sunsets become a serene and magical experience.
Mouth-watering Karoo cuisine driven by the acclaimed Chef Cris Greff - there is simply not a more compelling spot for dining!
Apron Strings is well-known by the locals for its tea and scones. The restaurant offers breakfasts, lunches and teas. Guests have the choice of sitting outside in the lush garden with swings for the children. Blankets are also available for a more picnic-style experience. The interior has a fireplace for those cold days.
Trading hours are from Wednesday to Sunday, from 9 am to 5 pm. The restaurant caters for functions.
This unique boutique-style restaurant is located in the beautiful green suburb of Benoni. Café Bellini offers a cool peaceful respite from the hustle and bustle of city living. Wholesome food with the focus on fresh ingredients is served and every dish is made fresh on the spot. The menu offers a variety of dishes - mentionable are the pastas. The restaurant is a great venue for private functions.
Open: Breakfast, Lunch.
Mon - 08:00 - 16:00
Tues - Sat - 08:00 - 17:00
Sun - 08:00 - 15:00
Bravo lounge is situated in the Garden Route Casino and is a trendy and stylish bar-lounge serving both food and drinks. This upmarket dining option caters for groups of up to 200 people and often hosts local entertainers like Elvis Blue, Heinz Winkler and Charlize Berg, just to name a few.
The Bravo lounge is also a great venue to enjoy a light lunch, whilst surfing the internet utilizing their free Wi-Fi facilities.
This laid-back restaurant in the heart of Newlands serves hearty food and provides a bustling, vibey atmosphere. This is the epitomy of 'the meeting place' and the homely feel adds to the warmth.
The service is top notch and the efficiency the same. Diners can sit in- or outside - the outside area boasts beautiful views of the surrounds. This place is often visited by our local rugby heroes as it is situated right by the Newlands Rugby Stadium.
Breakfast and lunch are served and the dishes are unpretentious, but hearty and satisfying. An extensive pizza menu is available and the tramezzini's with various fillings are definitely recommended. Panini's and regular toasties are also available. Salads, light meals, wraps and yummy pasta's complete the menu.
The restaurant is fully licensed and offers quite a few brews on tap. This is a fun, laid-back experience not to be missed.
This beautiful, stylish, yet relaxed restaurant is situated in the beautiful wine route town of Wellington. The restaurant offers a wide selection of lunchtime dishes and platters, as well as an extensive and comprehensive wine list that feature vintages from the area, as well as less known varieties.
Kongoni Camp has rooms, restaurant and bar. Its situated on the edge of Nanyuki Town overlooking Mount Kenya in the distance. The restaurant specializes in international cuisine, has great steak and homemade pizzas cooked Italian style in a wood-fired oven. Has a great top-shelf in the bar and the coffee is the best in Nanyuki. All reasonably priced.
This quaint bistro offers a seasonal menu that uses the freshest, locally sourced ingredients. The terrace offers a cool spot with beautiful views to be enjoyed during summer, and the interior is complemented by a roaring fireplace that provides a warm respite from the elements.
Salt of the Earth is a farmstall-type restaurant situated close to Camp Hill, in the Hemel en Aarde district.
Customers can sit inside of restaurant or on the patio; a blanket is offered if the weather is too cold.
Every last Sunday of the month they offer live music called Music of Yesterday. The restaurant is ideal for kids where they can run around in the veld and still be safe.
Enjoy the lovely farm-style breakfast that is a quite substantial meal, light meals or tea and cake. Choose from the daily specials and freshly prepared dishes.
The Docks Restaurant is in Cape Town's V & A Waterfront is next to the Nelson Mandela Gateway, home of the Robben Island ferry. Popular with passersby and locals, the area in front of The Docks is the playground for the local seal population. Known as the seal pen, The Docks is on the same site as the old Bertie's Landing. Its extensive menu, relaxed atmosphere and fabulous location right on the water's edge, in front of the Clock Tower, make The Docks a popular place to sit back and relax, and take in the fabulous views of Cape Town, Table Mountain and the harbour.
The Docks serves breakfast, lunch, dinner, light meals and cocktails. The wine list is extensive and features some of the best South African wines. The menu has something for everyone, from burgers to seafood, grills to pasta, as well as salads and traditional South African fare. The dinner menu also features specialities such as ostrich, game and lobster.
Relaxed and family orientated, with fabulous views The Docks Restaurant offers patrons a varied menu that caters for all tastes and good friendly service. Patrons are often treated to shows from the local buskers on the dockside next to the restaurant, with acts including gumboot dancers, a marimba band, mimes and signers.
Housed inside Romney Park Hotel and Spa, George Restaurant is a welcoming and comfortable dining establishment lit by a backdrop of the Atlantic Ocean, Robbin Island and Green Point Stadium.
This elegant eatery boasts delicious and wholesome meals alongside a lounge bar and pool terrace perfect for soaking up the summer ambiance over a cooled cocktail and light meal from the seasonal menu.
Enjoy breakfast, lunch or dinner in elegant surrounds or curl up next to a roaring winter fire admiring the view.
Great grills and a cosy, Old World ambience creates a get-together spot that is conducive to socializing and good times. The Lion's Den is open for breakfast and lunch and good quality food served in large portions are the order of the day. The menu is varied and reasonably priced and this, together with a glass of your favourite vino will make for an experience to be repeated.
This beautiful, quaint, warm and inviting gem of a restaurant is situated in the midst of bustling Durbanville. Although bistros generally serve food at higher prices, this one will suit your pocket.
Delicious comfort food with a touch of elegance flies out the kitchen where the chef chops away with passion rarely seen anymore. The exquisite wood-fired pizzas are a must - wait - the menu is a must. Hearty meals with just enough flair to be unpretentious are sure to leave diners satisfied.
The interior is simple and elegant, relaxed and ambient, and diners can literally kick off their shoes, sit back and enjoy one of the many vintages on the well thought out wine list.
Breakfast, lunch and dinner are served and once the word is out you might want to make a reservation. Happy feasting.]
Check out the Olive Bistro here!


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Which Member Of The Justice League Might Get Their Solo Movie In 2015 Too?
Justice League has had it's fair share of rumors. From whether or not certain characters will be in the movie to it's plot, there has been a lot of speculation on the film. One of the things that has been speculated on its release date. The first we had heard the film was being released in 2015. That year not only boasts Marvel's second Avengers movie, but also the likes of Star Wars, Fantastic Four, and Ant-Man. Then there were rumors that WB was getting cold feet and that they had decided to push it back a year or two.
Now, Harry Knowles over at Ain't it Cool News, has just reported that the film actually may be indeed back on for 2015. Harry was handed document from a company that works close with studios and setting release dates for films. What name was on that document you ask? Why none other than Justice League.
But that's not all. There was another movie on the list scheduled for a 2015 release as well. Another solo DC movie…Batman. That's right folks, as of right now there is a possibility we could be getting our Batman reboot in as little as 2 years.
There have been a number of rumors on how Warner Brothers plans on bringing Batman back to the big screen. The most recent one being that they are considering doing a Batman Beyond story. However, nothing has been set in stone as of yet.
As of right now it seems as if this could be announced sometime during San Diego Comic Con. However, even Harry admits that this could be nothing, and to not get your hopes up too high, but it is curious that the movie would be on the list. Whatever the case may be, keep checking back here at Comic Book Therapy for the latest.
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Source : Aint It Cool


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The body of 16-year-old Madison Wallace is recovered from the Big Sioux River at Falls Park in Sioux Falls, S.D. Friday, March 15, 2013. / Emily Spartz / Argus Leader
The body of 16-year-old Madison Wallace has been recovered from the Big Sioux River, according to Sioux Falls Fire Chief Jim Sideras.
Crews continue the search for Lyle Eagletail, 28, who went into the river with Wallace to save the girl's 6-year-old brother, Garrett.
They have been at Falls Park since last night searching for Wallace and Eagletail.
Sioux Falls Fire Rescue Chief Jim Sideras said emergency crews are continuing to battle the water in the area to be able to continue searching, also having some issues with ice in that area. He said the recovery operation is being assisted by officials across all city departments, but he is unsure how much longer it will take to locate Eagletail.
Crews diverted water upstream from to aid in the search and recovery effort, but higher water levels earlier may have pushed the body further along the river, Sideras said.
Emergency crews have also been dealing with a large amount of foam in the river, which he said at some points last night, was up to 10-feet deep. The water in the river is murky, also hindering search efforts.
Everybody here has their eyes on water. Looking for something as small as a knee, patch of clothing, Sideras said.
He said he has been in contact with Wallaces father, who is in a state of shock.
Our prayers are with them, we want to help them cope as best they can, he said.
The Vermillion School District has brought together guidance counselors and outside resources to meet today with students grieving the drowning death of a classmate.
Madison Wallace was a sophomore at Vermillion High School, Superintendent Mark Froke said this afternoon.
Her younger brother, Garrett, 6, attends kindergarten in Vermillion.
Froke said the school districts crisis team, made up of administrators and guidance counselors, met this morning and assembled resources to meet with students.
Even though this is quite a sad and shocking situation for everyone at the school, were trying to maintain a normal school day and be respectful and help all of those who need assistance with their grieving, he said.
A decision will be made later today on whether to offer counseling at the school on Saturday, the superintendent said.
Follow Argus 911 and Argus Leader Media for updates.


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The BMW Zentrium / Courtesy of BMW Manufacturing Co.
Robots weld a BMW X5 in the body shop. / Courtesy of BMW Manufacturing Co.
For those fortunate enough to call Greenville and the Upstate home, the culture, quality of life, scenic beauty and cosmopolitan feel of the city and surroundings are irresistible. Part of this allure is the diversity of our attractions. New experiences wait around every corner, and unforgettable discoveries can be found in the most familiar of territories.
Some of the best new discoveries hide in plain sight. Located on a 1,150 acre site along I-85 and State 101, the BMW Manufacturing plant, Zentrum and Performance Center have become Upstate landmarks. In the 15 years since the first BMW rolled off the line, the Greer factory has produced more than 1.5 million vehicles and is the most visible component of BMW's $4.2 billion investment in South Carolina. Three hundred thousand people have toured the plant, and another 60,000 have experienced the Performance Center.
With the recent introduction of The Ultimate BMW Experience, BMW combined these three unique resources to give visitors an opportunity not available anywhere else in the United States. The Ultimate BMW Experience is a simple yet remarkable way to experience the performance, passion and pride of BMW at one location.
One of the best surprises is the price. At only $99, the program is offered Mondays, Wednesdays and Fridays and includes a visit to the Zentrum museum, an exclusive guided plant tour, and a 2-hour driving program at the Performance Center.
The BMW Experience begins at the only BMW museum in North America the BMW Zentrum. Ensconced in a building as alluring as the legendary vehicles and exhibits housed inside, the Zentrum is an attraction not to be missed. Forty thousand people visit the Zentrum each year, enjoying the museum, café and gift shop along with iconic BMWs such as the James Bond Z3.
The plant tour begins here, as participants join their guide for a tour of the factory floor. From inception in the body shop, to coming of age during the assembly process, tour participants witness the magic behind the creation of the X5 and X6 Sport Activity Vehicles. The tour showcases each stage of the manufacturing and assembly process, from the building of the underbody to the roll booth and final inspection as approximately 600 vehicles roll off the assembly line each day.
The crowning touch to the experience is the two hour driving program. Upon completion of the plant tour, participants regroup at the BMW Performance Center, where certified BMW performance driving instructors put you behind the wheel of some of the hottest Ultimate Driving Machines available.
In our session, each participant drove a 335 hp Z4 Roadster, the all-new 5-Series Gran Turismo, a 555 hp twin turbocharged X5 M, and a 500 hp V-10 powered M5. Each lap around the Performance Center track is an enthusiast's dream, where the threat of speed limits and radar guns disappear as quickly as tire smoke from the hot pavement. Drivers are encouraged to feel the heart-stopping performance engineered into every BMW, creating a visceral connection to the heritage and engineering highlighted during the Zentrum and factory tours.
In addition to the high performance driving experience, participants take to the Performance Center's off-road course to test the extensive capabilities of the X5 Sport Activity Vehicle. Obstacles such as a water crossing, the frame twister and multiple hill ascents and descents disappear with ease in the rear view mirrors of these sure-footed machines.
With The Ultimate BMW Experience, Upstate residents, tourists, enthusiasts and curious visitors have an incredible opportunity simply not found anywhere else. Don't let this one pass you by. The program is open to anyone possessing a valid driver's license, from teenagers to seasoned drivers.
For more information on The Ultimate BMW Experience or to schedule an experience, call 1-877-9BMW-EXP (1-877-926-9397).


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We sold our Moody 33 'Azrar III' at the beginning of 2008 to buy a blue water yacht with the intention of exploring distant and not so distant shores while we were still relatively young, fit and healthy. So we hung up our business suits, bought 'Pipistrelle' and set off to enjoy early retirement and to draw on the not inconsiderable experience we had both gained by sailing the classic yachts 'Overlord', 'Sea Scamp' and many other cruising yachts and dinghies over the years!
The Offshore Cruising Club (OCC) is centred around 'Overlord', a 10 berth 58 ft Bermudan sloop, built in 1936 in Germany. With a membership of over 200, from experienced sailors to those who have never set foot on a yacht before, we have cruised on her in various parts of Europe – Bob as Skipper, Elaine as Watchleader. We also took an active interest in club affairs, with Bob being Commodore for two years, and Elaine serving on the Committee variously organising refit or social events. For more information about the OCC, go to www.sailoverlord.org.uk.
After giving a presentation about Overlord and the Offshore Cruising Club to the Gerard's Cross Sailing Association (GXSA) before we set off, we were invited back to talk at one of their winter meetings, about our journey on Pipistrelle, specifically our passage across the Pacific in 2011. The GXSA calls itself 'the off-season club for boating enthusiasts', with meetings, courses, as well as a social and summer sailing programme. Find the website under www.gxsa.org.uk.
Having crossed the Atlantic on Pipistrelle in 2009 with the ARC, we both met the criteria to join the Ocean Cruising Club (also abbreviated to OCC). Membership is granted only to those who have completed a continuous ocean passage of 1000 nm or more in a vessel not exceeding 70 ft (LOA). Since joining this august association, we have encountered fellow members flying the distinctive blue and yellow 'Flying Fish' burgee in far flung places, which has often resulted in convivial exchanges both of wide ranging, challenging cruising experiences and ships' liquid stores! For more information about the Ocean Cruising Club, go to www.oceancruisingclub.org.


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CANTON, OH (Sept. 11, 2012) – Professional photographer Tedd Perkins of Canton won a first place award and the coveted "Best of Show" in the 24th annual Pro Football Hall of Fame Enshrinement Festival Photo Contest for his shots of the Drum Corps International Competition. Perkins was also awarded one honorable mention, bringing his personal prize package to $375.
The annual photo contest, sponsored by Western Reserve Group, was open to amateur and professional photographers alike, and any photos of outdoor Hall of Fame Enshrinement Festival events qualified for entry. The photos were judged based on creativity, clarity, depth and color, overall composition and print quality, with nine photographers taking home cash prizes.
Other professional photographers winning prizes included Dennis Valentine of Louisville, with a $100 first place photo from the Timken Grand Parade, plus one $25 honorable mention award. Scott Heckel of North Canton won $100 for his Balloon Classic/Jackson Belden Food Fest & Fireworks first place photo.
The non-professional category was led by Douglas Perry of Canton who received $200 for two first place winning photos, one from Concert & Fireworks and one from Drum Corps International Competition. Other $100 award winners in the non-professional category included Doug Froelich of North Canton (Balloon Classic/Jackson-Belden Food Fest & Fireworks) and Michael Markilinski of Ford City, Pa. (Timken Grand Parade). Markilinski also won a $25 honorable mention for a Timken Grand Parade photo, as did Tina Baxter of Clifton Park, N.Y. (Ribs Burnoff), Matt Moser of Massillon (Balloon Classic/Jackson Belden Food Fest & Fireworks), and Larry Clapper of Massillon (Drum Corps International Competition).
The winning photos will be on display at the Joseph Saxton Gallery of Photography, located at 520 Cleveland Ave. N in downtown Canton, from Oct. 5 through 15. The photos will also be showcased on the Enshrinement Festival's Web site at www.profootballhofef.com.
The M.K. Morse Company won the 2012 "Creative Costume Award" in a popular competition for helium balloon sponsors in the Timken Grand Parade. Balloon handlers are encouraged to dress in costume to match the theme of their balloon. Entries were judged on creativity, energy level, entertainment value, and overall appearance. The M.K. Morse Company coordinated their outfits to match Jokey the Smurf, with some of the adventurous male handlers even dying their beards blue! The Aultman Hospital balloon handlers, escorting the shiny gold dragon along the parade route, finished a close second.


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December 1, 2015
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GARDEN CITY, Kan (KAKE) -- Garden City police are investigating the death of a four-month old boy.
Police were called to the 1400 block of north Main Street Tuesday. Officers found the child on a couch, unresponsive and not breathing. The child was taken to St. Catherine Hospital in Garden City where he died.
Police said the death remains under investigation.
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