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Anesthesiology This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.
This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 3.
Funtabulously Frivolous Friday Five 119
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia…introducing Funtabulously Frivolous Friday Five 119 Question 1 Which surgeon had a mortality rate of 300% during a single operation? How did this happen? + Reveal the Funtabulous Answer expand(document.getElementById('ddet109074172'));expand(document.getElementById('ddetlink109074172')) Robert Liston (1794-1847) Liston operated in a time before anaesthesia. It was recognised that a speedy operation could significantly improve the outcomes for a patient, and Mr Liston w...
Source: Life in the Fast Lane - October 2, 2015 Category: Emergency Medicine Authors: Niall Hamilton Tags: Frivolous Friday Five capecitabine ciguatera FFFF louis pasteur Oncology rabies robert liston virchow Source Type: blogs
Tap that Knee! Basics of Arthrocentesis
Part 2 of a Series Our series on joint care has given you a basic overview on knee arthrocentesis. Typically, it is not necessary to have an orthopedic consultant come to the bedside in the emergency department to do this procedure. Arthrocentesis is a procedure you can do well and feel confident about your technique. Take a moment to review our last blog post on knee pain before reading this post and watching the accompanying video. (http://bit.ly/1Q7dG4h.) As always, review the anatomy; it plays a key part in successful bedside technique. Ultrasound-guided arthrocentesis is always a favored approach. Although em...
Source: The Procedural Pause - October 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Research & Reviews in the Fastlane 102
This study reviewed data from over 30,000 OHCA and found that the initiation of early CPR (prior to EMS arrival) was associated with increased 30-day survival (10.5% vs. 4.0%). Unfortunately, the database has only limited information on neurologic function and thus, improved functional status cannot be assessed from this data set. However, this study further supports the need for increased lay person training as well as methods of bringing those lay providers to the patient (i.e. GoodSam application, mobile phone programs etc). Recommended by Anand Swaminathan Trauma Reith G et al. Injury pattern, outcome and characteri...
Source: Life in the Fast Lane - October 1, 2015 Category: Emergency Medicine Authors: Soren Rudolph Tags: Anaesthetics Education Emergency Medicine Emergency Medicine Update Infectious Disease Intensive Care Pre-hospital / Retrieval R&R in the FASTLANE Review Toxicology Trauma critical care literature research and reviews Source Type: blogs
America's Nursing Crisis
By SUSAN DENTZER Many of the nation's nurses understandably erupted in anger when the co-hosts of ABC's The View mocked Miss America contestant Kelley Johnson for her pageant-night monologue about being a nurse — and for wearing scrubs and a "doctor's stethoscope" (their words) in the talent competition. The co-hosts, Joy Behar and Michelle Collins, have since apologized, especially for implying that only doctors use stethoscopes. "I didn't know what the hell I was talking about," Behar later said. It would be easy to attribute this episode solely to the ignorance of some TV pers...
Source: The Health Care Blog - September 26, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB National Academy of Medicine Nursing Practice Programs Professional Rivalries Robert Wood Johnson Foundation Susan Dentzer Source Type: blogs
The 21st Century Cures Act: More Homework To Do
In July, the US House of Representatives approved the 21st Century Cures Act, which heads to the Senate for a vote this fall. While no one can complain about the Act's purported goal of "bring[ing] our health care innovation infrastructure into the 21st Century," or increasing funding for the National Institutes of Health, the optimism surrounding the legislation obscures measures buried within that many agree will make newly approved drugs and medical devices less safe and effective, increase the cost of medical products, and discourage innovation in biomedical research. Long-term value to the public's health is b...
Source: Health Affairs Blog - September 24, 2015 Category: Health Management Authors: Susan Molchan, James Rickert and John Powers Tags: Costs and Spending Drugs and Medical Technology Featured Health Professionals Hospitals Public Health Quality 21st Century Cures Act Big Pharma Drug approval Fred Upton Research funding Thurgood Marshall Source Type: blogs
Maintenance of Certification: American Board of Anesthesiology Ends 10-Year Exam; ABIM Considers New Continuous Testing Model As Well
Recently, the American Board of Anesthesiology (ABA) announced it will become the first medical board to restructure its Maintenance of Certification (MOC) program. The Maintenance of Certification in Anesthesiology Program, or MOCA, has required physicians to take a recertification test every 10 years. It will be replaced by a program known as "MOCA 2.0," which will allow anesthesiologists to continuously assess themselves and identify knowledge gaps through an online portal, including a "MOCA Minute" that allows physicians to answer multiple-choice questions at their own convenience. This shift is noteworthy because ...
Source: Policy and Medicine - September 21, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
The human cost of breast cancer screening
This article originally appeared in Forbes. Image credit: Shutterstock.com Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - September 19, 2015 Category: Journals (General) Authors: Peter Ubel, MD Tags: Conditions Cancer Source Type: blogs
Research and Reviews in the Fastlane 100
This study, using skin tests, found that 0 out of 211 patients demonstrated cross-reactivity between penicillin and aztreonam. The authors recommend skin testing prior to administration and skin testing isn't a perfect surrogate for a systemic reaction upon IV administration but the best evidence we have shows that cross-reactivity is highly unlikely. Recommended by: Anand Swaminathan Pediatrics Park G et al. Randomized single-blinded clinical trial on effects of nursery songs for infants and young children's anxiety before and during head computed tomography. Am J Emerg Med. 2015. PMID: 26314215 This RCT randomi...
Source: Life in the Fast Lane - September 17, 2015 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Education Emergency Medicine Emergency Medicine Update Haematology Immunology Infectious Disease Intensive Care Palliative care Pediatrics R&R in the FASTLANE critical care literature recommendations research and r Source Type: blogs
Promising news from ABIM
Discussion of Changes to ABIM Certification and MOC Here is the short story: Key recommendations from the report include: Change the MOC exam. The Task Force recommends replacing the 10-year MOC exam with more meaningful, less burdensome assessments. Focus assessments on cognitive and technical skills. Assessment of cognitive skills assures the public that physicians are staying current with the clinical knowledge relevant to patient care. Assessment of technical skills ensures that physicians can apply that knowledge to adequately perform the technical procedures appropriate to the discipline. Recognize specialization. Th...
Source: DB's Medical Rants - September 16, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
8th Annual Pediatric Bioethics Conference
Discussion: Ethical Issues Surrounding Childhood Immunizations Bruce McIntosh, MD Co-Interim Statewide Child Protection Team Medical Director Ray Moseley, PhD Bioethics, Law and Medical Professionalism; Director, CTSI Academy of Research Excellence, University of Florida College of Medicine, Gainesville Samir Midani, MD Nemours Children's Specialty Care, Infectious Disease CME Accreditation Statement (CMEs): (Source: blog.bioethics.net)
Source: blog.bioethics.net - September 16, 2015 Category: Medical Ethics Authors: Thaddeus Mason Pope Tags: Health Care medical futility blog syndicated Source Type: blogs
What to say when medical certainty is elusive
Doctors do not know everything. We make mistakes and mistakes in judgment. Sometimes we make the mistake of speaking when we should keep silent. At times, patients ask us questions that we can't or shouldn't answer; and yet we do. It shouldn't be our objective to force certainly into an issue that is amorphous and murky. Here's a response that I recommend in situations where certainty is elusive. "I don't know." I saw a patient for the first time when he was sent to me for a colonoscopy. Prior to the procedure, we interviewed him to be acquainted with his medical history. We are always particularly interested...
Source: Kevin, M.D. - Medical Weblog - September 15, 2015 Category: Journals (General) Authors: Michael Kirsch, MD Tags: Physician Cancer GI Source Type: blogs
Wisdom versus knowledge for practicing internists
I have given my Learning How to Think like a Clinician several times recently. Each time physicians in the audience seem to particularly like one line that I use – Wisdom trumps Knowledge. In 2015, we all have rapid access to information. My team regularly uses smartphones, pads or computers to get precise information while on rounds. We cannot remember everything. More important than knowing is knowing what information we need. In our 2014 Annals of Internal Medicine editorial we called for a formative rather than summative process. A formative process describes a process in which the learner gets frequent feedback ...
Source: DB's Medical Rants - September 15, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Penalized for "On-Label" Marketing? In Wake of Amarin, Pacira Files First Amendment Complaint Against FDA
Last week, Pacira Pharmaceuticals, Inc. filed a lawsuit against the Food and Drug Administration (FDA) seeking to establish its right to provide truthful and non-misleading information to doctors about its anesthetic product, Exparel. This case follows last month's decision in Amarin v. FDA, in which the Southern District of New York held that, under the First Amendment, FDA could not restrict Amarin Pharma's ability to promote truthful non-misleading off-label information about Vascepa. Pacira's case brings a number of interesting facts to the table that have the potential to further shape how FDA regulates promotion ...
Source: Policy and Medicine - September 14, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Now is the time for acute pain medicine specialists
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Since September is Pain Awareness Month, it's time to recognize that not all pain is equal. Chronic pain can be alleviated, but "acute" pain (sudden onset, brief in duration, often with an identifiable cause) must be eliminated. This requires a systems-based approach led by physicians dedicated to understanding the physiological processes associated with acute pain and investigating new ways to treat it. The solution is definitely not to give patients more and more opioids. As our understanding of pain mechanisms has ...
Source: Kevin, M.D. - Medical Weblog - September 13, 2015 Category: Journals (General) Authors: Edward R. Mariano, MD Tags: Conditions Pain management Source Type: blogs
The AMA's Forgotten Fight Against Physician Greed
By MICHAEL MILLENSON Perhaps the most well-known part of the 1965 Medicare creation tale is the opposition by the American Medical Association (AMA) to "socialized medicine." Yet with financial incentives assuming a new prominence for provider and patient alike, we shouldn't overlook the AMA's equally unsuccessful battle against the excesses of capitalistic medicine. The forgotten story of the professionalism's failure to contain physician greed provides an important policy perspective. The Myth Of Medicine's 'Golden Age' Medical practice pre-1965 is often portrayed as a mythical "Golden Age." The truth...
Source: The Health Care Blog - September 10, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
Medicare, Fair Pay, And The AMA: The Forgotten History
Perhaps the most well-known part of the 1965 Medicare creation tale is the opposition by the American Medical Association (AMA) to "socialized medicine." Yet with financial incentives assuming a new prominence for provider and patient alike, we shouldn't overlook the AMA's equally unsuccessful battle against the excesses of capitalistic medicine. The forgotten story of professionalism's failure to contain physician greed provides an important policy perspective. The Myth Of Medicine's 'Golden Age' Medical practice pre-1965 is often portrayed as a mythical "Golden Age." The truth, as I found researching ...
Source: Health Affairs Blog - September 10, 2015 Category: Health Management Authors: Michael Millenson Tags: Costs and Spending Health Professionals Hospitals Medicaid and CHIP Medicare Payment Policy Quality Affordable Care Act American Medical Association George H.W. Bush Kenneth Arrow Physicians Richard Nixon socialized medicine Source Type: blogs
Research and Reviews in the Fastlane 099
This study took a sample from healthy pregnant patients (n=760) at different stages of gestation. They found, unsurprisingly, that d-dimer increases with gestational age, congruent with limited prior literature. They propose a continuous increasing d-dimer in pregnancy. With PE experts such as Dr. Kline proposing gestation adjusted d-dimer, this is a research space to watch. Recommended by: Lauren Westafer Systems and administration Del Portal DA, et al. Impact of an Opioid Prescribing Guideline in the Acute Care Setting. J Emerg Med 2015. PMID: 26281819 As many EDs implement voluntary opioid prescribing guidelines, this...
Source: Life in the Fast Lane - September 9, 2015 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Cardiology Education Emergency Medicine Haematology Intensive Care critical care literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs
Wanted: Pharmacology, Physiology, and Biological Chemistry Division Director
Search Committee Members: Helen Sunshine, National Institute of General Medical Sciences, Chair René Etcheberrigaray, Center for Scientific Review Irene Glowinski, National Institute of Allergy and Infectious Diseases Sherry Mills, Office of Extramural Research, NIH Philip Cole, Johns Hopkins University School of Medicine Judith James, University of Oklahoma Health Sciences Center Scott Miller, Yale University With the recent retirement of Dr. Michael Rogers, the search is now open for an outstanding individual to serve as director of our Division of Pharmacology, Physiology, and Biological Chemistry (PPBC). This positio...
Source: NIGMS Feedback Loop Blog - National Institute of General Medical Sciences - September 8, 2015 Category: Biomedical Science Authors: Monique Hall Tags: Job Announcements Source Type: blogs
Perfect Job, perfect specialty??
I remember how difficult it was for me to choose a specialty. Initially (as in before medical school), I wanted to be a dermatologist. I loved cosmetics and hair products, and as a college student I thought I'd go into some sort of 'beautifying' medical specialty.Once in medical school they forced upon us that primary care crap tried to encourage us to consider careers in primary care. And I did...seriously. I really, really liked the idea of family practice. The doctor that sees the entire family, and watch the kids grow up, and have continuity of care, and keep the family healthy, yadda yadda yadda.Then, I started having...
Source: EM Physician - Backstage Pass - September 8, 2015 Category: Emergency Medicine Authors: Taylor Source Type: blogs
You can easily become the physician that you judge
A recent paper in the Annals of Internal Medicine has sparked a large media response. In it, two incidents are described: In one, a male OB/GYN is prepping a patient's vaginal area for surgery, which involves running a brush soaked in Betadine or ChloraPrep solution over the labia, mons pubis, perineum, and inner thighs when the patient is already put to sleep by anesthesia. He makes an appalling joke, "I bet she is enjoying this." In the second, another male OB/GYN resident runs into a room with a patient bleeding to death from her vagina. He controls the bleeding with manual pressure, putting his ...
Source: Kevin, M.D. - Medical Weblog - September 8, 2015 Category: Journals (General) Authors: Vamsi Aribindi Tags: Physician OB/GYN Source Type: blogs
Infant Dies Following 5 Vaccine Doses
Life after losing a loved one to vaccines is very painful. With a heavy heart, we share Sebastian Ryan Morley's story. He was a healthy boy whose life ended after routine vaccinations. Sebastian's mother and grandmother have worked many years in both the veterinary and human healthcare fields. What they were taught in school led them to believe vaccines were safe, but now they will never vaccinate again. We thank his family for coming forward and sharing very important information the public isn't usually made aware of. Sebastian's grandmother, Valerie Murfin, shared: "On December 11, 2002, when my grandson Sebas...
Source: vactruth.com - September 5, 2015 Category: Allergy & Immunology Authors: Augustina Ursino Tags: Augustina Ursino Human Top Stories adverse reactions dtap Hepatitis B vaccine Sebastian Ryan Morley truth about vaccines Vaccine Death vaccine injury VAERS Valerie Murfin Source Type: blogs
"Our Family Secrets" Exposed — The Ethics of Whistleblowing
This week the Annals of Internal Medicine published an article so controversial they felt the need to publish an accompanying editorial, explaining their decision to publish the anonymous article. The article, "Our Family Secrets" describes two experiences where a health care provider has acted inappropriately while patients were under anesthesia. The editorial describes the acts with poignant alarm: "The first incident reeked of misogyny and... // Read More » (Source: blog.bioethics.net)
Source: blog.bioethics.net - August 29, 2015 Category: Medical Ethics Authors: Sarah Sawicki Tags: Health Care bioethics Culture / Ethnicity / Gender / Disability Ethical Method / Grounding Health Care Practice syndicated Source Type: blogs
What Should Public Health Officials Be Doing About E-Cigarettes?
Are electronic cigarettes a safer alternative to combustible cigarettes, or are they a new gateway to a lifetime of nicotine addiction? In the past month, the editors of The New York Times noted the opposite conclusions from the British agency Public Health England that reported e-cigarettes can reduce the health risks of smoking by 95 percent, compared to a study in the Journal of the American Medical Association, which showed that ninth graders who tried e-cigarettes were far more likely to then use regular combustible tobacco within a year. In a step that may help resolve this controversy, the Food and Drug Administrati...
Source: Health Affairs Blog - August 27, 2015 Category: Health Management Authors: John Maa Tags: Costs and Spending Drugs and Medical Technology Featured Global Health Population Health Public Health Children e-cigarettes FAA FDA Prevention Smoking tobacco vaping Source Type: blogs
The Real Dark Side of Health Care: Health Care Corruption
The editors of the prestigious Annals of Internal Medicine just stated they they were shocked, shocked to find out that physicians occasionally express disrespect for patients when the patients cannot hear or see them. The occasion was an editorial signed by three editors whose title included the phrase, "shining a light on the dark side of health care."(1) The editorial referred to an anonymous narrative that recounted two incidents from the past.(2)Two Alleged Incidents of Physicians' Expression of Disrespect for Patients The first incident, discussed second hand, was of a obstetrician who made a sexist comme...
Source: Health Care Renewal - August 25, 2015 Category: Health Management Tags: anechoic effect Annals of Internal Medicine health care corruption medical journals professionalism Source Type: blogs
Maybe health costs should be a quality measure
How do we measure a doctor? Hospital length of stay? Infection rate? Flu shot compliance? Waiting time? These reality surrogates do not tell us how a patient feels or the quality of life. They are complex to measure, require major data crunching and may not focus on an individual physician. This week, two patients reminded me of a basic screening tool for good care: How much is the bill? 15 years ago, I took care of Melissa for gallbladder cancer. She received surgery, radiation and has been in remission ever since. In fact, because she has no need of a grouchy oncologist, I have not seen her in years. Melissa works full ...
Source: Kevin, M.D. - Medical Weblog - August 25, 2015 Category: Journals (General) Authors: James C. Salwitz, MD Tags: Conditions Cancer Source Type: blogs
The "Dark Side" of Medical Education?
It is rare that a medical journal would publish an essay by a physician anonymously which describes the "dark side of medicine" and perhaps including the "dark side" of medical education. The article is in the August 18 2015 issue of the Annals of Internal Medicine and in an editorial in the same issue, the following:We hope that medical educators and others will use this essay as a jumping-off point for discussions that explore the reasons why physicians sometimes behave badly and brainstorm strategies for handling these ugly situations in real time. By shining a light on this dark side of the profes...
Source: blog.bioethics.net - August 24, 2015 Category: Medical Ethics Authors: Maurice Bernstein, M.D. Tags: Health Care syndicated Source Type: blogs
How Stanford Med Got "Work-Life Balance" Wrong
By KAREN SIBERT, MD Did it ever occur to some of today's physicians that many people work awfully hard and complain a lot less than they do about "burnout" and "work-life balance"? Did it ever occur to them that "work-life balance" is the very definition of a first-world problem, unique to a very privileged class of highly educated people, most of whom are white? Every day, I go to work and see the example of the nurses and technicians who work right alongside me in tough thoracic surgery cases. Zanetta, for instance, is the single mother of five children. She leaves her 12-hour shift at 7 p.m. and then faces...
Source: The Health Care Blog - August 24, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Karen Sibert Stanford Medicine Workplace Wellness Source Type: blogs
Research and Reviews in the Fastlane 096
This study assessed the speed and accuracy of medication administration in simulated pediatric resuscitations. 10 teams consisting of physicians and nurses participated in a cross over study, so that they did one simulation with the new syringes and one without. Time to delivery of medications was quicker with the new syringes (47 versus 19 seconds, a difference of 27 seconds; 95%CI 21-33 seconds). Teams were also more accurate using the new color-coded syringes, with dosing errors occurring 17% of the time with the conventional approach and 0% of the time with the new syringes (absolute difference 17%; 95% CI 4-30%). Obvi...
Source: Life in the Fast Lane - August 20, 2015 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Airway Anaesthetics Cardiology Education Emergency Medicine Pediatrics Resuscitation Trauma EBM Intensive Care literature R&R in the FASTLANE recommendations research and reviews Respiratory urology Wilderness Medicine Tagg Source Type: blogs
The most feared medical specialty? It's actually one of the safest.
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. I often hear patients say, "I am not afraid of the surgery, just the anesthesia." But should patients worry? Physician anesthesiologists suffered a crisis in confidence in 1982 when the ABC television program 20/20 aired, "The Deep Sleep: 6,000 Will Die or Suffer Brain Damage," about anesthesia complications, brain injury, and death. At that time, physician anesthesiologists were having difficulty obtaining malpractice insurance because, although anesthesia claims were not the most frequent, they were the most costly du...
Source: Kevin, M.D. - Medical Weblog - August 18, 2015 Category: Journals (General) Authors: Susan G. Curling, MD Tags: Physician Surgery Source Type: blogs
Patients can spot the fake: They need the authentic
"There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle." – Albert Einstein "Miracles happen every day; change your perception of what a miracle is, and you'll see them all around you." — Jon Bon Jovi "The miracle is this: The more we share, the more we have." — Leonard Nimoy It is amazing when things in medicine work just the way they are supposed to — it's like a miracle. When I take an antihistamine, I can breathe, and all the itching and sneezing stops. When I get an injection of local anesthetic, I can touch a...
Source: Kevin, M.D. - Medical Weblog - August 16, 2015 Category: Journals (General) Authors: Kathryn A. Hughes, MD Tags: Physician Surgery Source Type: blogs
Harnessing Big Data – MedTech Innovation that Segments Patients According to Need
A recent interview with Battelle researchers David Giles and Stephanie Kute proves that big data is here to stay. An incredible amount of innovation is happening in the world of medical devices as technology improves, growing increasingly smarter and recording more information about its users. This innovation raises a few new questions: how can we utilize new technology to be most effective, and how can we ensure that private information is kept secure? Stephanie Kute, platform lead for the Battelle analytics and health research team, spoke to MassDevice about Battelle's strategies in the rapidly-changing world of big da...
Source: Disruptive Women in Health Care - August 5, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Innovation Patients Source Type: blogs
Report on Incorrect DNR Order from Veterans Affairs Inspector General
In October 2014, I blogged about the case of Roland Mayo. A California VA facility had erroneously placed a DNR order on him. A few days ago, the Department of Veterans Affairs Office of Inspector General released a new report titled "Healthcare Inspection: Delay in Emergency Airway Management and Concerns about Support for Nurses VA Northern California Health Care System Mather, California." The OIG found:Facility staff did not follow through on the patient's request upon admission to discuss advance directives. We found no evidence of advance care planning discussion during the patient's hospital s...
Source: blog.bioethics.net - August 4, 2015 Category: Medical Ethics Authors: Thaddeus Mason Pope Tags: Health Care medical futility blog syndicated Source Type: blogs
Evaluation of a continuous monitoring and feedback initiative to improve quality of anaesthetic care: a mixed-methods quasi-experimental study
This study evaluated the impact of a continuous quality monitoring and feedback initiative in anaesthesia. The results support the potential of quality monitoring and feedback interventions as quality improvement mechanisms and provide insight into the positive response of clinicians to this type of initiative, including documentation of the experiences of anaesthetists that participated as users and codesigners of the feedback. Report Summary Abstract (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - August 4, 2015 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Patient involvement, experience and feedback Quality of care and clinical outcomes Source Type: blogs
Solving the Problem of Delivering Oxygen during Needle Cricothyroidotomy
BY RICAURTE A. SOLIS, DO When faced with a "can't intubate, can't oxygenate" crisis, the decision to move to a surgical airway must be made rapidly and deliberately. A surgical cricothyroidotomy is debatably the better approach in these situations, but a needle cricothyroidotomy may sometimes be indicated. It may be easier to perform in a very small child, for example, and although it is probably less than ideal in an adult, a rapid needle cricothyroidotomy may provide an oxygenation bridge that will prevent a critically hypoxic patient from arresting until a more definitive airway is secured. Cricothyroido...
Source: M2E Too! Mellick's Multimedia EduBlog - August 3, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
A Procedure's Impact on Patient Comfort, Care, and Outcome
This blog teaches procedures, with its case studies and videos intended to help you perfect your technique and strengthen your confidence. This month we explore issues related to procedural patient impact. How will your intervention positively or negatively affect patient outcome? What happens when we decide to step in and complete a procedure? A risk is always inherent when a provider undertakes a procedure, no matter how insignificant. Carefully, we weigh the pros and cons of the potential procedure with our patients. Will our intervention cause a positive effect or outcome? Our goals are to repair, resolve, or restor...
Source: The Procedural Pause - August 3, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Young physicians must take a leadership role. Here's why.
My young patient was dying as a blood clot under the cover of her brain accumulated and began compressing the fragile tissue within her skull. She needed surgery to remove the clot that would save her life. As the team pushed her from CT scanner to the operating room, it was soon realized labs were missing and were needed before opening her cranium. "There's no order in the computer!" someone shouted out. As I pushed the patient into the operating room, what was I supposed to do at that critical moment? Drop what I was doing and find a computer to enter the order or continue in trying to save her life? The world of...
Source: Kevin, M.D. - Medical Weblog - August 2, 2015 Category: Journals (General) Authors: Hakeem Shakir, MD Tags: Physician Hospital Source Type: blogs
Rise of the Machines
By SHIRIE LENG, MD "We are convinced the machine can do better than human anesthesiologists." This statement was made by a doctor. Not only a doctor but an anesthesiologist. Not just an anesthesiologist but a pediatric anesthesiologist. Not just any old pediatric anesthesiologist but one in charge of pediatric anesthesia research at the University of British Columbia medical school in Vancouver. One can only assume that this guy has a pretty low estimation of what his colleagues can do. Must make for great break room conversation. The doctor making this statement, one JM Ansermino, is co-creator of a new automated ...
Source: The Health Care Blog - July 31, 2015 Category: Consumer Health News Authors: suchandan roy Tags: THCB Shirie Leng Source Type: blogs
Research and Reviews in the Fastlane 093
This study of 50 volunteers suggests that three commonly taught methods for finding the cricothyroid membrane (general palpation, four-finger, skin crease) are relatively inaccurate, using ultrasonography as the gold standard. I conclude:1. The landmark techniques are inaccurate for finding the CTM *and that's okay.* Make your best guess using general palpation and if you feel nothing, use four-finger or skin crease **and then make a long vertical incision.** Once you get through the skin you are very likely to be able to feel the CTM, and even if you still can't at that point, that's fine too, cut to air...
Source: Life in the Fast Lane - July 30, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Education Emergency Medicine Intensive Care R&R in the FASTLANE Trauma critical care EBM literature recommendations research and reviews Source Type: blogs
Surviving an EHR launch: The trauma of Go Live
An excerpt from The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age (McGraw-Hill, 2015). The YouTube video opens to show a balding middle-aged man sitting on a stool, strumming a guitar. In a gentle, twangy croon, the man, Robert Schwab, chief quality officer for Texas Health Presbyterian Hospital in Denton, Texas, sings "The Ballad of Go-Live," a week-by-week chronicle of what happened when his hospital turned on its electronic health record system in 2012. He set his lyrics to the melody of the Simon and Garfunkel folk ballad "Homeward Bound." I'm sitting at the nurses' station, ...
Source: Kevin, M.D. - Medical Weblog - July 25, 2015 Category: Journals (General) Authors: Bob Wachter, MD Tags: Tech Health IT Source Type: blogs
Research and Reviews in the Fastlane 092
This study, on the other hand, was a well done, RDCT comparing tamsulosin to nifedipine to placebo in 1136 patients and showed no statistically significant difference for the primary outcome (need for further intervention at 4 weeks). Subgroup analysis showed a slight benefit for lower tract stones and the issue of utility in larger stones (> 5 mm) remains unanswered. However, with the move to reduce CT use in renal colic, we won't know stone location or size on many patients making this drug far less useful in the real world. Recommended by Anand Swaminathan Read More: The Adventure of the Impassible Stone (EM...
Source: Life in the Fast Lane - July 23, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Emergency Medicine Intensive Care R&R in the FASTLANE Renal Resuscitation Trauma Urology critical care EBM Education recommendations research and reviews Source Type: blogs
Summer is a busy season for trauma anesthesiologists
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Summer is immortalized in popular culture for good reasons — no other season can match it for the variety of fun and exciting activities it brings. Unfortunately, that variety of activities and the large volume of people enjoying them inevitably lead to accidents and mishaps of all kinds. The summer months (May through August) show a significant increase in unintentional injury and deaths, particularly for those aged 0 to 14 years. Thankfully, there are many skilled people always at the ready to treat the injured. Trauma anesthesio...
Source: Kevin, M.D. - Medical Weblog - July 15, 2015 Category: Journals (General) Authors: Maureen McCunn, MD and Karla Villacin, MD Tags: Physician Emergency Surgery Source Type: blogs
Surgical Complication Rates just got Simple: MedicineBall Is the New MoneyBall
By JORDAN SHLAIN, MD In an age where the importance of data, statistics and predictive modeling can win games for baseball teams and make money for high-frequency traders, the last bastion of opacity is in the midst of getting a whopping dose of sunshine. Every modern industry uses detailed information, mostly via the Internet, to lie out their foundational strategies for gaining market share and building their brands. Fortress medicine has received a shot over the bow regarding the power of data and how they will need to craft a strategy that includes the bright light of outcomes into their institutions. Propublica, i...
Source: The Health Care Blog - July 15, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
Surgical Complication Rates and the New Data Perspective
By JORDAN SHLAIN, MD + (UPDATED) In an age where the importance of data, statistics and predictive modeling win big games for baseball teams and make fat money for high-frequency traders, we are at the dawn of a new age of transparency in healthcare It behooves every actor, in every sector, to use this new perspective to constructively illuminate best practices and design an infrastructure for true operational, clinical and logistic efficiencies at large scale and the local level – all in the spirit of getting the patient the best outcome. Every modern industry uses 'big data' to understand �...
Source: The Health Care Blog - July 15, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
In The War on Wheat, this enlightened physician fights back
A University of Toronto physician speaks out about the Fifth Estate production that purports to have debunked the Wheat Belly arguments: To the producers of the above named show. I did not find that you presented the issue fairly to the public. The show was basically about which guru people should follow—Dr. Davis and a host of glamorous hucksters or the skeptical debunkers. A debunking of a popular movement always feeds into people's cynical nature and makes good, entertaining TV and a smug audience. Unfortunately, the truth took a big hit. So did an opportunity to educate Canadians to some important issues Dr. Davis ...
Source: Wheat Belly Blog - July 14, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle autoimmunity blood sugar grains insulin Source Type: blogs
Bungled Payments
By PAUL KECKLEY The proposal involves a five-year bundled payment model across 75 geographic areas whereby hospitals would be eligible for a bonus if their costs and outcomes were optimal or be penalized if not based on results 90 days post-discharge. The agency noted that in 2013, it spent more than $7 billion on hospitalization for these procedures with the payments for hospitalization and recovery ranging widely from 16,500 to $33,000. Comments about the proposal will be received by CMS through September 8, 2015, aiming for implementation January 1, 2016. Their rationale, according to Secretary of Health and Human Servi...
Source: The Health Care Blog - July 13, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB bundled payments Burwell CMS Paul Keckley Source Type: blogs
Acupuncture tropes on parade
I sometimes catch flak for repeating this, but there was a time when I thought there might be something to acupuncture. I don't care, because, as a blogger, when I write a post I assume that a significant fraction of people reading it have never seen this blog before and therefore aren't even the least… (Source: Respectful Insolence)
Source: Respectful Insolence - July 13, 2015 Category: Surgery Authors: Orac Tags: Complementary and alternative medicine Quackery acupuncture acupuncture anesthesisa Elissa Miolene James Reston Nadia Bouhdili pseudoscience traditional Chinese medicine Transformational Acupuncture Washingtonian Magazine Source Type: blogs
Smiling patients and "Stunning" survival rates with heart transplantation !
Heart transplantation as a treatment modality was conceptualized by Christian Barnard in 1967 . Still considered as an "Act of God" this surgery is regularly performed worldwide by dedicated transplant team consisting of cardiac surgeon , physician , Anesthetist , pathologist and others .Unlike other organs , heart transplant cannot have a "live donor" .Though started half a century ago, the real pace has picked up only in last 2 decades .Currently it is "globally accepted standard" intervention in terminal cardiac failure...
Source: Dr.S.Venkatesan MD - July 12, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Heart transplantation longest survivor with heart transplant survival with heart transplantation Source Type: blogs
Post-call accidents – time to revamp the system
(image credit to FMT) In the last few months we have seen couple of young doctors losing their lives in road traffic accidents post call. In May Dr Nurul Wahida Md Noor died in an accident having been on call the day before. Just 2 days ago, a young anaesthetic MO, Dr Afifah Mohd Ghazi tragically died in an accident also post-call, leaving behind her husband a neurosurgical MO and a 1 year old child. Our heartfelt condolences go out to their families and we can't imagine the grief they are going through. Medical Officers go "on-call" which is different from going on shift duty that House officers and othe...
Source: Malaysian Medical Resources - July 10, 2015 Category: Global & Universal Authors: palmdoc Tags: - Health tips Accident Call doctor MVA Source Type: blogs


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Daniel Bryan and Randy Orton Fined for Chairshot During Their Street Fight Match
by Amish Patel - June 28, 2013
— Both Randy Orton and Daniel Bryan have been fined "an undisclosed amount" following a chairshot to the head during their Street Fight match on this past Monday's RAW. The particular spot saw Orton holding up a chair in an attempt to block Bryan's suicide dive through the ropes.
The WWE story features a quote from WWE Executive/Superstar Triple H, saying, "We don't allow chair shots to the head in WWE. We understand it was in the heat of the moment but we take this very seriously and as a result, Orton and Bryan were fined."
Orton also reacts to the fine amount saying, "Trust me, it was enough."
WWE released a statement in 2011 relating to chair shots being used by superstars;
"Pursuant to WWE's Concussion policy, the stunt of using a folded metal chair shot to the head is prohibited. Triple H and The Undertaker have both been fined for violating this policy at WrestleMania XXVII. WWE penalizes through fine and/or suspension for violation of this policy, which is unchanged and still in effect."
|WWE RAW Results For May 2nd, 2016: The Usos & Roman Reigns vs. AJ Styles, Karl Anderson & Doc Gallows
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|The Reason Why Ryback Was Pulled From WWE TV
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|Backstage Update On Bret Hart Possibly Having Heat With WWE Officials
|Vince Russo Comments On Why Roman Reigns Is Not Getting Over With Fans

subset: commoncrawl


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Home > > Serie A > Napoli > Squad > Profile: Antonio Esposito
Antonio Esposito Napoli
Profile of the footballer Antonio Esposito, who currently plays as a at Napoli. The -year old player Esposito joined Napoli from and wears the number shirt.
Antonio Esposito Career
Antonio Esposito Photos
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Antonio Esposito : Napoli News
Antonio Esposito Career Honours
Source: wikipedia.org
Antonio Esposito Wiki, Stats & Links
J�rgen Klopp hails Daniel Sturridge after Liverpool conquer Villarreal
Leicester City confident of keeping Riyad Mahrez as speculation mounts
Leicester vice-chairman intervened to force Jamie Vardy to focus
Leicester title is the exception and not the rule, says Roberto Mart�nez
Liverpool 3-0 Villarreal (agg 3-1): five Europa League talking points
J�rgen Klopp�s prediction comes to pass as Liverpool vanquish Villarreal


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Margaret Atwood puts the human heart to the ultimate test in an utterly brilliant new novel that is as visionary as The Handmaid's Tale and as richly imagined as The Blind Assassin. Stan and Charmaine are a married couple trying to stay afloat in the midst of an economic and social collapse. Job loss has forced them to live in their car, leaving them vulnerable to roving gangs. They desperately need to turn their situation around - and fast.
Margaret Atwood's classic novel, The Handmaid's Tale, is about the future. Now, in Oryx and Crake, the future has changed: it's much worse. The narrator of this riveting novel calls himself Snowman. When the story opens, he's sleeping in a tree, wearing an old bedsheet, mourning the loss of his beloved Oryx and his best friend Crake, and slowly starving to death.
"Compulsive Listen"
The Republic of Gilead offers Offred only one function: to breed . If she deviates, she will, like dissenters, be hanged at the wall or sent out to die slowly of radiation sickness. But even a repressive state cannot obliterate desire - neither Offred's nor that of the two men on which her future hangs....
"A great book to listen to :)"
Margaret Atwood's The Robber Bride is inspired by The Robber Bridegroom, a wonderfully grisly tale from the Brothers Grimm in which an evil groom lures three maidens into his lair and devours them, one by one. But in her version, Atwood brilliantly recasts the monster as Zenia, a villainess of demonic proportions, and sets her loose in the lives of three friends.
Even now, at the age of 82, Iris lives in the shadow cast by her younger sister Laura. Now poor and trying to cope with a failing body, Iris reflects on her far from exemplary life, in particular the events surrounding her sister's tragic death.
Marian is determined to be ordinary. She lays her head gently on the shoulder of her serious fiancé and quietly awaits marriage. But she didn't count on an inner rebellion that would rock her stable routine, and her digestion. Marriage a la mode, Marian discovers, is something she literally can't stomach ... The Edible Woman is a funny, engaging novel about emotional cannibalism, men and women, and desire to be consumed.
A man-made plague has swept the Earth, but a small group survives, along with the green-eyed Crakers - a gentle species bio-engineered to replace humans. Toby, one-time member of the Gods Gardeners and expert in mushrooms and bees, is still in love with street-smart Zeb, who has an interesting past. The Crakers' reluctant prophet, Snowman-the-Jimmy, is hallucinating; Amanda is in shock from a Painballer attack; and Ivory Bill yearns for the provocative Swift Fox, who is flirting with Zeb.
"The best book of the trilogy!"
Adam One, the kindly leader of the God's Gardeners - a religion devoted to the melding of science and religion, the preservation of all species and the tending of the Earth - has long predicted the Waterless Flood. Now it has occurred, obliterating most human life. Two women have avoided it: the young trapeze-dancer, Ren, locked into the high-end sex club; and former SecretBurgers meat-slinger turned Gardener, Toby, barricaded into a luxurious spa. Have others survived?
"A Sharp Divide"
A man finds himself surrounded by women who are becoming palel, more silent and literally smaller; a woman's intimate life is strangely dominated by the fear of nuclear warfare; a melancholy teenage love is swept away by a hurricane, while a tired, middle-aged affection is rekindled by the spectacle of rare Jamaican birds...
"spare and sophisticated"
Sixteen years have passed since Grace was locked up, at the age of 16, for the cold-blooded murders of her employer and his housekeeper/lover. Her alleged accomplice in the crimes, James McDermot, paid the extreme sentence of the law and was hanged on November 21, 1843. But some thought Grace was innocent, and her sentence has been commuted to life imprisonment. After a spell in the Lunatic Asylum she now claims to have no memory of the murders.
"Gripping and mesmerising"
In each of these tales Margaret Atwood deftly illuminates the single instant that shapes a whole life: in a few brief pages we watch as characters progress from the vulnerabilities of adolescence through the passions of youth into the precarious complexities of middle age. By superimposing the past on the present, Atwood paints interior landscapes shaped by time, regret, and life's lost chances, endowing even the banal with a sense of mystery.
A collection of highly imaginative short pieces that speak to our times with deadly accuracy. Vintage Atwood creativity, intelligence, and humor: think Alias Grace. Margaret Atwood turns to short fiction for the first time since her 2006 collection, Moral Disorder, with nine tales of acute psychological insight and turbulent relationships bringing to mind her award-winning 1996 novel, Alias Grace.
Nominated for the Man Booker International Prize, 2007.Laura Chase's older sister Iris, married at 18 to a politically prominent industrialist but now poor and 82, is living in Port Ticonderoga, a town dominated by their once-prosperous family before the First War. While bewailing her unreliable body and deriding those who try to help her, Iris reflects on her far from exemplary life and her perilous times, but in particular on the events surrounding her sister's tragic early death.
"Excellent book"
From fat girl to thin, from red hair to mud brown, from London to Toronto, from Polish count to radical husband - Joan Foster is utterly confused by her life of multiple identities. She decides to escape to an Italian hill town to take stock of her life. But first, she must organise her own death.
Most kids write stories. Only a few of them grow up to be successful authors. But before there was Carrie, there was Jhonathan and the Witchs. And before there was Rabbit Angstrom, Toyota Dealer, there was Manuel Cirarro, famous detective. Could we have seen the seeds of success in Stephen King's and John Updike's juvenilia? A funny and surprisingly informative gathering of childhood creations by today's most celebrated writers.
Triathlon for the Every Woman is a hilarious, fun and informative read - full of expert advice, training tips, and stories to turn a tired, busy woman into a tired, busy woman triathlete - no matter her size, age, or place in life. Meredith Atwood, an overweight and overworked wife, mother, and attorney, went from the couch to the finish of a half Ironman triathlon in a little over a year. Her book, full of contributions from expert coaches, nutritionists and athletes, takes the reader through the disciplines of swimming, biking and running.
"Move yout butt"
Jeremiah Scott was returning to Weatherton, Wyoming, after a six-year absence. Now that both of his parents had passed, he planned to renew the family ranch he'd left after his father's death. The train ride from Chicago to Cheyenne reminded him how lonely winters in the West could be without someone to share them. While in Cheyenne, arranging business deals and outfitting his ranch, he decided to find an impromptu bride.
Career-driven Dani Trahan wasn't interested in finding a husband. At only 28, she had plenty of time in her future to settle down and have a family, but for now, her sole focus was keeping her restaurant afloat. When tragedy strikes, however, she's forced to examine her priorities and relationships.
Rob Jackson didn't do relationships. He'd long ago accepted that happily ever afters didn't belong to him. That was a decade ago, right around the time he stopped believing in God. Then he met Dani, and for the first time in 10 years, he wanted to believe again: in love and in God.
To move beyond friendship, Dani and Rob must first accept several truths, but can they learn to rely on faith before it is too late?
For Penelope, wife of Odysseus, maintaining a kingdom while her husband was off fighting the Trojan War was not a simple business. Already aggrieved that he had been lured away due to the shocking behaviour of her beautiful cousin Helen, Penelope must bring up her wayward son, face down scandalous rumours, and keep over 100 lustful, greedy, and bloodthirsty suitors at bay.... And then, when Odysseus finally returns and slaughters the murderous suitors, he hangs Penelope's 12 maids.
"A retelling of a story that adds new facets."
Rennie Wilford, a young jounalist running from her life, takes an assignment to a Caribbean island and tumbles into a world where no one is what they seem. When the burnt-out Yankee Paul (does he smuggle dope or hustle for the CIA?) offers her a no-hooks, no strings affair, she is caught up in a lethal web of corruption.


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Congratulations Andersen Corporation! 2016 Energy Star® Partner of the Year Award
The U.S. Environmental Protection Agency (EPA) hasRead More
The U.S. Environmental Protection Agency (EPA) has recognized Andersen Corporation, including its subsidiaries, with a 2016 ENERGY STAR® Partner of the Year – Product Brand Owner Award for its outstanding contribution to reducing greenhouse gas emissions by manufacturing energy-efficient products and educating consumers about energy efficiency. Andersen's leadership in energy efficiency is exemplified through products Read MoreKEEP READING
Spring Is Here, Color Is Everywhere, And New Growth All Around by, Bill Holzman Andersen is no longer one-size or one-color fits all. It was all so easy once when you had White or Terratone, with grille or without, screen or no screen. Just take a look at the options for interior colors that Andersen Read MoreKEEP READING
Blueskin® VP100 is a self-adhered water resistive air barrier membrane. This next generation vapor permeable air barrier picks up where traditional polymeric wraps leave off. Ideal for wood frame construction, Henry Blueskin VP100 is a fully adhered, peel-n-stick system that eliminates air leakage while functioning as a water-resistant barrier and rain barrier. Features Increases building Read MoreKEEP READING
by Joe Madera, Boise Cascade has introduced the FIREBREAK HITS system to meet the 2012 IRC, Section 501-3 requirement that I-joist floor systems in unfinished habitable spaces of basements meet the 15-1/2 minute fire performance of 2×10 dimensional lumber. FIREBREAK™ HITS HIGH INTUMESCENT THERMAL SHIELD OVER CERAMIC FIBERBOARD:FIREBREAKS' High Intumescent Thermal Shield reacts to heat Read MoreKEEP READING
Friday, March 18, 2016 Rhode Island Convention Center Join Shepley and Andersen at the premier construction show for residential remodelers and builders in the Northeast! FREE Pass to the exhibit hall ▪ FREE Transportation ▪ FREE Lunch Registration deadline: Monday, March 7th at 5:00 PM (NO EXCEPTIONS) Cancellation deadline: Monday, March, 14th at 5:00 PM Read MoreKEEP READING
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Original Deforest Radio & Tel. Spherical Audion * First Triode * Nice
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Original Deforest Radio & Tel. Spherical Audion * First Triode * Nice :
Here's a nice original DeForest spherical Audion (double wing). The tube filament is open, but the tube itself still has vacuum, everything inside of it appears to be structurally sound, and the plates and grids are still firmly attached to the glass press. Nice original red and green sheathing on the leads, and the leads are still firmly planted in the tip. Excellent base, still firmly attached to the glass envelope. If you like the tube and are interested in a great way to display it, please see my other sales. I'm listing an excellent DeForest RJ-5 replica/forgery that was probably built by the late Phil Weingarten. A photograph of this Audion, mounted in the RJ-5, is pictured in that other sale.That's about it. Iwill package the tube carefully and properly, and Ican assure you thatit willshow upat your doorstepin the samefine condition in which it leaves mine. I have been shipping antique phonographs and radios for years, and if you check my response, you'll see that I know how to do it correctly. Buyer prepays and includes shipping. Paypal okay.
Original Deforest Radio & Tel. Spherical Audion * First Triode * Nice :
Vintage Mighty Atom Wireless Crystals In Original Tin
Shielded Variometer Coil For Antique Crystal Radio
8lo7i (8ЛО7И) Russian Crt Oscilloscope Cathode Ray Tube With Shield And Sockets


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Manufactured By: Muscle Advance Sports Nutritionals 2049 N.
Lincoln St.
Burbank, CA 91504
It is without a doubt the most important substance you can use to help build mass, increase size, and get stronger, period.
But, with so many creatine products on the market, how do you know which one is the right one?
Well, we have personally used several dozen different types of creatines, and we believe that Muscle Advance Creatine is one of the most pure and effective creatines on the market.
Our results with Muscle Advance Creatine were better than average, and we want to show you why this is the best creatine supplement on the market.
Every guy has a certain amount of creatine that is right for him, and using too much of it can actually have the OPPOSITE EFFECT!
Take Creapure for instance, it has over 6000 mg of creatine in it.
The human body can only process so much of it at one time, so taking 6,000 mg, or even 10,000 mg, won't do much help.
The main reason behind this is the fact that it simply contains the highest quality creatine on the market.
It does not contain any other synthetic chemicals, harmful by products, or any stimulants.
Muscle Advance is just pure, simple, creatine.
The added Benefits are:
The truth is, it really doesn't matter whether or not you take creatine in a capsule or powder form, you will still see the same results.
What makes the difference for me, though, is the fact that I can take it anywhere with me, instead of lugging around a huge tub of creatine.
Finally, after trying out several different types of creatine products, we found that this one was the best one in terms of results.
Not only did it give me extreme amounts of energy for the gym, but it also helped to increase my lean muscle mass and fat burning capability.Starting off, I only weighed in at around 165 pounds, which for me was way too low being 6 ft tall.
I decided that the best thing for me was to "load up" for about 5 days, and then do a 3 week maintenance phase.
During the load up phase, I took 3 capsules of Muscle Advance Creatine 4 times a day, then during the maintenance phase I took 3 tablets a day.
It really doesn't matter whether you load up or not, you will just see faster results this way.
After using Muscle Advance Creatine for about 6 months, I gained 30 pounds of almost complete lean muscle mass, which was phenomenal!
Of course, I had to combine it with a heavy eating regiment, cut out crap foods, and did very little cardio.
I was surprised to see that the majority of my weight was not actually water weight, and I could tell this because the amount I was lifting went up significantly.
The currently have a special running, where you can buy 3 bottles and get 3 free.It comes out to about $150 total, but the results you will get from it will be well worth the price.
Click here to submit your review.
Q: Would creatine be advisable to take while I'm trying to lose weight without losing muscle? I don't want to end up with loose skin after losing weight. -Floyd
A: A lot of people avoid creatine while they're trying to lose weight because of the potential for bloating. But it's actually a great addition to a cutting stack because it helps you workout harder. The harder you work out, the more you burn. The water weight goes away soon after you stop taking it.
Q: Hi rob Would it be OK to take la Norateen with crazy mass products which are all natural products -Tony
A: It should be safe, yes.
Q: Hi rob what is the best way to pop your calves out only that is the only thing thats laging -Tony
Q: Hi is cee creatine better than mono -Tony
A: Creatine Ethyl Ester absorbs better, so that could make it more effective, and you can use less. Ultimately, they both do the same thing. If you find a form that you prefer, then stick with it.
Q: Is it ok to take testofuel, and Muscle advance creatine at the same time? -Hayden
A: Absolutely it's a great stack for putting on muscle mass. Sign up for my Getting Strong ebook for great tips and advice on the meal and workout side of things.
Hey There,
I'm Rob Miller, the founder of SupplementCritique.com. Thanks for visiting my site!
Contact Me Here if you have any specific questions about a product on the site.
Disclosure: We are a professional review site that receives compensation from some of the companies whose products we review. We test each product thoroughly and give high marks to only the very best. We are independently owned and the opinions expressed here are our own.
©2015 SupplementCritique.com All rights reserved.


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...Likewise, I have experience in tutoring students with disabilities. My teaching philosophy is that with a positive attitude and willingness to learn, math can be easy and fun. The success rate of my tutoring is positive and many students have improved their grades by a letter grade or more.
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Greetings to you all! I am an emeritus professor in Biology and an excellent aid if you need to deal with any kind of Spanish homework, project or even if you are getting ready to travel for working or to visit a Spanish speaking country. I love to teach and help students, not just to learn a specific science or language subject, but to enjoy the time while studying.
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Anyone who had bothered to read the thought of one of the greatest Israeli novelists of the 20-21st century would have already known Yehoshua's views. He certainly expressed them in an interview pubished in English in David Grossman's book 10 or 15 years ago. Whether his position reflects some kind of widespread animosity or distancing of Israelis from Diaspora Jews, I don't know. I tend to doubt it. I think the relationship between Israeli and Diaspora Jes is classic co-dependence, in the most neurotic sense of the term: Israelis need Diaspora Jews to define themselves in all their chauvinistic glory and delusions of grandeur, and Diaspora Jews need Israelis as a surrogate for Jewish authenticity and -- of all things! -- spirituality. Diapora Jew love to be abused by our Old Testament/Hebrew-speaking daddy who fights our battles for us against the big bad Goyim. So don't worry, the more Yehoshua humiliates us, the more checks we will write to subsidize the abuse.
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Parallels between civil wars and the escalating crisis within American Anglicanism are now being made, says Giles Fraser. Issues of truth and justice cannot be suppressed by a false and forced kind of unity.
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Who, any more, has a baby - naturally - at 50? Me? Well, maybe ...
OPINION: As I write this, I could have a belly full of dividing cells. Or, it might just be that I have a belly full of belly; it has become increasingly difficult to discern. If I am indeed pregnant at 49, by the time I give birth I will have hit 50, and the only thing I'll be rocking will be a cradle. The medical term for the condition in a woman older than 35 is "geriatric pregnancy". So, what would that make me? Greatly geriatricly gravid?
I was 47 years old, and had been married for six months, the first time I played what I've come to know as the insanely torturous Am I or Am I Not? game. Beset with symptoms that included wild hormone swings, nausea, extreme tiredness, strange food cravings and aversion to alcohol, I did the obvious and took a pregnancy test. When that plastic stick blushed negative, I was overwhelmed by a combination of disappointment and relief. The next day my period arrived, three months late.
Despite my being what is charmingly known as "perimenopausal" (one of those bizarre "women's business" words), there is a possibility, albeit a biblical one, that I might still become pregnant. Having only one (adult) child, I have often had a yearning for another, but circumstances have never been conducive - and now that they are (sort of), it's probably too late.
My son has just turned 21 - an age at which it's starting to look a whole lot more appropriate (and not nearly as creepy) for him to be a father than it is for me to become a mother again. And if I were to become a mother again, I could not help but be both thrilled and aghast. Thrilled at what would be an absolute miracle baby, and aghast at what it would mean to have a baby at my age. I mean, I now find it difficult enough just to get up in the middle of the night to go to the bathroom. How would I cope with the relentless slog and terminal exhaustion of caring for a newborn?
My husband is 12 years older than me, and is not so keen on the idea of becoming a grandpa-dad. Then there's my weight: I'm "working on it". My health is not bad, but I take various prescription medications for one thing or another. The statistics for healthy older women who have babies with birth defects - let alone those for women who are not so healthy - are horrendous.
The sense of horror, however, is offset by a sense of delight at the thought of being blessed with a miracle baby. Sober medical statistics tell me that it's almost impossible for a woman between the ages of 45 and 60 to become pregnant and, without medical intervention, to carry the baby to full-term. And that's the rub: there remains a one or two per cent chance that I could get pregnant. Those better-than-lottery-winning odds might be low, but they are still odds to be respected.
After my first "scare", I did not think about the possibility of being a pregnant old lady again, until two months later, and then the month after that, and the month after that ...
My husband and I choose not to use contraception, hence my monthly schizoid state. I have gone from having a reliable monthly menstrual cycle to one that's all over the shop and often late ... very late. And so this game of Am I or Am I Not? goes on. And it likely will until the annoyingly unpredictable "peri" part of perimenopausal has departed from this mad equation. But until The Change has irrevocably changed me, I'll remain "capable".
That post-marriage pregnancy test was the first of many (eight, but who's counting?). Being a highly suggestible person, every time my period is more than three weeks late, I start feeling ever so pregnant, and I take myself off to get a pregnancy test (I've started buying them in packs of five). Without fail, my period turns up within two days of peeing on a stick.
Whenever he spies the discarded wrapper in the bathroom, my husband says that he expects the emotional Godzilla he has been living with will soon be replaced by her sweet and docile doppelgänger, snug and wrapped up with a heat pad and painkillers, in bed with a good book.
Last year, there was a four-month interlude when my cycle went back to its old, reliable ways, and I had a period every 28 days on the knocker; but apart from that, every couple of months I find myself in a fractured state that alternates between being horrified and delighted.
If I'm honest, I would love to be given a second chance to be a mother - in part because I was so, so far from perfect the first time around. And so, until The Change blows in, I will continue to torture myself with the game of Am I or Am I Not?
-Daily Life
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Waikato DHB serves the best hospital food in the country, patients say
Is it ever OK to complain about other people's kids?Related story: (See story)


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Schweinsteiger doubtful for Euro 2016Read full article on Schweinsteiger doubtful for Euro 2016
Germany captain Bastian Schweinsteiger could miss Euro 2016 through injury, says Manchester United boss Louis van Gaal.
Germany captain Bastian Schweinsteiger could miss Euro 2016 through injury, says Manchester United boss Louis van Gaal.
Germany midfielder Sami Khedira describes Saturday's friendly defeat by England as "unnecessary and stupid".
Manchester United midfielder Bastian Schweinsteiger will miss Germany's friendly against England after injuring a knee ligament.
He is £80,000 poorer, banned from Nutella and dropped for the England game - a bad week for Germany striker Max Kruse.
Northern Ireland's World Cup qualifier against holders Germany on 11 October next will be played in Hannover.
Several sporting fixtures in France are postponed after a series of attacks across Paris kill at least 128 people.
France beat world champions Germany in a match overshadowed by a series of attacks in Paris.
The president of the German football federation (DFB) resigns over claims surrounding a payment to Fifa.
World champions Germany book their place at Euro 2016 with an unconvincing win over Georgia.
The Republic of Ireland produce a stunning win over Germany to leave automatic qualification for Euro 2016 in their own hands.
Republic of Ireland manager Martin O'Neill tells his players to have "no regrets" after the Euro 2016 qualifier against Germany.
Payback for the 7-1 defeat? Brazil charity prevented from collecting kit from World Cup winners Germany.
No Philipp Lahm or Miroslav Klose and a shock defeat by Poland - so why are the 2014 World Cup winners still the team to beat?
England will play world champions Germany in a friendly on 26 March in Berlin to prepare for Euro 2016.
Bobby Wood's late strike gives Jurgen Klinsmann's USA victory over Germany in a friendly in Cologne.
As the Champions League final heads to Berlin, a former winner recalls his time as a teenager in the former East Germany.
England produce a late fightback to beat Germany and extend their fine run going into the European Championship.
Co-pilot Andreas Lubitz, suspected of deliberately crashing an A320 plane in the Alps, required treatment for depression, German media report.
Ex-Bayern Munich president Uli Hoeness is granted day release for the rest of his three-and-a-half year sentence for tax evasion, justice officials say.
England will face world champions Germany and hosts France in the build-up to the 2016 European Championship.
Pick your favourite team from our selection of the greatest players in the history of the World Cup.
Twenty-two shootouts, 204 kicks and millions of broken hearts – the ultimate guide to World Cup penalty shootouts.
In the run-up to the 2014 World Cup in Brazil, BBC Sport looked back at 100 of the greatest World Cup moments.
With every country's World Cup squad confirmed, this is your one-stop shop to all 736 players in this summer's tournament.
Scotland face a tough challenge to take something from a Germany team brimming with talent, writes Alasdair Lamont.
Germany manager Joachim Low has concerns over his strikeforce ahead of the Euro 2016 qualifier against Scotland.
Tommy Docherty talks to BBC Scotland's Tom English about captaining Scotland who beat world champions West Germany.
Germany were worthy World Cup winners at the end of a vibrant tournament, says chief football writer Phil McNulty.
Argentina fans took over Rio but Germany helped Brazil escape their worst nightmare in a World Cup final to remember.
Which Germany player impressed with his high-tempo work-rate, and how will Lionel Messi's final contribution be remembered?
BBC Sport profiles the 22 players starting the World Cup final between Germany and Argentina.
Germany is a country united in the belief that its team will be world champions on Sunday, says German football writer Patrick Strasser.
Astonishing, humiliating and devastating - BBC pundits on Germany's destruction of Brazil at the World Cup.
How do the teams compare? Which will be the deciding factors? Who will win? Our chief football writer tells you all you need to know.
There was something of the old, teutonic Germany about their World Cup defeat of France - but their work is not done yet.
BBC Sport's football expert Mark Lawrenson gives his predictions for the World Cup quarter-finals.
Who is playing? How can you watch? Who will win? Everything you need to know on day 23 of the 2014 Fifa World Cup.
Germany survive an epic struggle against Algeria as the unrelenting drama continues to unfurl at the 2014 World Cup.
BBC Sport's football expert Mark Lawrenson gives his predictions for the first round of knockout matches at the World Cup.
Brazil thrive on momentum and pressure but Argentina, Germany and Netherlands are all capable of destroying their dream.
Who is playing? How can you watch? Who will win? Everything you need on day 15 of the 2014 Fifa World Cup.
The unspectacular striker defenders say they don't worry about has somehow secured his place in World Cup history, writes Ben Smith.
Who is playing? How can you watch the games? Who will win? All the information you need on World Cup day 10.
The world's best player has some catching up to do after Germany's 'false nine' Thomas Muller steals the show
Run by the BBC and partners
For more ideas, information and inspiration, visit bbc.co.uk/getinspired


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We expose slave masters and people smugglers in suburban Britain.
South Africa's Julius Malema talks to Al Jazeera
10 Apr 2013 07:32 GMT | Middle East, Jordan
An estimated two-thirds of the 477,000 Syrian refugees who have fled their homeland live outside of the camps set up for them in Jordan.
Many are forced to crowd together in abandoned buildings.
Refugees who live outside of the camps face another challenge because less humanitarian aid is allocated to assist them.
Al Jazeera's Nisreen El-Shamayleh reports from Ramtha, near the Syria-Jordan border.
Source: Al Jazeera
Jordan launches urgent appeal for aid after 20,000 Syrian refugees cross into country over past seven days.
Politics, Middle East, Jordan, Syria, United Kingdom
At least 10,000 refugees arrive in Jordan in last 72 hours, army sources say.
Politics, Middle East, US & Canada, Jordan, Lebanon
Region's first brick-oven pizza parlour hopes to inspire entrepreneurs and move the DRC beyond cycles of violence.
Africa, Democratic Republic of Congo
Will Department of Justice reforms change a culture of violence in the New Mexico police department?
Magazine, Racism, Gun violence
Child inmates are left to languish in prison with no visitors or legal assistance as many wait years for a trial.
Is a communist village in Andalusia where most villagers work for a cooperative really as utopian as it seems?
Officials say talks under way to extend "regime of silence" as Arab League mulls session to discuss ongoing bombardment.
Middle East, War & Conflict, Syria's Civil War, Aleppo Bombing
Prime Minister Abadi issues call for arrests as 24-hour sit-in ends but protesters vow to return if demands are not met.
Politics, Middle East, Iraq
We examine how cyber thieves are hacking the world's financial architecture and why it's not just about money.
Business & Economy, Science & Technology, Crime
We follow the journey of Kenyans seeking justice for Britain's role in the torture during the 1950s Mau Mau uprising.
Kenya, United Kingdom, Africa
People & Power investigates the environmental consequences of palm oil plantations in equatorial Africa.
Environment, Africa, Cameroon
Five years on, Misratans reflect on the siege of their city and how it played a role in the downfall of Gaddafi.
Libya, War & Conflict, Muammar Gaddafi


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Will Nanopore Sequencing Make it Obsolete?
New Clinical Data Network Technologies Improve...
Financial Structures Can Determine Where Startups...
Bridging Drug Discovery's Valley of Death...
Jiangsu Aosaikang Pharmaceutical (ASK) signed on to manufacture, develop, and commercialize Access Pharmaceuticals' anticancer agent for the Greater China Region. ProLindac™ is currently in Phase II studies and is active in a wide variety of solid tumors, according to the firms. The compound is a platinum prodrug.
The Greater China region includes China, Hong Kong, Macau, and Taiwan. ASK will pay Access an upfront fee and subsequent milestone payments along with a double-digit royalty upon commercialization of ProLindac. In addition, ASK has committed to fund and execute two Phase II trials in colorectal cancer and another trial with an as yet undetermined focus. The companies believe that these Phase II studies would cost up to $20 million if conducted in the U.S. or Europe.
ASK has also agreed to become a second source for the manufacturing of ProLindac. In addition, the company will be responsible for obtaining the necessary regulatory approvals for ProLindac.
"ProLindac is a synergistic product to our current product portfolio and represents a significant innovation in the area of platinum-based cytotoxic agents," says Qingcai Chen, Ph.D., president and chairman of ASK.
Do you think that the recent backpedaling on "heart healthy" practices, and other conflicting studies that claim coffee either causes or prevents cancer, confuse the public more than actually help them make informed choices about their diets?
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Product Details
Is it any wonder that only the best-of-the-best pro athletes get their own pro-models? Well if you want to preform better this season, then check out the Electric Rider Inspired Design Series EGB2 Goggles. Including both the Andreas Wiig and Cheryl Mass pro models, you're sure to have your choice of inspiring eye-wear for all winter conditions. Increase your confidence on the mountain this year by looking like a pro with the Electric Rider Inspired Design Series EGB2 Goggles.
Trending Gear Reviews
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|Too small
|Somewhat small
|Fits as expected
|Somewhat large
|Too large
Neil Allyn Men's Tuxedo Shirt Wing Collar 1/8 Inch Pleat
|$16.49 - $35.55 & FREE Returns on some sizes and colors. Details
- Poly / Cotton
- Wing Collar Construction
- Convertible Front and Cuff
- Poly / Cotton Combo
- 1/8 inch pleating
Customers Who Bought This Item Also Bought
Product Description
The Pintuck is perfect for the formal wear consumer who does not want a full pleat on their tuxedo shirt. The 1/8" pintuck is a slight design which will add a touch of fashion. Be Smart! Shop Smart! Smart Tuxedo a Fashion Company
- Shipping Information: View shipping rates and policies
- Date first available at Amazon.com: June 3, 2006
- #10 in Clothing > Men > Shirts > Tuxedo Shirts
- Average Customer Review:
Customer Reviews
Top Customer Reviews
Ultimately, I would avoid this shirt unless you're a) desperate for a tux shirt and can't make it into a brick and mortar near you, or b) you don't plan on taking off the tux jacket and don't care that you're wearing a tablecloth.
Two stars instead of one because it is made to a high quality, but without a proper fit it's useless.
The quality of the shirt is less than expected. The shirt is very thin and the button holes are not well constructed. When putting buttons on and off, the fabric around the button hole shreds - which may become a problem with repeated wear. However, if used only occasionally, I think this shirt could last for about as long as you would need it.
The bottom line: If you need a tux shirt for a low price that looks good, go for it.
It gets only four stars because it goes down to my knees.
Most Recent Customer Reviews
It was a nice shirt, however, button covers are shown in the picture by the seller and none were included. Overall, great shirt for the money spent, though!Published 14 days ago by JL Franklin
Ordered a 151/2, 32/33 for my teenage son who is normally a men's medium. The shirt is WAY TOO WIDE and INCREDIBLY LONG in the torso. Read morePublished 1 month ago by kilomike
The collar and sleeves were as expected, but the body was HUGE! Thankfully, it was very simple to take in the sides (by about 4 inches) and now it fits great.Published 1 month ago by Daniel
It fit in the shoulders, but the sleeves were longer than expected, and was really long in the torso. Comfortable and breathable, though, even under a vest and jacketPublished 4 months ago by Samantha Bundy
Very comfortable shirt for the very few times a year when I need to wear it!Published 5 months ago by Student
Customers Who Viewed This Item Also Viewed
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Clothing, Shoes & Jewelry > Men > Clothing > Shirts > Tuxedo Shirts


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Coachman Motor Inn, Long Jetty
- Free WiFi and free parking
Main amenities
- 7 smoke-free guestrooms
- Outdoor pool
- Breakfast available
- Room service
- Free use of bicycles
- Terrace
- Daily housekeeping
- Garden
- Library
- Self-serve laundry
- Multilingual staff
- Barbecue grills
What's around
- Swadling Reserve (1.1 mi / 1.8 km)
- Blue Bay (1.1 mi / 1.8 km)
- Toonwoon Bay Beach (1.3 mi / 2.1 km)
- Crackneck Lookout (3.7 mi / 5.9 km)
- Magenta Shores Beach (5.5 mi / 8.8 km)
Coachman Motor Inn, Long Jetty
Hotel Info: 866-539-8117from $79
- 2 Room Suite (1 Bedroom and 1 Sitting Room)
- Boutique Double (2 night minimum)
- Boutique Double
- Single / Rep Special (2 night min)
- Single / Rep Special
- Superior Queen Room (2 night minimum)
- Superior Queen Room
Also popular with travelers from the USA
At a glance
Key facts
Hotel size
- This hotel has 7 rooms
- This hotel is arranged over 1 floor
- Check-in time 3 PM-8 PM
- Check-out time is 10 AM
- Express check-in
There is no after-hours reception at this property. Guests arriving late won't be able to check in until the next morning.
Required at check in
- Credit card or cash deposit required
- Government-issued photo ID required
- Minimum guest age is 20
- Minimum check-in age is 20
Travelling with others
- No cribs (infant beds)
- No pets or service animals allowed
- Free WiFi in public areas
- Free WiFi in rooms
- Free self parking (limited)
Other information
- Smoke-free property
- No alcohol served onsite
- Caters to adults only
Nearby Three Star Long Jetty hotels
In the hotel
- Continental breakfast daily (surcharge)
- Room service (during limited hours)
- Barbeque grills
- Outdoor pool
- Free bicycles on site
- Hiking/biking trails nearby
- Kayaking nearby
- Scuba diving nearby
- Front desk (limited hours)
- Laundry facilities
- Free newspapers in lobby
- Luggage storage
- Number of buildings/towers - 1
- Garden
- Terrace
- Library
In the room
- Coffee/tea maker
- Iron/ironing board
- Individually decorated
- Individually furnished
- Private bathroom
- Shower only
- Hair dryer
- DVD player
- Desk
- Free WiFi
- Daily housekeeping
Top Long Jetty hotels
Recently reviewed hotels in Long Jetty
Nearby hotels
Coachman Motor Inn, Long Jetty's small print
This property's policy is to refuse certain bookings for the purpose of group events or parties, including pre-wedding stag/bachelor and hen/bachelorette parties.
Only registered guests are allowed in the guestrooms.
Some facilities may have restricted access. Guests can contact the property for details using the contact information on the booking confirmation.
This property does not have elevators.
The name on the credit card used at check-in to pay for incidentals must be the primary name on the guestroom reservation.
Optional extras
Continental breakfast is offered for an extra charge of AUD 10 per person (approximately)
We have included all charges provided to us by this hotel. However, charges can vary, for example, based on length of stay or the room you book.
Is the description of this hotel not correct? Tell us


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Uploaded by Hurricane C. on May 19, 2011
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Severity: Notice
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Filename: controllers/ideas.php
Line Number: 207
Within a kingdom the prince or princess has died or been killed and the Queen has been driven half-insane with grief.What if one of the PC's was mistaken for the dead prince or princess and not allowed to leave? There would be advantages in accepting the role, but would it be worth it?
What if dragon-sightings and evidence of such was treated with the same skepticism and mockery as modern UFO sightings? More for a low magic world where dragons 'dont' exist.


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Drink between: 2008 - 2012 (Add My Dates)
26 Tasting Notes
514 Tasting Notes
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I am not a great fan of this wine. But this bottle was great.
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XL Group Enhances Employment Practices Liability Insurance For Privately Owned Businesses With New Risk Management HELPLINE
HARTFORD, Connecticut, Feb. 10, 2014 /PRNewswire/ -- XL Group's Private Commercial Insurance team has partnered with Enquiron™ to deliver the XL Employment Risk Management HELPLINE giving many XL Group's Private Commercial Employment Practices Liability Insurance (EPLI) clients easy access to Human Resource advice and best practices. Policyholders can benefit from expert guidance to proactively avoid human resource-related errors that can be expensive in terms of time and money. In recent years, the U.S. Equal Employment Opportunity Commission (EEOC) reported significant increases in job bias charges, resulting in millions of dollars in monetary recovery from employers. XL recognizes these challenges and is proud to now provide the XL Employment Risk Management HELPLINE solution to help avoid costly scenarios.Through the XL Employment Risk Management HELPLINE's phone service, online portal and monthly HR Express Updates, XL Group's Private Commercial clients are offered risk management guidance to avoid costly EPLI claims. Expert advice is available on more than 50 HR topics, among them Hour & Wage, American Disabilities Act (ADA), termination, and hiring practices. "XL Group is excited to partner with Enquiron for this industry-leading EPL risk management solution that offers our clients added protection with their EPLI policies", says Paul Rowe, Vice President of XL Group's Private Commercial business. "This new services will be invaluable to our clients, directing them to pre-qualified experts who can help them strengthen their HR policies and procedures to avoid claims of harassment, discrimination, retaliation and other wrongful employment decisions." "For small and mid-size companies, a costly workplace lawsuit jeopardizes reputation and their future viability," says Bruce Simmons, XL Group's Private Commercial Product Manager. "That's why we're pleased to provide our clients with both comprehensive insurance coverage to address EPLI-related expenses as well as a tool, like HELPLINE, that can help avoid adverse employee claims altogether." For more information please visit www.xlhelpline.com/overview. XL Group's Private Commercial unit offers a broad suite of management liability coverages, including EPLI and D&O tailored for small and mid-size private companies. About XL Group plc's Insurance Operations XL Group plc's insurance companies offer property, casualty, professional and specialty insurance products globally. Businesses that are moving the world forward choose XL as their partner. To learn more, visit xlgroup.com/insurance About XL Group plc XL Group plc (NYSE: XL), through its subsidiaries, is a global insurance and reinsurance company providing property, casualty and specialty products to industrial, commercial and professional firms, insurance companies and other enterprises throughout the world. XL is the company clients look to for answers to their most complex risks and to help move their world forward. To learn more, visit xlgroup.com XL Group is the global brand used by XL Group plc's insurance and reinsurance subsidiaries. About Enquiron™ Enquiron™, headquartered in Boston, Massachusetts, provides consultative business solutions to employers in all 50 states, across various industries, sectors and sizes. Since 1996, Enquiron has revolutionized the way that services impacting HR, Employment Law, Healthcare, and more are delivered to and utilized by employers. Enquiron has locations across the United States and is a trusted partner to organizations who need specific answers to specific questions. SOURCE XL Group
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