text:
These resources are produced to stimulate ideas to make special services more creative and meaningful times. They are not necessarily the views of the Presbyterian Church but are suggestions for use. Please adapt for your own family/parish/group needs but please respect our copyright.
Other resources which you may also find useful include:
These are available in hard copy only - to obtain a copy send your name and address to


text:
Oracle PartnerNetwork Exchange @ OpenWorld - Promoção especial até dia 27/Jul/2012
By dbalde on Jul 20, 2012
Register Now and Save
You're sure to discover new ways to optimize your systems, new
solutions that will help you take your business to the next level, and
new practices that will make you more successful in your job and in your
industry. Oracle PartnerNetwork Exchange @ OpenWorld 2012. September 30
- October 4, 2012.
Package Pricing (for Stand Alone Partners)
Oracle PartnerNetwork Exchange @ OpenWorld $595 - Take this opportunity and register until July, 27.
- Early Bird March 31 May - July, 27, 2012
- Pre Registration : July 28 - Sept, 28, 2012
- Onsite: Sep, 29 - 04, Oct, 2012
Among others, this package benefits includes:
Access to over 30 Oracle PartnerNetwork Exchange sessions
- Global Partner Keynote (Sunday)
- Keynote sessions for Oracle OpenWorld and JavaOne
- Executive Solution sessions
- Scene and Be Heard presentations
- Oracle PartnerNetwork Lounge
- Oracle Users Forum
- Oracle User Groups Pavilion
- Conference meals Monday through Thursday (morning break, lunch, afternoon break)
- Oracle OpenWorld Reception
- Executive Solution sessions
- Wireless Network and Social Avenue Centers
- Transportation to and from Moscone Center to some official conference hotels. Note: some hotels are within walking distance to Moscone Center. To get to the Zone, you need to transfer buses at Moscone West.
Register Four (4) attendees, Get the Fifth Free
SPECIAL OFFER for all Oracle PartnerNetwork Exchange @ OpenWorld attendees:
Register and buy four (4) Oracle PartnerNetwork Exchange @ OpenWorld passes and get one (1) free pass!
All attendees must be registered from the same company and all four (4) packages must be paid in full to qualify for the one (1) free registration towards Oracle PartnerNetwork Exchange @ OpenWorld. This discount cannot be combined with any other discounts/offers.
Please contact the Oracle OpenWorld 2012 help desk and provide the name and company of the four (4) unique registrations to receive your one (1) free pass. Call 1.866. 382.7147 (U.S. and Canada) or +1.650.226.0812 (International) Monday through Friday, 6:00 a.m. to 6:00 p.m. (Pacific time) or e-mail us at firstname.lastname@example.com and reference the four (4) full paying attendees by name/company to receive your one (1) free registration pass to Oracle PartnerNetwork Exchange @ OpenWorld.
Visa Invitation Letter
If you require a Visa invitation letter find out Required Information needed
Within the registration process, you will be asked if you require a letter of invitation. Select "Yes" and be prepared to provide your passport and embassy information. Once your registration is completed, Visa letters will be processed as soon as the registration is paid in full and all of the required information has been received. Please note that Visa letters will not be processed for Discover packages.
Registration and Housing Questions:
For answers to questions regarding Oracle PartnerNetwork Exchange @ OpenWorld 2012 Registration and Housing, contact us at 1.866.382.7147 (U.S. and Canada) or +1.650.226.0812 (International) Monday through Friday, 6:00 a.m. to 6:00 p.m. (Pacific time), or e-mail us at firstname.lastname@example.com.
Do not loose the opportunity to go to the Open World. Register Now!

subset: commoncrawl


text:
Adah Isaacs Menken1835–1868
Adah Isaacs Menken was a writer, lecturer, and actress whose infamous private life brought widespread attention to her acting career. Born near New Orleans, most likely of African American, white, and Creole heritage, Adah Isaacs married affluent businessman Alexander Isaac Menken when she was around 21 and adopted his faith, Judaism. In 1856, Menken began a successful and lucrative acting career in New Orleans. While she was well known for her dramatic roles, Menken longed for literary recognition. Her poetry condemns male domination and its effects on creative women, and celebrates Judaism and women's lives. She died of tuberculosis in her early 30s in Paris.


text:
Dec 24, 2009 12:16 PM
We're easily bored with workout routines, so were intrigued by the new The Pussycat Dolls Workout DVD ($11). Yes, the routines are hyper-sexualized (think cardio striptease amped up a notch or ten), but it's a welcome break from Pilates or the treadmill. Robin Antin, the creator of the PCD, teaches you three 30-second dance routines, and be warned: she moves fast. You'll probably have "Don't Cha" stuck in your head for a week, but you'll have fun nonetheless... and be left wondering just how much plastic surgery Robin Antin has had. Yowza.
See more cardio dance workouts.
If you've got a product or service that you'd like to promote on Outblush, click here to find out about our advertising opportunities.
Outblush is a blog for girls who love to shop. Our staff digs up the best clothes, home stuff, beauty items, and more. New items are posted every day — bookmark us and check out:


text:
I have a Dell server on which I have installed Ubuntu Server Edition. I had it running with two arrays (one RAID 1, the other a RAID 5). My system has gone bad due to me not using a power backup combined with a power-surge/power-outage (not sure which). The hardware is fine, my arrays are healthy, and ram has been tested, therefore I believe it is a software problem.
I am not sure whether to re-install vs. try repairing my system. I have tried to repair, however my knowledge of shell commands and usage is extremely limited (to give you an idea, I was able to set up my server utilizing the shell however this is all I could manage). I think it would be easier to simply re-install, however whenever I try to re-install it prompts me to format my RAID 5 array (which has my data). Any ideas/tips/anything would be very much appreciated!


text:
LOS ANGELES (LALATE) – Dennis Quaid and Kimberly Buffington-Quaid are divorcing. Dennis Quaid, whose marriages to Meg Ryan and PJ Soles ended in divorce as well, has decided the third time wasn't the charm. Kimberly Buffington married Quaid in 2004.
In 2007, the couple's twins were in peril. Thomas Boone and Zoe Grace Quaid suffered an alleged accidental overdose while inside at Cedars-Sinai Medical Center in Los Angeles. The twins were given Heparin, a blood thinner, in incorrect amounts says reports.
Kimberly Buffington-Quaid has filed for divorce. She is seeking spousal support and fees. The couple have yet to comment to news. Her petitions states "The marriage has become insupportable because of discord or conflict of personalities … that destroys the legitimate ends of the marriage relationship and prevents any reasonable expectation of reconciliation."
Quaid is asking a court rule that his soon to be ex-wife should get nothing. She is seeking half of the couple's community property.


text:
Although digital pictures come in a variety of file formats, many of the pictures on your computer probably use the common JPEG format. This is the file format most digital cameras use to save good-quality images without creating large files. In addition, many programs can open pictures that are saved in the JPEG format.
However, you might have pictures (or drawings) that you want to convert and save as a different type of picture file. When you save a picture in a different format, the original picture isn't replaced; instead, a new picture file is created and saved.
Open Paint by clicking the Start button , clicking All Programs, clicking Accessories, and then clicking Paint.
Type a file name in the File name box, and then click Save.
Paint doesn't work with all types of picture files. For example, you can't open a picture in RAW format using Paint. For file types that Paint doesn't support, you'll need to use a photo editing program.


text:
Sunderland 1 Southampton 0
by Stuart Vose
Black Cats through to FA Cup quarter-finals.
A thunderbolt from Craig Gardner saw off Southampton and booked Sunderland's place in the last eight of the FA Cup with Budweiser.
The midfielder plundered the winner with a fine strike four minutes into the second half to settle the fourth clash between these two sides this season.
Gardner's third goal of the season was a fine one – a rising drive from outside the box which found the net off the underside of the crossbar.
Both sides had chances in a competitive encounter, but it was Sunderland who came out on top to make it eight wins in cup ties this season.
And they deserved the victory, with Nacho Scocco particularly impressive on his debut after joining the club last month.
Gus Poyet opted to make nine changes with only John O'Shea and Fabio Borini remaining from the team which started against Hull.
As expected, Scocco came in and was joined in the starting line-up by fellow Argentinians Oscar Ustari and Santiago Vergini.
Meanwhile, Gardner, Ondrej Celustka, Andrea Dossena and Emanuele Giaccherini all returned, while Seb Larsson and Lee Cattermole made their 100th career starts for the club.
The visitors, who made six alterations of their own, struggled to get on the ball early on as Sunderland – playing two up front – got men forward.
But the away side created the first chance 11 minutes in, with Ustari getting down well to claim James Ward-Prowse's scuffed shot after Rickie Lambert had nodded down Adam Lallana's cross.
Sunderland had a penalty shout turned down soon afterwards, with referee Mike Dean waving away the appeals when Borini went down under a challenge from Luke Shaw on the right-hand edge of the box.
Despite getting plenty of deliveries into the penalty area, Sunderland couldn't get a clear sight of goal against a Southampton side who have conceded just 16 league goals on the road this term.
Gardner saw a powerful drive from the edge of the box deflected over the top eight minutes before the break, while a powerful effort from the impressive Giaccherini was blocked moments later.
Vergini was called into action at the other end to prevent the Saints going in one up at the break, producing a super tackle to clear the ball behind with Lambert looking set to slide home Nathaniel Clyne's cross.
But the match was lit up by a moment of brilliance four minutes into the second period as Sunderland surged into the lead.
Scocco did well down the right only to be dispossessed, but the ball ran to Gardner who jinked past Victor Wanyama and advanced before crashing a fine shot in off the underside of the crossbar from just outside the box.
It was a stunning finish from the midfielder, with Southampton keeper Kelvin Davis left with no chance at full stretch.
Gardner was inches away from another chance when he just failed to get on the end of a super ball over the top after Steven Davis had fired into the side-netting at the other end.
Scocco made way for Connor Wickham with 21 minutes to play, receiving a richly-deserved ovation from the home crowd following an impressive debut.
And Wickham was soon in the thick of the action, narrowly denied when trying to poke a Larsson cross through the legs of Davis from close range.
Gardner then fired straight at Davis before Marcos Alonso replaced Dossena for the final 13 minutes of a competitive second half.
Southampton were far from out of the contest, with Lallana touching a Clyne cross wide at the near post before Lambert spurned a golden chance to equalise 10 minutes from time.
Clyne once again got down the right and supplied a perfect low cross for his colleague, who somehow lifted the ball over an open goal from just three yards out.
Poyet replaced goalscorer Gardner with Jack Colback just after Lambert's miss, and his side had chances to kill the game on the break as the visitors pushed forward in search of an equaliser.
Good work from Wickham set up a three-on-one break four minutes from time, but the striker opted to shoot and fired just wide with Borini unmarked in the middle.
Then some neat interplay carved out an opportunity for Borini in the box and the Italian got plenty of power behind his shot, but Davis was equal to it and tipped the ball away to his left.
The second goal just wouldn't come – but it didn't matter in the end as Gardner's goal proved enough to move Sunderland within just one tie of another Wembley appearance.
SAFC's tweets
Team Sheet
- Ustari
- 32
- Dossena (Alonso)
- 3
- O'Shea
- 16
- Vergini
- 27
- Celustka
- 12
- Cattermole
- 33
- Yellow Larsson
- 7
- Gardner (Colback)
- 8
- Giaccherini
- 23
- Scocco (Wickham)
- 30
- Borini
- 31
- Davis
- 1
- Hooiveld
- 26
- Yoshida Yellow
- 3
- Clyne
- 2
- Shaw
- 23
- Do Prado (Rodriguez)
- 21
- Ward-Prowse (Schneiderlin)
- 16
- Lallana (McQueen)
- 20
- Wanyama
- 12
- Davis Yellow
- 8
- Lambert
- 7
- Roberge
- 29
- Wickham
- 10
- Mannone
- 25
- Mavrias
- 35
- Alonso
- 28
- Colback
- 14
- Ki
- 4
- Schneiderlin
- 4
- Cork
- 18
- McQueen
- 45
- Fonte
- 6
- Gazzaniga
- 25
- Rodriguez Yellow
- 9
- Chambers
- 22


text:
Indiana has a serious problem with overweight kids — and studies show that if kids don't change their behavior when they're young, they'll most likely always have trouble with their weight. That means a lifetime of health risks.
That's why I want to do something about childhood obesity right now — and why I'd like to introduce you to Project 18: a program created for you by Peyton Manning Children's Hospital at St.Vincent in partnership with Marsh Supermarkets and Ball State University. We've developed a program to help kids and their parents set goals, eat smarter, and get active — and we'd love for your school to get involved.
Project 18 is an 18-week health and wellness curriculum designed to address the major risk behaviors in elementary school students in the areas of nutrition, physical activity, and holistic (body, mind and spirit) health. The curriculum is standards-based, addressing the performance indicators for all eight Indiana Health and Wellness Standards.
- Project 18 is school friendly. Project 18 can be used to supplement the required fifth-grade hygiene education. It's also flexible enough to fit as part of existing health and wellness programs at your school. The 18 lessons can also stand alone as third- or fourth-grade health and wellness curriculum and meet all required content as outlined by the Indiana Statutes on health education for fourth grade.
- Project 18 is student friendly. It gives students an opportunity to move around and interact with their classmates. Students get to practice their skills in fun, real-life situations.
- Project 18 is family friendly. It allows parents and caregivers to get directly involved in their child's education with weekly take-home activities that correlate directly to the lesson taught in class. There are also supplemental materials for parents and children to do together — found here on the Project 18 website.
I'd like to personally invite you to get involved with Project 18. Please take a moment to send us an email or call us at 338-KIDS (317-338-5437) if you'd like to use the program in your school. We'll give you everything you need to help fight childhood obesity — and create a brighter, healthier future for kids across Indiana.
Peyton Manning
View More About Project 18:
Challenge Winners
Resources for Parents
Resources for Kids
Resources for Teachers


text:
The WeatherBeeta® Airflow Detach-A-Neck Combo Fly Sheet has more coverage for added protection. Strong polyester mesh is lightweight and allows maximum air flow to help keep your horse stay cool while it protects him from flies. Reduce bites on your horse's neck by adding the detachable neck cover.
Affordable and effective, the crocheted Ear and Eye Net has fabric ears to keep bugs out. This colorful ear bonnet is classically styled with yarn tassels to brush flies away from your horse's eyes.
A perfect match for the Rambo® Grand Prix line, the Grand Prix Ear Net from Horseware® Ireland is in cool, cotton crochet with stretchy fabric for the ears. Decorative cording and color combinations coordinate with the Grand prix show sheets and blanket.
The Kensington™ Protective UV/Fly Sheet offers your horse protection from harmful UV rays and flies. It also helps keep your horse cleaner and drier year-round. Constructed of Textilene® mesh that is formulated to withstand fading, mildew, soiling and wear and tear in the most extreme weather conditions.


text:
Oct. 17, 2000
What is Elliot Silvers, the person off the field, like? What do people not know about you?
Silvers: "I am deep, and complex and twisted. There is a lot more to me than what people see. There is a lot more depth to me.
"There is not one thing that encapsulates me. I am kind of a wide mix of things. I am a little bit of everything, kind of like a sampler platter. Sometimes it seems like I have multiple personalities. There are just many different sides of me. There is the football player side. Something happens on the field and I am kind of violent I guess. That is what offensive lineman do. Then I also definitely have the politician in me, and I also have the clown and the child. The politician in me is the one who does the interviews, the one that makes sure everything is smooth. He doesn't rock the boat, he just tells people what they want to hear. He doesn't question authority at all. It just depends what mood I am in and which side of me it is. Sometimes I am difficult to get along with, sometimes I am not. It just depends on which day you catch me. I am real moody. My seratonin levels aren't exactly a straight line, they are kind of like a heartbeat. I am consistently inconsistent.
"For the clown side of me to come out, I have to be in the right mood, then I joke around a lot. Most of the time I am serious though. I think Jim Morrison said it best. He was `a mature, responsible adult with the soul of a clown, which caused him to blow things at the most crucial moment.' I am a big fan of Jim Morrison."
What is it about Jim Morrison you like so much?
Silvers: "He is just an intriguing person. He was intelligent, lived life fast and was rebellious. There are different kinds of rebellion, though. There is a senseless rebellion where there is not a lot of thought involved. Then there is a calculated rebellion, that is the kind Morrison had. I think that there was definitely a method behind the madness with him. I like his music too. He had stage presence. I like his poetry too. I have his poetry books."
Do you read a lot of books?
Silvers: "I read what I want to read, but I don't really read a lot. But (my book collection) is like my music collection. I read everything. I have Morrison's poetry, Aldus Huxley's `The Doors of Perception', Manufacturing Consent', ` A People's History of the United States,' some books on politics and some Howard Zinn. When I read a book it is usually something that has some meaning to it, not just a story that someone has made up. I am not a real big fan of that. Unless it benefits me in some way, I don't really enjoy it."
What about movies? What kind of movies do you like? Do you have a favorite?
Silvers: "I like them all. It is too hard to choose just one as my favorite. I definitely like movies that make you think, like "Usual Suspects" where it leads you through the movie and then at the end it just leaves you (thinking about it). I like those movies."
Sounds like you are into developing yourself as a person. Is that accurate?
Silvers: "I am into what most kids are into, finding out who I am as a person. I am into expanding my horizons in all directions. I am not focused on just one thing. I am scatter-brained sometimes."
When you look for a girlfriend, do you look for the same qualities that you have?
Silvers: "The first thing I look for, is that I have to be able to talk to the person. If I can sit there and talk with the person for hours and not be bored then that is definitely a plus. I have been around plenty of gorgeous women that I could not talk to for the life of me. No matter how bad I wanted to talk to them, it was a struggle to talk to them. There is this thing with some people where you can talk and it just clicks and you definitely need to have that. I cannot handle not having that. But at the same time I need to be comfortable in silence with the person. It has to be okay to sit there and not say anything at times, and not feel like you have to be talking. If that person happens to be good looking, it is just another plus."
What would you do with that perfect person on a date?
Silvers: "There is no perfect person. [Okay, the person you are looking for.] I usually take my date out to a nice restaurant. The last date serious date I went on, we went to the Waterfront, down on Pier 70. It is a nice restaurant, a real nice restaurant, with a piano player and a real nice bar, out on the water. I definitely think that the first date needs to be interactive. Going to the movies for a date, you don't even talk to the person and get to know them at all. I am not a big fan of the movie date. I am not a big fan of the whole dating thing. It is not really my style. I usually just meet (a girl) somewhere and we talk, then we talk on the phone a little bit and hang out. There are definitely aspects in my life that I need structure in, and dating is not one of them."
What areas of your life do you need structure in?
Silvers: "I think with football there definitely has to be structure. There has to be structure or there is chaos and the team does not really work out."
What do you think has made you successful both as a football player and as a person?
Silvers: "When the sperm hit the egg. I am serious. That is what it is with a lot of us. There is hard work involved, but the majority of it is when the sperm hit the egg. We are gifted. There are a lot of people who would love to be in our shoes, playing football in front of 74-75,000 people every weekend. We are the lucky ones I guess. We get to do what others can't do."
Is there anything that people always ask you that bugs you?
Silvers: "I always get asked, `What size shoe do you wear?' It is the same basic question over and over. Here is how the conversation goes: What size shoe do you wear? I say 18. Then they say can you buy those in the store. I say no. They say do you have to special order those. I say yes. Well, where do you get them? I say catalogs. Do they cost extra? I say no. You would think that they would cost extra because it is made out of more material. I say yes, but they don't. Next question. [Being as big as you are, you don't fit into a lot of cars.] No, trucks mostly. I have a Chevy pickup truck."
They say you can tell a lot about a person by the car they drive? What does yours say about you?
Silvers: "I think you can tell a lot about a person by their collection of music."
What can people tell from your music collection? What kind of music do you listen to?
Silvers: "I think people could tell I am really open-minded by looking at my music. I think if you limit yourself to one genre of music, like rap or rock or reggae, it shows that you are narrow minded and not willing to open up to other ideas. I have a little of everything from Frank Sinatra to reggae to rap to classic rock. You name it, I have it. Operas too. [Operas?] `Cabaret', `Les Mis(erables).' [Even country?] No, I don't own any country CDs, but there are some country songs I like. I just haven't gone out and bought the CDs."
What is your favorite food?
Silvers: "Italian food. My favorite dish is Chicken Parmesan. It is so good. I like Mexican food too.
So, you are very eclectic.
Silvers: That is me summarized in one word, eclectic. No, you can't summarize me. There is no short summary of Elliot Silvers. I need to write a book, Elliot Silvers Rants and Raves. That is what I will call it, since I go on these little rants all the time."
Your major is political science. What do you plan to do with that?
Silvers: Could you see me running for office. Holding babies, taking pictures, cutting ribbons. [Not really.] Why not? Is there some stereotype against me that you think I couldn't do that (he jests). I don't know what I am going to do with it though."
Do you have a nickname?
Silvers: "Train. It used to be L-Train, but it turned into just Train. I've had it since I was in sixth or seventh grade and it just kind of stuck."
Do you have a favorite sports team or athlete?
Silvers:No. [Are you watching the Baseball Playoffs?] No, I am not a big fan of baseball. [Did you watch the Olympics] No, not really. [Do you watch Sports Center, anything sports related?] I do watch Sports Center because it is short and to a point. You don't have to watch the whole game, you just see the highlights and lowlights. I can't sit there and watch a whole sporting event, I don't have the attention span. I would rather be playing it than watching it."
Do you play any sports besides football?
Silvers: "I played a little indoor soccer this summer. It was cool. I hadn't played since I was in third or fourth grade, but it is pretty fun. I have to say that soccer is the most physically demanding sport, endurance-wise because it seems like you run forever. It is intense. I will watch soccer on TV. It is boring, but I like watching it for some reason."
One of your hobbies is surfing. Are there any similarities between football and surfing?
Silvers: They both require balance, but that is about it. I think balance definitely comes into play in football. If you look at the Arizona State game tape, you will see me balanced a few plays and you will see me fall on my face a few plays. Surfing has helped my balance, but there is not really a correlation between the two."
What is it like to play in Husky Stadium?
Silvers: "It is awesome. I almost cried the first time I ran out into the stadium. It is a really emotional experience. The first time I ran out, I don't remember which game it was, but I remember walking down the tunnel in my uniform and hearing people chanting the whole way down the tunnel. You can hear sort of hear the rumble of the crowd outside. You can see them from the tunnel but not very well, then all of a sudden you run out of the tunnel and there are all these photographers taking pictures and there are TV cameras. Then the crowd bursts out into a cheer. It is an emotional moment. It is a big deal. Not everyone can experience that kind of thing. It is appreciated.
Is it a different feeling the more times you do it?
Silvers: "It is. It shouldn't be, but it is. I definitely think the first year you do it and the last year you do it stick out. In the beginning you think, `Wow, this is a new experience, this is the greatest thing ever.' And then somewhere in between you lose it a little bit and take it for granted. And then in the end, during your senior year, you think `I only have a few more times to walk down this tunnel,' and you appreciate it for what it is worth."
Being a senior, what is it like to know that this could be the end of football for you?
Silvers: "It is tough. I haven't really done anything else but go to school and play football. If that is over at the end of the season, I will just have to stop, look around and say `What do I do know' and then regroup. I have no idea what lies ahead in life after football. I know it is going to be a hard adjustment. I think it is hard on everybody."
Do you think you will still spend time with the guys after football? Is there a comraderie among football players?
Silvers: "I can't say definitely, but I hope so. Life takes you in strange directions sometimes.
"There is something special about being on the team. I would do anything for the guys on the team. They are like my extended family, whereas you might not like everybody, but they are still your family."
You suffered a knee cap injury your red-shirt freshman season, how did it happen? How did it effect the way you played when you came back?
Silvers: "It happened in the game against Arizona State in 1997. It was on a counter lead play and Olin Kreutz threw someone into my knee. It hurt pretty badly. I was out for seven games, but I played in the bowl game at the end of the year. It was tough to come back, but it was good because I got to finish out the year with the guys on that team. It was a good experience, we ended up winning that bowl game. For a little while (the injury) slowed me down. I was a little timid when I first came back and I think it showed. It was definitely pointed out to me several times."
What was it like being sidelined for those seven games? Did you learn anything from being forced to watch and not play?
Silvers: "You never really understand how much you love football and really love the game, until it is taken away from you. With an injury, it is snatched away from you so abruptly. It is not fun sitting on the sidelines. When you are hurt like that, you go through practice everyday hating it. Some days it is a real drag but you have to fight through it to play. When you are hurt, you would give anything just to practice. It is weird."
What do you like best about playing offensive tackle? Is there any other position you would like to play?
Silvers: "I don't know. I just know that it is something I am fairly good at. I guess if I could play another position, I would play tight end or defensive end. But I am an offensive lineman, that is all I would really want to play. I like my position. That is just what I can do, what I am good at. I am not really good at anything else."
What is it like to be an offensive lineman, knowing your main responsibility is to protect the quarterback, in this case, Marques Tuiasosopo?
Silvers: "It is exciting because you never know what he is going to do. He is definitely a playmaker. It is exciting to watch him and to play with him. You never know what he is going to do so you have to keep blocking until the whistle blows."
"It doesn't matter who is back there at quarterback, though. It is still a big responsibility. But because he (Marques) is the guy, you have to work especially hard, because he is such a big part of our offense. If he goes down, it is going to hurt us a little bit."
"I think the offensive line has the potential to make a quarterback look good or bad. I probably made Brock (Huard) look bad a few times back in 1998."
Knowing that you could have that much of an impact on a quarterback's success, is that one of the bad parts of the job?
Silvers: "No. It just means the stakes are a little bit higher and it means that you have to play well and come through for the team."
In the Arizona State game, the offense did not produce as well as it has in other games this season, does that fall on the shoulders of the offensive line?
Silvers: "Anytime we don't play well (on offense), I think it is a reflection on the offensive line. If we can't run or pass the ball, I think it is always to some extent our fault."
This year, the team has faced several different defensive styles, does that effect how the offensive line prepares for a game?
Silvers: "It doesn't really effect the offensive line that much. We might block plays a little bit different, but in the end we still have to block our guys. If we don't get that done, it hurts the offense and it hurts the team. It comes down to each man defeating his man. When everybody is on the same page, doing the same thing, the play works out. If one of us messes up, a lot of times, the play doesn't work out the way it was drawn up."
Anything else you want to tell the people reading this?
Silvers: "Question authority. Be yourself. Don't buy into the image that society expects you to fit into. Just be yourself. Don't be what other people want you to be. Do what you want to do, within reason of course. I am just so tired of people being fake and saying what other people want to hear and not what they feel. I think that people aren't honest with themselves anymore. I would rather someone come out and tell me what they think about me, instead of smiling to my face and patting me on the back, and then kicking me in the butt as I walk away."
"I don't really care what people think of me. I care what certain people think about me, but for the most part, if a person doesn't have some impact or bearing on my life, I could really care less what they have to say or what they think about me."
That being said, do you pay attention to the media's reports about the team?
Silvers: "I don't read the paper and I don't watch the TV coverage that involves us, because I think you are never as good as everyone says and you are never as bad as everyone says. People start to believe the hype and a lot of times that is their downfall."
"I think that was the 1997 team's downfall. That was our downfall actually, I was part of it. We started to believe the hype. Everybody started to believe that we were really that good and that was our downfall. When you think that you are that good, you think that you can just show up and beat people. It is almost like people think the other team is just going to roll over and play dead. It doesn't matter if a team hasn't won a game or if they have won every game, they are going to come in and try to beat you. I think you have to respect all of your opponents."
What are your thoughts on the upcoming California game?
Silvers: "We just want to win. We want to play well and we want to win. That is all there is to it. That is why we play, because we want to win. No one wants to lose. We have to play well in order to win. That is it."


text:
Mathlete helps develop critical math skills in additions, subtraction, multiplication and division.
The app centers around taking 60 second test. There are 4 difficulty levels: Beginner, intermediate, advance and expert. In beginner you might get questions like 2 + 2. In Expert mode you will encounter questions like 137 x 75.
Mathlete is simple, elegant and effective to use.
What's New
Version 1.1:
- Add ability to rescale main window. This not only lets you make the window larger but will allow the window to be scaled down for viewing on smaller screens.
RequirementsMac OS X 10.6.6 or later
Similar SoftwareOpen Comparison
Suggest Other Similar Software


text:
Halloween is a day that tests the willpower of even the strongest—and lithest—among us. So though we might resist a triple fudge bar on our best day, few people are above a little professional help when it comes to resisting the temptation of buckets (and buckets) of candy on the 31st. Susan Albers, author of Eating Mindfully and a psychologist at the Cleveland Clinic, shared some tricks to keep us from gorging on all the treats.
How to Not Eat Your Halloween Candy (It's for the Kids)
Halloween is a day that tests the willpower of even the strongest—and lithest—among us. So though we might resist a triple fudge bar on our best day, few people are above a little professional help when it comes to resisting the temptation of buckets (and buckets) of candy on the 31st. Susan Albers, author of Eating Mindfully and a psychologist at the Cleveland Clinic, shared some tricks to keep us from gorging on all the treats.
Beauty Advice, Beauty Products
Tips For Organizing Your Makeup
A few of us at Allure are back at work after three straight days of being stuck in our apartments, or our friends' apartments, while riding out Hurricane Sandy. What did we do with all that time on our hands? There was a lot of movie watching, card-game playing, eating of emergency snacks, closet cleaning, drinking, and, in my case, organizing my makeup collection. My goal? To weed out the unnecessary items (products I rarely use, shades that are basically identical) and to store things in a way that makes finding exactly what I need quick and easy. My collection has reached hoarder-level status, so to get a better look at what I was dealing with, I laid everything out on the living-room floor and got to work.
Beauty News
Cure Your Halloween Beauty Hangover: How to Rid Yourself of Tonight's Makeup Melee
Shannon Ray was the winner of the 2012 Allure Beauty Blogger Awards and is now contributing to the Daily Beauty Reporter.
Tonight is the night, you guys. The Great (Big?) Pumpkin comes and makes us all into slutty or classy pumpkins (whatever your thing may be). If you have big plans for Halloween tonight, chances are you will be getting down with some serious makeup/hair/costumery. But what happens when the night ends and you are left with the hot, hot mess of the aftermath? No one needs to see crunchy, tangled hair, walk-of-shame-esque makeup remnants, and half a fake eyelash strip hanging off your eyeball on November 1. The scary time is supposed to be over, people. But don't worry, you can erase the evidence. I'll be the accessory after the fact to your hooligan beauty antics.Read more >
Beauty Advice, Hair, How-Tos
Are You Making Any Of These 6 Shampoo Mistakes?
Read more >
Learn how to shampoo hair from BellaSugar!
If you've experienced dull hair, limp strands, or a flaky scalp, it might not be just because of the weather. It turns out all these issues can be caused (and solved) by the way you're shampooing your hair. Celebrity colorist Beth Minardi breaks down the dos and dont's of washing your hair step-by-step when you keep reading.
Beauty Products, Fragrance
View From the Beauty Closet: Sample Set
Dawn and Samantha, the lovely sisters behind the scent branding company 12.29, came by recently to talk olfactory logos, scented fashion shows, and their newest venture, 12.29 candles (out this spring). What ensued was a serious smell-a-thon, with Dawn pulling these tiny vials out of her coffret to give me a whiff of some of their projects. My fave: the clean, crisp, slightly steely scent created for the Japanese restaurant Niko.
Man Sues Wife For Being Ugly—And Wins
So this really happened: Jian Feng, a man in northern China, successfully sued his wife for $120,000 for misrepresenting herself as attractive and tricking him into marriage.
Beauty News
In Defense of a Superquick Morning Routine
How long does it take you to get ready in the morning? Five minutes? Thirty minutes? Three hours? According to a recent poll by British drugstore Superdrug, 12 percent of people claim to spend two minutes or less getting ready each morning. "Lazy Brits" shouted the Daily Mail headline. (OK, I know a headline doesn't shout, but that font was huge.) I'll concede that two minutes doesn't sound like a lot, but I can personally attest to the fact that a lot can be accomplished, beauty wise, in not very much time. Here are a few of the speediest tricks for getting ready:
Bargains, Beauty Products, Hair
Fight Thinning Hair With Pantene's Ageless Beauty Collection
Along with wisdom, we all know that age can bring crow's-feet, smile lines, and sagging skin. Age can also, unfortunately, take a toll on your hair.Read more >
Masquerade Beauty: How to Wear Your Makeup Under a Mask
If you're wearing a mask to a Halloween party this weekend, you probably haven't given much thought to your makeup (hello, it's called a mask). But the last thing you want is to take off your mask at the end of the night and really scare people. I talked to makeup artist Sarah Tanno, who's worked with masked crusaders like Lady Gaga and Katy Perry, on how to do your makeup when it's being covered for most of the night. Aren't you glad we're here to solve these practical, real-life problems?
Look We Love: The Power of Red Lipstick
Behold the diversity of red lips! At last night's Flaunt magazine party, artist Liz Goldwyn and her friend Dita Von Teese were prime examples of the versatility of red lipstick.


text:
The UMass women's lacrosse team moved up to 18th in the InsideLacrosse.com/deBeer Media Poll on Monday. UMass played one game last week - an 11-4 win at New Hampshire. The IWLCA coaches poll will be out later today. UMass is one of 13th teams nationally to remain undefeated. The Minutewomen will host Stony Brook this Saturday afternoon at Garber Field.
Women's Lax Moves Up To 18th Nationally
No TrackBacks
TrackBack URL: http://cstv.collegesports.com/mt5.2/mt-tb.cgi/16534


text:
Soccer Kick About
All students are invited to play (or cheer) on the international, co-ed soccer team that meets weekly at the Indian Valley Campus. It's a great way to get exercise and make friends with our growing global student population. Last semester, about 100 international students attended the Intensive English Program in Novato or credit classes in Kentfield. What an opportunity to meet friends from around the world! For more information, contact Brady Meyring who wrote an article about international students on campus in the Echo Times student newspaper.
September Data Nugget
Do you know these facts about COM's enrollment data? What are the ages of the youngest and oldest students attending credit/noncredit classes at College of Marin this semester (fall 2013)?
Distance Education/Moodle Office Relocated
The Distance Education office has moved to LC 65, right next to Media Services. Help with Moodle is available for students and faculty on a drop-in basis. You can also contact firstname.lastname@example.com for answers to individual questions, visit the Moodle update page or to set up an appointment for face-to-face assistance.
Upcoming Events
Reset Your Future: A Four-Week Workshop Series for Student Veterans
Student veterans are invited to take advantage of a unique offering – a free series of coaching workshops specifically designed to help veterans get clear about the steps they need to take for successful re-entry into civilian society. Professional life coaches, Ann V. Moreno and Marilyn Spoja, will lead the program. Each participant will get to set a goal, create a plan and learn strategies to navigate life challenges as well as receive a coaching session and access to an online supportive community 24/7. Register at the Office of Student Affairs, in the Vet Center, or online. More information is available at Reset-Go.
A Streetcar Named Desire Opens Tonight
By Tennessee Williams
When it made its Broadway debut in 1947, A Streetcar Named Desire paved the way for a whole new genre of theatrical experience steeped in the technique of "method acting." Emotionally fragile Blanche DuBois, struggling to hang on to her stability and the disappearing world of Southern gentility, arrives in the hot, steamy, squalid French Quarter of New Orleans where her pregnant sister Stella is living with her husband Stanley Kowalski. Stanley is a force of nature, primal, brutish, and sensual. When Blanche sets up court in his house, Stanley becomes infuriated and the collision between the two causes Blanche to draw deeper into the world of illusion and fantasy. One of Broadway's most celebrated plays of all time, "Streetcar" won the 1948 Pulitzer Prize for Drama and New York Drama Critics' Circle award for Best Play and has enjoyed many awards and nominations throughout several revivals since its premiere. On Oct. 13, the director and members of the production will be available to speak to the audience after the show. For more information about upcoming events, visit the Drama Department seasonal calendar.
Thursday, October 3 at 8 p.m., First Dress Preview: $10
Box Office hours: Tuesday through Friday, 2 – 6 p.m. and one hour before Saturday and Sunday performances; (415) 485-9385. Online purchases can be made at brownpapertickets.com.
Health Center Flu Shots
Flu shots will be available on both campuses to anyone over 18 years of age for $20. The Health Center does not bill insurance plans and is not a Medicare provider. Call (415) 485-9458, for more information.
Fridays, September 27, October 4 and 11
Monday, September 30
Jazz Ensemble Benefit Concert
The College of Marin Jazz Band will be sharing the stage with local saxophone master Mel Martin, who has been performing and recording with Bebop and Beyond, a group he founded and serves as artistic director. Martin has a rich history of collaboration with stars such as Frank Sinatra, Dizzy Gillespie, Ella Fitzgerald, Benny Carter, McCoy Tyner and Freddie Hubbard. He is equally at home playing rock and pop and has performed and recorded with James Brown, BB King and Santana. We hope you join us for this special event. Half of all ticket sales will benefit the College of Marin Music Department. For more information or to order tickets, contact the Fenix box office at (415) 813-5600.
Board of Trustees Meeting
You can view the reports from the September 17 Board meeting online. They include the Fall Enrollment Report, the Midterm Report 2013 presentation and the Tech Plan Update/Action. The next meeting is:
Resume Workshops
Twice a year the COM Job Placement Center sponsors seasonal job fairs for students, alumni and community members to meet the employers directly and network with others. We invite and encourage potential employees to attend with resumes in hand, dressed for success.
Diebenkorn Lecture Series
College of Marin will host a series of free lectures in conjunction with the Intimate Diebenkorn: Works on Paper 1949–1992 exhibit at the College of Marin Fine Arts Gallery. The three-lecture series will focus on this extraordinary exhibit of internationally acclaimed artist Richard Diebenkorn whose work is on display through November 14. The Fine Arts Gallery is open weekdays, 10 a.m. – 5 p.m., and until 8 p.m. on Thursdays.
Lecture Series No. 1: The Figuration of Abstraction
Anu Vikram, professor of Art History, College of Marin and San Jose State University
Lecture Series No. 2: Richard Diebenkorn: The Berkeley Years
Timothy Anglin Burgard, Ednah Root Curator of American Art for the Fine Arts Museums of San Francisco. Burgard was co-curator of Richard Diebenkorn: The Berkeley Years and author of a major essay in the accompanying artist's Catalogue published earlier this year.
Lecture Series No. 3: Diebenkorn and Drawing
John Rapko, professor of Art History and Ethics, College of Marin and UC Berkeley
Annual Fall Job Fair
Employers from various growing Bay Area companies will be on hand to meet prospective employees among the student population, alumni and community members. Come explore entry-level, technical and professional positions in full-time, part-time, temporary and volunteer situations. Bring your resumé for on-the-spot advice and immediate job applications. Don't forget to check the free online job search provided by COM, powered by NACElink. It has local, national, and international positions available for students, alumni and community members. Participating employers include Macy's, AT&T, Jamba Juice, Home Depot, Target, UPS, Subway, Cedars of Marin, Wells Fargo, After College, Urban Outfitters, Susie Cakes, Mountain Mikes Pizza, Nelson Staffing, Express Employment Professionals, Legal Shield, and the U.S. Army. For more information, contact the Job Placement Center, (415) 485-9410.
College of Marin Yard Sale of Surplus District Property
The best way to recycle is find new uses for old things. Come by and discover great deals on hundreds of items looking for new homes. On sale are file cabinets, desks, couches, chairs, thousands of books, and a variety of equipment such as hospital beds, stretchers, computer-related items and audio-visual equipment. Items will be sold for pennies on the dollar and prices are negotiable. Sales are final. All items have been approved as surplus by the district Board of Trustees. Proceeds will benefit the College general fund. For more information, contact Melinda Molloy(415) 884-3101.
Transfer Day
Students, their families and members of the community are invited to meet with representatives from more than 30 colleges at the annual College of Marin Transfer Day. The free event is an opportunity to explore transfer options to a four-year college or university such as a University of California, California State University, or an independent, on-line or out-of-state institution. School representatives will be available to discuss admission requirements, academic programs, fees, housing, scholarships and financial aid. They will also highlight majors they offer and provide an overview of campus life. College of Marin counselors and staff will be on hand to make this a special event. For more information, visit the Transfer and Career Center to see scheduled workshops hosted by Counseling Services and call (415) 485-9671 to reserve a spot.
Advanced Voice Recital: Feminine Musique
Linda Noble Brown, instructor
Ongoing Events
The Intimate Diebenkorn: Works on Paper 1949–1992
Come by the new Fine Arts Gallery and experience this extraordinary exhibit of internationally acclaimed artist Richard Diebenkorn. On display are 38 pieces that have never been publicly viewed. It is a unique and celebratory exhibit offering an intimate glimpse into the artist's evolution spanning more than 40 years. The seven-week exhibit has been curated by Chester Arnold, chair of the Fine Arts Department, in collaboration with the Diebenkorn Foundation . After its debut at the new College gallery, it will travel to other educational and community venues throughout the country. The show is open to the public free of charge.
Preparedness: Beyond Dialing 9-1-1
Evening Administration Information
Evening administrators are available on both campuses Monday through Thursday from 4 p.m. to 8 p.m. If you need assistance, please contact an administrator at the number listed below:
Midweek and Weekend Hours for IVC Farm and Garden
Buy fresh organic produce at the Indian Valley Organic Farm & Garden. To learn more about what's growing on the Farm, sign up for the Farm Bulletin.
Wednesdays and Saturdays
IVC Food Truck Hours
Monday through Friday
Women's Soccer vs. Solano
Submissions to the Weekly Briefing
Please submit information no later than Friday for the following week. Submissions received later than Friday will be included in the next week's edition.
Have a great weekend,
President's Weekly Briefing Web Page


text:
College Hockey:Report: Merrill leaves Michigan for deal with the Devils
According to NHL.com, the New Jersey Devils on Wednesday signed Michigan junior defenseman Jon Merrill to a three-year, entry-level contract.
Merrill was a second-round pick (38th overall) of the Devils in the 2010 NHL draft.
"I'm leaning towards it's going to be time for Jonny to move," Michigan coach Red Berenson said Tuesday to annarbor.com. "I think [the Devils have] been really patient."
The 21-year-old Merrill had two goals, 11 points and 14 penalty minutes in 21 games for the Wolverines this past year after missing the first half of the season with a fractured vertebra he sustained in an exhibition game on Oct. 9.
Merrill was a CCHA rookie of the year finalist in 2011 and in 82 career games, tallied 11 goals and 47 points.
On Friday, it was announced Merrill had signed an amateur tryout contract with the AHL's Albany Devils.
The following is a self-policing forum for discussing views on this story. Comments that are derogatory, make personal attacks, are abusive, or contain profanity or racism will be removed at our discretion. USCHO.com is not responsible for comments posted by users. Please report any inappropriate or offensive comments by clicking the "Flag" link next to that comment in order to alert the moderator.
Please also keep "woofing," taunting, and otherwise unsportsmanlike behavior to a minimum. Your posts will more than likely be deleted, and worse yet, you reflect badly on yourself, your favorite team and your conference.


text:
March 8, 2010
TUSCALOOSA, Ala. - The Alabama Gymnastics team remains the No. 1 team in the nation this week thanks to its fifth 197-plus score of the season, a 197.275 at No. 2 Oklahoma last Friday. The Crimson Tide became the first team in the nation to break the 197 mark for its regional qualifying score with a 197.155 this week.
The regional qualifying score formula takes a team's top three road scores and its next three highest scores, drops the high mark and averages the remaining five. Oklahoma is more than two-tenths of a point behind the Tide in the rankings with a 196.920 RQS followed closely by No. 3 UCLA's 196.900. Florida and Georgia round out the top five. The Southeastern Conference remains dominant in this week's rankings, with three teams in the top five, five in the top 10 and all seven in the top 20.
Alabama is also the nation's No. 1 ranked team on the vault and is second on the uneven bars and floor exercise and third on the balance beam.
Individually six UA gymnasts are ranked in the top 25 in at least one event. Senior Morgan Dennis, sophomore Ashley Priess and senior Ricki Lebegern are all ranked in the top 25 in the all-around with Dennis at No. 5, Priess at No. 9 and Lebegern at No. 24. Dennis moved to No. 1 on the floor exercise and is also seventh on the vault and 17th on the balance beam this week. Priess is seventh on both the uneven bars and balance beam and 22nd on the floor exercise. Lebegern is also ranked 14th on the vault.
Sophomore Geralen Stack-Eaton is 11th on the vault and 16th on the uneven bars while junior Kayla Hoffman is 14th on the uneven bars and 19th on the vault. Senior Kassi Price is 10th on the uneven bars.
Alabama has this weekend off from competition and returns to action Friday, March 19 for its regular season and home finale against No. 12 Michigan. It will be Senior Night in Coleman Coliseum with the meet getting underway at 7:30 p.m. Tickets are available at the Alabama Ticket Office (205.348.2262) and online at RollTide.com.


text: Sterling silver 1922 New York Giants season pass. Pennant shaped pass has bat as flag pole with "N. Y. Giants 1921 World Champions" surrounded by dark blue enamel on front. Back stamped "The Giants Bid You Welcome 1922 Mr. & Mrs. J. Monheimer 321 Chas. A. Stoneham. Pres." and "Lambert Bros". Very nice shape.


text:
Man Bites Shark
— Today we revisit an Advocacy post from 2007 on the cruel practice of shark finning, which involves slicing off a shark's fins and tail and mindlessly tossing the still-living creature back into the water to die. Most fins are harvested for soup. In a market in Sydney, Australia, a single shark fin can command as much as $1,000.
— Since our article was published, there have been signs of hope that this brutal practice is losing some ground with consumers. Nine U.S. states now ban the possession or sale of shark fins. The European Union strengthened its policies against shark finning in June of 2013 by requiring that all sharks caught at sea be returned to land with their fins still attached to their bodies. And in December 2013 China, a longtime top market of shark fin, banned shark-fin dishes at official state functions. Some hotels and banquet halls in the country followed suit and removed the dish from their menus. By mid-2014 sales of shark fins had dropped considerably in the country.
— But with recent research calculating that as many as 100 million sharks may be killed for their fins each year, it's clear there's still much work to be done to protect these endangered animals.
The shark—shaped by evolution to be a swift, powerful predator and a fearsome menace to swimmers—is now itself becoming prey to man's insatiable appetite for exotic foods. Worldwide shark populations are dropping to alarming levels, and several species are already endangered. It is estimated that populations of some species have declined by 90 percent.
The worst threat to shark populations is the growing appetite for the Asian delicacy shark-fin soup. Once a regional Cantonese dish affordable by only the wealthy and therefore a symbol of lavish hospitality, the dish is becoming increasingly common as China, Thailand, and other nations become more prosperous. Even though the price can be as much as $100 a bowl, shark-fin soup is widely available in East and Southeast Asia as well as in Asian enclaves abroad. A reporter found dried shark fins being sold in San Francisco for $328 per pound. Ironically, the dried and processed fins have no taste, but they add a desired gelatinous body to the soup. continue reading…


text:
from Never the Same: Coming to Terms with the Death of a Parent
by Donna Schuurman
Perhaps you had permission to express yourself, or at least didn't feel that you were being discouraged to do so, but you really didn't know how. Welcome to the club! Mainstream American society does a very poor job, I believe, in encouraging or accepting ritual and expressions for grieving beyond the funeral or memorial service. Working adults get three days of funeral leave and return to work where coworkers frequently ignore them out of fear of saying the wrong thing. Children return to school and the routines of life without constructive ways to express their feelings of anger, fear, rage, relief, guilt, and anxiety, among others.
Thinking back, do you remember what you did to express how you felt in the weeks and months after your parent's death? Was there someone you could talk to? Did you express yourself through art, play, sports? At The Dougy Center, we provide a variety of opportunities for children and teens to express themselves if they choose to, ranging from mask making, painting, chalk, clay work, physical (and cerebral) games, to our "Volcano Room," a padded safe room where they can hit a punching bag, tumble, throw pillows and stuffed animals, and get out the energy they're so frequently being told by adults to keep inside. A lot of the kids at the center, we're told, have behavioral problems, sometimes referred to as "acting out." Often, their "behavioral problems" are really adults' "perception problems" and their "acting out" is a young person's way of saying, "Look at me; I need help!" Too often, instead of attending to their needs, children are ostracized by adults and other kids, which only perpetuates the cycle.
All kids "act out" what's inside of them. Adults do, too, if you really think about it. We're all acting out what is inside of us, the accumulated hurts and pains, the successes, fears, and hopes. It's part of being human. As James Hollis states in a simple yet true reductionism, "All behavior is anxiety management." We're all "acting out" all the time in ways that will relieve our anxiety and keep us safe. Children do so out of a sense of necessity because the world is so much bigger than them, and they have so little say in it. As we age, we find ways to cope, but that scared child is still inside all of us. Have you found ways to express yourself, or are you still carrying your fears and concerns bottled up inside? If they're still in there, unexpressed, they'll wait. But they will not remain silent forever.
*Donna Schuurman is the Executive Director of The Dougy Center, a children's grief support program in Portland, Oregon and the source of excellent resources on grief and loss. www.dougy.org
Call Us: 501-364-1100 or TDD 501-364-1184


text:
Senate Committee to Vote on Medicare Drug Bill
Sarah Lueck reports on efforts to let the government negotiate Medicare drug prices.
The Senate Finance Committee will send a shot across the bow of the drug industry Thursday when it considers legislation allowing the federal government to negotiate with drug makers for lower prices in the Medicare prescription-drug benefit. Chairman Max Baucus (D., Mont.) released a framework for a bill he says would "untie" the hands of the Health and Human Services Secretary by removing language in the current Medicare law that prohibits HHS from "interfering" in negotiations between drug makers and the private health insurers that provide the coverage to Medicare beneficiaries.
The bill would also give congressional support agencies, such as the Congressional Budget Office and the Government Accountability Office, access to data on the rebates, discounts and other price concessions insurers are getting from drug makers in the Medicare drug benefit. Mr. Baucus is calling on the CBO to use the data to inform Congress on a range of issues, including how the Medicare drug prices compare to the prices the government pays in Medicaid, the federal-state program for the poor.
The legislation also requires the HHS Secretary to create a prioritized list of "comparative effectiveness" studies that the insurers providing Medicare drug coverage would be required to use when determining which products are covered. The research would compare drugs to others used for the same illnesses, as well as drugs compared to other forms of treatment.
The House has passed legislation requiring the HHS Secretary to negotiate with drug makers for lower Medicare prices, a slightly farther step than Mr. Baucus has been willing to go. But acting in some form to lower drug prices in the program remains a top Democratic priority, and it could head to the full Senate floor next week.
The legislation faces a fight in the committee, where it may well pass. But it faces even bigger hurdles on the Senate floor, where Republicans are likely to filibuster. Republicans say the benefit is working well as it is, and that government negotiation would not mean big savings. In any case, if Democrats are unable to get the 60 votes necessary to end debate, Republicans will have saved President Bush from having to veto legislation that seems to have strong public support.


text:
Webcast: Supercharge Your Web Applications with One-Click Content Updates
By Kellsey Ruppel-Oracle on Nov 01, 2010
Improved Web Content Management Is Only a Click Away!
With Oracle's revolutionary one-click Web content management, you can add services that enable content to be updated in real time by authors. Take advantage of in-context Website editing and instant updates to accelerate content development. Choose to add functionality by dragging and dropping a content management service into your application. Or customize the content management solution by creating your application in Oracle's development environment. Oracle Web content management is the only system that gives you that flexibility.
Join us on November 11 for this live webcast and learn more about Oracle Web Content Management. Brian Dirking and Michelle Huff of Oracle will discuss:
- Three unique roles for managing Websites
- A strong central framework with distributed permissions for controlling navigation and content
- Digital asset management for creating fast ROI
- A revolutionary way to enable content management services into existing Web applications
Register today for this live Webcast.


text:
"Menopausal hormone therapy for the primary prevention of chronic conditions: U.S. Preventive Services Task Force recommendation statement." has been saved, and will be accessible from the My NGC page.
Go to My NGC
Alert me when this guideline summary is updated.
This is the current release of the guideline.
This release updates a previously published guideline: U.S. Preventive Services Task Force. Hormone therapy for the prevention of chronic conditions in postmenopausal women: recommendations from the U.S. Preventive Services Task Force. Ann Intern Med 2005 May 17;142(10):855-60.
Chronic conditions including:
To update the 2005 U.S. Preventive Services Task Force (USPSTF) recommendation statement on hormone therapy for the prevention of chronic conditions in postmenopausal women
Postmenopausal women who are considering hormone therapy for the primary prevention of chronic medical conditions
Note: These recommendations do not apply to women who are considering hormone therapy for the management of menopausal symptoms, such as hot flashes or vaginal dryness, or women younger than 50 years who have had surgical menopause.
Hormone replacement therapy (HRT):
Key Question 1: What are the benefits of menopausal hormone therapy when used to prevent chronic conditions?
Key Question 2: What are the harms of menopausal hormone therapy when used to prevent chronic conditions?
Key Question 3: Do benefits and harms differ by subgroups? Subgroups include women with premature menopause; women with surgical menopause; age of use; types, doses, and modes of delivery of hormones; and presence of comorbidities.
Note from the National Guideline Clearinghouse (NGC): A systematic evidence review was prepared by the Oregon Evidence-based Practice Center (EPC) for use by the U.S. Preventive Services Task Force (USPSTF); see the "Availability of Companion Documents" field.
Data Sources and Searches
In conjunction with a research librarian, Evidence-based Practice Center (EPC) staff searched the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the third quarter of 2011), MEDLINE (2002 to 30 November 2011), reference lists of articles, and SCOPUS for relevant English-language studies and systematic reviews.
Study Selection
Reviewers selected studies on the basis of inclusion and exclusion criteria developed for each key question. For all key questions, only randomized, controlled trials of postmenopausal hormone therapy versus placebo were included. Observational studies were not included because of the existence of published randomized trials designed to address the key questions directly and the known biases inherent in observational studies of menopausal hormone use. Trials were included that matched the target population, evaluated the primary prevention of new conditions rather than treatment of existing conditions, and provided risk reduction or elevation estimates for hormone therapy compared with placebo. Estimates for individual hormone therapy regimens were included and estimates that pooled results from different regimens were excluded. For trials that enrolled women with preexisting conditions, such as coronary heart disease (CHD) in the Heart and Estrogen/Progestin Replacement Study (HERS), data were used for all outcomes except preexisting conditions and related conditions.
For trials that reported outcomes at various times, results appropriate to specific outcome measures were selected. For conditions known to be related to ongoing exposure to hormone therapy, such as thromboembolic disease and osteoporotic fractures, results reported at the end of the trial intervention phase. For conditions that were initiated during exposure but continued after the intervention phase, such as cancer, results reported at the end of the trial's postintervention phase were used, if available. The review team reviewed their selection of results from the Women's Health Initiative (WHI) trials with the WHI investigators.
Out of 704 full-text articles reviewed for relevance to key questions, 51 full-text articles from 9 trials met inclusion criteria. An article with new results from the Women's Health Initiative (WHI) that was published after the literature search was also included.
Not applicable
Data Extraction and Quality Assessment
From the included studies, an investigator abstracted details of the patient population, study design, analysis, follow-up, and results. Key data elements were confirmed by a second investigator. By using predefined criteria developed by the USPSTF for randomized trials, two investigators independently rated the quality of studies (good, fair, or poor) and resolved discrepancies by consensus.
Data Synthesis and Analysis
The Evidence-based Practice Center review team used results from the Women's Health Initiative (WHI) trials, including the main trials, the Women's Health Initiative Memory Study (WHIMS), and the Women's Health Initiative Study of Cognitive Aging (WHISCA), as the main estimates for each outcome rather than perform meta-analysis of all trials because the trials were heterogeneous, they were most applicable to the key questions, and their results would dominate the meta-analysis because of their large enrollment. As a group, the research team used methods developed by the USPSTF to assess the overall quality of the body of evidence for each key question (good, fair, or poor) on the basis of the number, quality, and size of studies; consistency of results between studies; and directness of evidence.
The U.S. Preventive Services Task Force (USPSTF) systematically reviews the evidence concerning both the benefits and harms of widespread implementation of a preventive service. It then assesses the certainty of the evidence and the magnitude of the benefits and harms. On the basis of this assessment, the USPSTF assigns a letter grade to each preventive service signifying its recommendation about provision of the service (see Table below). An important, but often challenging, step is determining the balance between benefits and harms to estimate "net benefit" (that is, benefits minus harms).
Table 1. U.S. Preventive Services Task Force Recommendation Grid*
*A, B, C, D, and I (Insufficient) represent the letter grades of recommendation or statement of insufficient evidence assigned by the U.S. Preventive Services Task Force after assessing certainty and magnitude of net benefit of the service (see the "Rating Scheme for the Strength of the Recommendations" field).
The overarching question that the Task Force seeks to answer for every preventive service is whether evidence suggests that provision of the service would improve health outcomes if implemented in a general primary care population. For screening topics, this standard could be met by a large randomized, controlled trial (RCT) in a representative asymptomatic population with follow-up of all members of both the group "invited for screening" and the group "not invited for screening."
Direct RCT evidence about screening is often unavailable, so the Task Force considers indirect evidence. To guide its selection of indirect evidence, the Task Force constructs a "chain of evidence" within an analytic framework. For each key question, the body of pertinent literature is critically appraised, focusing on the following 6 questions:
The next step in the Task Force process is to use the evidence from the key questions to assess whether there would be net benefit if the service were implemented. In 2001, the USPSTF published an article that documented its systematic processes of evidence evaluation and recommendation development. At that time, the Task Force's overall assessment of evidence was described as good, fair, or poor. The Task Force realized that this rating seemed to apply only to how well studies were conducted and did not fully capture all of the issues that go into an overall assessment of the evidence about net benefit. To avoid confusion, the Task Force has changed its terminology. Whereas individual study quality will continue to be characterized as good, fair, or poor, the term certainty will now be used to describe the Task Force's assessment of the overall body of evidence about net benefit of a preventive service and the likelihood that the assessment is correct. Certainty will be determined by considering all 6 questions listed above; the judgment about certainty will be described as high, moderate, or low.
In making its assessment of certainty about net benefit, the evaluation of the evidence from each key question plays a primary role. It is important to note that the Task Force makes recommendations for real-world medical practice in the United States and must determine to what extent the evidence for each key question—even evidence from screening RCTs or treatment RCTs—can be applied to the general primary care population. Frequently, studies are conducted in highly selected populations under special conditions. The Task Force must consider differences between the general primary care population and the populations studied in RCTs and make judgments about the likelihood of observing the same effect in actual practice.
It is also important to note that one of the key questions in the analytic framework refers to the potential harms of the preventive service. The Task Force considers the evidence about the benefits and harms of preventive services separately and equally. Data about harms are often obtained from observational studies because harms observed in RCTs may not be representative of those found in usual practice and because some harms are not completely measured and reported in RCTs.
Putting the body of evidence for all key questions together as a chain, the Task Force assesses the certainty of net benefit of a preventive service by asking the 6 major questions listed above. The Task Force would rate a body of convincing evidence about the benefits of a service that, for example, derives from several RCTs of screening in which the estimate of benefits can be generalized to the general primary care population as "high" certainty (see the "Rating Scheme for the Strength of Recommendations" field). The Task Force would rate a body of evidence that was not clearly applicable to general practice or has other defects in quality, research design, or consistency of studies as "moderate" certainty. Certainty is "low" when, for example, there are gaps in the evidence linking parts of the analytic framework, when evidence to determine the harms of treatment is unavailable, or when evidence about the benefits of treatment is insufficient. Table 4 in the methodology document listed below (see the "Availability of Companion Documents" field) summarizes the current terminology used by the Task Force to describe the critical assessment of evidence at all 3 levels: individual studies, key questions, and overall certainty of net benefit of the preventive service.
Sawaya GF et al. Update on the methods of the U.S. Preventive Services Task Force: estimating certainty and magnitude of net benefit. Ann Intern Med. 2007;147:871-875.[5 references].
What the U.S. Preventive Services Task Force (USPSTF) Grades Mean and Suggestions for Practice
USPSTF Levels of Certainty Regarding Net Benefit
Definition: The USPSTF defines certainty as "likelihood that the USPSTF assessment of the net benefit of a preventive service is correct." The net benefit is defined as benefit minus harm of the preventive service as implemented in a general, primary care population. The USPSTF assigns a certainty level on the basis of the nature of the overall evidence available to assess the net benefit of a preventive service.
A formal cost analysis was not performed and published cost analyses were not reviewed.
Peer Review. Before the U.S. Preventive Services Task Force (USPSTF) makes its final determinations about recommendations on a given preventive service, the Evidence-based Practice Center and the Agency for Healthcare Research and Quality send a draft evidence review to 4 to 6 external experts and to Federal agencies and professional and disease-based health organizations with interests in the topic. The experts are asked to examine the review critically for accuracy and completeness and to respond to a series of specific questions about the document. After assembling these external review comments and documenting the proposed response to key comments, the topic team presents this information to the USPSTF in memo form. In this way, the USPSTF can consider these external comments before it votes on its recommendations about the service. Draft recommendation statements are then circulated for comment among reviewers representing professional societies, voluntary organizations, and Federal agencies, as well as posted on the Task Force Web site for public comment. These comments are discussed before the final recommendations are confirmed.
Responses to Public Comment. A draft version of this recommendation statement was posted for public comment on the USPSTF Web site from 29 May to 26 June 2012. In response to the comments received, the USPSTF clarified the populations to which the recommendations apply; the specific form, dosage, and route of administration of the estrogen and progestin and estrogen-only therapies considered; and the reasons for not considering bioidentical hormone therapy.
Comparison with Guidelines from Other Groups. Recommendations from the following groups were discussed: The American Heart Association, the American Congress of Obstetricians and Gynecologists, the Canadian Task Force on Preventive Health Care, the American Academy of Family Physicians, and the North American Menopause Society.
The U.S. Preventive Services Task Force (USPSTF) grades its recommendations (A, B, C, D, or I) and identifies the levels of certainty regarding net benefit (High, Moderate, and Low). The definitions of these grades can be found at the end of the "Major Recommendations" field.
Summary of Recommendations and Evidence
The USPSTF recommends against the use of combined estrogen and progestin for the prevention of chronic conditions in postmenopausal women. (This is a D recommendation.)
The USPSTF recommends against the use of estrogen for the prevention of chronic conditions in postmenopausal women who have had a hysterectomy. (This is a D recommendation.)
This recommendation applies only to postmenopausal women who are considering hormone therapy for the primary prevention of chronic medical conditions. This is not a recommendation about the use of hormone therapy to treat menopausal symptoms, such as hot flashes or vaginal dryness; the USPSTF did not review the evidence related to this possible indication because it falls outside of the mission and scope of the USPSTF. This recommendation also does not apply to women younger than 50 years who have had surgical menopause.
Clinical Considerations
Patient Population Under Consideration
This recommendation applies only to postmenopausal women who are considering hormone therapy for the primary prevention of chronic medical conditions. It does not apply to women who are considering hormone therapy for the management of menopausal symptoms, such as hot flashes or vaginal dryness. It also does not apply to women younger than 50 years who have had surgical menopause.
Assessment of Risk
This recommendation applies to the average-risk population. Risk factors for a specific chronic disease or individual characteristics that affect the likelihood of having a specific therapy-associated adverse event may cause a woman's net balance of benefits and harms to differ from that of the average population.
Use of Preventive Medication
Although combined estrogen and progestin therapy decreases the risk for fractures in postmenopausal women (about 46 fractures of any type prevented per 10,000 person-years), there is an accompanying increased risk for serious adverse events, such as stroke, invasive breast cancer, dementia, gallbladder disease, deep vein thrombosis (DVT), and pulmonary embolism (see Table 1 in the original guideline document). It does not decrease a woman's risk for coronary heart disease (CHD), and results from the Women's Health Initiative (WHI) randomized, controlled trial show a trend toward an increased likelihood of having a cardiac event (hazard ratio [HR], 1.22 [95% confidence interval (CI), 0.99 to 1.51]).
Estrogen-only therapy is associated with a reduction in the risk for fractures (about 56 fractures of any type prevented per 10,000 person-years), as well as a small reduction in the risk for invasive breast cancer (about 8 fewer cases per 10,000 person-years) and for dying of the disease (about two fewer deaths per 10,000 person-years) (see Table 2 in the original guideline document). The biological mechanism underlying the apparent protective effect of estrogen alone, as compared with the harmful effect of estrogen and progestin combined, on the development of invasive breast cancer in postmenopausal women is unclear. However, estrogen-only therapy is also associated with important harms, such as an increased likelihood of stroke, DVT, and gallbladder disease. It does not reduce the risk for CHD (WHI results: HR, 0.95 [CI, 0.78 to 1.15]).
In addition to other harms, combined oral estrogen and progestin and oral estrogen-only therapy have both been shown to be associated with an increased incidence of stress, mixed, or any urinary incontinence in previously asymptomatic women after 1 year. This outcome was measured by a self-administered questionnaire; additional randomized trials that focus on urinary incontinence as a primary study end point and use urodynamic testing as part of the assessment strategy would be useful to further clarify the effect of hormone therapy on urinary symptoms.
U.S. Food and Drug Administration (FDA)–approved indications for hormone therapy in postmenopausal women are limited to the treatment of menopausal symptoms and the prevention of osteoporosis. A black box warning indicates that estrogen with or without progestin should be prescribed at the lowest effective dose and for the shortest duration of use consistent with treatment goals and risks for the individual woman.
Timing of Intervention
No randomized trials have prospectively evaluated the effect of the timing of initiation of hormone therapy relative to menopause onset on associated benefits and harms. Post hoc subgroup analyses suggest an increased probability of harm with increasing age at initiation and longer duration of use, but these findings are not consistent across all trials and generally do not reach statistical significance.
Other Approaches to Prevention
Women have different characteristics and risk factors, such as age, family history, and comorbid medical conditions, that affect their likelihood of developing a given chronic disease; they may also differentially value preventing specific outcomes. As such, any choice of therapy should be based on the intersection of a woman's clinical situation, preferences, and values to maximize benefits over harms.
In the case of fractures, other effective interventions for treating women with low bone density include weight-bearing exercise, bisphosphonates, and calcitonin (the USPSTF addressed screening for osteoporosis in 2011). In women at high risk for breast cancer, the use of tamoxifen or raloxifene could potentially be a preventive strategy in selected situations, depending on the woman's underlying risk for stroke and thrombolic events. In addition to breast cancer chemoprevention and screening for osteoporosis, the USPSTF has issued recommendations on other relevant interventions for the primary or secondary prevention of chronic diseases in women, including medications for cardiovascular disease and screening for CHD, high blood pressure, lipid disorders, colorectal cancer, breast cancer, and dementia. All are available at www.uspreventiveservicestaskforce.org .
None provided
The type of supporting evidence is not specifically stated for each recommendation.
Combined Estrogen and Progestin
Many health outcomes potentially associated with the use of hormone therapy in postmenopausal women have been examined. The U.S. Preventive Services Task Force (USPSTF) found convincing evidence that estrogen and progestin therapy (specifically, oral conjugated equine estrogen, 0.625 mg/d, plus medroxyprogesterone acetate, 2.5 mg/d) is of moderate benefit in reducing the risk for fractures in postmenopausal women. Table 1 in the original guideline document provides absolute risk difference estimates for the benefits and harms of estrogen and progestin therapy.
Estrogen Alone
The use of estrogen without progestin has generally been restricted to women who have had a hysterectomy because unopposed estrogen use increases the risk for endometrial cancer in women with an intact uterus. The USPSTF found convincing evidence that estrogen (specifically, oral conjugated equine estrogen, 0.625 mg/d) is of moderate benefit in reducing the incidence of fractures. There is adequate evidence that the use of estrogen alone results in a small reduction in the risk for developing or dying of invasive breast cancer. There is convincing evidence that estrogen does not have a beneficial effect on coronary heart disease (CHD). Table 2 in the original guideline document provides absolute risk difference estimates for the benefits and harms of estrogen therapy.
The U.S. Preventive Services Task Force (USPSTF) found adequate evidence that use of combined estrogen and progestin therapy is associated with moderate harms, including an increase in the risk for stroke, dementia, gallbladder disease, and urinary incontinence. There is convincing evidence of a small increase in the incidence of invasive breast cancer and adequate evidence of a small increase in breast cancer deaths. There is also convincing evidence that estrogen and progestin therapy is associated with a small increased risk for deep venous thrombosis (DVT) and pulmonary embolism. Convincing evidence shows that the use of estrogen and progestin therapy does not have a beneficial effect on coronary heart disease (CHD) and probably increases the risk for its occurrence. Table 1 in the original guideline document provides absolute risk difference estimates for the benefits and harms of estrogen and progestin therapy.
The use of estrogen without progestin has generally been restricted to women who have had a hysterectomy because unopposed estrogen use increases the risk for endometrial cancer in women with an intact uterus. The USPSTF found adequate evidence that its use is associated with moderate harms, including the risk for stroke, gallbladder disease, and urinary incontinence, as well as a small increase in the risk for DVT. There is convincing evidence that estrogen does not have a beneficial effect on CHD. Table 2 in the original guideline document provides absolute risk difference estimates for the benefits and harms of estrogen therapy.
The experiences of the first and second U.S. Preventive Services Task Force (USPSTF), as well as that of other evidence-based guideline efforts, have highlighted the importance of identifying effective ways to implement clinical recommendations. Practice guidelines are relatively weak tools for changing clinical practice when used in isolation. To effect change, guidelines must be coupled with strategies to improve their acceptance and feasibility. Such strategies include enlisting the support of local opinion leaders, using reminder systems for clinicians and patients, adopting standing orders, and audit and feedback of information to clinicians about their compliance with recommended practice.
In the case of preventive services guidelines, implementation needs to go beyond traditional dissemination and promotion efforts to recognize the added patient and clinician barriers that affect preventive care. These include clinicians' ambivalence about whether preventive medicine is part of their job, the psychological and practical challenges that patients face in changing behaviors, lack of access to health care or of insurance coverage for preventive services for some patients, competing pressures within the context of shorter office visits, and the lack of organized systems in most practices to ensure the delivery of recommended preventive care.
Dissemination strategies have changed dramatically in this age of electronic information. While recognizing the continuing value of journals and other print formats for dissemination, the USPSTF Task Force will make all its products available through its Web site . The combination of electronic access and extensive material in the public domain should make it easier for a broad audience of users to access USPSTF materials and adapt them for their local needs. Online access to USPSTF products also opens up new possibilities for the appearance of the annual, pocket-size Guide to Clinical Preventive Services.
To be successful, approaches for implementing prevention have to be tailored to the local level and deal with the specific barriers at a given site, typically requiring the redesign of systems of care. Such a systems approach to prevention has had notable success in established staff-model health maintenance organizations, by addressing organization of care, emphasizing a philosophy of prevention, and altering the training and incentives for clinicians. Staff-model plans also benefit from integrated information systems that can track the use of needed services and generate automatic reminders aimed at patients and clinicians, some of the most consistently successful interventions. Information systems remain a major challenge for individual clinicians' offices, however, as well as for looser affiliations of practices in network-model managed care and independent practice associations, where data on patient visits, referrals, and test results are not always centralized.
Not applicable: The guideline was not adapted from another source.
The U.S. Preventive Services Task Force (USPSTF) is a federally-appointed panel of independent experts. Conclusions of the USPSTF do not necessarily reflect policy of the U.S. Department of Health and Human Services (DHHS) or DHHS agencies.
The U.S. Preventive Services Task Force (USPSTF) is an independent, voluntary body. The U.S. Congress mandates that the Agency for Healthcare Research and Quality support the operations of the USPSTF.
U.S. Preventive Services Task Force (USPSTF)
Task Force Members*: Virginia A. Moyer, MD, MPH (Chair) (Baylor College of Medicine, Houston, Texas); Michael L. LeFevre, MD, MSPH (Co-Vice Chair) (University of Missouri School of Medicine, Columbia, Missouri); Albert L. Siu, MD, MSPH (Co-Vice Chair) (Mount Sinai School of Medicine, New York, and James J. Peters Veterans Affairs Medical Center, Bronx, New York); Linda Ciofu Baumann, PhD, RN (University of Wisconsin, Madison, Wisconsin); Kirsten Bibbins-Domingo, PhD, MD (University of California, San Francisco, San Francisco, California); Susan J. Curry, PhD (University of Iowa College of Public Health, Iowa City, Iowa); Mark Ebell, MD, MS (University of Georgia, Athens, Georgia); Glenn Flores, MD (University of Texas Southwestern, Dallas, Texas); Adelita Gonzales Cantu, RN, PhD (University of Texas Health Science Center, San Antonio, Texas); David C. Grossman, MD, MPH (Group Health Cooperative, Seattle, Washington); Jessica Herzstein, MD, MPH (Air Products, Allentown, Pennsylvania); Joy Melnikow, MD, MPH (University of California, Davis, Sacramento, California); Wanda K. Nicholson, MD, MPH, MBA (University of North Carolina School of Medicine, Chapel Hill, North Carolina); Douglas K. Owens, MD, MS (Veteran Affairs Palo Alto Health Care System, Palo Alto, and Stanford University, Stanford, California); Carolina Reyes, MD, MPH (Virginia Hospital Center, Arlington, Virginia); and Timothy J. Wilt, MD, MPH (University of Minnesota Department of Medicine and Minneapolis Veteran Affairs Medical Center, Minneapolis, Minnesota).
*Members of the USPSTF at the time this recommendation was finalized. For a list of current Task Force members, go to http://www.uspreventiveservicestaskforce.org/Page/Name/our-members .
The U.S. Preventive Services Task Force (USPSTF) has an explicit policy concerning conflict of interest. All members disclose at each meeting if they have a significant financial, professional/business, or intellectual conflict for each topic being discussed. USPSTF members with conflicts may be recused from discussing or voting on recommendations about the topic in question.
Disclosure forms from USPSTF members can be viewed on the Annals of Internal Medicine Web site .
Electronic copies: Available from the Annals of Internal Medicine Web site .
The following are available:
Evidence Reviews:
Electronic copies: Available from the U.S. Preventive Services Task Force (USPSTF) Web site .
Background Articles:
Electronic copies: Available from the USPSTF Web site .
The following are also available:
The Electronic Preventive Services Selector (ePSS) , available as a PDA application and a web-based tool, is a quick hands-on tool designed to help primary care clinicians identify the screening, counseling, and preventive medication services that are appropriate for their patients. It is based on current recommendations of the USPSTF and can be searched by specific patient characteristics such as age, sex, and selected behavioral risk factors.
Print copies: Available in English and Spanish from the Agency for Healthcare Research and Quality (AHRQ) Publications Clearinghouse. For more information, go to http://www.ahrq.gov/research/publications/index.html or call 1-800-358-9295 (U.S. only).
Myhealthfinder is a new tool that provides personalized recommendations for clinical preventive services specific to the user's age, gender, and pregnancy status. It features evidence-based recommendations from the USPSTF and is available at www.healthfinder.gov .
Please note: This patient information is intended to provide health professionals with information to share with their patients to help them better understand their health and their diagnosed disorders. By providing access to this patient information, it is not the intention of NGC to provide specific medical advice for particular patients. Rather we urge patients and their representatives to review this material and then to consult with a licensed health professional for evaluation of treatment options suitable for them as well as for diagnosis and answers to their personal medical questions. This patient information has been derived and prepared from a guideline for health care professionals included on NGC by the authors or publishers of that original guideline. The patient information is not reviewed by NGC to establish whether or not it accurately reflects the original guideline's content.
This summary was completed by ECRI on June 30, 1998. The information was verified by the guideline developer on December 1, 1998. This summary was updated on October 11, 2002. The information was verified by the guideline developer on October 11, 2002. This summary was updated by ECRI on May 3, 2005. The information was verified by the guideline developer on May 9, 2005. This summary was updated by ECRI Institute on December 10, 2010 following the U.S. Food and Drug Administration (FDA) advisory on Bisphosphonates. This NGC summary was updated by ECRI Institute on December 5, 2012. The updated information was verified by the guideline developer on December 31, 2012.
Requests regarding copyright should be sent to: Lisa S. Nicolella, Senior Editor, Office of Communications and Knowledge Transfer, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850; E-mail: firstname.lastname@example.com.
The National Guideline Clearinghouse™ (NGC) does not develop, produce, approve, or endorse the guidelines represented on this site.
All guidelines summarized by NGC and hosted on our site are produced under the auspices of medical specialty societies, relevant professional associations, public or private organizations, other government agencies, health care organizations or plans, and similar entities.
Guidelines represented on the NGC Web site are submitted by guideline developers, and are screened solely to determine that they meet the NGC Inclusion Criteria which may be found at http://www.guideline.gov/about/inclusion-criteria.aspx.
NGC, AHRQ, and its contractor ECRI Institute make no warranties concerning the content or clinical efficacy or effectiveness of the clinical practice guidelines and related materials represented on this site. Moreover, the views and opinions of developers or authors of guidelines represented on this site do not necessarily state or reflect those of NGC, AHRQ, or its contractor ECRI Institute, and inclusion or hosting of guidelines in NGC may not be used for advertising or commercial endorsement purposes.
Readers with questions regarding guideline content are directed to contact the guideline developer.
To access this feature, Sign In or Create a Free Account
My NGC allows you to save your favorite guideline summaries and organizations, create custom e-mail alerts, and set up topic alerts.
Already have an account? Sign In...
New User? Create an account...


text:
The Tour Brandenburg, at 1,111 kilometres, shows this beautiful region in all its diversity. Along the way it takes you through glorious scenery and to the region's many historical towns.
Spree Forest, Lusatia, the Havelland region and more: this long-distance cycle route passes through the varied scenery of Brandenburg with its extensive lakelands, its forests, moors and countryside. And as if that wasn't enough, there are 31 historical towns to explore as well. Cyclists are recommended to seek out the inns and restaurants on the wayside, where they can enjoy Brandenburg specialities such as Beelitz asparagus, Spree Forest gherkins and Teltow turnips together with local fruit wine and beer. All good reasons to choose the Tour Brandenburg!
Terrain: mainly flat route; the paths are asphalt for the most part, though a number of sections are paved, surfaced with crushed brick/stone or unmade.
Scenery: the circular route takes you all around Brandenburg and its biosphere reserves, nature/national parks and river landscapes, passing through 31 historical towns along the way.
Lisage siia oma lemmikud. Kinnitage, liigitage, jagage ja printige oma valik ning plaanige nii terve oma Saksamaa-reis.
0 Lemmikud on välja valitud
Kaks kasulikku klahvikombinatsiooni brauseris suumimiseks:
Suurendamine: +
Vähendamine: +
Täpsemat teavet saate, kui klõpsate brauseri pakkuja ikoonile: